3rd bds, intro to dentures, shammasm, removable prosthodontics

2. ARRANGEMENT OF
POSTERIOR TEETH

3. Learning outcomes
1. Explain individual posterior tooth
arrangement.
2. Define balanced articulation.
3. List the factors affecting balanced
articulation.

4. Maxillary Anterior Teeth
Checklist
Anteriors
– Arch Form
– Symmetry

5. MAXILLARY POSTERIOR TEETH
Maxillary First and Second Premolar

6. Maxillary First Premolar

7. Maxillary Second Premolar

8. The long axis of the premolars should be
perpendicular to the occlusal plane and the
buccal and lingual cusp tips should touch the
occlusal plane.
Maxillary Premolar Teeth
Occlusal
plane

9. Both the buccal and lingual cusp tips
of the maxillary premolars should
contact the plane of occlusion.
The Maxillary Premolars

10. MAXILLARY POSTERIOR TEETH
 Maxillary First and Second Molar

11. Maxillary First Molar

12. Maxillary First Molar

13. Maxillary 1st
Molar
The mesio-palatal cusp tip of the 1st
molar
contacts the occlusal plane but the buccal
cusp tips and the distal lingual cusp are
elevated about 0.5mm off the occlusal plane.

14. Maxillary Second Molar
1.0 mm above the occlusal plane
1.5 mm

15. Maxillary Second Molar
1.0 mm above the occlusal plane
1.5 mm

16. Maxillary 2nd
Molar
Occlusal
plane
No cusps touch the occlusal plane.

17. The maxillary teeth viewed from the
occlusal surface should follow the
following guidelines:
The distolabial surface of the canine, the
buccal surfaces of the premolars and the
mesiobuccal surface of the 1st
molar
should follow a straight line.

18. The distobuccal surface of the 1st
molar
and buccal surfaces of the 2nd
molar are
slightly inwards and are placed so that
all buccal surfaces of the 1st and 2nd
molars follow a straight line.

19.  Posteriors
 Ridge Relationship
 Arch Form
 Arch Symmetry
 Compensating Curve
Compensating Curve

20.  Compensating curve
The anteroposterior curving and the
mediolateral curving of the occluding
surfaces and incisal edges of artificial
teeth that is used to develop balanced
occlusion.

21. Christensen’s phenomenon
 The space that occurs between
opposing occlusal surfaces during
mandibular protrusion.

22. Christian Phenom.AVIChristian Phenom.AVI

23. MANDIBULAR POSTERIOR
TEETH
Mandibular First Molar
This tooth is KEY TOOTH in
occlusion so it has to be
arranged first.

24. Mesiobuccal cusp of upper
first molar occludes with
mesiobuccal groove of
lower first molar
Key of occlusion

25. Setting the Mandibular Posterior Teeth
The Mandibular 1st Molar
Begin by positioning the mandibular 1st
molar. The
mesial buccal cusp tip should engage the embrasure
between the 1st
molar and 2nd
premolar.

26. Mandibular 2nd
Premolar
Position the mandibular 2nd
premolar. The
buccal cusp of the 2nd
premolar should
occlude with the adjacent marginal ridges
of the maxillary 1st
and 2nd
premolars.

27. The Mandibular 1st
Premolar
The buccal cusp of the mandibular 1st
premolar should engage the mesial
marginal ridge of the opposing 1st
premolar.

28. The Mandibular 2nd
Molar
The mandibular 2nd
molar is placed with
the mesiobuccal cusp should engage
between the maxillary 1st
and 2nd
molars
and contact with their marginal ridges.

29. Mandibular Posterior Teeth
 The mandibular cusps tips are
designed to engage the embrasures of
the opposing maxillary teeth.
Completed set up
Centric

30. Additional Guidelines for Arranging the
Mandibular Posterior Denture Teeth
2/3 up the retromolar pad

31.  Verify that the posterior
mandibular teeth are centered
over the crest of the ridge.

32. Completed teeth arrangement
 Centric occlusion=Centric relation in
complete dentures

33. Complete Denture Occlusion
 Bilateral Posterior
Centric Contact
 Centralized Forces
 “Balanced” Articulation
to minimize tipping

34.  Mobile bases on mucosa
 Teeth move as an unit
 Malocclusion affects entire
base immediately
 Non-vertical forces affect all
teeth and is traumatic
 Incising affects all teeth
attached to base
 Bilateral balance is often
desired for base stability
 Decreased tactile sense
 Retained in PDL
 Teeth move independently
 Malocclusion effects not
immediate
 Non-vertical forces affect
only teeth involved and
usually well tolerated
 Incising doesn’t affect
posteriors
 Bilateral balance is rare
 Tactile sensitivity
Natural Dentition Denture “Dentition”
Differences between Natural and
Complete Denture Occlusion

35. Goals of Complete Denture
Occlusion
 Decrease trauma to the
supporting structures
 Preserve remaining
structures
 Enhance stability
 Improved Esthetics,
Speech and Mastication

36. Difference between occlusion
and articulation
 Occlusion: the static relationship
between the incising or masticating
surfaces of the maxillary or
mandibular teeth.

37.  Articulation: the
static and
dynamic contact
relationship
between the
occlusal
surfaces of the
teeth during
function.

38. Balanced articulation
 The bilateral, simultaneous
anterior and posterior occlusal
contact of teeth in centric and
eccentric positions.

39. Balanced occlusion - Stability

41. Bilateral Balanced Denture Articulation
Protrusive Balancing Working
Centric

42. Bilateral Balanced Denture
Articulation
Protrusive

43. Balancing Side
Protrusive
Centric Occlusion
Bilateral Balanced Denture
Articulation
Working Side
HOW DO WE ESTABLISH.
. .

44.  Five Factors Affecting Occlusal
Balance
1. Condylar Guidance
2. Incisal Guidance
3. Orientation of Occlusal Plane
4. Compensating Curve
5. Cuspal Inclination

45. Condylar Guidance

46.  Condylar Guidance is due to the path the
condyles follow in TMJ.
 In complete denture, of the five factors, the
patient presents you with Condylar Guidance.

47. Incisal Guidance

48. Orientation of Occlusal Plane

50. Compensating Curve

51. Cuspal Inclination

52. Types of posterior teeth

53. Condylar Guidance, Incisal Guidance, Orientation of
Occlusal Plane, Compensating Curve, Cuspal Inclination

54. Balancing Side
Protrusive
Centric Occlusion
Bilateral Balanced Denture
Articulation
Working Side