The document discusses monoplane occlusion with balancing ramps for dentures. It aims to minimize lateral tipping forces by reducing inclined plane contact between maxillary and mandibular teeth. This is achieved by positioning teeth on a flat occlusal plane and adding balancing ramps. The summary provides instructions for setting up anterior and posterior teeth to achieve this occlusion scheme.

1. 18. Occlusal Schemes - Monoplane with Balancing Ramps John Beumer III, DDS, MS and Michael Hamada DDS Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry UCLA School of Dentistry This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.

4. Monoplane with Balancing Ramps

5. Monoplane with Balancing Ramps Begin by positioning the appropriate protrusive insert. Check to ensure that the incisal guide pin is set at zero and in contact with the incisal guide table. Protrusive inserts Protrusive insert Zero setting

6. Mark the casts indicating midline, crest of the ridge, and the retromolar pad . These landmarks will be used to check your denture setup. Maxilla Midline Anterior land Mandible Ridge Retromolar pad Cast Landmarks

7. Anterior land Cast Landmarks - Maxilla Midline Incisive papilla

8. Lines indicating the crest of the ridge Cast Landmarks -Mandible Midpoint of retromolar pad Land Mark on land indicating the midpoint of the retromolar pad

10. To set the remaining maxillary anterior teeth a clear glass or plastic slab is positioned on the mandibular record base to represent the plane of occlusion. Setting the Maxillary Anterior Teeth Mark indicating midpoint of the retromolar pad

11. Setting the Maxillary Anterior Teeth Soften some baseplate wax and attach some to the ridge lap portion of the other maxillary central incisor and attach it to the record base as shown. Set the lateral incisors and cuspids as shown previously. For details see Section 13c, 1a, Lingualized occlusion.

12. Setting the Maxillary Anterior Teeth Note the angulations of the anterior teeth in relation to the occlusal plane when viewed in profile. Occlusal plane

13. Setting the Maxillary Anterior Teeth “ Toed-in” Position Note how the cervical and incisal edges of the cuspid are aligned vertically (yellow line). The facial surface of the cuspid however, is canted inward and appears “toed in” (red line) due to the prominence of the cervical area of the tooth (yellow arrow). The centrals and laterals are inclined slightly towards the distal.

16. Setting the Mandibular Anterior Teeth The horizontal overlap should be consistent throughout the anterior region. In this setup it is about 1.5 mm.

17. Setting the Mandibular Anterior Teeth Positions of the anterior teeth. The lateral incisors should be placed similar in angulation to the central incisors. Note that the cuspids are towed out at the cervical.

21. Monoplane with Balancing Ramps Note that the distal surface of the most posterior maxillary tooth extends 1-2mm distal to the distal surface of the most posterior mandibular tooth.

24. Monoplane with Balancing Ramps The flatness of the maxillary premolars is provided by the flat buccal and lingual cusps. Note that in this set up both lingual and buccal cusps contact the plane of occlusion.

28. Monoplane with Balancing Ramps Working Balancing