This document describes how to set up a lingualized opposing monoplane occlusion with balancing ramps. Key steps include setting the maxillary anterior teeth to the occlusal plane using landmarks on the casts, setting the mandibular anterior teeth with 1-2mm of horizontal overlap, and positioning the posterior teeth on a flat occlusal plane with the maxillary teeth contacting the central grooves of the mandibular teeth. Balancing ramps are added to provide three points of contact in lateral excursions to maintain bilateral balance.

1. 19. Occlusal Schemes - Lingualized
Opposing 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
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2. Lingualized Opposing Monoplane with
Balancing Ramps

3. Lingualized Opposing Monoplane with
Balancing Ramps
Zero
setting
Protrusive inserts
Protrusive
insert
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.

4. Setting the Maxillary Anterior Teeth
As previously mentioned (13c, 1a), the wax rim is ideally contoured on
the patient and used to mount the upper cast with a facebow transfer
Midpoint of Midpoint of
retromolar retromolar
pad pad
The three landmarks used to identify the plane of occlusion are:
The midpoint of the retromolar pads bilaterally as previously marked on
the mandibular cast.
The incisal edge of the maxillary central incisors

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

6. Setting the Maxillary Anterior Teeth
Mark indicating midpoint
of the retromolar pad
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.

7. 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 (Section 13c, 1a Lingualized
occlusion).

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

9. 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.

10. Setting Mandibular Anterior Teeth
Patients with skeletal Class I relationships
• Vertical overlap (0-1mm)*
• Horizontal overlap (1-2 mm)
• No contact is centric occlusion
*When using monoplane teeth
with balancing ramps the the
vertical overlap is kept to a
minimum.

11. Setting Mandibular Anterior Teeth
Patients with skeletal Class II or Class III relationships
Magnitude of horizontal overlap?
In Class II patients the mandible tends to
travel farther anteriorly in function than the
typical Class I patient and consequently
more horizontal overlap is necessary to
allow for this functional movement.
In contrast Class III patients often
demonstrate little or no anterior movement
of the mandible during function.
Consequently, little or no horizontal overlap
is developed in the set up.

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

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

14. Lingualized Opposing Monoplane with
Balancing Ramps
Background - Setting the posterior teeth
The number and combination of the denture teeth utilized
varies depending on the arch length of the patient.
The mandibular occlusal table should end prior to the
ascending ramus.

15. Lingualized Opposing Monoplane with
Balancing Ramps
Position the posterior
mandibular teeth over the
crest of the ridge. Check to
ensure they are set to a flat
plane and on the plane of
occlusion.
Make corrections as
necessary

16. Lingualized Opposing Monoplane with
Balancing Ramps
 Position the maxillary
posterior teeth. The tips of
the maxillary lingual cusps
should contact the central
groove of the mandibular
posterior teeth as shown.

17. Lingualized Opposing 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.

18. Lingualized Opposing Monoplane with
Balancing Ramps
By properly centering
the lingual cusps of
the maxillary teeth
over the central
grooves of the
mandibular teeth the
horizontal overlap
should be ideal and
should be sufficient
Horizontal
overlap

19. Lingualized Opposing Monoplane with
Balancing Ramps
 Note that the
maxillary premolars in
the of the Ivoclar
Ortholingual denture
teeth are of sufficient
length to harmonize

20. Lingualized Opposing Monoplane with
Balancing Ramps
 Verify that all the maxillary teeth, with the exception of the
lateral incisors and perhaps the cuspids, are on the plane
of occlusion. Make corrections by manipulating the
maxillary teeth. When you have completed this step,
thoroughly cool the wax before proceeding to the next step.

21. Lingualized Opposing Monoplane with
Balancing Ramps
 Reestablish centric
contacts as necessary by
manipulating the
mandibular posterior
teeth. Make sure that the
incisal guide pin
maintains contact with
the incisal guide table
when you have
completed this step.

22. Lingualized Opposing Monoplane with
Balancing Ramps
 The balancing ramps are added as shown.
 Note that the maxillary 2nd molar extends slightly posterior to
the mandibular 2nd molar in order that it may engage the
balancing ramps during lateral excursions.

23. Lingualized Opposing Monoplane with
Balancing Ramps
Bilateral balance with balancing ramps
Working Balancing
 In all lateral excursions you should observe at least three
points of contact bilaterally to maintain bilateral balance.