5 - Occlusal Schemes, Lab 5a (Setting Lingualized Posterior Teeth), Lab 5b (Festooning) Flashcards
how many mm anterior horizontal and vertical overlap
1mm horizontal
1 mm verical
in centric, do anterior have occlusal contact
no
why is there minimal horizontal and vertical overlap in complete denture
- minimize forces applied to mand and max anterior ridges in centric
- create appropriate relationship of anterior teeth during production of siblant speech sounds
- create bilateral balance (so anterior teeth can function properly with most posterior occlusal schemes)
describe class II skeletal relationship
mandible travel further anteriorly in function than class I so horizontal overlap is necssary to allow for movement
describe class III skeletal relationship
little or no anterior movement of mandible during function, so less or no horizontal overlap is developed
denture occlusion is designed to ___ to best stabilize the denture during function
share occlusal foces
do we ever use canine guidance in complete denture
never
what types of teeth can create cross arch bilateral balances occlusion
- anatomic (30 degree)
- nonanatomic teeth (0 degree)
- lingualized teeth (15 degree)
- combinations of teeth above
T/F: Mandibular arch covers a smaller area than the maxillary arch, mandibular arch requires more muscular control for its stability
true
what is the area the occupies a position that functions best with surrounding lip, cheek, and tongue musculature?
neutral zone
the flatter the ___ the flatter the ___
the flatter the ridge, the flatter the cusp angles
factors to choose an occlusal scheme
age of patient
neuromuscular control
quality of the residual ridge (PDI
classification)
esthetic concerns of the patient
condylar inclination
skeletal relationship (Class I, Class Il,
Class III
residual ridge relationship
indications for monoplane occlusion
~Poor Residual Ridges
~Poor Neuromuscular Control (Bruxers, CP, etc.)
~Previously successful with monoplane dentures or severely worn occlusion on previous denture
~Arch discrepancies (Skeletal Class II, III or Cross-bite)
~ACP Class III or IV
~Immediate Dentures (except when opposing
natural dentition)
~Potential poor follow-up
indications for anatomic occlusion teeth
~Good Residual Ridges (height)
~Skeletal Class I
~ACP Class I or II
~Well Coordinated Patient
~Previously successful with anatomic dentures
~Denture opposes natural dentition
~When “lingualized” or anatomic bilateral balance occlusion is desired
advantages and disadvantages of monoplane occlusion
do 0 degree posterior teeth have anatomy on the teeth?
YES! it just doesnt have any cusp height
anatomic (cusped) occlusion advantages and disadvantages
how many degrees are:
ortholingual
orthotype
postaris
teeth
15 Degree Ortholingual Teeth
22 Degree Orthotype Teeth
33 Degree Postaris Teeth
how do you determine what angle teeth to use
look at condylar inclination, use teeth of same degree or less
e.g., if CI = 20 degrees, use teeth 20 degree or less
what does balanced articulatin provide
- natural esthetics
- inciasal overlap
- centrilized occlusal forces
- better bolus penetration
- requires precise records (protrusive and/or lateral records)
what are the 3 points of contact on anatomic occlusal plane
3 points of contact: maxillary buccal cusp
incline contacts MD buccal cusp incline, MX lingual cusp to incline of MD buccal cusp and mandibular incline of the MD lingual cusp
macxillary occlusal plane should project where
1 to 2 mm below top of retromolar pad
can you set teeth on the ascending ramus of the mandible?
NO
where must mandibular posterior teeth be positioned
over the ridge
what does buccal alignment mean
teeth should not be set beyond the vestibule. inner land area of cast is absolute limit.
canine and premolars are even
1st and 2nd molars are even
what maxillary posterior tooth do you set first when mounting in class I relationship? why?
set 1st molar
horizontal overlap prevents cheek biting
monoplane occlusion is also called what
“flat” occlusion
what type of occlusion:
- decreaes lateral forces
- food stability
- good for class II or III patients
- patients that have ridge discrpancy
- simple
- horizontal overlap is critical
monoplane occlusion
what occlusion:
- verify maxillary teeth (except lateral incisors) are all on the plane of occlusion
- both buccal and lingual cusps contact the plane of occlusion
- correct monoplane mandibular arch
set up on maxillary teeth before addressing
nonanatomic (monoplane) occlusal plane
how to create bilateral balance with monoplane
- add balancing ramps to compensate for Christenen’s phenomenon to idealize stability of mandibular denture
or
- position 2nd molar about 15 degree up from occlusal plane
what is the term use for the space that ocurs between opposing occlusal surface during mandibular protrusive movement
Christensen’s phenomenon
maxillary lingual cusps should only contact what of the mandibular posterior teeth
central groove
maxillary buccal cusps should have how many mm of space between lingual incline of buccal cusp and buccal slop of mandibular bucal cusp
1 mm
what occlusal scheme are we using for setting posterior teeth in lab? how many degree
lingualized posterior teeth 15 degree
there should be an ID size card space behind what tooth on both side
behind mandibular canines
what cusp on what tooth is 0.5 mm above occlusal plane
DB/DL cusp of mandibular 1st molar
what cusp on what tooth is 1 mm above occlusal plane
MB/ML cusp on mandibular 2nd molar
what cusp on what tooth is 1.5 mm above the occlusal plane
DB/DL 2nd molar
what type of occlusion are we setting teeth in lab
cross tooth, cross arch bilateral balanced occlusion
maxillary buccal cusps should be flared how many mm
1 mm
in dentures, what are carvings in wax that simulate the contours of the natural tissues that are being replaced by the denture (root anatomy, alveolar bone, gingival roll etc)
festooning
benefits of a properly contoured denture
- improved esthetics (especially patient with a high smile line who displays a significant amount of gingiva)
- improve tolerance and comfort
- improve neuromuscular control and stability of the lower denture (lingual concavity & shape of the buccal shelf of facial side of denture)
- limit biting of the lip or cheek
- appropriate tongue space for normal speech articulation
what must be flat or slightly convex to provide a more natural appearance and prevent food impaction
interdental papilla
what posteriorly helps deflect the buccal mucosa away from biting surfaces
gingival roll
what is very important in patients with high smile line (speaking and smiling)
gingival contours
What are proper contours than minimize biting of lips and cheeks
lip contours
what contour raises the lip and corner of the mouth
maxillary cuspid eminence - lip support and contour
what eminences provide lip support and contour
maxillary and mandibular cuspid eminence
T/F: thickness of labial flange impacts lip contours, this is developed during border molding the impression
TRUE
what should the palatal thickness be
2-3 mm
what contour promotes proper speech articular and reduce the incidence of gaggin
palatal contour
what contour is placed on mandible to deflect food
posterior buccal bulge
what contour on mandible facilitates stability and control of denture
lingual concavity
when are you done with denture
- all teeth set and anatomically waxed
- pin at zero and holds shimstock with incisal guide table
- posterior teeth hold shim stock
- anterior teeth drag shim
