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29 Cards in this Set
- Front
- Back
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During consultation for rebase, reline, what questions to ask?
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1. How old?
2. How old is liner? 3. allergic to materials? 4. how did break occur? 5. ask about and evaluate the occlusion |
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Natural occlusion rules
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• Anterior contact in CO (+/-)
• Incisal guidance in Protrusion • Canine guidance in Lateral • CO ≠ CR |
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Denture occlusion rules
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• No anterior contact in CO
• No incisal guidance in Protrusion • No canine guidance in Lateral • CO= CR first and max contact, we do this since its reproducible. This is the key for denture occlusion. |
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Rules of balanced occlusion
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• Bilateral posterior contact in CO
• Bilateral posterior contact in Protrusion • Bilateral posterior contact in Lateral • CO= CR • Optional anterior contact in Protrusion • No anterior contact in Lateral |
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What are 2 goals of balanced occlusion
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1. prevent anterior occlusion : accomplish by increase H, decrease V
2. Maintain posterior occlusion but increasing cusps and curves. |
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When do you use curves?
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start at 1/2 RMP, and go up to 2/3 RMP for anatomical set up.
Monoplane: when H and V are sufficient If H and V are insufficent, do flat cusp curved plane. If H, V, and curve are insufficient but ridge is sufficient, you must use a curved cusp curved plane = anatomical. |
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Christensens phenomena
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If occlusal plane is flat, but mand path is curved, then posterior teeth will disclude in excursions.
If this is insufficient, then we have 2 choices to curve. 1. Take plane and curve it to build in Curve of Spee 2. Take last tooth of set up, and bring it up slightly or add wax distal to your first molar. This creates a balancing ramp. Both are options for a monoplane set up |
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How to decide which cusp to use?
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1. Residual ridge: the flatter the ridge, the flatter the cusp
2. Angle's class (cross bite), Bruxism (wear), and Coordination (reproduciblity) |
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What teeth are required for resorbed ridges?
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Flat teeth.
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What are 3 types of axial inclinations nad arch form for anterior teeth?
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Square- 2 centrals are straight across.
Tapering Ovoid |
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What does lingualizing the teeth help to do? Describe the set up of teeth for monoplane and anterior set up
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Helps resist lateral forces.
Monoplane lowers are centered to crest Anatomical lowers are lingual to crest Monoplane lowers are set first and are centered to crest Anatomical uppers are set first and are centered to crest • Monoplane Anatomical Monoplane lowers are set first and are centered to crest Anatomical uppers are set first and are centered to crest using a line 3mm buccal to crest Monoplane uppers are set last and are labial to crest Anatomical uppers are set first and are centered to crest using a line 3mm Monoplane uppers are set last and are labial to lowers Anatomical lowers are set last and are lingual to crest |
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1. For anatomical, what teeth are perpendicular to plane?
2. Which is set off the plane? |
1. Bicuspids
2. Molar is titled so that only ML cusp contacts the plane Need to have a consistent progression upwards. The actual phyiscal number isn't important. There is a buccal and lingual curve of spee. Difference between B and L curve of spee is the curve of Wilson. |
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Anatomical set up for posteriors
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1. MB cusp of upper aligns w/ B groove of lower. Set the premolars next.
2. THen finish with anteriors. Vertical overlap is created by raising the lowers. 1 mm vertical overlap 1-2 mm horizontal overlap tilt as above Lower 1st bicuspid may be set before or after the anteriors. -if mand anteriors are set last, need to be rotated and lapped to fit teeth into arch |
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Lingual view of the anatomical set up should show what?
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-No daylight in the posterior
-No contact in the anterior |
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If set up was correct why is equilibration necessary?
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-Wax on occlusal surface results in a space between tooth and investment
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What are some mistakes that can happen before processing, during, and after?
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Before:
Poor tooth position Wax shrinkage During: Wax on teeth Poor luting Exothermic reaction Overpacking Packing too slowly Insufficient pressure Excess flash Heating too fast Cooling too fast AFter: heat from polishing dessication |
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Objectives of equilibration
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• To have CO= CR
• To maintain VDO • To distribute stress • To retain cusp shape • To achieve balanced occlusion • To smooth contacting surfaces |
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3 steps of equilibration sequence
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1st Centric interferences
2nd Lateral interferences 3rd Protrusive interferences |
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Centric inferences
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1. only one side contacts
2. posterior not in CR |
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Lateral interferences
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1. only one side contacts (working or balancing)
2. only one tooth contacts - canine interference |
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Protrusive interferences
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1. only anteriors contact
2. only some teeth contact or anteriors are too far apart |
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Describe primary and secondary supporting cusps. What do you change if you have centric or centric + eccentric interferences?
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Primary - don't move but 2ndary cusps are movable.
-Grinding supporting cusps results in loss of CO and VDO. Before grinding, we need to check excursions - right, left lateral and protrusion. No protrusive interference, then grind the fossa. Don't touch cusp! If centric and RL has interference, then grind the cusp. Centric only: fossa Cenentric and eccentric: grind cusp |
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For horizontal interferences, what is changed?
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MUDL = mesial of upper, distal of lower.
if its in the posterior. |
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Lateral inferences
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Primary supporting don't move but secondary does. Grinding non supporting wont change CR or VDO.
For working interference, grind BULL (buccal upper, lingual lower) these are non supporting cusps. Balancing side: grinding a supporting changes CR and VDO. Only grind the inner incline of a secondary supporting cusp. Only touh the lower. BL inclines only Remove lateral inferences using 2 colors of articulating paper. grind only incline and excursive. |
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What if you have posterior sides both discluding?
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Canine guidance - everything discludes in lateral.
-start w/ lowers first. lower cuspid lower first premolar maxillary canine - adjust lingual (increase H) |
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Protrusive interferences
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1. contact between supporting + non supporting cusp inclines. Buccal cusps control what you have.
-gring non supporting cusp inclines when possible - Max B cusp, distal inclines. -grind DUML. For incisal guidance, grind the lowers = beveling will increase horizontal overlap. |
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How do you increase the horizontal overlap? Decrease vertical overlap?
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Cut if denture,
rotate if in wax.. Decrease vertical: cut and move |
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Wear facets?
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If you have protrusive interference in the anterior then lower wear facets.
For posterior - DUML |
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Posterior inferences in monoplane setup?
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Upper buccal cusp needs to be adjusted.
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