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SettingPosteriorTeethSetforFunctionPhilosophiesofDentureOcclusionManyphilosophiesofarrangingdentureocclusionNo

definitive

scientificstudiesproveoneocclusalschemeclearlysuperiorRationaleforDalhousieApproachPrincipalstochooseanocclusalschemeBasedonclinicalexperienceDalhousie:twoocclusalschemes:LingualizedOcclusionMonoplaneOcclusionBasedontheUCLA/IVOCLAR/ACPSeriesLingualizedOcclusion

Centriccontactsaremaxillarylingualcusptocentralfossa/marginalridgeLingualizedOcclusionAnatomicteethusedinmaxillaBetterestheticsthanMonoplaneShallowcuspedmandibularteethForcescenteredovermandibularridgeLingualizedOcclusionNooverbiteMayormaynothavebalancingcontactsinexcursionsAnteriorteeth-mustmakeatleastgrazingcontactsinexcursionsLingualizedOcclusionMaxillaryanatomic(33°)MandibularTeethSteepCondylarGuidanceShallowcusped(Anatoline)ShallowCondylarGuidanceNon-anatomic(Portrait0°)Setmandibularpremolars&1stmolar:LevelwithocclplaneCenteredoverridgeOcclusalplaneLineindicatingthecrestoftheridgeIfusingalingualizedposteriortoothform(DentsplyAnatoline)littleornoCurveofWilsonlingualandbuccalcuspsof

levelwithplaneofocclusionMax.lingualcuspscontactcentralfossae/marginalridge~1mmspacebetweenbuccalcuspsMaxillarylingualcuspsfirmlycontactbilaterallysimultaneouslyVerifycentricNomax.buccalcuspcontactsin: ?Centric ?LateralexcursionsCentricPositionVerifyexcursivecontactsAnteriorteethareincontactduringlateralexcursionsWorkingExcursionsNotethebalancingcontactsBalancingExcursionsAchievingBalanceCondylarangulation

RecordedwithprotrusiverecordCuspangle

SelectedbydentistAchievingBalanceOcclusalPlane

DeterminedbydentistwithwaxrimsCurveofSpee&CurveofWilsonControlledbyinclinationofteethAssessingBalanceJumpsorbumpsareduetocusptipsmovingoverothercusptips,inclines,marginalridgesOcclusalRefinement

OcclusalAdjustment,SelectiveGrindingSetteethascloseto:MaximumintercuspationBalanceAllsetupswillneedsomeadjustment‘IIF’Rule IIFyouhavecontactsontheInnerInclinesofFunctionalcuspstheyarebalancingcontactsFindtheBalancingContactFindtheBalancingContactWhattypeofContact?WhattypeofContact?WhattypeofContacts?WhattypeofContact?AssessContactsCentricStopsExcursionsNon-Balanced

LingualizedOcclusionMaxillaryanatomicopposingmandibularnon-anatomicMortar&pestleocclusionwithoutmaxillarybuccalcuspcontactLackofmandibularcuspanglesandnoattempttobalancetheocclusionNocompensatingcurvesNooverbiteNooverbiteMagnitudeofOverjetMoreforClassIIpatients

ClassIClassIIMagnitudeofHorizontalOverlapClassIIIpatientsLittleornooverjetClassIIISettingtheposteriorteeth

Teethshouldendpriortotheascending

ramusMandibularteethsettoaflatplaneandontheplaneofocclusionMaxillarylingualcuspscontactcentralgroove/marginalridgeoftheopposingteethThehorizontaloverlapshouldbeidealandshouldbesufficienttopreventbitingofthecheekandcornerofthemouthHorizontaloverlapAllmaxillaryteeth,withtheexceptionofthelateralincisorsandcuspids,shouldbeontheplaneofocclusionReestablishcentriccontactsasnecessaryBalancingRampIfbilateralbalanceisdesiredabalancingrampcanbegeneratedInlateralexcursions,atleastthreepointsofcontact(bothbalancingrampsandanteriorincisorcontacts)BilateralbalancewithBalancingRampsWorkingBalancingMonoplaneOcclusionMonoplaneOcclusionCusplessteeth(0°)onaflatplanewith1.5-2.0

mmoverjetNocusptofossarelationshipNoanteriorcontactsincentricpositionMonoplaneOcclusionEliminatecuspslateralforcesreducedimprovesstabilitySimplifiestootharrangementMonoplaneOcclusionNooverbite(wouldcausetilting)Overjetof2mmisusedtocreateanillusionofoverbiteMonoplaneOcclusionExcursions-mayormaynotcontactonbalancingsidesDependsoncondylarinclinationandotheraspectsofthetootharrangementMonoplaneOcclusionAnteriorteethmakecontactinexcursionsModificationshavebeenproposedtominimizethetiltingpotential:BalancingrampsCompensatingcurvesMonoplaneOcclusion

withoutcondylarinfluenceMonoplaneOcclusionMonoplaneOcclusion AdvantagesTechnicallyeasiertoachieveUsewhen:Difficultyobtainingrepeatablecentricrecords(muscleincoordination)Skeletalmalocclusion(ClassII,III)SevereresidualridgeresorptionReduceshorizontalforcesMonoplaneOcclusion DisadvantagesPoorerappearanceCanbeunstableifcondylarguidanceissteep(posterior

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