Transcript Lingual Contact Occlusion as it applies to Implant Restoration

Lingual Contact Occlusion
as it applies to Implant Restoration
Dr. Gabie Ingraham
S H Payne and Edison Farmer
Dental Digest 1941
Different Occlusal Schemes
Why not use one that is
uncomplicated and easy to
understand and teach, as long as it
does not compromise the esthetic
and functional requirements of the
patient?
Denture Occlusion Options
Lingualized
(lingual contact)
Semi-anatomic
Non-anatomic
(ramp)
Anatomic
Non-anatomic
(monoplane)
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Lingualized (lingual contact)
One Centric contact
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Lingualized (lingual contact)
Uncomplicated mandibular central fossa
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Lingualized (lingual contact)
Uncomplicated mandibular central fossa
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Lingualized (lingual contact)
…therefore maxillary lingual cusps can articulate
anywhere along the mandibular central fossa
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Lingualized (lingual contact)
…therefore maxillary lingual cusps can articulate
anywhere along the mandibular central fossa
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Lingualized (lingual contact)
Non functional maxillary buccal cusp
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Lingualized (lingual contact)
Anatomic
Lingualized
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Anatomic / Semi-anatomic
Forces “buccal”
to crest of ridge
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Lingualized (lingual contact)
Forces “lingual”
to crest of ridge
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Lingualized or Lingual
Contact Occlusion
Lingualized Occlusion
Advantages
Indications for use
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High esthetic demands
Severe mandibular ridge atrophy
Displaceable supporting tissues
Malocclusion
Previous successful denture with
Lingualized Occlusion
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Good esthetics
Freedom of non-anatomic teeth
Potential for bilateral balance
Centralizes vertical forces
Minimizes tipping forces
Facilitates bolus penetration
(mortar and pestle effect)
Ortholingual tooth moulds are specifically
designed for the lingualized (lingual contact)
occlusal scheme and provides bilateral balance.
The dominant maxillary lingual cusp and the
uncomplicated mandibular central fossa create the
mortar and pestle (lingual contact) occlusal pattern.
Occlusal plane
Set the mandibular
premolars and the 1st molar.
Make sure these teeth are
on plane and on the ridge.
Use the marks on your cast
to help you visualize the
occlusal plane and crest of
the ridge.
Line indicating the crest of the ridge
Both sides have now been set. Before setting the maxillary
posterior teeth make sure the posterior mandibular teeth are
centered over the ridges.
Position the maxillary
posterior teeth. There
should be about a
1mm space between
the lingual inclines of
the buccal cusps of
the maxillary teeth
and the the buccal
slopes of the buccal
cusps of the
mandibular teeth.
The lingual cusp tips
should be in contact
with the central fossae
of the opposing
mandibular teeth.
However, as opposed
to anatomic teeth set to
bilateral balance, they
need not be arranged
in a cusp – embrasure
relationship.
• All of the maxillary teeth have been positioned. Note
that the maxillary lingual cusps all firmly contact the
central fossae of the mandibular teeth.
Articulating a maxillary anatomical denture teeth
opposing non-anatomic mandibular teeth is also a form
of lingualized occlusion. It provides the mortar & pestle
occlusion without maxillary buccal cusp contact.
Setting the posterior teeth (Neutrocentric
concept)
• 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.
• Ideally, the distal surface of most posterior maxillary
denture teeth should extend 1-2mm distal to the most
posterior mandibular denture teeth.
• 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
Centric position
Verify centric and make adjustments as necessary. The lingual
cusps of the maxillary posterior teeth must rest in the central fossa
of the opposing mandibular teeth. There should be no buccal cusp
contacts of posterior teeth in centric or in lateral excursion.
In Summary……
The concept of lingualized (lingual contact) occlusion has
become the occlusal scheme of choice for implant-supported
removable denture restorations in an attempt to minimize lateral
forces.
Questions?