3. Balanced occlusion
! Our objective with this tooth form (Ivoclar Ortholingual) is to
create a balanced occlusion. We wish to insure that all the
posterior teeth as well as the anterior teeth, contact in
excursions.
! To ensure bilateral balance we place an anterior-posterior
curve in the arch, called a compensating curve, which is
analogous to the curve of Spee in natural dentition.
! In addition , we develop a slight curve from side to side, the
so called curve of Wilson, with the posterior tooth
arrangement.

6. Clinically determined by
• Phonetics
• Esthetics
• Lip support
Utilizing
• Wax Occlusion Rims
• Wax Trial Denture Set Up

7. The amount
required is
determined by
The need for lip both the wax rim
support from the and the trial
teeth and denture denture.
flange varies
depending upon the
degree of ridge
resorption.

10. The mandible travels down and forward to create a small
space between the maxillary and mandibular incisors during
the production of sibilant sounds.

12.  Setting the Maxillary Anterior Denture Teeth

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

14. Anterior land
Incisive
papilla
Midline

15. Midpoint of
retromolar pad
Mark on land
Land
indicating the
Lines indicating the midpoint of the
retromolar pad
crest of the ridge

16. The three landmarks used to determine 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

17. 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.

18. Soften some baseplate wax and attach the other
central incisor to the ridge lap portion of the maxillary
central incisors and attach it to the record base

19. The mesial of each tooth should be on the midline
(arrow) and the incisal edge should be parallel to and
in contact with the occlusal plane.

20. Viewed from the facial perspective, the maxillary
central incisor is placed so that the long axis shows a
slight distal inclination to the perpendicular.

21. When viewed from profile the cervical
aspect of the tooth should be slightly
depressed. Note that the incisal 2/3 of
the central incisors are perpendicular to
the plane of occlusion
In this particular patient, appropriate lip support was achieved by placing
the labial surface of the central incisors on a curve coinciding with the
inner edge of the land of the cast (red line). This may vary, and in many
patients the incisors project more anteriorly, particularly in those with
severe resorption of the premaxilla.

22. The maxillary lateral incisor is should be positioned with a
slight distal inclination and is usually ½ to 1 mm above the
plane of occlusion.

23. When viewed in profile
note that the lateral
incisor is positioned with
a slight distal inclination Note again that the lateral
in relationship with the incisor is positioned slightly
central incisor. above the plane of occlusion.

24. When viewed from the occlusal, the incisors should follow
the same curvature as the internal aspect of the land.

25. When viewed in profile the cuspid has a slight distal inclination
from the perpendicular and the incisal tip touches the occlusal
plane (arrow).

26. 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).

27. The cuspid has two planes on
the labial surface – a mesial
plane (yellow line) and a distal
plane (red line). When viewed
from the anterior only the mesial
plane should be visible.

28. When viewed from the
occlusal the anterior teeth
follow the curvature of the
internal portion of the land.

29. Note the inclination of the anterior teeth.

30. Determinants of Mandibular Anterior Tooth
Position
• Phonetics
• Jaw relations
• Occlusal schemes with bilateral balance

31. Patients with skeletal Class I relationships
• Vertical overlap (1-2 mm)**
• Horizontal overlap (1-2 mm)*
• No contact is centric occlusion

32. 1. We desire to minimize the forces
applied to the mandibular and
maxillary anterior ridges in centric
occlusion.
2. Create the appropriate
relationship of the maxillary and
mandibular anterior teeth during
the production of sibilant speech
sounds.

33. 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.

34. As noted previously, during the production of sibilant sounds
the mandible travels down and forward and a space of about
1 mm is created between the maxillary and mandibular
incisors.

35. In most patients the labial
surface of the mandibular
incisors should be roughly
perpendicular to the occlusal
plane.

36. In the setup shown here, the initial vertical overlap chosen was
1.0 mm and the amount of horizontal overlap was 1.5 mm.

38. The incisal angle varies
depending on the
magnitude of the vertical
and horizontal overlap,
the arrangement of the
occlusal plane and the
condylar inclination. It is
generally advisable to
keep the incisal angle to
a minimum in complete
dentures.

39. Position the remaining mandibular 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. The vertical overlap can be easily
appreciated from frontal perspective.

40. The vertical overlap should be
1.0 mm throughout the
anterior region at this stage of
the setup.
Note that the cuspid is slightly
inclined to the distal whereas
the lateral incisor is relatively
vertical.

41. The horizontal overlap should be consistent throughout the
anterior region. At this stage it should be about 1.5 mm.

42. From the anterior perspective the angulation of the
mandibular anterior teeth should be as indicated. Note
that the cervical of the cuspids are in the towed out
position.

43. The anterior teeth have now been
positioned. The final positions will be
determined during the trial denture
appointment.

44. Set the mandibular
premolars and the 1st molar.
Make sure these teeth are
on plane and on ridge. Use
the marks on your cast to
help you visualize the
occlusal plane and crest of
the ridge.

45. When using this
lingualized posterior
tooth form (Ivoclar
Ortholingual) there
should be little or no
curve of Wilson. In this
set up both the lingual
and buccal cusp tips of
the premolars and the 1st
molar were on the plane
of occlusion.

46. 15 degrees
Position the 2nd molar. The curve of Spee is created by
slightly elevating the distal half of the 1st molar and by
elevating the the 2nd molar by about 15 degrees up from
the occlusal plane.

48. 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.

49. 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
relation ship.

50.  All of the maxillary teeth have been positioned. Note
that the maxillary lingual cusps all firmly contact the
central fossae of the mandibular teeth.

54. Develop protrusive contacts as shown. Light contact of
the anterior teeth in protrusion enhances stability. Note
the contacts in the 2nd molar region.