Tif denture mand-setup
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Transcript of Tif denture mand-setup
© Merz Dental GmbH, Germany 1
Part 2 – Mandibular Setup
Total prosthetics in Function (TiF)According to Karl-Heinz Körholz, MDT
Merz Dental Prosthetic Training
© Merz Dental GmbH, Germany 2
Tooth setup – Mandibular
Mandibular setup steps according to TiF®
Static setup lines: Posteriors
Mandibular first premolars
Mandibular second premolars
Mandibular second molars
Overview
Mandibular canines
Tools
Mandibular first molarsMandibular lateral incisors
Mandibular central incisors
Concept, graphics and texts: Martin J. Hauckbased on the TiF method by Karl-Heinz Körholz
© Merz Dental GmbH, Germany 3
Angle template REF 10903909° for integral® sizes S, L, M6° for integral® size XS and artegral®
Four burrs
Triangle Small sliding caliper
Thin round elastic thread
Tooth setup tools
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Setting up the mandibular central incisors
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Basal surfaceson the crest midline
Setting up the mandibular central incisors
Labial surfaces not beyond the middle of the mucobuccal fold
Incisal edges at the height of the occlusal plane
Incisal edges point tothe upper mucobuccal fold
Occlusal plane
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Setting up the mandibular central incisors
Surveying the labial surfaces during study cast analysis and marking them on the anterior aspect of the cast
Checking the labial limitof the mandibular central incisors
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Setting up the mandibular lateral incisors
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Setting up the mandibular lateral incisors
Basal surfacesat the crestal midline Labial surfaces not
beyond the middle of the mucobuccal fold
Occlusal plane Incisal edges at the height of the occlusal plane
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Cervix slightly protruding on the labial side
Setup similar to the central incisors
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Setting up the mandibular canines
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Setting up the mandibular canines
Crestal midline
Occlusal plane
1 mm above the occlusal plane
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Basal surfaces in front of the crestal midline
Canine tips approx. 1 mm above the occlusal plane
Distal incisal edges aligned with definitive setup line, but at least at the buccal edges of the retromolar pads
Occlusal plane
Labial surfaces inclined lingually
1 mm above the occlusal plane
Crest midline
Setting up the mandibular canines
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Setting up the mandibular posteriors
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Definitive setup lineStatic lines – Definitive setup line
Ideal line
Based on the individual atrophy status
Maxilla: Marks the ideal position of the palatal (working) cusps, except for the first premolars.
Mandible: Marks the ideal position of the central fossae, except for the first premolars.
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Modified outer correction
Balancing:
Static lines – Outer correction
Offers a broad contact zone
Marks the vestibular contact limit of the maxillary and mandibular buccal cusps
If exceeded in the maxilla, the cusps must be placed out of contact to prevent rocking or tilting
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Marks the vestibular contact limit of the maxillary and mandibular buccal cusps
If exceeded in the maxilla, the cusps must be placed out of contact to prevent rocking or tilting
Lingualized setup according to Gerber
Static lines – Outer correction
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Definition: Inner correction
Delimits the positions of the maxillary palatal cusps
Delimits the lingualmost positions of the mandibular central fossae to allow freedom of movement of the tongue, alternatively, the mylohyoid line may be used
Static lines – Inner correction
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Setting up the mandibular first premolars
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Setting up the mandibular first premolars
1 mm above the occlusal plane
Occlusal plane
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Almost at a right angle, viewed from buccally
Definitive setup line between the buccal cusp and the central fossa
Exceeds the occlusal plane and the canine by approximately 1 mm
Same inclination as the canine
Located at the so-called first premolar position
1 mm above the occlusal plane
Occlusal plane
Setting up the mandibular first premolars
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Setting up the mandibular second premolars
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Setting up the mandibular second premolars
Occlusal plane
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Buccal facet aligned with the first premolar
At a right angle to the occlusal plane, viewed from buccally
Central fossa on the definitive setup line
Mesiolingual cusp is higher than the lingual cusp of the first premolar
Occlusal plane
Cusp tip at the height of the occlusal plane
Setting up the mandibular second premolars
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Setting up the mandibular first molars
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Setting up the mandibular first molars
1. The first molar position
Most important stepping and functional point (masticatory center)
Definitive setup line must intersect the central fossa
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2. Respecting the stop line
Dorsal limit of the setup, prevention of anterior sliding
To be decided at this point: Setup extends to the first molar Setup extends to the second
molar
Setting up the mandibular first molars
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4. Last tooth of the setup (which extends to the first molar)
Distobuccal cost of the first molar exceeds the occlusal plane (mean: 1 mm, to ensure protrusive support)
3. Last tooth but one of the setup
Mesiobuccal cusp of the first molar at the level of the occlusal plane
Distobuccal cost of the first molar exceeds the occlusal plane by less than the mandibular first premolar
Setting up the mandibular first molars
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3. Last tooth but one of the setup
Mesiobuccal cusp at the height of the occlusal plane
The distobuccal cusp minimally exceeds the occlusal plane
Setting up the mandibular first molars
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4. Last tooth of the setupThe distobuccal cusp exceeds the height of the occlusal plane by
approx. 1 mm.
Mesiobuccal cusp at the height of the
occlusal plane
Setting up the mandibular first molars
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5. Posterior stepsBetween the first premolar and the first molar, the proximal marginal ridges and lingual cusps form minimal steps, as in the natural dentition; these steps facilitate protrusive support without exceeding the tongue equator
Cf. Lerch, P.: Die totale Prothetik (”Total Prosthetics”). Berlin 1986.
Setting up the mandibular first molars
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5. Posterior stepsBetween the first premolar and the first molar, the proximal marginal ridges and lingual cusps form minimal steps, as in the natural dentition; these steps facilitate protrusive support without exceeding the tongue equator
Cf. Lerch, P.: Die totale Prothetik (”Complete Prosthodontics”). Berlin 1986.
Setting up the mandibular first molars
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buccal lingual
6. Lingual inclination of the molarsintegral® and artegral® are fully anatomic teeth with lingual cusps.The following thus applies tocomplete prosthodontics: 9° (± 1°) or 6° transversal
molar inclination relative to the occlusal plane (angle template)
Objective: Uniform steps Protrusive support
Setting up the mandibular first molars
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buccal lingual
Setting up the mandibular first molars
6. Lingual inclination of the molarsintegral® and artegral® are fully anatomic teeth with lingual cusps.The following thus applies tocomplete prosthodontics: 9° (± 1°) or 6° transversal
molar inclination relative to the occlusal plane (angle template)
Objective: Uniform steps Protrusive support
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Inclination check, mandibular first molar
9°
buccal lingual
occlusal planeα1
α2α1 = α2
6. Lingual inclination of the molarsA 9° or 6° inclination facilitates: Uniform molar steps Balancing Protrusive support
Setting up the mandibular first molars
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TipSandblasted burrs prevent slipping.
7. Occlusal burr test for checking molar inclination
9° template for integral®
S, M, L
6° template for integral®XS and artegral®
Setting up the mandibular first molars
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Position the burr on the integral® molars
Align the angle template with the alveolar crest (90°)
No burr test for the artegral®
Viewing direction
Setting up the mandibular first molars
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8. Occlusal burr test:Molar parallelism between quadrants - integral® only
A symmetrical alignment on the left and right presupposes The same degree of atrophy A perfect alignment of the definitive setup lines
Setting up the mandibular first molars
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Setting up the mandibular second molars
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Same criteria as for the first molar
Exceptions: Mesial marginal ridges have the
same height as the distal ridges of the first molars Mesiobuccal cusp slightly exceeds
the occlusal plane Distobuccal cusp exceeds the
occlusal plane by approx. 1 mm in fixed-average mounting, as for the first premolar
Setting up the mandibular second molars
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Mesiobuccal cusp at the height of the occlusal plane
The distobuccal cusp only mini-mally exceeds the occlusal plane
Setting up the mandibular first molars
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Caution: Denture beds are never symmetrical.Symmetrical alignment on the left and right would require: The same degree of atrophy A perfect alignment of the definitive setup lines
Setting up the mandibular second molar
Occlusal burr test:Molar parallelism between quadrants - integral® only
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Viewing direction
Position the burr on the molars (integral® only).
Align the angle template with the alveolar crest (90°)
Setting up the mandibular second molar
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