INTRODUCTION
1. Prosthodontics
Branch of dental art and science pertaining
to the restoration and maintenance of oral
function by the replacement of missing teeth
and associated structures by artificial
devices
Divided into:
▪ Fixed – in place ; indirected restoration
▪ Removable
- Removable Partial Prosthodontics
- Complete Denture Prosthodontics
2. Removable Prosthodontics
Branch of prosthodontics concerned with
the replacement of teeth and contiguous
structures for edentulous or partially
edentulous patients by artificial substitutes
that are readily removable from the mouth
Only partially edentulous or has remaining
natural dentition and can be removed
anytime
3. Fixed Prosthodontics
Area of prosthodontics focused on
permanently attached (fixed) dental
prostheses.
Such dental restorations, also referred to as
indirect restorations, include crowns,
bridges (fixed dentures), inlays, onlays, and
veneers
Use dental cement to attach teeth
4. Maxillofacial Prosthodontics
Artificial replacement to restore the function
of the face
Different from maxillofacial surgery
Ex. Artificial eye; those who suffer from
trauma, accident, cancer, cleft palate
5. Implant Prosthodontics
Best material that has good compatibility
with bone is TITANIUM
Dental implant is an artificial tooth root
replacement and is used to support
restorations that resemble a natural tooth or
a group of teeth
Dental implant is a device made from one or
more biomaterials that is intentionally
placed within the jaw to support and/or
retain a dental prosthesis
2 Stages:
▪ Surgery
- Open gums ! drill a hole ! place
implant ! cover then wait for the
bone to integrate with the implant
! 4-6 months later, open it again !
do the prosthetic part
▪ Implant Prosthodontics
- Phase of dentistry concerning the
restoration following implant
placement
*Caution integration – wait for implant to be accepted/
rejected
6. Prosthesis
Replacement of an absent part of the
human body by an artificial part (ex. artificial
leg, hand, ear, mandible, denture)
Dental Prosthesis – Artificial replacement
of 1 or more teeth and/or associated
structures
7. Crown
Anatomic– Portion of a natural tooth that
extends from its dentinoenamel junction to
the occlusal surface or incisal edge
Artificial – Fixed restoration of the major
part of the entire coronal part of a natural
tooth. Usually metal, gold, porcelain/
ceramic, synthetic resin, or their
combination (acrylic crown not a good
candidate for long term use of crowns)
▪ In a crown, everything is extracoronal.
(if majority of restoration is intracoronal
then it is an inlay or onlay)
▪ Before placing an artificial crown, your
prepare the tooth first (make it smaller)
Can be a complete veneer crown or partial
veneer crown
a. Complete or Full Veneer Crown
Restoration that covers all the of the
clinical crown (until gingival line)
b. Partial Veneer Crown
Covers portions of clinical crown
*Partial – prosthesis for partially edentulous patients
*Complete – prosthesis for edentulous patients
8. Bridge / Fixed Partial Denture
Restoration of one or more of, but less than
all of, the natural teeth
Primarily supported by the teeth or roots
It is often designated as “Fixed Bridge”
9. Abutments
Natural tooth or root used for the support or
attachment of a fixed or removable
prosthesis
Either terminal or intermediate
10. Pontics
Artificial tooth being replaced on a fixed
partial denture
Replaces the lost or missing natural tooth,
restores the function, and usually occupies
the space occupied by the natural crown
11. Retainers
That part of a fixed partial denture which
attaches the prosthesis to the abutment
Maybe be an inlay, partial veneer crown, or
a complete crown
Covers the abutments

12. Joint or Connectors
Part of a fixed partial denture that unites its
component parts
I.e. Pontics& Retainers
May be rigid or nonrigid
DIAGNOSIS& TREATMENT PLANNING
1. Diagnosis
Identification of any abnormality
History
▪ Medical History
- Any medication being taken
- Any allergic reactions to medicine
to know what the problem is
▪ Dental History
- When was the last treatment
- When was the prosthesis made
- History of extraction
- Any allergic reaction to anesthesia
2. Treatment Plan
OP
Exo
Endo
Perio
VERY LAST: Prostho
❖ 1st Treatment Plan: Implant
- Patient hasno caries, no previous
restoration, adjacent PM and molar
are in perfect condition, young
❖ 2nd Treatment Plan: Maryland Bridge/
Etch Cast Restoration
- Patient is diabetic, heavy smoker,
has heart problems taking blood
thinner (contraindications) and cant
afford implants
- Porcelain metal crown
- Attachment on the lingual (metal
wing) bonded by composite
- Etch the metal by the technician
- Etching of enamel and dentin for 15
seconds ! wash ! dry with cotton
! apply bonding agent ! use
special composite luting agent
(composite designed as a cement)
❖ 3rd Treatment Plan: Fixed Bridge
➢ Implants supporting a CD (attachment on the
implant and on the denture) !denture is supported
by tissues, mucosa and residual bone; retention is
the implant !IMPLANT RETAINED TISSUE
SUPPORTED DENTURE
➢ Porcelain Jacket Crown/All Ceramic Crown (PJC)!
blends with the original
➢ Porcelain Fused To Metal Crown (PFMC)! there is
always an exposed metal on the lingual
➢ All Metal Crown ! only on the posteriors
➢ BIOLOGIC WIDTH ! areas immediately below the
gums (attached gingiva); area approximating the
attached gingiva ! if the crown goes in below the
gums, encroach on attach gingiva ! soft tissue
inflammation ! increased osteoclastic activity !
resorption ! mobility ! pocket formation
!
➢ The selection of the type of material and the design
of the restorations are based on these factors (use
composite or crown?):
- Destruction of tooth structure
- Esthetics
- Plaque control
BASIC REQUIREMENTS OF FIXED PROSTHESIS
1. Restoration of normal function
2. Biologic acceptability
3. Acceptable esthetics
OBJECTIVES OF FIXED PROSTHESIS
1. Restoration of masticatory function
2. Restoration of proper phonetics
3. Restoration of acceptable esthetics
4. Maintenance of health of investing tissue
(periodontium)
5. Maintenance of arch integrity
6. Maintenance of stable occlusion
7. Pulpal protection (covering exposed dentinal
tubules)
8. Splinting of teeth when indicated (perio surgery)
4 Elements of a Good Diagnostic Workup in Preparation
For Fixed Prosthodontic Treatment:
1. History
2. Intra-oral Exam
3. Diagnostic Cast
4. Full Mouth Radiograph
Indication For Fixed Prosthesis
1. Whenever properly distributed & healthy teeth exist
to serve as abutments
2. Prove that these teeth have suitable crown to root
ration, and on the basis of radiograph, diagnostic
cast, and oral exam, seem capable of sustaining the
additional load
3. In General, an FPD is preferred to a removable
prosthesis/denture
 4. Teeth and the immediate adjacent oral structures
have also a direct influence
FIXED PARTIAL PROSTHODONTICS
Abutments
- Should be careful in choosing an abutment because
they will also be carrying the load of the pontic
along with their own load
- Should be in good optimum health
- No periodontal disease, good bone support, no
inflammation of the gums, no resorption of bone, no
widening of the periodontal ligaments
Factors Influencing the Design of the Prosthesis
1. Crown Length
o Want it to be very long
o Adequate accluso-cervical crown length for
sufficient strength
o (X) Mand. Incisors & Max.LI
2. Crown Form
o Want it to be very big/bulky
o Most desirable candidate: Canine, Upper
CI, Post. Teeth
o Least desirable candidate:
Lower CI (in danger of pulp exposure) and
Upper LI
3. Degree of Mutilation
o Amount of tooth tissue destroyed
o Location of carious lesions
o Can restoration last? Will it help strengthen
tooth? IF NOT, go for crown
4. Root Length & Form
o Roots broader labio-lingually than mesio-
distally are better than roots with round
cross section
o Multirooted and flared roots give better
support than roots that converge, fuse or
generally conical in shape
o Shape of upper PM root: Irregular shape
(offers better stability)
o Shape of CI: Circular shape
5. Crown-Root Ratio
o Measure of tooth occlusal to alveolar crest
compared to length of root embedded within
bone
o 1:2 !ideal
o 1:1.5 ! satisfactory
o 1:1 ! minimal
o Use radiographs to check this
o Opposing occlusion is a removable denture
! diminished forces (not as strong) !
mastication force is only 10%
6. Ante’s Law
o Root surface area of abutments should be
equal or greater than the root surface area
of the teeth being replaced with pontic
7. Periodontal Health
o Poor periodontal health will lead to bone
loss
o Extensive bone loss ! need more
abutment teeth or RPD
8. Mobility
o Healthy tooth = slight mobility due to
periodontal ligament space
o Pathologic mobility = bone loss already
o Errors in restoring back the patient’s normal
occlusion, upon delivery of FPD, will lead to
tooth mobility
o When checking for mobility of the tooth, get
the end of 2 mouth mirror and place one on
the buccal and one on the lingual (has to be
blunt instruments) and move it back and
forth
o Don’t use fingers because they are soft
9. Span Length & Thickness
o The longer the bridge ! more flexing of the
bridge ! create problems on the abutment
due to too much force exerted ! break the
porcelain
o Anything more than 3 units = Chances of
error increases
o Thickness of connector should be cervico-
occlusal
10. Pier Abutment
o A tooth to be used as an abutment, free
standing with a tooth missing on the mesial
and on the distal, creating a lone free tooth
will act as a fulcrum when it forms a part of
FPD
o 5 unit bridge = Lever arm
o Tooth in the middle = Fulcrum
 o To lessen the forces on the pier abutment, esthetic will be compromised in the cervical
split the 5 unit bridge into 2 parts (3 units & area, and will create large embrasures to
2 units) ! use a non-rigid connector to restore facial contour
connect the 2 parts o Can be fixed by bone grafting

*non-rigid connectors – broken stress mechanical union of PRINCIPLES OF TOOTH PREPARATION

retainer to pontic. It allows a slight movement w/o involving
the pier abutment Types of Forces That Are Directed Against a Prosthesis
During Function

1. Tipping Force
- bucco-lingual or mesio-distal

2. Twisting or Rotational Forces

- restoration moves circumferentially

3. Path of Insertion Forces

- apico or occlusally directed depending on opening
and closing of mandible (mandible moves in a
o Problems of teeth with a pier abutment: teardrop motion)
Sensitivity, pain, widening of periodontal
space = Trauma form occlusion *Distal extension case – no teeth up to retromolar pad (RPD
/ implant)
❖ A bridge only supported on one end
instead of both ends = CANTELEVER Principles
o Advantage 1. Preservation of Tooth Structure
▪ Tooth conservation Avoid excessive destruction of remaining tooth
▪ Shorter chair time tissue after preparation
▪ Easier impression To reinforce and protect the remaining enamel
making and dentin
▪ Less laboratory fee If you’re very near the pulp already, before
o Disadvantage placing composite or amalgam, place Calcium
▪ Tooth displacement Hydroxide first ! put protective layer of glass
during occlusion ionomer (can be etched) ! composite ! tooth
❖ NEVER place a cantelever (sp?) on the prep ! crown
posterior Some put Glass Ionomer Liner first
Preservation = Talking about the tooth in its
entirety not the actual prep
Ex. Patient goes to you with a badly broken
down tooth, due for exo but you found a way to
restore it (RCT, resto inside root canal,
composite) ! prepare tooth ! cover with crown
! preserve remaining tooth

11. Path of Insertion

o Abutments should always be prepared
parallel

12. Age of Patient

o Younger patients have larger pulp so there
is a danger of accidental pulp exposure
o What you do: minimal prep ! put an acrylic 2. Retention and Resistance Form (Shape of prep)
crown for the mean time ! can easily
Retention Form
degrades, change color ! change every 6
- The shape of the prep prevents removal of the
months until the right age (16 yrs old) ! restoration along path of insertion or the long axis of
remove acrylic crown ! do correct amount the tooth preparation
of reduction ! final impression ! more
permanent restoration

13. Esthetic / Alveolar Ridge Form

o If edentulous area exhibit severe bone
resorption, and is to be restored by FPD,

- Shape
of prep
should
be
tapered
3°-5°.
Combined taper is 6⁰-10⁰, increase of more
than 6⁰-10⁰ reduces retention
- Any conscious attempt to taper can easily
result to over taper
- Proximity of the axial wall of the prep to the
inner surface of restoration should be small
- Retention can be improved by limiting the
number of paths that a restoration can be
removed. Maximum retention is achieved
when there is only a single path
Resistance form
- The shape of the prep prevents the crown
from displacement in any other direction except
from the long axis
▪ Placement of grooves and boxes to
make the path of displacement only 1
▪ Adequate occluso-cervical height /
length of axial wall
SHAPE
OF PREP
IS THE
MOST
▪ When preparing a cavity
prep for an inlay, NEVER
put an undercut
▪ For inlay to stay in place,
there should be close
adaptation between the
inlay and the cavity wall
▪ The closer the fit, the better
retention
Preparing a crown
▪ NEVER use an undercut
▪ There should be close proximity
between the internal wall of the crown
and the external wall of the prep
Purpose of cement
▪ Even with a good fitting crown over the
prep, there are still microscopic spaces
▪ Cement covers these gaps
Degree of tapering
▪ As you increase the degree of taper,
you reduce the amount tooth tissue to
resist displacement
▪ Still want a slight taper
- If you provide a slight taper, it will
be easier for the technician to
withdraw the wax pattern from the
die
- The technician finishes the crown, it
will be easier to fit the crown on a
tapered prep on the master cast
- For the clinician, it’s easier to fit
during try in
- Easier to sit the crown during
cementation
- WHY NOT 0⁰? Because it will have
no space for the cement and will be
difficult to fit or remove
*Cement film (thinner = better fit)

IMPORTANT FACTOR UNDER THE DENTIST

CONTROL

Passive Fit
▪ Want to see the space ▪ Occlusal wider than cervical = Creates
inside the crown and the an undercut (divergent)
shape of the prep fit in a
▪ Over tapered prep = Place grooves or
way that it’s not too tight or boxes ! limit the path of withdrawal to
too loose a single direction ! good retention and
▪ Influenced by the resistance
technician
Good retention and resistance form for an inlay
 ▪ Sufficient height for good retention and a) Measure amount of tooth structure already
resistance removed. Delineates extent of cut in an apical
direction
b) Evaluate accuracy of impression
c) Evaluate quality of die
d) Evaluate quality of restoration
e) For correct mariginal adaptation of wax patterns
f) To check if restoration is properly seated during
cementation

When fitting the crown over the prepared tooth

there should be a perfect seal
Seal is not good ! microscopic opening !
debris will go in ! cannot clean it ! becomes
bacteria ! eats enamel and dentin !
secondary caries
Finishing line = Just the line itself
Margin = Covers a wider area
Crown should terminate exactly on the margin
or finishing line

Types of Margin
▪ Shoulder / Butt joint
- Finish line of choice for all PJC
- Wider than chamfer, average width is
1.25mm. 90⁰, L shaped

-
-There is
adequate
tooth
reduction
to
achieve
proper
3. Structural Durability color
Strength of final restoration through
Always make sure that the master cast you material
provided is accurate ! where the technician thickness
make the restoration o Since metal substructure
Adequate thickness makes the crown strong ! (inner wall of PFMC)
by providing the occlusal clearance needed for follows the form of the
the technician ! through adequate reduction shoulder, this makes it
more resistant to distortion
during porcelain firing.

▪ Knife edge – to lessen amount of tooth

reduction on tipped area. Not well defines
as chamfer

▪ Shoulder w/ bevel – forms obtuse angle w/

axial wall. May be used on facial when
preparing tooth to receive PFMC. There’s a
bit more reduction and bevel part is located
subgingiva

▪ Beveled shoulder – butt joint that is angled

more than 90⁰ (around 115⁰)

▪ Chamfer
4. Marginal Integrity - Lingual
- Margin / Finish line = point at which a preparation - Narrower and rounder
terminates on a tooth - Correct use = Only use half the
diameter of the chamfer width
Functions: - Always less than 1mm (0.75mm)
 Location of Usual size of reduction = 1.5-2mm
the Finish Line
▪ Achieve this by using the diamond bur
▪ Supragingiva
- Advantage: ▪ Make a series of cuts
o Less periodontal irritation ▪ Orientation grooves
How will you know that your guide is right? !
o Healthier, easier to make an
MARGIN
impression
o Better access
5. Preservation of Periodontium
- Disadvantage: - Accdg to G.V. Black, decay does not occur as long
o Ugliest crown
as margins are covered by health gingival tissue
o Original enamel is visible
- Then clinicians found out that the deeper the
- NEVER USE due to esthetics restoration margin extend into the gingival sulcus,
- Exception = On 2nd molars and the the more severe the inflammatory response
lingual surfaces - Accdg to Christensen, experienced restorative
dentists could miss margin defect up to 74% of
proximals of a PFMC
- Accdg to Scholer, the legitimate reasons why we do
subgingival margins:
o Existing caries
o Extension and previous restorations
o Retention and esthetics
o Subgingival tooth fracture
o Root sensitivity
- Crown margin should not be placed closer than
2mm away from the alveolar crest or bone
▪ Equigingiva resorption will occur
- Balance between supra and subgingiva - Biologic width is the combined width epithelial and
- A compromise connective tissue attachement & is normally about
2mm. inflammation will occur if crown margin
intrudes this area

TOOTH PREPARATION

- Orientation grooves, depth cuts, guide / control

grooves
o Prevent over & under reduction
- PFMC
o It combined the strength and accurate fit of
metal with esthetic effect of porcelain
o Have greater strength than PJC due to
metal substracture

❖ Average of 1.5-2 mm reduction in order to

accommodate the different layers of the PFMC

▪ Subgingiva 1. Proximal Reduction

- BEST due to esthetics
To isolate the tooth right away
- 0.5 above attached gingiva
Use pointed diamond so that you won’t cut the
- Emergence profile ! an illusion as if adjacent tooth
the tooth is growing out of the gingiva To prevent injury on the adjacent, you can insert
- Disadvantage: matrix band
o Periodontal inflammation
2. Labial Orientation Grooves
 3. Incisal Reduction 2. Individual engaged in contact sports where incidence of
Long tapering flat end fracture is high
1.25 mm reduction 3. Patients who have decreased inter-occlusal distance or
edge to edge occlusion, that is accompanying heavy
4. Labial Reduction musculatory musculature
Labial surfaces are not flat ! cut labial in 2 4. Cervical erosion making tooth prep impossible
planes (Biplanar Reduction) 5. Anterior teeth with constricted cervical circumference
2 Planes 6. Short clinical crown
▪ Cervical to middle 3rd ! straight 7. Teeth that are thin labio-lingually
▪ Middle to incisal ! slightly curved
PORCELAIN FUSED TO METAL CROWN (PFMC)
5. Lingual Reduction Indications:

Chamfer diamond 1. When incsal angle have been fractured beyond a point
where conservative restoration cannot serve equally well in
6. Lingual Concavity terms of function & esthetics
Oval diamond 2. Excessive proximal caries or multiple restorations have
To cut the fossa been placed in the past
3. Discolored teeth due to hypocalcification, tetracycline
7. Round off sharp angles stains, after endodontic treatment & cannot be corrected by
Corner produce stress bleaching
4. When anterior teeth are rotated or laterally displaced and
❖ How would you know your lingual reduction is ortho treatment is not feasible
sufficient ! patient to close mouth and check for 5. used in conjunction with ortho treatment
space ! at least 1mm space ! enough to make 6. Where maximu9m esthetics is required
crown ! structural durability 7. Single or multiply restorations of both anteriors and
posteriors
ACRYLIC JACKET CROWN 8. Retainers for RPD
Advantages:
 9. Teeth with morphological variations
1. Economics (ex. Job interview) 10. Splinted periodontal prosthesis
2. Ease of fabrication, easily repaired
3. Cheaper lab fee COMPLETE VENEER METAL CROWN
Indications: Generally on posteriors where esthetics is not a
Disdvantages:
 problem

1. Poor color stability 1. Extensive caries and to prevent further fracture
2. Easily abraded 2. Tooth fracture
3. Does not posses natural tooth shade 3. Greater than average occlusal forces
4. High dimensional change owing to water sorption and 4. Existing large defective restorations
thermal changes (margin opens up) 5. A need to change tooth contours especially around the
abutment that are to receive RPD
Indication: 6. Short occluso-cervical height
1. For very young patient (larger pulp) 7. Long edentulous span (w/o porcelain, bridge is not
2. Economic reason subjected to porcelain firing at a very high temperature)
3. Primary use is as temporary / provisional crown 8. Abutment alignment that requires full coverage
preparation to achieve adequate retention
PORCELAIN (PJC / ALL CERAMIC CROWN)
Advantages:
 MARGIN FACIAL LINGUAL
1. Durable, greater strength
2. Color stability Metal Chamfer Chamfer
3. Meet most esthetic requirements (color,form)
All Ceramic Shoulder Shoulder
Disadvantages:

PFMC Shoulder Chamfer
1. Require artistic skill & experience to manipulate
2. More equipment for fabrication
3. More expensive
METAL
- Older techniques use platinum foil. Newer use castable - Has less reduction than PFMC ! absence of
ceramics ceramic
- Brittle
- Used when maximum esthetics is required ALL CERAMIC
- Prone to fracture ! provide sufficient thickness for
Contraindications: crown ! more reduction
1. Younger patients (have larger pulps; prone to pulp
exposure since this crown requires a lot of tooth reduction to PFMC
achieve sufficient thickness of crown) - Always has an exposed metal on the lingual
- Needs sufficient reduction on the labial ! shoulder
 - Lingual has just metal ! chamfer o Hinge Axis ! imaginary line on horizontal
plane
❖ CONCLUSION: o Movement in sagittal plane
The type of final restoration determines the type of o Produce rotational opening and closing
margin to be used movement around hinge axis that extends
on both condyles
❖ Lower 2nd molar ! short clinical crown ! grooves
or boxes for retention-resistance form ! instead of 2)Vertical
equigingiva, make it subgingiva to increase height oOn a
of the crown (gain 1mm in height) ! for retention- vertical
resistance form plane in one
condyle
OCCLUSION/TEMPOROMANDIBULAR JOINT oDuring
Bones Comprising It lateral
1) Temporal Bone movement
o Glenoid fossa or Mandibular Fossa One
2) Articular Eminence condyle
o Distal Slope – doesn’t make up directly the more or less
TMJ but it affects mandibular movements remains stationary
o Mesial Slope Occurs in horizontal plane
3) Condylar Process of mandible Movement of working side condyle
o Located a little anterior to the fossa ! rotates and moves laterally and
4) Meniscus or Articular Disk posteriorly
o Between the condyle the fossa is a cartilage Center of rotation is a vertical axis
o Can only see this when you open up the extending through the working side
cadaver of the condyle

3) Sagittal
oOn a
horizontal
plane but in a
single
condyle
oForward and
downward
and medial
movement
Mandibular Fossa (translation) on a non-working side ! due
- Can easily palpate the condyles to the DISTAL SLOPE of articular eminence
- Anterior and below auditory meatus
- Meet the articular eminence which is the post end of
the zygomatic process
- The ones being palpated are the lateral pole of the
condyle ! the fossa is narrower than the width of
the condyles

Articular Disc
- Fibrous CT b/w fossa and condyle
- Little movement in the first opening movement of
mandible
- When you open the condyles ! the articular disc
follows
- There is a clicking ! when opening the condyles Definition of Terms
(mandible) the articular disc is left behind ! leaving - When you move your mandible to the RIGHT
a space o WORKING SIDE ! the right side
- LOCK JAW It is the direction where the
o Condyles are displaced in front of the mandible moves
articular eminence Shift laterally and usually posterior
o Bilateral or Unilateral Right Posterior Working Side &
Right Working Side Condyle
Mandibular Movements o NON-WORKING SIDE ! the left side
- Imaginary lines It is away from the direction of the
1) Horizontal movement
 Will arc forward and move medially
Left Posterior Non-working Side
& Left Non-working Side Condyle
- When you move your mandible to the LEFT
o WORKING SIDE ! the left side
o NON-WORKING SIDE ! the right side

Centric Relation/Terminal Hinge Position

- Can’t keep the mandible open for a very long time
because you are straining the muscle and pulling
the ligaments
- Always goes back to the centric relation position
- Habitual, most comfortable position for the patient
and it is repeatable
- Teeth not in contact when in centric position
- When you occlude the teeth in centric relation !
MAXIMUM INTERCUSPATION
- Condyles are at its most superior anterior position in
relation to the distal slope of the articular eminence

Mandibular Opening
- 2 Stages:
o Maximum Hinge Opening
There is ROTATION of the condyles
o Maximum Opening of the Jaw The Determinants for Mandibular Movements
2 Movements - When it comes to POSTERIORS
▪ Rotation o They are closer to the TMJ so the shape of
▪ Forward & Downward (due to the posterior should conform to function of
the DISTAL SLOPE) ! the TMJ movement ! determined by the
TRANSLATION movement of the TMJ
o The posterior will be influenced partially by
the joints and partially by anterior guidance
o We don’t have control

- When working with ANTERIORS

Bennett Movement/Immediate sideshift
- When you move your mandible to the left or right,
don’t rotate right away ! there is a slight,
immediate bodily shift (1-2 mm) before the rotation
- Mandibular excursion / excursive movement /
mandibular lateral movement
Border Movement of the Mandible
- Posselt’s Movement
**During mandibular maximum opening, moves forward
and downward due to distal slope
- Translation is happening
**From CR to F ! mandible protrudes; there is curvature
because of translation
**CR ! centric relation; teeth not in contact (habitual)
**CO ! Centric occlusion (maximum intercuspation)
**From CR to B ! Maximum hinge opening (rotation)
**From CR to E ! Maximum opening of jaw; with curvature
because of translation
**From F to E ! no more curvature since the jaw already
translated during CR to F
o They are further away from TMJ ! have a
little control over them
o The anterior will be influenced greatly by
teeth of max and mand arch and only
slightly by the TMJ
o We have little control
o Guides the mandible in several ways
▪ Posteriors act as vertical stops
▪ Anteriors guide the mandible during
lateral excursive movements &
straight protrusive movements
❖ Try to restore the teeth to be in harmony with the
TMJ ! result to less stress on the teeth and less
effort by the neuromuscular system to produce
mandibular movements ! smooth gliding contact
❖ If you don’t adjust the shape of the tooth !
ABRASION of the natural teeth
Interference
- When the teeth are not in harmony with the joints
and with the movement of the mandible
- When you move the mandible to the RIGHT or
LEFT
 o The working side should have CONTACT
o On the non-working side there should be
NO CONTACT
- When you protrude the mandible ! Edge to edge
o There should be NO CONTACT between
the posteriors
- 4 Types:
o Centric
o Working
o Non-working
o Protrusive 3) Mutually Protected Occlusion
o Canine Protected Occlusion or Organic
- Among the different interferences, NON-WORKING
SIDE & PROTRUSIVE should be corrected if Occlusion
o The anteriors protect the posteriors at some
present ! There shouldn’t be any contact on the
non-working side and during protrusion on the positions and vice versa
o For natural dentition
posterior
o During maximum intercuspation
- TREATMENT: Enameloplasty ! trim ! smoothen
All the load is carried by the
! put fluoride
posteriors
Anteriors are open
Criteria for Occlusion
Posteriors protect the anteriors
o During lateral movement
a) Firm contacts of all teeth when condyles are in an
The anteriors carry the load
anterior superior position
Posteriors are open
b) Anterior guidance which harmonizes with the
Anteriors protect the posteriors
patient’s costumary envelope of movements
c) Disclusion of the posterior when the mandible
protrudes (to prevent protrusive interference)
d) Disclusion of the posterior on the non-working side
during lateral excursion (to prevent non-working
interference)

3 Concepts of Occlusion
1) Bilateral Balance Occlusion
o There should be contact on both the
working and non-working side
o For artificial dentition (complete denture)
POSTERIOR TOOTH PREPARATION

1. Proximal reduction
2. Orientation grooves
3. Buccal reduction
4. Lingual reduction
5. Occlusal reduction

**Bevel the functional cusp

- To satisfy the principle of structural durability !
crown with sufficient thickness
2) Unilateral Balanced Occlusion
o Contact in on working side only and not on
non-working side
o For natural dentition
o If with contact on working side, should be
contoured to be free of contact
 2 basic Designs of Semi-adjustable Articulators
1) Arcon
o Articulator Condyle
o Condyle is on the lower member
o Simulate normal anatomy
2) Non-Arcon
**For posteriors at least 2 mm occlusal space for PFMC o Non-articulator
**For lower molars o Condyle attached to the upper member !
- Outline is a rounded square doesn’t follow anatomy

**Every cusp should always have a mesial and distal Facebow

incline - Calliper like device to measure the relationship of
jaws to TMJ
ARTICULATORS & FACEBOWS - Records the gleno-maxillary relationship
- device that represent TMJ, upper & lower jaw to which max - Aid in supporting the cast while mounting
and mand cast may be attached to simulate jaw movements - Need an anterior reference point ! nasion
(Whipmix), ala of the nose (Phenar??), infraorbital
Classifications foramen (Hanau)
1) Simple Hinge - Transfer facebow record from patient to the
- only for convenience articulator ! FACEBOW TRANSFER
- permit horizontal and vertical motion but not orient
motion to TMJ
- does not allow a face bow transfer

**Ball bearing represents the condyle

**The large dissimilarity b/w the hinge axis of the simple
articulator and the hinge axis of the mandible will
produce a large discrepancy in the arc of closure of the
articulator

2) Semi-adjustable
- accept facebow transfer
- simulate arc of closing and opening & condylar
pathways and inclination
3) Fully Adjustable
- accept 3 dimensional registration
- kinematic facebow may be used
- more accurate mandibular movements, used
primarily for extensive treatment