Professional Documents
Culture Documents
D E N T I S T RY
R E S T O R AT I V E
Working side
D E N T I S T RY
Non-working side
Mandibular
position in ICP
RLE
LATERAL MOVEMENT
Non-working Side
The side away from which the mandible
has moved is termed the non-working
side but NOT the balancing side.
Balancing side contacts are used in
complete denture construction to gain
balanced articulation and improve
denture stability during excursive
movements. Balance is a prosthetic
term in edentulous cases whereas nonworking side contacts occur in dentate
subjects. Non-working contacts may
become interferences should any of the
previous situations exist as for the
RCPICP slide and/or:
l Palatal cusps fracture;
l Increased tooth mobility occurs
with a healthy periodontium (1
Trauma from occlusion);
l Increasing tooth mobility occurs
with pre-existing chronic adult
periodontitis (2 Trauma from
occlusion);
l Pain or pulpal necrosis is located
to one or two teeth with no other
obvious cause, e.g. caries.
It should be remembered that many
individuals adapt to developmental
malocclusions and deranged
occlusions such that a non-working
contact is not necessarily an
interference. Despite this, the nonworking contact can result in alteration
in mandibular leverage and non-axial
forces. Providing there are no signs or
symptoms of disorder/disease, then a
watchful eye is acceptable.
PROTRUSIVE GUIDANCE
This is a combination of anterior or
incisal guidance and condylar
guidance. Protrusion is the anterior
movement of the mandible. An
edentulous individual can protrude his/
her mandible. During protrusive
guidance, in Class 1 relation, the incisal
edges are guided by the palatal aspects
Working Side
Lateral mandibular movement is guided
by condyle-fossa relationships and
tooth relationships. During canine
guidance the palatal surface provides
guidance which may disclude all the
other teeth on the side to which the
mandible has moved (the working side).
Alternatively, multiple working side
contacts may be present, called group
function, or a combination of initial
group function with canine rise towards
360
R E S T O R AT I V E
UR6
LR6
Right Lateral Excursion
UL6
LL6
Non-working side contact
THE FACTORS OF
OCCLUSION
The clinical significance and interrelationship of the previously
discussed factors may not be apparent.
Cusp height, fossa depth, ridge and
groove direction in both natural and
restored dentitions are determined by
these factors of occlusion.
Occlusal determinants are:
l Incisal guidance;
l Condylar guidance;
l Sagittal or mesio-distal curve
(Curve of Spee in prosthodontics);
l Curve of Wilson or medio-lateral
curvature (Curve of Monson in
prosthodontics);
l Lateral or Bennett shift.
In an individual with a reduced
overbite, there exists a greater potential
for cuspal contacts during protrusive
movement should there be a co-existent
steep sagittal curve. In this situation,
shorter, flatter cusps would reduce the
potential for posterior interferences. As
this curvature becomes flatter, this
potential reduces. The flat occlusal
plane is safe with respect to cuspal
clashes when coupled with some incisal
or canine guidance. Anterior Open Bite
with symptoms of stomato-gnathic
dysfunction pose a particular problem
as it is unlikely that posterior
disclusion is achievable without
recourse to orthognathic surgery.
The posterior determinant of cusp
height and fossa depth is the condylar
guidance angle. Steep anterior and
condylar guidances are theoretically
harmonious and tend to provide
disclusion allowing for steeper cuspal
anatomy. Shallow condylar guidance,
even with a good overbite, can thus
still result in cuspal contacts nearer the
back of the mouth.
The influence of lateral shift on cusp
height is more difficult to describe.
Consider the medial movement of the
D E N T I S T RY
R EFERENCES
1.
2.
3.
4.
5.
6.
7.
JULY/AUGUST
CPD Answers
1. A, B, C, D
6. B, C
2. A, B, C
7. B, C
3. B, D
8. A, B
4. A, B, C
9. B, C, D
5. B, C, D
10. A, C
361