The Complete Denture: A Clinical Pathway by MacEntee

Author:MacEntee
Language: eng
Format: epub
Tags: ebook
Publisher: International Quintessence Publishing Group
Published: 2014-07-09T14:41:02+00:00

Condylar guidance on the articulator

It should be possible now to observe directly in the mouth the influence of the patient’s TMJs on the separation of the maxillary and mandibular molars when the patient makes light contact between the incisors. However, the patient will need guidance and practice before protruding the mandible on demand to this incisal position as the clinician stabilizes the mandibular baseplate on the residual ridge. Typically, there is very little separation of the molars if the articulator’s condyles were tilted 25 to 30 degrees bilaterally and the teeth were arranged with a slight occlusal curve to maintain contacts between the distal molars when the incisor teeth were edge to edge (Fig 7-13). However, if the molars separate noticeably when the patient moves the incisors edge to edge while the clinician stabilizes the baseplate securely on the mandibular ridge, the condylar guides of the articulator can be adjusted to reproduce the same molar separation on the articulator. This visual estimate of molar separation is not exact but is sufficient for adjusting the molars on the articulator to remain in contact when the patient moves the jaws eccentrically. Continuous contact between molars is achieved by “ramping” the distal molars at an angle that allows them to remain in contact from the retruded rest position until the incisors meet edge to edge.3 Typically, mandibular complete dentures move around in the mouth when chewing food and make only fleeting occlusal contact with the maxillary denture, which supports the saying “enter bolus, exit balance.” 4

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