ANTERIOR GUIDANCE: Restoring upper & lower ant teeth

Anterior guidance: Steps in harmonizing the anterior guidance Restoring of lower anterior teeth:

Restoring the upper anterior teeth

Duplicating the incisal edge outline conclusion

Anterior Guidance

Natural dentition
Two posterior controls or the temporomandibul ar joints The anterior control or the incisal guidance

Two condylar guidances of the articulator

Incisal guide pin of the articulator

Articulator

anterior guidance is considered to be not a fixed but a variable factor. It can be altered by dental procedures such as restorations, orthodontia, and extractions. It can also be altered by pathologic conditions such as caries, habits, and tooth wear

Classification of maxillofacial prosthesis

To incise food

To aid in speech

Functions
To protect the posterior teeth, by directing the teeth together in centric occlusion so that the closing forces will be vertically directed onto the posterior teeth

To aid in esthetics

If the closing motion of mandible is stopped by the incisal edges of all six lower ant teeth we have not only taken advantage of the position of the front teeth but also strehgthened this position by distributing stress.

Williamson demonstrated that disculsion of all posterior teeth in eccentric jaw position reduces muscle contraction in elevator muscles. This enables us to reduce the load on both the TMJs and the posterior teeth in all excursions

 Damaging horizontal forces of eccentric movement must be directed to the anterior teeth

You crack the nuts closer to the fulcrum, where youre Anterior teeth receive less stress because they are maximum mechanical advantage resides. Well the same the furthest from the TMJ, which is the fulcrum n principles of physics apply to teeth, muscle force.

The relationship between the incisal guidance and cuspal inclination.

B. The upper and lower posterior teeth have steep lateral occlusal contours which are in harmony with the steep incisal guidance

D, The upper and lower posterior teeth have reduced steepness of the lateral inclines which are in harmony with incisal guidance

RELATION BETWEEN ANTERIOR AND CONDYLAR GUIDANCE

Kohno and Nakano The inclination of the incisal path should be equal to the inclination of the condylar path. The incisal path should not be flatter than the condylar path in the sagittal plane.

A jerky condylar movement will result from an incisal path that is flatter than the condylar path.

What happens when condyles slide curved pathways of ementiae

If the condyles slide forward the lower ant teeth have to move forward too. It is a popular fallacy that whatever the condyles follow must be duplicated in the lingual surface of the upper ant. teeth so the lower ant teeth can follow the same path.

This allows the front end of the Condylar paths do not dictate mandible to followand a completely the ant guidance there is different pathtry without no need to even to make interfering with the condylar the ant guidance duplicate path. condylar guidance.

advocates of such concept they have failed to recognize that the condlyes rotate as they move along their protusive pathways.

The path that the condyles the outer limitsbut to Each of these patients has travel same dictates outer limits of motion which the mandible can move. Path that front end of the each has different envelope of function. Even though condylar mand follows dictated by ant functional of muscle guidance is is same the teeth movements would be contoured as it relates the lower ant teeth to upper ant teeth in the differently. chewing cycle.

Ant guidance is a separate entity and must be determined in the mouth where the determinants of ant tooth position can be observed in function.

 Analyze lower anterior segment from several different perspectives. If the teeth are stable , function comfortably and are esthetically acceptable to the patient there would be rarely any need to change them

 There shud be no signs of instability. Like wear, hypermobility, tooth migration etc.
Every contour has a purpose that is related to function.

 Both visual and digital examination should be used to determine whether any teeth are being moved during lateral excursions Correction usually consists of reshaping the upper lingual contours. Correction of upper lingual contours is patterned to accomplish two effects : redirection of force vector and improved distribution of forces.

Steep incisor guidance

Increase VDO when indicated Reduce incisal edges of lower ant. Place pin ledge inlays on lingual surface of upper anteriors
Restore tooth contact in centric position Formation of fav. Ecc. Incisor guide contours

 There should be no deviation from centric contact . Incase present should be removed by removing interferences If no contact on some teeth are present after deviation is eleminated we hv three choices

Extend centric stops forward at the same vertical to include light closure from the postural rest position.

Lingual line angle is too low result problem movements is poor with esthetics n

excursive

Rounded edge are the first Worst

esthetic contour
Not acceptable holding contact

Proper incisal edge contour is necessary for optimum occlusal stability. It can be! analyzed from two perspectives: a lateral view and an incisal view.

A correct lingual line angle is higher than the labio incisal angle

The lower incisal edges viewed together form the incisal plane. It is as important to phonetics as it is to esthetics.

Relation during speech:

During speech the lower ant teeth are in view and the upper teeth are generally covered.
During smiling, the lower teeth are completely covered and the upper ant teeth are exposed.

 Observing the condition of the alveolar process on the labial surface and noting its contour. Observing the angulation of the anterior teeth. outward pressure of the tongue and the inward pressure of the perioral musculature set the limits within which the teeth can he stable.

 The procedure advocated by Frederick involves a surgical cut vertically-through the buccinator muscle just anterior to mental foramen.
This is foIlowed at the same appointment by vestibuloplasty from mesial of the second bicuspid around to the opposite side at the same position.

The labial contours of upper ant teeth should support the upper lip at rest. It should neither sink nor bulge Natural drape should be der. the upper half of the labial contour relates directly to the labial contour of the alveolus. It should be nearly parallel and continuous with tissue over root.

Lower lip should go smoothly past the labio incisal line angle of upper incisors. There should be no feeling of strain

When f and v sound are made upper incisal edges should contact the vermilion border of lip.

The smile line: the incisal edges should contact the smiling lip line contour without strain

In making S sound the flow of air must be constricted into a flat wide band between the hard surfaces of the lower and upper teeth. The position may vary from near contact in some patients to edge to edge contact in others.

 It the s sound is made at an edge to edge position the lower incisal plane is likely to be flatter.

 As a general rule more convex the incisal plane on the upper teeth more convex it will be on lower teeth. A convex upper incisal plane caannot make a clear s sound at end to end position because air leaks out at sides.

If the lower incisal plane does not closely approximate the contour of the upper arch during the s sound lisping results because of using the tongue to fill in the void so that the air can be squeezed into the flattened band to produce a crisp s sound.

 Complete oral rehabilitation is one of the most complex services the dentist is called upon to render. Its successful completion requires unusual knowledge, judgment, and dexterity acquired only by diligent study and application.

 Dawson P. Functional Occlusion: From TMJ to Smile Design. St. Louis, MO: Mosby; 2006:347. Lawrence A. WEINBERG. Incisal and condylar guidance in relation to cuspal inclination in lateral excursions. 1959;9:5. Schuyler The function and importance of incisal guidance in oral rehabilitation. 2001:86;3. Schuyler, C. H.: Correction of Occlusal Disharmony of the Natural Dentition, New York J. Den. 13:445-462, 1947. Schuyler, C. H.: Factors Contributing to Traumatic Occlusion, J. Pros. Den. 11:708-717, 1961. Stallard, H., and Stuart, C. E.: Eliminating Tooth Guidance in Natural Dentitions, J. Pros. Den. 11:474-479, 1961.

Incisal guide angle:

Anatomically, the angle formed by the intersection of the plane of occlusion and a line within the sagittal plane determined by the incisal edges of the maxillary and mandibular central incisors when the teeth are in maximum intercuspation.

On an articulator, that angle formed in the sagittal plane, between the plane of reference and the slope of the anterior guide table, as viewed in the sagittal plane