Prosthodontics & Occlusion · patient case question
In a fully dentate patient such as this one, which guidance should disclude the posterior teeth during protrusion?
Patient case: Occlusal analysis with articulating paper
Patient: Female, 41 years old
Chief Complaint: Referred for occlusal assessment before restorative treatment.
Background: Full dentate arches. No history of orthodontic treatment.
Current Findings: Articulating paper has been used to mark the maxillary arch through a range of mandibular movements. A single isolated blue mark is present on the LINGUAL cusp of tooth #4 (maxillary right first premolar), shown below.
Show answer and explanation
Correct answer: C. Incisal (anterior) guidance
- A. Condylar guidance is set by the anatomy of the articular eminence. It is a determinant of mandibular movement, but it is not adjustable and is not what discludes the posteriors.
- B. A balanced (bilaterally balanced) scheme deliberately maintains simultaneous contacts in excursions and is used for COMPLETE DENTURES, where it aids stability. In a dentate patient it produces destructive interferences.
- C. CORRECT. In a dentate patient the anterior teeth carry the protrusive load and immediately disclude the posterior teeth. Incisal guidance is the one determinant of occlusion the clinician can actually alter — condylar guidance is fixed by anatomy.
- D. Group function distributes WORKING-side lateral contacts across several posterior teeth. It is an alternative to canine guidance for lateral movements, not the protrusive mechanism.
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