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    Anterior Guidance

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    malak2103524

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    © All Rights Reserved
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    Anterior Guidance

    Uploaded by

    malak2103524
    7 views21 pages

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    7 views21 pages

    Anterior Guidance

    Uploaded by

    malak2103524

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 21

    Anterior Guidance

    What We Will Learn Today


    • Define anterior guidance.
    • Explain the role of anterior guidance in achieving neuromuscular
    coordination.
    • Identify cases where anterior guidance is unachievable.
    • Describe the clinical sequence required for incisal edge position
    determination.
    • Describe the clinical sequence required for anterior guidance
    determination.
    What is Anterior Guidance?
    Anterior Guidance \an-tîr΄e-or gıd΄ns\:
    • 1. the influence of the contacting surfaces of anterior teeth, limiting
    mandibular movements;
    • 2. the influence of the contacting surfaces of the guide pin and
    anterior guide table on articulator movements; comp, ANTERIOR
    GUIDE TABLE;
    • 3. the fabrication of a relationship of the anterior teeth
    preventing posterior tooth contact in all eccentric
    mandibular movements [POSTERIOR DISCLUSION]
    Why Posterior Disclusion?
    • Permits Coordinated
    Neuromuscular
    Function (you can’t
    stress what you can’t
    load)
    • Prevents Attritional
    Wear of Posterior Teeth
    (you can’t wear what
    you can’t rub)
    • Reduces Horizontal
    Forces on Anterior
    teeth Closing Muscles
    Shut Off When Back
    —> elevator muscles
    Teeth Separate
    Without Posterior Disclusion
    If there are posterior interferences that
    require displacement of the TMJs to
    achieve anterior contact, the result
    will be the potential for any or all of
    the following:
    • 1. Overload on posterior teeth You Can’t Determine a PRECISE
    • 2. Excessive wear, hypermobility, Anterior Guidance Until ALL
    and tooth migration (unstable Posterior Interferences are
    dentition)
    • 3. Mandibular slide forward into
    Eliminated
    anterior overload
    • 4. Hyperactive incoordinated
    muscles
    using articulating paper—> this
    will mark only on anterior teeth in
    movements—> post teeth—>
    dots of centric holding cusps &
    fossa
    Is Posterior
    Disclusion for
    Everyone?
    • Whenever Possible……Yes
    • However…..
    • The anterior guidance cannot do its
    job in the following situations:
    • 1. Class 1 occlusion with extreme overjet
    • 2. Class 2 division 1 occlusion
    • 3. Class 3 occlusion with all lower
    anterior teeth outside of the upper
    anterior teeth
    • 4. Some end-to-end bites
    • 5. Anterior open bite
    The Key to Successful
    Anterior Tooth
    Restoration or
    Replacement is
    Precise Placement of
    the Incisal Edges
    steps to anterior guidance—>
    1)CR is determined
    2) placement of incisal edge

    …..Then you can work out


    the Anterior Guidance
    The Key to Locating the Optimal
    Incisal Edge Position is
    Conforming to the Patient’s
    Own
    Centric Relation,
    Neutral Zone,
    Lip Closure Path,
    Envelope of Function and
    Phonetics
    NOT ON ARTICULATOR—> ONLY BORDER MOVEMENTS NOT FUCNTIONAL MOVEMENTS

    • Any restorative change of incisal edge position must be worked out


    and confirmed in provisional restorations in the mouth

    wax up on articulator—> longer to be adjusted in mouth


    all these steps are done before provisional

    1 CR

    You Can’t Determine a PRECISE


    Anterior Guidance Until ALL
    Posterior Interferences are
    Eliminated
    CERVICAL CONTOUR OF LABIAL Lip support in line with alveolar
    SURFACE—> continuation of alveolar
    process
    contour. The upper half of the labial
    2 contour can be determined fairly
    well on the cast. The upper
    impression must include the
    complete contour of the alveolar
    process
    Lip-closure path. This is a critical
    determinant for the incisal half of
    correct horizontal position of incisal edge 3 labial contour. It can only be
    determined in the mouth.
    Determine incisal edge length
    (using the smile line). This
    4
    vertical position of incisal edge
    relationship is important for
    phonetics of the F and V positions as
    guided by lip curvature
    well as for the best esthetics.

    F,V
    ‫ف‬
    account for long centric—> postural
    effect on habitual closure
    centric bite position—> supine
    upright—> articulating paper
    detect discrepencies & remove
    5
    centric holding to incisal edge

    S
    ‫س‬
    contours of cingulum—> rounding of
    centric holding contacts between cingulum

    6 & fossa (ant guidance

    T,D
    ‫د‬,‫ت‬
    1
    2 3 lip closure
    p a t h — >
    horizontal
    position
    centric holding
    contacts are
    determined
    to determine
    work out anterior guidance—>
    incisal edge
    relief to long centric contacts &
    position—>
    alveolar process
    4 determine guidance through S

    5
    vertical & phonetics f,v
    smile
    6

    CONTOURS OF PALATAL SURFACE t&E

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