35
The rationale for utilizing the diagnostic
data obtained from protrusive and later-
al checkbite records is as follows.
When the protrusive inclination of the
superior fossa wall is adjusted to the lat-
eral checkbite record, a characteristic of
the orbiting condylar path is diagnosed.
This characteristic is associated with the
balancing inclines of posterior teeth on
the orbiting side
__
the mandibular buc-
cal cusps’ lingual inclines’ mesial
aspects and the maxillary lingual cusps’
buccal inclines distal aspects.
When the protrusive inclination of the
superior fossa wall is adjusted to the
protrusive checkbite record, the inclina-
tion of the patient’s protrusive condylar
path is diagnosed. This inclination of the
superior fossa wall is associated with
the protrusive contacts of posterior
teeth
__
the mesial aspects of mandibular
cusps and the distal aspects of maxil-
lary cusps.
The orbiting path inclination of the supe-
rior fossa wall adjusted to lateral check-
bite records is always equal to or greater
than the protrusive path inclination of
the superior fossa wall adjusted to the
protrusive checkbite record.
FIXED RESTORATION AND
REMOVABLE PARTIAL DENTURE
RESTORATIONS
Adjusting the protrusive inclination of
the superior fossa to an angle which is
slightly less than the patient’s protrusive
condylar path (5 to 10 degrees less)
when the restoration is fabricated will
prevent the fabrication of protrusive
contacts, or balancing contacts on the
orbiting side of posterior teeth in the
laboratory. This is due to the fact that
when the restoration is seated in the
patient’s mouth and the patient’s
condyle tracks a steeper protrusive and
orbiting condylar path, the posterior
teeth will separate in both the protrusive
excursion and in the lateral excursion on
the orbiting side.
COMPLETE DENTURES
Method 1. Adjusting the articulator to
the patient’s protrusive condylar
path inclinations for both the pro-
trusive and lateral excursive move-
ments allows the fabrication of pro-
trusive balance in the laboratory,
When the restoration is seated in
the patient’s mouth and the patient
executes a lateral mandibular
movement with the teeth in contact,
the patient will feel the primary
occluding pressures on the working
side. If the patient’s orbiting path is
slightly steeper than the articulator
setting when the restoration was
fabricated, the patient would per-
ceive minimal occluding pressures
on the balancing side. However
orbiting side occlusal contact
would prevent loss of peripheral
seal.
Method 2. Adjusting the inclinations of
the superior fossa wall to the
patient’s orbiting path inclinations
allow the fabrication of bilateral bal-
anced occlusion in lateral excursive
movements in the laboratory.
Subsequent adjustment of the
articulator to the patient’s protru-
sive condylar path inclinations per-
mit adjustment of the occlusion to
protrusive balance. This method
permits development of full arch
balanced occlusion. (Note: Ob-
taining accurate eccentric check-
bite records on extensive tissue
borne restorations, although theo-
retically attainable, is a difficult
accomplishment).
IX. TREATMENT PROCEDURES
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