cusp fossa relationship

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    Introduction to Occlusion:Cusp Cryptoprocta ferox

    Relationship

    Brian B. Nov, DDS

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    Cusp Fossa Relationship

    Found in only 5% of the population

    Idealized occlusion

    Full mouth cases Occlusal forces concentrated near the center of

    each tooth

    Less food impaction Tooth-to-tooth relationship

    The concept is easy to teach and learn

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    Cusp Fossa Relationship

    Functional cusp contacts

    opposing tooth at three points

    Very stable

    Results in minimal tooth wear

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    Nov Nugget:

    Maxillary Mesial

    manDibular Distal

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    Terminology

    Functional Cusps

    Lingual of maxillary teeth

    Facial of mandibular teeth

    Non-Functional Cusps

    Facial of maxillary teeth

    Lingual of mandibular teeth

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    National Board Terminology

    Supporting cusps

    Guiding cusps Guiding inclines

    Functional Outer Aspect

    (FOA)

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    Supporting Cusps

    The working or functional

    cusp

    Mandibular facial

    Maxillary lingual

    Responsible for

    supporting the forces

    of occlusion

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    Guiding Cusps

    Non-functional cusps

    Mandibular lingual

    Maxillary facial

    Cusp is not in function

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    Guiding Inclines

    Inclines of the guiding

    cusps from the cusp tip

    toward the center of the

    tooth Lingual incline of facial

    cusp of maxillary teeth

    Facial incline of lingual

    cusp of mandibular

    teeth

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    Functional Outer Aspect (FOA)

    The outside 1-2 mm of the

    supporting cusp which

    makes contact with the

    guiding inclines of the

    guiding cusps of the

    opposing dentition when in

    occlusion

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    Cusp Fossa Relationship

    ABC Contacts

    Use a sagittal view

    A & C contacts Between functional

    and non-functional

    cusps

    B contacts

    Between both

    functional cusps

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    ABC Contacts

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    Dr. Nov, why

    do we have toknow this?

    Because, if you create cusp-fossa

    relationships in your restorations, you

    create/allow a phenomenon called,DISCLUSION.

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    Disclusion

    Teeth are arranged such thatthe overlap of the anteriorteeth prevent the posteriorteeth from making anycontact on during working ornon-working excursivemovements.

    This protects teeth from beingworn down during normalfunction (aka attrition).

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    Laboratory Procedure

    Step one:

    Determine cusp placement

    In line with adjacent cusps Same height as adjacent cusps

    Functional cusps in fossa ofopposing tooth

    No interferences in excursivemovements

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    Laboratory Procedure

    Step two: Mark the location of cusps and fossas

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    Waxing Procedure

    Step three:

    Create wax cones

    Upper facial cusps Upper lingual cusps

    Lower facial cusps

    Lower lingual cusps

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    Waxing Procedure

    Be sure to check

    excursive movements

    after each step

    .or you will wish youhad later on!

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    Waxing Procedure

    Step four:

    Create various ridges

    Cusp ridges Marginal ridges

    Triangular ridges

    Fish mouth concept

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    Waxing Procedure

    Cusp marginal ridge

    placement

    Upper ridges

    Lower ridges

    Thomas notch

    Note the Thomas Notches!

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    Waxing Procedure

    In creating the axial

    contour dont forget

    that teeth havecorners (line angles

    and point angles)

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    Waxing Procedure

    Triangular ridges

    Upper triangular ridges

    establish A contact

    with lower tooth Lower triangular ridges

    establish C contact

    with upper tooth

    Establish B contact

    with opposing B

    contact

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    Waxing Procedure

    Fossas and grooves

    Tripodization

    Developmental grooves

    Supplemental grooves

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    Waxing Procedure

    Finishing

    Careful polishing

    Microbrushes work well

    in grooves

    Light flaming

    Re-check contacts with

    zinc stearate

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    Where are the dots supposed to be?

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    Everything should be

    made as simpleas possible.

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    Everything should be

    made as simpleas possible,

    but not simpler.-Albert

    Einstein

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    Peace be with you

    d l ith th f