tif denture mand-setup

© Merz Dental GmbH, Germany 1

Part 2 – Mandibular Setup

Total prosthetics in Function (TiF)According to Karl-Heinz Körholz, MDT

Merz Dental Prosthetic Training


Tooth setup – Mandibular

Mandibular setup steps according to TiF®

Static setup lines: Posteriors

Mandibular first premolars

Mandibular second premolars

Mandibular second molars

Overview

Mandibular canines

Tools

Mandibular first molarsMandibular lateral incisors

Mandibular central incisors

Concept, graphics and texts: Martin J. Hauckbased on the TiF method by Karl-Heinz Körholz


Angle template REF 10903909° for integral® sizes S, L, M6° for integral® size XS and artegral®

Four burrs

Triangle Small sliding caliper

Thin round elastic thread

Tooth setup tools


Setting up the mandibular central incisors


Basal surfaceson the crest midline


Labial surfaces not beyond the middle of the mucobuccal fold

Incisal edges at the height of the occlusal plane

Incisal edges point tothe upper mucobuccal fold

Occlusal plane

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Surveying the labial surfaces during study cast analysis and marking them on the anterior aspect of the cast

Checking the labial limitof the mandibular central incisors


Setting up the mandibular lateral incisors


Setting up the mandibular lateral incisors

Basal surfacesat the crestal midline Labial surfaces not

beyond the middle of the mucobuccal fold

Occlusal plane Incisal edges at the height of the occlusal plane

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Cervix slightly protruding on the labial side

Setup similar to the central incisors


Setting up the mandibular canines



Crestal midline

Occlusal plane

1 mm above the occlusal plane

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Basal surfaces in front of the crestal midline

Canine tips approx. 1 mm above the occlusal plane

Distal incisal edges aligned with definitive setup line, but at least at the buccal edges of the retromolar pads

Occlusal plane

Labial surfaces inclined lingually


Crest midline


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Setting up the mandibular posteriors


Definitive setup lineStatic lines – Definitive setup line

Ideal line

Based on the individual atrophy status

Maxilla: Marks the ideal position of the palatal (working) cusps, except for the first premolars.

Mandible: Marks the ideal position of the central fossae, except for the first premolars.


Modified outer correction

Balancing:

Static lines – Outer correction

Offers a broad contact zone

Marks the vestibular contact limit of the maxillary and mandibular buccal cusps

If exceeded in the maxilla, the cusps must be placed out of contact to prevent rocking or tilting


Marks the vestibular contact limit of the maxillary and mandibular buccal cusps

If exceeded in the maxilla, the cusps must be placed out of contact to prevent rocking or tilting

Lingualized setup according to Gerber

Static lines – Outer correction


Definition: Inner correction

Delimits the positions of the maxillary palatal cusps

Delimits the lingualmost positions of the mandibular central fossae to allow freedom of movement of the tongue, alternatively, the mylohyoid line may be used

Static lines – Inner correction


Setting up the mandibular first premolars




Occlusal plane


Almost at a right angle, viewed from buccally

Definitive setup line between the buccal cusp and the central fossa

Exceeds the occlusal plane and the canine by approximately 1 mm

Same inclination as the canine

Located at the so-called first premolar position


Occlusal plane



Setting up the mandibular second premolars



Occlusal plane


Buccal facet aligned with the first premolar

At a right angle to the occlusal plane, viewed from buccally

Central fossa on the definitive setup line

Mesiolingual cusp is higher than the lingual cusp of the first premolar

Occlusal plane

Cusp tip at the height of the occlusal plane



Setting up the mandibular first molars



1. The first molar position

Most important stepping and functional point (masticatory center)

Definitive setup line must intersect the central fossa


2. Respecting the stop line

Dorsal limit of the setup, prevention of anterior sliding

To be decided at this point: Setup extends to the first molar Setup extends to the second

molar



4. Last tooth of the setup (which extends to the first molar)

Distobuccal cost of the first molar exceeds the occlusal plane (mean: 1 mm, to ensure protrusive support)

3. Last tooth but one of the setup

Mesiobuccal cusp of the first molar at the level of the occlusal plane

Distobuccal cost of the first molar exceeds the occlusal plane by less than the mandibular first premolar



3. Last tooth but one of the setup

Mesiobuccal cusp at the height of the occlusal plane

The distobuccal cusp minimally exceeds the occlusal plane



4. Last tooth of the setupThe distobuccal cusp exceeds the height of the occlusal plane by

approx. 1 mm.

Mesiobuccal cusp at the height of the

occlusal plane



5. Posterior stepsBetween the first premolar and the first molar, the proximal marginal ridges and lingual cusps form minimal steps, as in the natural dentition; these steps facilitate protrusive support without exceeding the tongue equator

Cf. Lerch, P.: Die totale Prothetik (”Total Prosthetics”). Berlin 1986.



5. Posterior stepsBetween the first premolar and the first molar, the proximal marginal ridges and lingual cusps form minimal steps, as in the natural dentition; these steps facilitate protrusive support without exceeding the tongue equator

Cf. Lerch, P.: Die totale Prothetik (”Complete Prosthodontics”). Berlin 1986.



buccal lingual

6. Lingual inclination of the molarsintegral® and artegral® are fully anatomic teeth with lingual cusps.The following thus applies tocomplete prosthodontics: 9° (± 1°) or 6° transversal

molar inclination relative to the occlusal plane (angle template)

Objective: Uniform steps Protrusive support



buccal lingual


6. Lingual inclination of the molarsintegral® and artegral® are fully anatomic teeth with lingual cusps.The following thus applies tocomplete prosthodontics: 9° (± 1°) or 6° transversal

molar inclination relative to the occlusal plane (angle template)

Objective: Uniform steps Protrusive support


Inclination check, mandibular first molar

9°

buccal lingual

occlusal planeα1

α2α1 = α2

6. Lingual inclination of the molarsA 9° or 6° inclination facilitates: Uniform molar steps Balancing Protrusive support



TipSandblasted burrs prevent slipping.

7. Occlusal burr test for checking molar inclination

9° template for integral®

S, M, L

6° template for integral®XS and artegral®



Position the burr on the integral® molars

Align the angle template with the alveolar crest (90°)

No burr test for the artegral®

Viewing direction



8. Occlusal burr test:Molar parallelism between quadrants - integral® only

A symmetrical alignment on the left and right presupposes The same degree of atrophy A perfect alignment of the definitive setup lines



Setting up the mandibular second molars


Same criteria as for the first molar

Exceptions: Mesial marginal ridges have the

same height as the distal ridges of the first molars Mesiobuccal cusp slightly exceeds

the occlusal plane Distobuccal cusp exceeds the

occlusal plane by approx. 1 mm in fixed-average mounting, as for the first premolar

Setting up the mandibular second molars


Mesiobuccal cusp at the height of the occlusal plane

The distobuccal cusp only mini-mally exceeds the occlusal plane



Caution: Denture beds are never symmetrical.Symmetrical alignment on the left and right would require: The same degree of atrophy A perfect alignment of the definitive setup lines

Setting up the mandibular second molar

Occlusal burr test:Molar parallelism between quadrants - integral® only


Viewing direction

Position the burr on the molars (integral® only).

Align the angle template with the alveolar crest (90°)

Setting up the mandibular second molar


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Phone +49 4381 403-0Fax +49 4381 403-100

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