1. 17. Occlusal Schemes - Anatomic and
Semi-anatomic
John Beumer III, DDS, MS
and
Michael Hamada DDS
Division of Advanced Prosthodontics,
Biomaterials and Hospital Dentistry
UCLA School of Dentistry
This program of instruction is protected by copyright ©. No portion of
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3. Semi-anatomic Denture Teeth
Zero
setting
Protrusive Inserts
Protrusive
insert
Begin by positioning the appropriate protrusive insert,
and check to ensure that the incisal guide pin is set at
zero and in contact with the incisal guide table.

4. Semi-anatomic Denture Teeth
Background - Balanced occlusion

5. Cast Landmarks
Mark the casts indicating midline, crest of the ridge, and the
retromolar pad. These landmarks will be used to check your
denture setup.
Maxilla Mandible
Midline Ridge
Anterior land Retromolar pad

6. Cast Landmarks - Maxilla
Anterior land
Incisive
papilla
Midline

7. Cast Landmarks -Mandible
Midpoint of
retromolar pad
Mark on land
Land
indicating the
midpoint of the
Lines indicating the
retromolar pad
crest of the ridge

8. Setting the Maxillary Anterior Teeth
As previously mentioned (13c, 1a), the wax rim is ideally contoured on
the patient and used to mount the upper cast with a facebow transfer
The three landmarks used to identify the plane of occlusion are:
The midpoint of the retromolar pads bilaterally as previously marked on
the mandibular cast.
The incisal edge of the maxillary central incisors

9. Setting the Maxillary Anterior Teeth
Mark indicating midpoint To set the remaining maxillary
of the retromolar pad anterior teeth a clear glass or
plastic slab is positioned on the
mandibular record base to
represent the plane of occlusion.
When setting anatomic posterior
teeth we recommend setting the
maxillary posterior teeth before
the mandibular posterior teeth. To
aid in positioning the maxillary
teeth, a line is inscribed on the
slab indicating the crest of the
mandibular ridge.

10. Setting the Maxillary Anterior Teeth
These two lines, inscribed
on the plastic plane, indicate
the crest of the alveolar
ridge. These lines will be
used to position the
maxillary posterior denture
teeth to insure that the
mandibular posterior teeth
are centered over the ridge.
The lingual
cusp tips of
the posterior
maxillary
Lines indicating the teeth should contact
these lines.
crest of the ridge

11. Setting the Maxillary Anterior Teeth
Soften some baseplate wax and attach some to the ridge lap
portion of the other maxillary central incisor and attach it to
the record base as shown. Set the lateral incisors and
cuspids as shown previously (Section 13c, 1a Lingualized
occlusion).

12. Setting the Maxillary Anterior Teeth
Occlusal
plane
Note the angulations of the anterior teeth in relation to the
occlusal plane when viewed in profile.

13. Setting the Maxillary Anterior Teeth
“Toed-in” Position
Note how the cervical and incisal edges of the cuspid are aligned
vertically (yellow line). The facial surface of the cuspid however, is
canted inward and appears “toed in” (red line) due to the prominence of
the cervical area of the tooth (yellow arrow). The centrals and laterals
are inclined slightly towards the distal.

14. Setting the Maxillary Posterior Teeth
Occlusal
plane
The long axis of the premolars should be perpendicular to the occlusal
plane and the buccal and lingual cusp tips should touch the occlusal
plane. Arranging the premolars in this way insures that the adjacent
marginal ridges will be on the same level. This is an important factor
when setting the opposing premolars.

15. Setting the Maxillary Posterior Teeth
The Maxillary Premolars
Both the buccal and lingual cusp tips of the maxillary premolars should
contact the plane of occlusion. The lingual cusp tips should also contact
the line inscribed on the plastic plane indicating the crest of the
mandibular ridge. This will ensure that when the opposing mandibular
denture teeth are properly positioned and in occlusion, their central
fossae will be centered over the mandibular ridge.

16. Setting the Maxillary Posterior Teeth
The Maxillary 1st Molar
The curve of Wilson and the curve of Spee begin in the molar region. The
mesial lingual cusp tip of the 1st molar contacts the occlusal plane but the
buccal cusp tips and the distal lingual cusp are elevated about .5mm off the
occlusal plane (yellow line).

17. Setting the Maxillary Posterior Teeth
The Maxillary 2nd Molar
The set up viewed in profile. Note that the mesial lingual cusp tip
touches the plane of occlusion along with the buccal and lingual cusps
of the premolars. The curve of Spee begins at the 1st molar.

18. Setting the Maxillary Posterior Teeth
The Maxillary 2nd Molar
Occlusal
plane
The curve of Spee is continued by elevating the 2nd molar off the plane of
occlusion as shown. The 2nd molar is elevated to an even greater degree
than the 1st molar, about 15 degrees in the average patient. When viewed
from the distal it is set, like the 1st molar, with a slight curve of Wilson.

19. Setting the Mandibular Posterior Teeth
Completed set up
Centric
 Note that with this particular posterior tooth form, the mandibular
cusps tips are designed to engage the embrasures of the opposing
maxillary teeth. This true of almost all anatomic tooth forms
designed for bilateral balance except the Ivoclar Ortholingual.

20. Setting the Mandibular Posterior Teeth
The Mandibular 1st Molar
Begin by positioning the mandibular 1st molar. The mesial buccal cusp tip
should engage the embrasure between the 1st molar and 2nd premolar.
Therefore adjacent marginal ridges of the maxillary premolar and molar
must be at the same level for the lower molar to properly engage them.

21. Setting the Mandibular Posterior Teeth
The Mandibular 1st Molar
Check the relationship from the
lingual side. Make sure that
the maxillary lingual cusp tips
engage the the central fossa of
the mandibular molar.

22. Setting the Mandibular Posterior Teeth
The Mandibular 1st Molar
Using a clear plastic ruler and the marks made on the cast check to insure
that the 1st molar is perfectly centered over the ridge. Make sure the central
fossa of the molar is properly aligned over the ridge. If the central fossa is
either buccal or lingual to the ridge make the appropriate adjustments.
It is apparent that the molar is
positioned too far to the buccal.

23. Setting the Mandibular Posterior Teeth
Note the alignment of the central
fossa.The molar is positioned too far
The Mandibular 1st Molar to the buccal and should be moved
towards to the lingual.
If the remaining mandibular
posterior teeth are arranged
Line indicating
on this line the denture will
the crest of the
be prone to tipping and its
ridge
stability will be impaired.
After repositioning this tooth focus your
attention on the maxillary posterior
teeth and reposition them lingually so
that the maxillary 1st molar and 2nd
premolar properly occlude with the
mandibular 1st molar. Do not forget to
move the 1st premolar as well.

24. Setting the Mandibular Posterior Teeth
The molar is twisted and
positioned too far to the lingual.
The Mandibular 1st Molar If the remaining posterior
mandibular teeth are arranged
Line along this line the space for the
indicating tongue will likely be insufficient.
the crest of The molar must be moved
the ridge
slightly to the buccal and twisted
clockwise so that the central
fossa is parallel to the ridge line.
After repositioning this tooth the
posterior maxillary teeth should be
moved to the buccal so that they
properly occlude with the
mandibular molar and permit
positioning the remaining
mandibular posterior teeth over the
ridge.

25. Setting the Mandibular Posterior Teeth
The Mandibular Premolars - Centric
Position the mandibular premolars. The buccal cusp of
the 2nd premolar should occlude with the the adjacent
marginal ridges of the maxillary 1st and 2nd premolars.

26. Setting the Mandibular Posterior Teeth
The Mandibular Premolars - Centric
The buccal cusp of the mandibular 1st premolar should engage
the mesial marginal ridge of the opposing 1st premolar. There
should be a space between the 1st premolar and the cuspid.

27. Setting the Mandibular Posterior Teeth
The Mandibular Premolars - Centric
Verify that the premolars are in solid centric occlusion.
If lingual centric contacts are lacking, contacts in
balancing position will be lacking.

28. Setting the Mandibular Posterior Teeth
The Mandibular Premolars - Working
When there is a lack of working side contacts at this stage of the
setup check for the following discrepancies in the following order:
Verify buccal centric
Check for balancing interferences on the opposite side
Slightly increase the curve of Wilson without compromising lingual centric

29. Complete Denture Occlusion
The Mandibular Premolars - Working
During the lateral excursion into working, with this cusp form,
when the teeth are properly arranged, there should be no
lingual cusp contacts between the maxillary and mandibular
teeth.

30. Setting the Mandibular Posterior Teeth
The Mandibular Molars – Balancing
When you lack balancing side contacts at this stage of the
setup, check for the following discrepancies in the following
order.
Verify lingual centric
Check for working interferences on the opposite side

31. Setting the Posterior Mandibular Teeth
The Mandibular 2nd Molar - Centric
Position the 2nd molars in centric. Inappropriate positioning and
angulation of the 2nd molars can cause significant discrepancies in
working, balancing and protrusive, and so you again must check the
excursions carefully.

32. Setting the Mandibular Posterior Teeth
The Mandibular 2nd Molar - Centric
Check lingual centric. Make sure that the lingual cusps
of the maxillary 2nd molar properly occludes with the
central fossa of the mandibular 2nd molar as shown.

33. Setting the Mandibular Posterior Teeth
Verify contacts in working excursions
Lack of working side contacts may be the result of:
Poor buccal centric
Insufficient curve of Wilson
Working interferences in the 2nd molar region
Balancing interferences on the opposite side *Check these in
the order cited.

34. Setting the Mandibular Posterior Teeth
Verify contacts in during balancing excursion
Lack of balancing side contacts may be the result of:
Poor lingual centric
Working interferences on the opposite side, particularly in the 2nd
molar region

35. Setting the Mandibular Anterior Teeth
The Central Incisors
Begin by setting the central incisors. The mesial
surfaces should be on the midline.

36. Setting the Mandibular Central Incisors
The Central Incisors
Occlusal
In most patients the plane
labial surface of the
mandibular incisors
should be roughly
perpendicular to the
occlusal plane.

37. Setting the Mandibular Anterior Teeth
Determining the Amount of Vertical and
The articulator is
placed in the working
and protrusive
position, and the
position of the central
incisors adjusted to
permit passive contact
during lateral
Working Protrusive
excursions.

38. Setting the Mandibular Anterior Teeth
Horizontal
overlap
Horizontal
overlap
Vertical
overlap
This practice will idealize the amount of horizontal and vertical overlap
and ensure that anterior guidance is not introduced into the setup.

39. Setting the Mandibular Anterior Teeth
The Lateral Incisors and the Cuspids
Working Protrusive
Position the lateral incisors and cuspids in the same fashion as the central
incisors. Take care not to introduce anterior guidance into the set up. The
anterior teeth should be in only passive contact during lateral excursions.

40. Setting the Mandibular Anterior Teeth
The Lateral Incisors and the Cuspids
Upon completion, the
amount of vertical and
horizontal overlap will be
idealized and anterior
guidance has not been
introduced into the setup.
Bilateral balance has been
maintained.

41. Semi-anatomic Denture Teeth
 Check to ensure you have
retained appropriate contacts in
Completed set up working, balancing and protrusive.
Balancing Working
Protrusive Centric

42. Anatomic Denture Teeth (30 degree)

43. Anatomic Denture Teeth (30 degree)
These teeth are arranged in the same fashion as the
semi-anatomic teeth shown previously.
Use the same sequence of steps as we have just shown.

44. Anatomic Denture Teeth (30 degree)
Zero
setting
Protrusive Inserts
Protrusive
insert
Begin by positioning the appropriate protrusive insert,
and check to ensure that the incisal guide pin is set at
zero and in contact with the incisal guide table.

45. Setting Anatomic Teeth (30 degree)
When you are finished check to see that the posterior
teeth are on plane and the posterior teeth centered over
the mandibular ridge. Make corrections as necessary.

46. Setting Anatomic Teeth (30 degree)
 Check buccal and lingual centric.

47. Setting Anatomic Teeth (30 degree)
Working
Balancing Protrusive
Check to ensure you have retained appropriate
contacts in working, balancing and protrusive.

48. Anatomic and Semi-anatomic Denture Teeth
Trouble shooting
Lack of working side contacts
Verify buccal centric. Restore centric contacts as
necessary.
Increase the curve of Wilson
Eliminate any anterior guidance present on the
working side.
Check for balancing interferences on the opposite
side and make adjustments as necessary.

49. Anatomic and Semi-anatomic Denture Teeth
Trouble shooting
Lack of balancing side contacts
Verify lingual centric. Restore missing contacts as
necessary.
Eliminate any anterior guidance present on the
opposite or working side.
Check for working interferences on the opposite
side particularly in the 2nd molar region.