Dr. Marlow asks:
Could somebody explain what “Reversed Lingualized Occlusion” is and how I use this? I have a patient who has a prominent Class III skeletal form with an edentulous maxilla and mandible.
The mandible is much wider than the maxilla especially in the
premolar-molar areas. My surgeon recommended that I have my lab use
this kind of occlusion to compensate for the jaw size discrepancy. I am
familiar with Lingualized Occlusion. Thanks for any help.
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when lower arch is wider than upper, you can set teeth in crossbite using upper teeth as lower and vice a versa.try it, it will give better stability to prosthesis
mandibular lingual cusps touching central fossae of maxillary.
Hello, Dr.Marlow.
To fully relate to your situation I want to refer to the anatomy of a Sceletal class III.
The posterior alveolar arch of the Maxilla has a form of a trapezoid with small base on top and flared axis walls to the bottom.
The Lower, Mandibular posterior alveolar arch continuous the form of the trapezoid with extending the flared wall: narrow axis’s on top (occlusial Plane ) and wider to the bottom (Mandibular arch).
The best way to evaluate this pattern is on the articulated upper and lower cast models viewing from the rear of the articulator.
The set up of teeth may be chosen either in cross bite as dr. satin joshi recommends
or better for facial esthetics, phonetics, occlusial equilibration and denture stability just ask the lab follow the axis of the trapezoid while doing the Set Up of teeth in posterior segment. The anterior has to be set in edge to edge way.
Beware of allowing plenty satisfactory vertical dimension.
You will get a very attractive and functional case.
Dr.Micki Gelb
212.661.2542
Have your lab use Ivoclar K Posts. The crossover takes place in the 2nd bi region…these posts work well and look great for class III’s.
Read C E Misch’s book on Contempoary Implant Dentistry … very detailed explanation
The key word you used to described the class III relationship was “prominent”, in this case compensation doesnt make any sense! restore in a class III, I have cases with excellent stability restored in class III, edge to edge relationship is way more agressive and destructive than a class III, so if that is what you would end up with in a “compensated scenario” you are better of with classIII.
In the anterior segment you could try the compensation and even the edge to edge but make sure the overbite is minimal, in fact hopefully no overbite!
good luck!
ivovlar vivadent has got special teeth set for classiii cases.