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14. Hanau’s Quint14. Hanau’s Quint
Michael Hamada DDSMichael Hamada DDSDivision of Advanced Prosthodontics, Biomaterials Division of Advanced Prosthodontics, Biomaterials
and Hospital Dentistryand Hospital Dentistry
UCLA School of DentistryUCLA School of Dentistry
This program of instruction is protected by copyright ©. No portion of this This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.information storage or retrieval system, without prior permission.
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Hanau’s QuintHanau’s Quint
Five Factors Affecting Occlusal BalanceFive Factors Affecting Occlusal Balance– Condylar InclinationCondylar Inclination– Incisal GuidanceIncisal Guidance– Occlusal Plane InclinationOcclusal Plane Inclination– Compensating CurveCompensating Curve– Cuspal InclinationCuspal Inclination
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Hanau’s QuintHanau’s Quint
Inter-relationship of these five factors may be Inter-relationship of these five factors may be described bydescribed by Theilman’s Formula Theilman’s FormulaIn order to maintain a balanced occlusion:In order to maintain a balanced occlusion:
C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
C=Balanced Occlusion
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
When all five factors are in “balance” . . .
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
. . .“Balance” is maintained in excursives
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
When Incisal Guidance is increased . . .
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
When Incisal Guidance is increased . . .
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
. . . Posterior Disclusion will occur unless . . .
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
. . . Occlusal Plane Inclination, . . .
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
. . . Cuspal Inclination, . . .
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
. . . or Compensating Curve is Increased
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Increasing the Compensating Curve
Correcting Posterior Disclusion by
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Use of Flat Plane or 0º Posteriors
Monoplane Denture Occlusion
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Use of Flat Plane or 0º Posteriors
Monoplane Denture Occlusion
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Use of Flat Plane or 0º Posteriors
Monoplane Denture Occlusion
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Posterior Disclusion with 0º Teeth
Monoplane Denture Occlusion
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Posterior Disclusion with 0º Teeth
May be corrected by “Balancing Ramps”
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Posterior Disclusion with 0º Teeth
Essentially increases Compensating Curve
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Posterior Disclusion with 0º Teeth
Alternate solution to maintaining “balance”. . .
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Posterior Disclusion with 0º Teeth
. . . is to decrease Incisal Guidance
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Posterior Disclusion with 0º Teeth
. . . is to decrease Incisal Guidance
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Posterior Disclusion with 0º Teeth
. . . is to decrease Incisal Guidance
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Posterior Disclusion with 0º Teeth
. . . is to decrease Incisal Guidance
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
Posterior Disclusion with 0º Teeth
is minimized by minimizing Incisal Guidance
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
The minimal disclusion can be corrected by
Balancing Ramp Addition (as before) or . . .
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
The minimal disclusion can be corrected by
. . . an increase in Occlusal Plane Inclination
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C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
The minimal disclusion can be corrected by
. . . an increase in Occlusal Plane Inclination
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Hanau’s QuintHanau’s Quint
Of the five factors, the patient presents you with Condylar Inclination
Occlusal Plane cannot be altered substantially since functional requirements dictate position
C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
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Hanau’s QuintHanau’s Quint
Of the five factors, the patient presents you with Condylar Inclination
Occlusal Plane cannot be altered substantially since functional requirements dictate position
C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
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Hanau’s QuintHanau’s Quint
Within the confines of esthetics and phonetics, minimize Incisal Guidance in Complete Dentures to minimize inclined tipping forces
Adjust remaining factors to maintain balance
C=Condylar Inclination
OccPlane
x Incisal Guidance
x Cuspal Inclination x CompCurve
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Bilateral Balanced Lingualized OcclusionBilateral Balanced Lingualized Occlusion
Working SideWorking Side
Centric OcclusionCentric Occlusion ProtrusiveProtrusive
Balancing SideBalancing Side