Dentaltown April 2020 - 74
Figs. 10-13 show the fi nal restorations on the
anterior, the bonded toppers on the posterior and
the ideal occlusal result.
* Pseudo-Class III patients
The pseudo-Class III patient appears as a skeletal
Class III occlusion, but if you seat the condyles in
CR, the result is more of an end-to-end occlusion.
As the lower incisors contact the upper incisal edges
on closure, it causes the mandible to skid into a more
forward maximum intercuspation.
Fig. 14 shows side-by-side images of the preoperative and provisionals in such a case. The key to a
successful, stable result is working in CR and opening
the VDO. As you open the vertical, the lower incisor
drops down and back into a more Class I occlusion,
as seen in Fig. 15.
Fig. 10a
Fig. 10c
Fig. 10b
Fig. 10d
Figs. 10a-d: We do cases four times. 10a: In our minds; 10b: in wax;
10c: in provisional prototypes; and 10d: in porcelain.
Fig. 13a: In patient's maximum intercuspation at the patient's VDO.
74
The point is to be sure to take a close look at the
actual skeletal relationship in CR before you choose
a treatment option. Pseudo-Class IIIs can often be
helped with restorative dentistry alone.
When can opening the VDO be harmful?
* Class II malocclusions
It is almost impossible to open the vertical on a
Class II patient (in CR) without making their occlusion
worse. This is because many times, the lower incisors
already lack contact with the upper maxillary teeth. As
the patient opens on the arc, the lower incisors rapidly
drop down and back, making the Class II worse.
If you believe in the requirements of occlusion as
previously described, these patients are better treated
with orthodontics and or orthognathic surgery. Fig. 16
illustrates the problem.
Fig. 11
Fig. 12
Fig. 12: AccuFilm II articulating film, left, and TrollFoil articulating foil.
Fig. 13b: As the jaw arcs open and leaves MI, the lower incisor drops down and
back, decreasing overbite and increasing overjet.
APRIL 2020 // dentaltown.com
DT0420_Cranham_VDO_AG.indd 74
3/19/20 3:22 PM
http://www.dentaltown.com
Dentaltown April 2020
Table of Contents for the Digital Edition of Dentaltown April 2020
Dentaltown April 2020 - Intro
Dentaltown April 2020 - Cover1
Dentaltown April 2020 - Cover2
Dentaltown April 2020 - 1
Dentaltown April 2020 - 2
Dentaltown April 2020 - 3
Dentaltown April 2020 - 4
Dentaltown April 2020 - 5
Dentaltown April 2020 - 6
Dentaltown April 2020 - 7
Dentaltown April 2020 - 8
Dentaltown April 2020 - 9
Dentaltown April 2020 - 10
Dentaltown April 2020 - 11
Dentaltown April 2020 - 12
Dentaltown April 2020 - 13
Dentaltown April 2020 - 14
Dentaltown April 2020 - 15
Dentaltown April 2020 - 16
Dentaltown April 2020 - 17
Dentaltown April 2020 - 18
Dentaltown April 2020 - 19
Dentaltown April 2020 - 20
Dentaltown April 2020 - 21
Dentaltown April 2020 - 22
Dentaltown April 2020 - 23
Dentaltown April 2020 - 24
Dentaltown April 2020 - 25
Dentaltown April 2020 - 26
Dentaltown April 2020 - 27
Dentaltown April 2020 - 28
Dentaltown April 2020 - 29
Dentaltown April 2020 - 30
Dentaltown April 2020 - 31
Dentaltown April 2020 - 32
Dentaltown April 2020 - 33
Dentaltown April 2020 - 34
Dentaltown April 2020 - 35
Dentaltown April 2020 - 36
Dentaltown April 2020 - 37
Dentaltown April 2020 - 38
Dentaltown April 2020 - 39
Dentaltown April 2020 - 40
Dentaltown April 2020 - 41
Dentaltown April 2020 - 42
Dentaltown April 2020 - 43
Dentaltown April 2020 - 44
Dentaltown April 2020 - 45
Dentaltown April 2020 - 46
Dentaltown April 2020 - 47
Dentaltown April 2020 - 48
Dentaltown April 2020 - 49
Dentaltown April 2020 - 50
Dentaltown April 2020 - 51
Dentaltown April 2020 - 52
Dentaltown April 2020 - 53
Dentaltown April 2020 - 54
Dentaltown April 2020 - 55
Dentaltown April 2020 - 56
Dentaltown April 2020 - 57
Dentaltown April 2020 - 58
Dentaltown April 2020 - 59
Dentaltown April 2020 - 60
Dentaltown April 2020 - 61
Dentaltown April 2020 - 62
Dentaltown April 2020 - 63
Dentaltown April 2020 - 64
Dentaltown April 2020 - 65
Dentaltown April 2020 - 66
Dentaltown April 2020 - 67
Dentaltown April 2020 - 68
Dentaltown April 2020 - 69
Dentaltown April 2020 - 70
Dentaltown April 2020 - 71
Dentaltown April 2020 - 72
Dentaltown April 2020 - 73
Dentaltown April 2020 - 74
Dentaltown April 2020 - 75
Dentaltown April 2020 - 76
Dentaltown April 2020 - 77
Dentaltown April 2020 - 78
Dentaltown April 2020 - 79
Dentaltown April 2020 - 80
Dentaltown April 2020 - 81
Dentaltown April 2020 - 82
Dentaltown April 2020 - 83
Dentaltown April 2020 - 84
Dentaltown April 2020 - 85
Dentaltown April 2020 - 86
Dentaltown April 2020 - 87
Dentaltown April 2020 - 88
Dentaltown April 2020 - 89
Dentaltown April 2020 - 90
Dentaltown April 2020 - 91
Dentaltown April 2020 - 92
Dentaltown April 2020 - Cover3
Dentaltown April 2020 - Cover4
Dentaltown April 2020 - 98
Dentaltown April 2020 - 99
Dentaltown April 2020 - 100
Dentaltown April 2020 - 101
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2024
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2023
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-january-2022
https://www.nxtbook.com/farran/dentaltown/dentaltown-december-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-november-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-new-grad-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-october-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-september-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-august-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-july-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-june-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-may-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-april-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-march-2021
https://www.nxtbook.com/farran/dentaltown/dentaltown-february-2021
https://www.nxtbook.com/farran/dentaltown/2021January
https://www.nxtbook.com/farran/dentaltown/2020December
https://www.nxtbook.com/farran/dentaltown/2020November
https://www.nxtbook.com/farran/dentaltown/2020NewGrad
https://www.nxtbook.com/farran/dentaltown/2020October
https://www.nxtbook.com/farran/dentaltown/2020September
https://www.nxtbook.com/farran/dentaltown/2020August
https://www.nxtbook.com/farran/dentaltown/2020July
https://www.nxtbook.com/farran/dentaltown/2020June
https://www.nxtbook.com/farran/dentaltown/2020May
https://www.nxtbook.com/farran/dentaltown/2020April
https://www.nxtbook.com/farran/dentaltown/2020March
https://www.nxtbook.com/farran/dentaltown/2020February
https://www.nxtbook.com/farran/dentaltown/2020January
https://www.nxtbook.com/farran/dentaltown/2019December
https://www.nxtbook.com/farran/dentaltown/2019November
https://www.nxtbook.com/farran/dentaltownuk/2019OctoberNovember
https://www.nxtbook.com/farran/dentaltown/2019October
https://www.nxtbook.com/farran/dentaltown/2019NewGrad
https://www.nxtbook.com/farran/dentaltown/2019September
https://www.nxtbook.com/farran/dentaltown/2019August
https://www.nxtbook.com/farran/dentaltown/2019July
https://www.nxtbook.com/farran/dentaltownuk/2019JuneJuly
https://www.nxtbook.com/farran/dentaltown/2019June
https://www.nxtbook.com/farran/dentaltown/2019May
https://www.nxtbook.com/farran/dentaltownuk/2019AprilMay
https://www.nxtbook.com/farran/dentaltown/2019April
https://www.nxtbook.com/farran/dentaltown/2019March
https://www.nxtbook.com/farran/dentaltown/2019February
https://www.nxtbook.com/farran/dentaltownuk/2019FebruaryMarch
https://www.nxtbook.com/farran/dentaltown/2019January
https://www.nxtbook.com/farran/dentaltownuk/2018Winter
https://www.nxtbook.com/farran/dentaltown/2018December
https://www.nxtbook.com/farran/dentaltown/2018November
https://www.nxtbook.com/farran/dentaltownuk/2018November
https://www.nxtbook.com/farran/dentaltown/2018October
https://www.nxtbook.com/farran/dentaltownuk/2018October
https://www.nxtbook.com/farran/dentaltown/2018NewGrad
https://www.nxtbook.com/farran/dentaltown/2018September
https://www.nxtbook.com/farran/dentaltownuk/2018September
https://www.nxtbook.com/farran/dentaltown/2018August
https://www.nxtbook.com/farran/dentaltownuk/2018July
https://www.nxtbook.com/farran/dentaltown/2018July
https://www.nxtbook.com/farran/dentaltownuk/2018June
https://www.nxtbook.com/farran/dentaltown/2018June
https://www.nxtbook.com/farran/dentaltownuk/2018May
https://www.nxtbook.com/farran/dentaltown/2018May
https://www.nxtbook.com/farran/dentaltownuk/2018April
https://www.nxtbook.com/farran/dentaltown/2018April
https://www.nxtbook.com/farran/dentaltown/2018March
https://www.nxtbook.com/farran/dentaltownuk/2018March
https://www.nxtbook.com/farran/dentaltown/2018February
https://www.nxtbook.com/farran/dentaltownuk/2018February
https://www.nxtbook.com/farran/dentaltown/2018January
https://www.nxtbook.com/farran/dentaltown/2017December
https://www.nxtbook.com/farran/dentaltownuk/2017Winter
https://www.nxtbook.com/farran/dentaltown/2017November
https://www.nxtbook.com/farran/dentaltown/2017October
https://www.nxtbook.com/farran/dentaltownuk/2017october
https://www.nxtbook.com/farran/dentaltown/NewGrad2017
https://www.nxtbook.com/farran/dentaltown/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017September
https://www.nxtbook.com/farran/dentaltownuk/2017August
https://www.nxtbook.com/farran/dentaltown/2017August
https://www.nxtbook.com/farran/dentaltown/2017July
https://www.nxtbook.com/farran/dentaltownuk/2017July
https://www.nxtbook.com/farran/dentaltown/2017June
https://www.nxtbook.com/farran/dentaltownuk/2017may
https://www.nxtbook.com/farran/dentaltown/2017May
https://www.nxtbook.com/farran/dentaltownuk/2017April
https://www.nxtbook.com/farran/dentaltown/2017April
https://www.nxtbook.com/farran/dentaltown/2017March
https://www.nxtbook.com/farran/dentaltownuk/dentaltownuk/2017march
https://www.nxtbook.com/farran/dentaltown/February2017
https://www.nxtbook.com/farran/dentaltown/2017January
https://www.nxtbook.com/farran/dentaltown/2016December
https://www.nxtbook.com/farran/dentaltown/2016November
https://www.nxtbook.com/farran/dentaltown/2016October
https://www.nxtbook.com/farran/dentaltown/2016nge
https://www.nxtbook.com/farran/dentaltown/2016september
https://www.nxtbook.com/farran/dentaltown/2016august
https://www.nxtbook.com/farran/dentaltown/2016july
https://www.nxtbook.com/farran/dentaltown/2016june
https://www.nxtbook.com/farran/dentaltown/2016may
https://www.nxtbook.com/farran/dentaltown/2016april
https://www.nxtbook.com/farran/dentaltown/2016march
https://www.nxtbook.com/farran/dentaltown/2016february
https://www.nxtbook.com/farran/dentaltown/2016january
https://www.nxtbook.com/farran/dentaltown/2015december
https://www.nxtbook.com/farran/dentaltown/2015november
https://www.nxtbook.com/farran/dentaltown/2015october
https://www.nxtbook.com/farran/dentaltown/2015nge
https://www.nxtbook.com/farran/dentaltown/2015september
https://www.nxtbook.com/farran/dentaltown/2015august
https://www.nxtbook.com/farran/dentaltown/2015july
https://www.nxtbook.com/farran/dentaltown/2015june
https://www.nxtbook.com/farran/dentaltown/2015may
https://www.nxtbook.com/farran/dentaltown/2015april
https://www.nxtbook.com/farran/dentaltown/2015march
https://www.nxtbook.com/farran/dentaltown/2015february
https://www.nxtbook.com/farran/dentaltown/2015january
https://www.nxtbook.com/farran/dentaltown/2014december
https://www.nxtbook.com/farran/dentaltown/2014decemberb
https://www.nxtbook.com/farran/dentaltown/2014november
https://www.nxtbook.com/farran/dentaltown/2014october
https://www.nxtbook.com/farran/dentaltown/2014newgrad
https://www.nxtbook.com/farran/dentaltown/2014september
https://www.nxtbook.com/farran/dentaltown/2014august
https://www.nxtbook.com/farran/dentaltown/2014july
https://www.nxtbook.com/farran/dentaltown/2014june
https://www.nxtbook.com/farran/dentaltown/2014may
https://www.nxtbook.com/farran/dentaltown/2014april
https://www.nxtbook.com/farran/dentaltown/2014march
https://www.nxtbook.com/farran/dentaltown/2014february
https://www.nxtbook.com/farran/dentaltown/2014january
https://www.nxtbook.com/farran/dentaltown/2013december
https://www.nxtbook.com/farran/dentaltown/2013november
https://www.nxtbook.com/farran/dentaltown/2013october
https://www.nxtbook.com/farran/dentaltown/2013newgrad
https://www.nxtbook.com/farran/dentaltown/2013september
https://www.nxtbook.com/farran/dentaltown/2013august
https://www.nxtbook.com/farran/dentaltown/2013july
https://www.nxtbook.com/farran/dentaltown/2013june
https://www.nxtbook.com/farran/dentaltown/2013may
https://www.nxtbook.com/farran/dentaltown/2013april
https://www.nxtbook.com/farran/dentaltown/2013march
https://www.nxtbook.com/farran/dentaltown/2013february
https://www.nxtbook.com/farran/dentaltown/2013january
https://www.nxtbook.com/farran/dentaltown/2012december
https://www.nxtbook.com/farran/dentaltown/2012November
https://www.nxtbookmedia.com