World Journal of Pharmaceutical Research

Avinash et al. SJIF Research

World Journal of Pharmaceutical Impact Factor 8.074

Volume 8, Issue 5, 1249-1253. Review Article ISSN 2277– 7105

1

PANKEY-MANN-SCHUYLER PHILOSOPHY- CRITICAL ANALYSIS

Kondumahanti V. N. Avinash*1, Ritika Sampathkumar2, Anju Lekshmi Swathi3,

Venkat Raghu4, Chiranjeevi Reddy G.5, Jayakar Shetty6 and Subash Munireddy7

1,3,4
Post-Graduate Student, Department of Prosthodontics, AECS Maaruti College of Dental
Sciences and Research Center, Bangalore, Karnataka, India.
2
Senior Lecturer, Department of Prosthodontics, AECS Maaruti College of Dental Sciences
and Research Center, Bangalore.
5,7
Professor, Department of Prosthodontics, AECS Maaruti College of Dental Sciences and
Research Center, Bangalore, Karnataka, India.
6
Professor and head of the Department, Department of Prosthodontics, AECS Maaruti
College of Dental Sciences and Research Center, Bangalore, Karnataka, India.

ABSTRACT
Article Received on
14 Feb. 2019, Occlusal Rehabilitation of dentition requires thorough knowledge of
Revised on 07 March 2019, various factors that play a key role in the maintenance of occlusal
Accepted on 28 March 2019
DOI: 10.20959/wjpr20195-14607 harmony. A prosthodontist should carefully plan and execute the
treatment plan accordingly. All the factors responsible for the patients

*Corresponding Author
current scenario should be kept in notice while fabricating the
Dr. Kondumahanti V. N. treatment plan. Various philosophies were advocated for successful
Avinash rehabilitation. Among them PANKEY-MANN-SCHUYLER
Post-Graduate Student,
PHILOSOPHY is most commonly applied. This is the critical analysis
Department of
on such a philosophy.
Prosthodontics, AECS
Maaruti College of Dental
KEYWORDS: Full Mouth Rehabilitation; pankey-mann-schuyler
Sciences and Research
Center, Bangalore,
philosophy; Hobo philosophy.
Karnataka, India.
INTODUCTION
Full mouth occlusal rehabilitation, which is one of the major challenges to a prosthodontist, is
the correlation of all indicated and required dental treatment for a particular patient in order
to restore his occlusion to normal function, to improve aesthetics, and to preserve tooth and
their supporting structures.[1]

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Review
Functional and parafunctional activities causes attrition that results in occlusal wear that
forms occlusal interferences which alters the existing occlusal plane.[2]

Glossary of Prosthodontic terms defines Bruxism as ‘‘Parafunctional grinding of teeth or an

oral habit consisting of involuntary rhythmic or spasmodic non-functional gnashing, grinding
or clenching of teeth in other than chewing movements of the mandible which may lead to
occlusal trauma’’.[3,4] Bruxism can be of two types.
1. Bruxism that occurs during wakefulness (Diurnal Bruxism).
2. Bruxism that occurs during sleep (Sleep Bruxism).

During the treatment procedure, various factors such as the vertical dimension of occlusion,
centric relation, occlusal pattern, esthetics and phonetics need to be considered. This
consideration should be done simultaneously for both anterior and posterior teeth. The
prosthodontist should also manage the existing restorations, pulpal exposure, missing teeth,
tooth sensitivity, supra erupted teeth and Tempero-Mandibular Joint pain.[5]

A comprehensive examination, diagnostic mounting, careful planning stands out to be the

crucial feature for the success of the treatment plan. Sequencing of various steps, discussion
with the patient of the different treatment alternatives and careful execution of the treatment
is also important in these types of cases.

The PMS philosophy aims at achieving the following principles of occlusion advocated by
Schuyler.[6]
a. Coordinated and static contacts of the maximum number of posterior teeth in centric
relation position of the mandible.
b. Functionally harmonious anterior guidance during the lateral excursive movements.
c. Disclusion of the posterior teeth during protrusion determined by the anterior guidance.
d. Absence of interferences during lateral excursions on the non-working side.
e. Group function on the working side during the lateral excursions.

Proper sequence advocated by PANKEY-MANN-SCHUYLER philosophy:

Part1: Examination, diagnosis, treatment planning and prognosis.
Part-2: Harmonization of the anterior guidance for best possible esthetics, function and
comfort.

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Part-3: Selection of an acceptable occlusal plane and restoration of the lower posterior
occlusion in harmony with the anterior guidance in a manner that will not interfere with
condylar guidance.
Part-4: Restoration of the upper posterior occlusion in harmony with the anterior guidance
and condylar guidance.[7, 8]

The management of teeth with severe attrition tooth wear is a subject of increasing interest in
the prosthodontic literature.[9,10] There are many philosophies to follow for an occlusal
rehabilitation; most important among them is Hobo's philosophy and Pankey Mann Schuyler
philosophy. Pankey Mann Schylur philosophy is one of the most practical philosophies for
occlusal rehabilitation.

Advantages of Pankey Mann Schuyler philosophy

1. It is possible to diagnose and plan treatment for the entire rehabilitation before a single
tooth is prepared.
2. It is a well organised and logical procedure.
3. This philosophy never advocates for preparing or rebuilding more than eight teeth at a
time.
4. It divides the rehabilitation into separate series of appointments.
5. There no danger of losing the patient’s present vertical dimension.
6. Functionally generated path and centric relation are taken on the occlusal surface of the
teeth to be rebuilt at the exact vertical dimension provide a better prognosis of the
treatment.
7. All posterior occlusal contours are programmed by and are in harmony with anterior and
condylar guidance.
8. Laboratory procedures are simple.[7,8]

Loss of occlusal vertical dimensions is a confounding issue in dentitions showing extensive

wear. A number of factors will be influencing the rest position recording. So a single method
will not provide the accurate vertical dimension. Two or more methods are always employed
to decide the vertical dimension. The changes should always be tried with provisional
restorations.[6,8] For example, physiologic method, esthetics and phonetics can be used to
assess the VDO. The result should be satisfactory with the short-term use of provisional
restorations.

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The incisal guidance formed by the anterior teeth has the most profound influence upon the
mandibular movement.[2] In oral rehabilitation, soon after deciding VDO it is important to
check for the presence of favorable incisal guidance which controls the necessary steepness
of all posterior teeth inclines.[11] The anterior guidance also separates the posterior teeth
during excursions providing mutual protection for each other.[2] This harmony between the
anterior and posterior teeth relies on the correct occlusal plane. The curve of Spee, which
exists in the ideal natural dentition, allows harmony to exist between the anterior tooth and
condylar guidance.[12] Pankey and Mann introduced an instrument for occlusal plane analysis;
broad rick flag analyzer is more popular for occlusal plane analysis.[13,14] This assists in the
reproduction of tooth morphology that is commensurate with the curve of Spee when
posterior restorations are designed.[7]

Occlusal protection of the final restorations with soft splint served to protect
dental/periodontal structures against adverse effects of hyper-loading and parafunctional
wear.[15]

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126–131.
2. Dawson PE Functional occlusion: from TMJ to smile design. Mosby, Canada, 2007.
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groaning. Arch Ital Biol, 2011; 149: 1–11.
5. Manoj Shetty, Niranjan Joshi et al. Complete Rehabilitation of a patient with occlusal
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Restoring The Lower Posterior Teeth. J Prosthet Dent, 1960; 10: 135-150.
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9. Song M-Y, Park J-M, Park E-J Full mouth rehabilitation of the patient with severely worn
dentition: a case report. J Adv Prosthodont, 2010; 2: 106–110.

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10. Pokorny PH, Wiens JP, Litvak H. Occlusion for fixed prosthodontics: a historical
perspective of the gnathological influence. J Prosthet Dent, 2008; 99: 299–313.
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patients. J Oral Rehabil, 2005; 32: 895–900.
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15. Dao TTT, Lavingne GJ Oral splints: the crutches for temporomandibular disorders and
bruxism. Crit Rev Oral Biol Med., 1998; 9: 345–361.

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