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INTRODUCTION
• Occlusion of the complete denture has a
direct effect on the success or failure of the
treatment
• So the occlusal scheme and concept should
produce masticatory efficiency, without
negative effect on the esthetic value of the
denture, the health of the supporting
tissues, and comfort of the patient
Terminology:
Occlusion:
• It is the act or process of closure or of being closed
or shut off.
• The relationship between the occlusal surfaces and
incisal edges of the maxillary and mandibular teeth
when they are in contact
• It is a static position (relation) when the jaws are
centrically or eccentrically related
(the way the teeth come together and function together)
Terminology:
Articulation:
Relationship between the occlusal surfaces of
the maxillary and mandibular teeth during
function (Dynamic relation)
Terminology:
Centric occlusion:
Occlusion of the opposing occlusal surfaces that provide the
maximum planned contact (Intercuspation) when the mandible is in
centric relation to the maxilla.
Eccentric occlusion: ( Protrusive occlusion & lateral
occlusion)
Describe the relation of opposing occlusal surfaces when the
mandible is moved forward or laterally
Terminology:
Balanced occlusion
-simultaneous contact of maxillary & mandibular teeth
on the right ,the left , in the anterior & posterior
occlusal areas when the jaws are in centric or
eccentric relation ( static position)
-simultaneous means even contact at the same time
Balanced articulation ( Balancing Sliding Occlusion):
Continuous sliding contact of maxillary & mandibular
cusps during all closed grinding movements of the
mandible (dynamic), without interference
Smooth Mandibular movement from centric to
eccentric positions & vise versa
Terminology:
Terminology:
The working side:
The side to which the mandible move in order to
break up a bolus of food,
The opposite side is termed The balancing side
(non working side)
Natural teeth Artificial teeth
-Periodontal ligament supports
teeth
-no periodontal ligament
-Function independently -function as group
- Bilateral balance, not necessary if
present considered pathological
-Bilateral balance is mandatory for
denture stability
-Non vertical forces well
tolerated
-Non vertical forces are
damaging to supporting tissues
Important differences between natural
and artificial occlusion
Incising doesn’t affect posterior
teeth
Incising affects all teeth on the
base
Second molar is favoured position
for mastication
Heavy pressures of mastication in
second molar region tilts base&
shifts it on inclined surface
Proprioceptive impulses give feed
back to avoid prematurities &
interferences-so a habitual
occlusion away from centric is
established
No feed back of proprioceptive
impulses& So any prematurity can
not be determined will shift
denture base
Important differences between natural
and artificial occlusion
Types of complete denture Posterior teeth
according to their occlusal morphology
1- anatomic ( 30-33˚ cusp incline)
2- semianatomic (20˚ cusp incline)
3- nonanatomic (0- dgree)
The following should be considered when
choosing the posterior teeth
1- Ridge morphology.
2- Arch relationship.
3- Esthetics.
4- Patient’s age, and neuromuscular coordination.
5- Previous denture- wearing experience.
6- Concept of occlusion.
Occlusal Concepts Of Complete dentures
I- Concept of occlusal balance(balanced occlusion):
occlusal contact of the opposing teeth in centric and eccentric
occlusion of the mandible within the functional range of jaw
movement ( Bilateral, simultaneous, anterior and posterior
occlusal contact of teeth in centric and eccentric positions)
II- Concept of Non occlusal balance (non balanced
occlusion):
maximum Occlusal contact of the opposing teeth in centric
occlusion only without contact in eccentric occlusion ………..
( N.B. When & how many no. teeth contact occur , Enter bolus
exit balance)
Balance in relation to complete denture:
This mean a state of equilibrium of the denture bases in
relation to their supporting structure when the opposing teeth
contact and there is a resultant forces
There are two types of balance which interact to stabilize the
denture :
1) Lever balance: dependant on tooth position as related to its
base
2) Occlusal balance: dependant on tooth contact
1) Lever balance :
The larger the ridge, the closer the teeth to the
ridge, The more lingual the teeth in relation to
the ridge crest, and the more centered the force
of occlusion antero-posteriorly……………..
more Lever balance and the
greater the stability of the base.
Equilibrium of the base on its supporting
structures when a bolus of food is interposed
between the teeth on one side and a space exist
between the teeth on the opposite side
Unilateral lever balance :
(Inter-bolus exit balance)
1. Placing the teeth over the ridge or slightly lingual
to it.
2. Denture base area covers as wide area on the
ridge as possible.
3. Placing the teeth as close to the ridge as other
factors will permit.
4. Using as narrow a buccolingual width occlusal
table as practical.
Functional lever balance , to stabilize the
denture during mastication:
2) Occlusal balance:
To create bilateral contacts from the centric to all
eccentric position, that are free from interferences,
smooth, uniform and in harmony with movement of
the mandible. Such contacts provide stabilizing
forces to the denture bases on their basal seat.
-Contact of opposing teeth in the working and
balancing sides when the mandible move laterally
- minimum three point of contact (one ant. And two
post. L & R)
Factors that affect Balanced
Occlusion
• There are five factors involved in eccentric occlusal
balance in complete denture to achieve simultaneous
gliding occlusal contacts from centric occlusion to
eccentric occlusal position.( Hanau Quint)
1- Inclination of the condylar guidance (C.G)
2- Inclination of the Incisal guidance (I. G)
3- Inclination of the cusps (Cusp height) ( C.H)
4- Orientation of the occlusal plane ( O. P)
5- Orientation of the Compensating curve ( C. C)
Factors that affect Balanced
Occlusion
Inclination of the condylar guidance & inclination of
the incisal guidance are the two most important
factors as they control the movement of the
articulator.
The remaining three factors ( orientation of the
occlusal plane, inclination of the cusps, and
compensating curve) are arranged to attain
harmony between all five factors to the articulator
movement.
1-Condylar guidance
2- Incisal guidance
3- Cusp height and inclination
4- PLANE OF OCCLUSION
(OCCLUSAL PLANE)
5- COMPENSATING CURVE
Curve of Spee
Curve of Wilson
Curve of Monson
I-Balanced Occlusal concept
A- With anatomic teeth ( Bilateral balanced occlusion)
B- With Modified anatomic teeth (Lingualized occlusion)
C- With non anatomic teeth:
- Compensating curves
- Tilting the second molars
- Balancing ramp
Non-anatomic teeth for balanced
occlusion
1. Arrange the teeth in compensating curve
2. Tilting the second molar to create an inclined plane
3. Balancing ramp creation
1- Zero Degree Teeth with a Compensating Curve
2. tilting the second molar to create an inclined plane
3-Balancing ramp:
Setting up the teeth in a flat
plane and utilize a balancing
ramp just distal to the second
molar.
II-Non-Balanced Occlusal concept
1- Neutro-centric occlusion ( monoplane occlusion)
2- Lingualized occlusion
II- NEUTRO-CENTRIC
OCCLUSION
• Neurocentric to denote two objectives in
denture construction.
A- Neutralization of inclines.
B- Centralization of occlusal forces acting on
the denture foundations.
• Five factors are involved, to achieve
these 2 objectives:
• Position of Posterior teeth in a central position
• Proportion of the teeth 40% reduction in the width
• Plane of occlusion is parallel with the mean
denture foundation area
• Form devoid of projecting cusps
• Number of teeth reduction in number
Neutrocentric concept:
a). Non-anatomic teeth
b). Plane of occlusion parallel to the residual
ridge.
C).No compensating curves, teeth are set flat
d). Maxillary & mandibular teeth arranged
without any vertical overlap.
(e). Complete intercuspation between the
upper & lower posterior teeth except second
molar.
(f).Narrow teeth selected to decrease occlusal
forces.
X
•The patients should
avoid incising with their
anterior teeth
Advantages of Neutro-centric occlusion:
• Simple Does not require precise records.
•By removing any inclines, lateral destructive
forces on residual ridges is reduced.
•Easier to adjust.
•Freedom in CR ( CR, CO)
•Crossbite patients, and class II, III cases
• good in patient with poor ridges
Disadvantages of Neutro-centric occlusion:
-Least esthetics
- position of the teeth more lingual may affect
tongue, and cheeck function
- decrease masticatory efficiency
- Christensen’s phenomenon ( no balance)
III- LINGUALIZED
OCCLUSION
This type of occlusion utilize the maxillary lingual
cusps as the centric holding cusps oppose mandibular
teeth with zero degree or shalllow cusp incline ( for
non balanced, or balanced arrangement)
To maintain the esthetic and food penetration
advantages of the anatomic form while maintaining
the mechanical freedom of the nonanatomic form
Reducing the efficiency of the lower buccal cusps,
Vertical forces are centralized on the mandibular
teeth. thus directing the forces to the lingual side of
the lower ridge crest to encourage lever
stability of the lower denture.
Indicated in patient with high priority on esthetics but
non anatomic teeth indicated eg.:
-Severe alveolar bone resorption.
- displaceble tissues.
- class II & III jaw relation.
-Parafunctional habits ( bruxism, clenching, grinding)
III- LINGUALIZED
OCCLUSION
• Aesthetics
• Cusps – better mastication
• Records – less precise
• Stability in lateral excursions
• Reduced lateral forces & centered vertical force
• One contact point ( mortar and pestle )
• Can be used in a variety of situations
“lingualized occlusion is an occlusion for all
saesons”
III- LINGUALIZED
OCCLUSION
Advantages:
The following principles of occlusion for complete dentures are
generally accepted:
1. Complete denture patients must make initial and complete
occlusal contact while in centric relation. This is called centric
occlusion.
2. All anterior and posterior denture teeth inclines and surfaces
must function as a “unit" during excursive movements.
3. Any prematurity preventing the movements described in
principles 1 and/or 2 must be eliminated.
4. Significant disclusion of the posterior denture teeth when a
patient protrudes is contraindicated.
5. Anterior tooth contact is contraindicated in centric occlusion.
Conclusion
Conclusion
Many occlusal schemes have
been proposed over the
years. Most schemes when
correctly used gives
satisfactory results. The
result is satisfactory if the
patient gets better
function, esthetics &
comfort without any
adverse changes in denture
foundation.
6 occlusion
6 occlusion

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6 occlusion

  • 1.
  • 2.
  • 3. INTRODUCTION • Occlusion of the complete denture has a direct effect on the success or failure of the treatment • So the occlusal scheme and concept should produce masticatory efficiency, without negative effect on the esthetic value of the denture, the health of the supporting tissues, and comfort of the patient
  • 4. Terminology: Occlusion: • It is the act or process of closure or of being closed or shut off. • The relationship between the occlusal surfaces and incisal edges of the maxillary and mandibular teeth when they are in contact • It is a static position (relation) when the jaws are centrically or eccentrically related (the way the teeth come together and function together)
  • 5. Terminology: Articulation: Relationship between the occlusal surfaces of the maxillary and mandibular teeth during function (Dynamic relation)
  • 6. Terminology: Centric occlusion: Occlusion of the opposing occlusal surfaces that provide the maximum planned contact (Intercuspation) when the mandible is in centric relation to the maxilla. Eccentric occlusion: ( Protrusive occlusion & lateral occlusion) Describe the relation of opposing occlusal surfaces when the mandible is moved forward or laterally
  • 7. Terminology: Balanced occlusion -simultaneous contact of maxillary & mandibular teeth on the right ,the left , in the anterior & posterior occlusal areas when the jaws are in centric or eccentric relation ( static position) -simultaneous means even contact at the same time
  • 8. Balanced articulation ( Balancing Sliding Occlusion): Continuous sliding contact of maxillary & mandibular cusps during all closed grinding movements of the mandible (dynamic), without interference Smooth Mandibular movement from centric to eccentric positions & vise versa Terminology:
  • 9. Terminology: The working side: The side to which the mandible move in order to break up a bolus of food, The opposite side is termed The balancing side (non working side)
  • 10. Natural teeth Artificial teeth -Periodontal ligament supports teeth -no periodontal ligament -Function independently -function as group - Bilateral balance, not necessary if present considered pathological -Bilateral balance is mandatory for denture stability -Non vertical forces well tolerated -Non vertical forces are damaging to supporting tissues Important differences between natural and artificial occlusion
  • 11. Incising doesn’t affect posterior teeth Incising affects all teeth on the base Second molar is favoured position for mastication Heavy pressures of mastication in second molar region tilts base& shifts it on inclined surface Proprioceptive impulses give feed back to avoid prematurities & interferences-so a habitual occlusion away from centric is established No feed back of proprioceptive impulses& So any prematurity can not be determined will shift denture base Important differences between natural and artificial occlusion
  • 12.
  • 13. Types of complete denture Posterior teeth according to their occlusal morphology 1- anatomic ( 30-33˚ cusp incline) 2- semianatomic (20˚ cusp incline) 3- nonanatomic (0- dgree)
  • 14. The following should be considered when choosing the posterior teeth 1- Ridge morphology. 2- Arch relationship. 3- Esthetics. 4- Patient’s age, and neuromuscular coordination. 5- Previous denture- wearing experience. 6- Concept of occlusion.
  • 15. Occlusal Concepts Of Complete dentures I- Concept of occlusal balance(balanced occlusion): occlusal contact of the opposing teeth in centric and eccentric occlusion of the mandible within the functional range of jaw movement ( Bilateral, simultaneous, anterior and posterior occlusal contact of teeth in centric and eccentric positions) II- Concept of Non occlusal balance (non balanced occlusion): maximum Occlusal contact of the opposing teeth in centric occlusion only without contact in eccentric occlusion ……….. ( N.B. When & how many no. teeth contact occur , Enter bolus exit balance)
  • 16. Balance in relation to complete denture: This mean a state of equilibrium of the denture bases in relation to their supporting structure when the opposing teeth contact and there is a resultant forces There are two types of balance which interact to stabilize the denture : 1) Lever balance: dependant on tooth position as related to its base 2) Occlusal balance: dependant on tooth contact
  • 17. 1) Lever balance : The larger the ridge, the closer the teeth to the ridge, The more lingual the teeth in relation to the ridge crest, and the more centered the force of occlusion antero-posteriorly…………….. more Lever balance and the greater the stability of the base.
  • 18. Equilibrium of the base on its supporting structures when a bolus of food is interposed between the teeth on one side and a space exist between the teeth on the opposite side Unilateral lever balance : (Inter-bolus exit balance)
  • 19. 1. Placing the teeth over the ridge or slightly lingual to it. 2. Denture base area covers as wide area on the ridge as possible. 3. Placing the teeth as close to the ridge as other factors will permit. 4. Using as narrow a buccolingual width occlusal table as practical. Functional lever balance , to stabilize the denture during mastication:
  • 20. 2) Occlusal balance: To create bilateral contacts from the centric to all eccentric position, that are free from interferences, smooth, uniform and in harmony with movement of the mandible. Such contacts provide stabilizing forces to the denture bases on their basal seat. -Contact of opposing teeth in the working and balancing sides when the mandible move laterally - minimum three point of contact (one ant. And two post. L & R)
  • 21. Factors that affect Balanced Occlusion • There are five factors involved in eccentric occlusal balance in complete denture to achieve simultaneous gliding occlusal contacts from centric occlusion to eccentric occlusal position.( Hanau Quint) 1- Inclination of the condylar guidance (C.G) 2- Inclination of the Incisal guidance (I. G) 3- Inclination of the cusps (Cusp height) ( C.H) 4- Orientation of the occlusal plane ( O. P) 5- Orientation of the Compensating curve ( C. C)
  • 22. Factors that affect Balanced Occlusion Inclination of the condylar guidance & inclination of the incisal guidance are the two most important factors as they control the movement of the articulator. The remaining three factors ( orientation of the occlusal plane, inclination of the cusps, and compensating curve) are arranged to attain harmony between all five factors to the articulator movement.
  • 25. 3- Cusp height and inclination
  • 26. 4- PLANE OF OCCLUSION (OCCLUSAL PLANE)
  • 27. 5- COMPENSATING CURVE Curve of Spee Curve of Wilson Curve of Monson
  • 28. I-Balanced Occlusal concept A- With anatomic teeth ( Bilateral balanced occlusion) B- With Modified anatomic teeth (Lingualized occlusion) C- With non anatomic teeth: - Compensating curves - Tilting the second molars - Balancing ramp
  • 29. Non-anatomic teeth for balanced occlusion 1. Arrange the teeth in compensating curve 2. Tilting the second molar to create an inclined plane 3. Balancing ramp creation
  • 30. 1- Zero Degree Teeth with a Compensating Curve
  • 31. 2. tilting the second molar to create an inclined plane
  • 32. 3-Balancing ramp: Setting up the teeth in a flat plane and utilize a balancing ramp just distal to the second molar.
  • 33. II-Non-Balanced Occlusal concept 1- Neutro-centric occlusion ( monoplane occlusion) 2- Lingualized occlusion
  • 34. II- NEUTRO-CENTRIC OCCLUSION • Neurocentric to denote two objectives in denture construction. A- Neutralization of inclines. B- Centralization of occlusal forces acting on the denture foundations.
  • 35. • Five factors are involved, to achieve these 2 objectives: • Position of Posterior teeth in a central position • Proportion of the teeth 40% reduction in the width • Plane of occlusion is parallel with the mean denture foundation area • Form devoid of projecting cusps • Number of teeth reduction in number
  • 36. Neutrocentric concept: a). Non-anatomic teeth b). Plane of occlusion parallel to the residual ridge. C).No compensating curves, teeth are set flat d). Maxillary & mandibular teeth arranged without any vertical overlap. (e). Complete intercuspation between the upper & lower posterior teeth except second molar. (f).Narrow teeth selected to decrease occlusal forces.
  • 37. X •The patients should avoid incising with their anterior teeth
  • 38. Advantages of Neutro-centric occlusion: • Simple Does not require precise records. •By removing any inclines, lateral destructive forces on residual ridges is reduced. •Easier to adjust. •Freedom in CR ( CR, CO) •Crossbite patients, and class II, III cases • good in patient with poor ridges
  • 39. Disadvantages of Neutro-centric occlusion: -Least esthetics - position of the teeth more lingual may affect tongue, and cheeck function - decrease masticatory efficiency - Christensen’s phenomenon ( no balance)
  • 40. III- LINGUALIZED OCCLUSION This type of occlusion utilize the maxillary lingual cusps as the centric holding cusps oppose mandibular teeth with zero degree or shalllow cusp incline ( for non balanced, or balanced arrangement) To maintain the esthetic and food penetration advantages of the anatomic form while maintaining the mechanical freedom of the nonanatomic form
  • 41. Reducing the efficiency of the lower buccal cusps, Vertical forces are centralized on the mandibular teeth. thus directing the forces to the lingual side of the lower ridge crest to encourage lever stability of the lower denture.
  • 42. Indicated in patient with high priority on esthetics but non anatomic teeth indicated eg.: -Severe alveolar bone resorption. - displaceble tissues. - class II & III jaw relation. -Parafunctional habits ( bruxism, clenching, grinding) III- LINGUALIZED OCCLUSION
  • 43. • Aesthetics • Cusps – better mastication • Records – less precise • Stability in lateral excursions • Reduced lateral forces & centered vertical force • One contact point ( mortar and pestle ) • Can be used in a variety of situations “lingualized occlusion is an occlusion for all saesons” III- LINGUALIZED OCCLUSION Advantages:
  • 44. The following principles of occlusion for complete dentures are generally accepted: 1. Complete denture patients must make initial and complete occlusal contact while in centric relation. This is called centric occlusion. 2. All anterior and posterior denture teeth inclines and surfaces must function as a “unit" during excursive movements. 3. Any prematurity preventing the movements described in principles 1 and/or 2 must be eliminated. 4. Significant disclusion of the posterior denture teeth when a patient protrudes is contraindicated. 5. Anterior tooth contact is contraindicated in centric occlusion. Conclusion
  • 45. Conclusion Many occlusal schemes have been proposed over the years. Most schemes when correctly used gives satisfactory results. The result is satisfactory if the patient gets better function, esthetics & comfort without any adverse changes in denture foundation.