Occlusion in Complete Denture

OCCLUSION IN
COMPLETE DENTURE
PART-1
Presentation by:
Dr. Vanshree Sorathia
MDS Prosthodontist Total slides: 163
1

Objectives of discussion…
• Definition
• Terminologies
• Development of dental occlusion
• Biomechanics of occlusion
- Mandibular movements
- Posselt’s envelope of motion
• Natural teeth v/s Artificial teeth
• Sear’s axioms of CD occlusion
• Ideal requirements
• Schemes of occlusion
• Concepts of occlusion
3

Occlusal concept
• Balanced occlusion
• Lingualized occlusion
• Monoplane articulation
• Neutrocentric occlusion
• Linear occlusion
• Physiologically generated occlusion
• Lineal occlusion
• Non-balanced occlusion
• Organic occlusion
4

Occlusion
• Ob+Claudre = ‘To close
up’
• The static relationship
between the incising or
masticating surfaces of
maxillary or mandibular
teeth or tooth
analogue.
-Glossary of
Prosthodontic terms-9
The Glossary of Prosthodontic Terms, 9th edition. J. Prosthet Dent 2017 May;
117(5S):e1-e105. (Pg. 63) 5

Terminologies
• Centric relation: A
maxillomandibular relationship,
independent of tooth contact, in
which the condyles articulate in the
anterior-superior position against the
posterior slopes of the articular
eminence; in this position, the
mandible is restricted to a purely
rotary movement; from this
unstrained, physiologic,
maxillomandibular relationship, the
patient can make vertical, lateral or
protrusive movements; it is clinically
useful, repeatable reference point.
-Glossary of Prosthodontic
terms-9
117(5S):e1-e105. (Pg. no. 20) 6

• Eccentric relation: Any relation of mandible
to maxilla other than the centric relation is an
eccentric relation.
• In complete denture,
- Protrusive relation
-Right and left lateral relations
117(5S):e1-e105. (Pg. no.33) 7

• Centric occlusion:
The occlusion of
opposing teeth when
the mandible is in
centric relation; this
may or may not
coincide with the
maximal intercuspal
position.
- Glossary of
Prosthodontic Terms - 9
117(5S):e1-e105 (Pg. No. 20). 8

• Maximal intercuspal position: The complete
intercuspation of opposing teeth independent
of condylar position, sometimes referred to as
the best fit of teeth regardless of the condylar
position.
Glossary of Prosthodontics Term- 9
117(5S):e1-e105. 9

• Eccentric occlusion: An occlusion other than
centric occlusion.
- Glossary of Prosthodontics Term - 9
• Articulation: The static and dynamic contact
relationship between occlusal surface of teeth
during function.
- Glossary of Prosthodontics Term- 9
117(5S):e1-e105. 10

Development of dental occlusion
Neonatal
occlusion
Primary
occlusion
Mixed
occlusion
Permanent
occlusion
Wheeler’s – Dental anatomy, physiology and occlusion, 9th edition, Elsevier, 2012
(Pg. no. 273)
11

Mandibular movements
• 4 determinants of
mandibular movements:
• 2 Basic movements are:
a. Hinge
b. Translatory
TMJ and associated
structures
Teeth and cusp
inclines
Neuromuscular
component
Charl M. Heartwell – Syllabus of Complete Dentures, 4th edition, K.M.Varghese
company 1992. (Pg. no. 220) 12

A. Hinge movement
1. Transverse axis
2. Vertical axis
3. Sagittal axis
company 1992.(Pg. no. 220) 14

1. Transverse axis
company 1992.(Pg.no. 221) 15

2. Vertical axis
company 1992. (Pg. no. 222) 16

3. Sagittal axis
company 1992. (Pg. no. 222) 17

B. Translatory movement
• Any direction
• Important ones are:
1. Protrusive movement
2. Mandibular lateral
translation / Bennett’s
movement.
3. Translatory movement
company 1992. (Pg. no. 222) 18

BENNETT’S MOVEMENT
• Dr. Norman Godfrey Bennett in 1908.
• Rotating condyles
• Orbiting condyles
company 1992. (Pg. no. 221) 19

company 1992.(Pg. no. 221) 20

• Possible pathways of orbiting condyle are:
1. Progressive side shift
2. Early or precurrent side shift
3. Immediate side shift
company 1992. (Pg. no. 221) 21

company 1992. (Pg. no. 221) 22

Bennett angle
• The angle formed by the sagittal plane and the path of the advancing
condyle during lateral mandibular movements as viewed in horizontal
plane.
- Glossary of Prosthodontics Term- 9
company 1992.(Pg. no. 221)
23
7.5-12.8⁰

4 movements of prime importance in
CD are:
Hinge like movement
Protrusive movement
Right or left lateral
Bennett movement
company 1992. (Pg. no. 220) 24

Border movements of mandible /
POSSElT’S ENVELOPE OF MOTION
1952
company 1992. (Pg.no. 222) 25

• Sagittal plane – BEAK TRACING
company 1992.(Pg.no. 223) 26

• Horizontal plane – DIAMOND diagram
company 1992. (Pg.no. 223)
27

• Frontal plane – SHIELD diagram
company 1992. (Pg. no. 224) 28

Natural v/s Artificial Teeth
NATURAL TEETH ARTIFICIAL TEETH
1. RETENTION Roots which are firmly
anchored to the bone
Denture base placed on
slippery mucosa
2. MOVES Independently in their
socket
As a unit on their base
3. MALOCCLUSION May remain uneventful for
a year
Evoke immediate instability
and pain
4. FORCES Occlusal force affect only
the concerned tooth
Forces acting on CD affect
the whole base
5. NON-VERTICAL FORCES Are tolerated much better Are usually not tolerated
well
Sheldon Winkler- Essentials of Complete Denture Prosthodontics, 3rd edition, AITBS
publisher, 2017. (Pg. no.284) 29

NATURAL TEETH ARTIFICIAL TEETH
6. MASTICATION Is usually done in 2nd molar
region
2nd premolar area is
preferred (it is the AP
center of the occlusal
table); in 2nd molar region
may cause shifting of
denture
7. BILATERAL BALANCE Not naturally found and is
considered detrimental
Usually considered
necessary for denture
stability
8. PROPRIOCEPTIVE Enable patient to avoid
prematurities and improve
control
Poor feedback mechanism
so neuromuscular control
is compromised
9. INCISING Does not affect posterior
teeth
Affects all the teeth on
base

Requirements of CD occlusion
• Stability in centric relation and in an area forward
and lateral to it.
• Balanced occlusal contacts bilaterally for all
eccentric mandibular movements.
• Unlocking the cusps mesiodistally.
• Control of horizontal force by buccolingual cusps

• Functional lever balance.
• Cutting, penetrating and
shearing efficiency.
• Lingual contact occlusion.
• Sharp ridges or cusps and
generous sluiceways to shear
and shed food with minimum
of force necessary.
publisher, 2017. (Pg. no. 285) 32

This requirements can be most easily applied if
the occlusion is divided into 3 distinct units:
Incising
unit
Working
occlusal
unit
Balancing
occlusal
unit
publisher, 2017. (Pg. no. 285)
33

A. Incising unit
Sharp
No contact
during
mastication
Flat incisal
guidance
Overjet
Contact only
during
protrusion
publisher, 2017. (Pg. no. 287) 34

B. Working occlusal unit
35
• Efficient in cutting and grinding.
• Decreased buccolingual width.
• Function as group.
• Be over the ridge crest – lever balance.
• Transmit force vertically.
• Center the work load near the anteroposterior
center of denture.
• Plane of occlusion – parallel to mean foundation
plane.

C. Balancing occlusal unit
• Contact on 2nd molar – when incising unit
contact in function.
• Contact at the end of chewing cycle – when
working unit contact.
• Smooth gliding contacts for lateral and
protrusive excursions.
publisher, 2017. (Pg. no. 287) 36

SEAR’S AXIOMS of artificial occlusion
Smaller area of occlusal forces
Vertical force applied - to inclined occlusal surface
- to denture base
- Outside the ridge crest
- Inclined supporting structures
publisher, 2017. (Pg. no.287)
37

SCHEMES of CD occlusion
• Selection of posterior teeth is important to
establish occlusion.
• These teeth can be divided into mainly 3
groups:
- Anatomic teeth
- Semi anatomic teeth
- Non-anatomic teeth

1. Anatomic teeth
• Designed to simulate natural tooth form.
• Dr. Alfred Gysi, 1914. TRUBYTE.
33⁰ inclination.
• Pilkington and Turner, 1932.
slightly shallower cusp of 30⁰.
• GOOD RIGDES.
publisher, 2017. (Pg. no. 291) 39

2. Semi-anatomic teeth
• Cuspal inclines are less steeper than
conventional anatomic tooth form of 33⁰.
• 20⁰
• MODERATE RIDGES.
40

3. Non-anatomic teeth
• Flat and has no cusp heights to interdigitate
with an opposing tooth.
• Articulates on flat surface in only 2
dimensions.
• RESORBED RIDGES.
Sheldon Winkler- Essentials of Complete Denture Prosthodontics, 3rd edition,
AITBS publisher, 2017. (Pg. no.299)
41

CONCEPTS of CD occlusion
Static
concept Dynamic
concept
Concepts of occlusion in prosthodontics: A literature review, part-I. J Indian
Prosthodont Soc. 2015 Jul-Sep;15(3):200-205. 43

OCCLUSAL CONCEPTS
Occlusal rehabilitation of CD fall into 4 occlusal
concepts:
• Unbalanced occlusion
• Monoplane occlusion

BALANCED OCCLUSION
• Definition
• History
• Objectives
• Mechanics
• Characteristic requirements
• Types
• Concepts
• Factors
• Characteristics of balanced occlusion in Complete Denture / Steps
• Advantages
• Pros and cons
• Indication
• Contraindication
46

Definition
• The bilateral simultaneous occlusal contacts of
the anterior and posterior teeth in excursive
movements.
- Glossary of Prosthodontic Terms-9.
NOT SEEN IN NATURAL DENTITION
John R. Ivanhoe – Textbook of complete denture 6th edition, PMPH USA,2009 47

History
• Concept of balanced occlusion can be traced
back to GYSI – introduced the 33⁰ cusp form
teeth.
• Followed by a 30⁰ posterior teeth form-
introduced by PILKINGTON and TUNNER.
48

Objectives
V Rangarajan – Textbook of prosthodontics, 1st edition. Elsevier, 2014.(Pg. no. 146) 49
Improve
stability
Improve
oral
comfort of
patient
Reduce
resorption
and
soreness

Mechanics of balanced occlusion
• In natural teeth / unbalanced occlusion –
CHRISTENSEN’S PHENOMENON.
• Lever balance.
• Interference.
John R. Ivanhoe – Textbook of complete denture 6th edition, PMPH USA,2009 50

Types
Sheldon Winkler- Essentials of Complete Denture Prosthodontics, 3rd edition,
AITBS publisher, 2017. (Pg. no.288)
51
Unilateral
lever balance
Unilateral
occlusal
balance
Bilateral
occlusal
balance
Protrusive
occlusal
balance

General considerations for balanced
occlusion
• Wider and larger the ridge, and tooth closer to
the ridge greater the lever balance.
• Narrower teeth buccolingually greater
the balance.
• More lingual to ridge crest are teeth placed
greater the balance.
• More centered the force of occlusion
anteroposteriorly greater the stability
of base.

CONCEPTS to attain balanced
occlusion
Prosthodont Soc. 2015 Jul-Sep;15(3):200-205.
53
• Gysi’s concept, 1914
33⁰ inclination of cusp.
Centric occlusion Lateral movements Extreme working
lateral position
Forces towards ridges Cusp contact bilaterally Forces directed outside
the ridge

(a) Gysi’s concept: In centric occlusion (b) Gysi’s concept:
In right lateral position
Prosthodont Soc. 2015 Jul-Sep;15(3):200-205.
54

• French concept
• Mandibular posterior teeth – occlusal surface
reduced to increase the stability of denture.
• Maxillary posterior teeth – slight lingual
occlusal inclines.

(a) French’s concept: In centric occlusion (b) French concept:
Centric occlusion Working side Balancing side
Buccal direction to
mandibular
residual ridge
Towards ridge Away from ridge

• Sears concept
Non – anatomic teeth.
i. Curved occlusal plane anteroposteriorly and
laterally.
ii. Use of 2nd molar ramp.

(a) Sear’s concept: In centric occlusion (b) Sear’s concept:
Towards residual
ridge
Towards ridge Buccal side of ridge

• Pleasure concept
 1937, Dr. Max Pleasure – Pleasure curve.
Reverse curve – bicuspid area
Flat scheme – 1st molar
Spherical – 2nd molar

(a) Pleasure’s concept: In centric occlusion (b) Pleasure’s concept: In right lateral
position
Towards residual
ridge
Towards lingual
side of lower ridge
Buccal side of ridge
ridge

• Frush concept
• 1967, Linear occlusal concept.
• Arbitrary articular balance
intraoral corrections.
Single mesiodistal ridge on lower posterior teeth
Flat occlusal surface of upper posterior teeth set at
an angle of horizontal.

(a) Frush’s concept: In centric occlusion (b) Frush’s concept: In right lateral position
Towards residual
ridge
Towards ridge Buccal side of ridge
ridge

• Hanau’s quint
 1925, Rudolph L. Hanau – “Articulation:- Defined, Analyzed
and Formulated.”
 Nine factors:
1) Horizontal condylar inclination
2) Compensating curve
3) Protrusive incisal guidance
4) Buccolingual inclination of tooth axis
5) Sagittal condylar pathway
6) Sagittal incisal guidance
7) Tooth alignment
8) Relative cusp height

• Hanau’s quint

• Trapazzano concept

• Boucher's concept

• Lott concept: Laws

• Bernard Levin concept: QUAD

• Definition
• Mandibular movements 1. Hinge
2. Translatory
Bennett’s angle
• Posselt’s envelope of motion 3
• Natural v/s Artificial teeth
• Requirements
• Schemes 3
• Concepts
• Balanced occlusion 1. Definition
2. History
3. Mechanism
4. Objectives
5. Requirements
6. Types
7. Concepts 70

OCCLUSION IN
COMPLETE DENTURE
PART-2
Presentation by:
Dr. Vanshree Katarya
(1st year Postgraduate)
Date: 18/07/18
Guided by:
Dr. Arun Gupta
(Professor)
Seminar no: 2
Total slides: 163

Objectives of discussion
 Factors
 Characteristics of balanced occlusion in complete denture
 Advantages
 Pros and cons
 Indication
 Contraindication
75

FACTORS affecting balanced occlusion
• 5 factors / Hanau’s Quint
Condylar guidance
Incisal guidance
Plane of occlusion
Compensating curves
Cuspal inclination
V Rangarajan – Textbook of prosthodontics, 1st edition. Elsevier, 2014. (Pg. no.146 ) 76

V Rangarajan – Textbook of prosthodontics, 1st edition. Elsevier, 2014. (Pg. no. 146) 77

1. Condylar guidance
• Mandibular guidance
generated by condyle and
articular disc traversing the
contour of articular
eminence.
- Glossary of
Prosthodontic Terms – 9
• The mechanical form
located in posterior region
of an articulator that
controls the movement of
its mobile member.
- Glossary of
Prosthodontic Terms - 9
117(5S):e1-e105.
78

• Condylar guide angle: The angle formed by the
inclination of condylar guide control surface of an
articulator and a specified reference point.
- Glossary of Prosthodontic Terms - 9
117(5S):e1-e105. 79

• Hanau – Primary dictator of occlusion.
• Kurth – Not same for varying incisal guidance.
• Weinberg – Condylar path varies owing to
variable pressure during function.
Only factor obtained from patient.
80

Horizontal
condylar
guidance Lateral condylar
guidance
Components

Significance
Shallow CG causes lesser posterior
tooth separation on protrusion.
Steep CG causes greater tooth
separation on protrusion.

Steep CG requires teeth with longer
cusps and deeper fossa

2. Incisal guidance
• The influence of contacting
surface of mandibular and
maxillary anterior teeth on
the mandibular movement.
- Glossary of
Prosthodontic Terms- 8
• The influence of contacting
surfaces of guide pin and
guide table on articular
movement.
- Glossary of
117(5S):e1-e105.
84

• Incisal guidance angle:
The angle formed between the
horizontal plane of occlusion and
a line drawn in sagittal plane
between the incisal edge of
maxillary and mandibular central
incisors when teeth are in
maximum intercuspation.
- Glossary of
117(5S):e1-e105.
85

86
OVERJET – horizontal overlap OVERBITE – vertical overlap

For CD, IG should be as FLAT as esthetics
and phonetics will permit.
Steep incisal guidance
Requires steep cusp
Steep occlusal plane or
Steep compensating curve to effect an occlusal
balance
Detriment the stability and equilibrium of
denture

If steep overbite is required for esthetics, a
corresponding increase in overjet will help to decrease
the IG.

3. Plane of occlusion
• Anteriorly – by height of
lower cuspid.
• Posteriorly – by height
of retromolar pad.
• Nearly coincides with
commissure of mouth.

• Also related to Ala -
tragus line or Camper’s
line.
• Its position can be
altered slightly without
creating serious
functional problems.

Plane of occlusion can be altered to a maximum
of 10⁰

4. Compensating Curve
• Anteroposterior curvature (in median plane)
and mesiodistal curvature (in frontal plane) in
the alignment of occluding surfaces and incisal
edges of the artificial teeth that are used to
develop balanced articulation.
- Glossary of Prosthodontic Terms- 9
Most important determinants of occlusal
balance.
117(5S):e1-e105.
92

• Determined by the inclination of posterior teeth and their vertical
relationship to the occlusal plane.
• So that the occlusal surface results in a curve that is in harmony
with the movement of mandible as guided posteriorly by condylar
path.
Steep condylar
path
Requires Steep
compensating
curve
If lesser
compensating
curve for
same CG
Result in
steeper IG
(anterior
interference)
Loss of molar
balancing
contacts

• In natural dentition,
I. Curve of spee
II. Curve of wilson
III. Pleasure curve

Curve of spee
Curve of wilson

Curve of monsoon

• Compensating curves,
I. Anteroposterior curve
II. Mesiodistal curve
III. Curve of monsoon
IV. Reverse curve

1. Anteroposterior curve –
curve of spee
 Raising the distal portion
of 1st and 2nd molar to
conform to a curve.
 Significance
 Without this, entire
occlusal plane would have
to be tilted to achieve
balanced occlusion.

2. Mesiodistal curve – Curve of wilson
Compensates for the wedge like opening formed
when the mandible is moved laterally to opposite
side.

3. Curve of monsoon –
George S. Monsoon.
Eponym for a proposed ideal
curve of occlusion in which
each cusp and incisal edge
touches or conforms to a
segment of the surface of a
sphere 8 inches in diameter
with its center in the region
of glabella.

4. Reverse curve / Pleasure curve /
Antimonsoon curve / Frequency curve.

5. Cuspal height or Inclinations
• Cusp inclinations: the angle made by the average
slope of a cusp with the cusp plane measured
mesiodistal or buccolingually.

• Cuspal angle should be
reduced to balance the incisal
guidance
Shallow
bite
• With steep IG, the separation
is more during protrusion so
teeth with high cuspal
inclines are required
Deep
bite

105
CONDYLAR
GUIDANCE
INCISAL
GUIDANCE
OCCLUSAL
PLANE
COMPENSATING
CURVE
CUSP
INCLINATION
Only factor
which is to be
recorded from
patient
Can be
modified by
dentist to
certain limit
Anteriorly-
commissure of
mouth
Curve of spee Not too steep
↓
Lateral force
Cannot be
modified
Overjet ↑
↓
Incisal
guidance↓
Posteriorly-
height of
retromolar pad
Curve of wilson Compensated
by
compensating
curve
Steeper the
condylar
guidance
Overbite ↑
↓
Incisal
guidance ↑
Parallel to Ala-
tragus line or
Camper’s plane
Curve of
monsoon
Decrease the
incisal
guidance
Steeper the
incisal
guidance
↓
Steeper cusp/
steep occlusal
plane/steep CC
Cannot tilt
plane > 10⁰
Pleasure curve/
reverse curve

THIELMANN’S FORMULA
CG X IG = Balanced occlusion
CH X CC X OP
Where, CG= Condylar guidance
IG= Incisal guidance
CH= Cuspal height
CC= Compensating curve
OP= Occlusal plane
Boucher’s – Prosthodont Treatment for Edentulous Patient, 9th edition, C.V. Mosby
1982.
106

Advantages of balanced occlusion
• SHEPPARD – “Enter bolus, exit balance.”
• Winkler – “Balancing the occlusion of CD is
like changing stumbling prose into poetry.”
publisher, 2017. (Pg. no.285) 107

Pros of balanced occlusion
Seat the denture in stable position.
Important during activities such as swallowing.
Static, stable and retentive position of denture maintained.
Base stable during bruxing activity.
108

Cons of balanced occlusion
Patient with irrelevant muscle
activity – encourage lateral
and protrusive grinding.
Difficult to achieve in
increased overbite patients.
Need of semi-adjustable or
fully-adjustable articulator.
109

Procedure
1. Anterior balancing : Protrusive
Rudd, Morrow, Rhoads – Dental Laboratory Procedure-Complete Denture, vol 1, 4th
Southasain edition, Elsevier. (Pg. no. 163)
110
Teeth are arranged following
general guidelines
Condylar elements in correct
terminal position
Condylar elements - touching
the centric stop and centric
lock nuts - tightened

Loosen centric lock nut gently ,
move chisel end of incisal pin
along the central track of incisal
guide table (within 5-6mm)
Till teeth comes to edge to
edge relation
Southasain edition, Elsevier. (Pg. no. 163) 112

• Lateral anterior balancing
Southasain edition, Elsevier.(Pg. no. 163)
114
Move the incisal pin to one side(right
side) of incisal table along the raised
lateral wing (balancing side)
At this position check the incisal edge
relationship on opposite side(left
side) working side.
Repeat the procedure to opposite
side.

• Posterior balancing
Southasain edition, Elsevier. (Pg.no. 164) 115
Centric lock nuts are loosened
Protrusive: Move upper
member of articulator till the
edge to edge contact
Lateral: Move upper member
to right and left side

Characteristics of balanced occlusion
in complete denture
CROSS ARCH and CROSS
TOOTH
1. In centric relation:
a) Anterior teeth: No
contact.
b) Posterior teeth: Multiple
uniform occlusal contacts.
Southasain edition, Elsevier. (Pg.no. 164) 116

2. In protrusive:
a) Anterior teeth- Maxillary and mandibular teeth
contact.
b) Posterior teeth-
i. Semi-anatomic/ anatomic: Multiple posterior buccal
cusp to buccal cusp and lingual cusp to lingual cusp
contacts between maxillary and mandibular teeth.
(CUSP TO CUSP)
ii. Flat plane/neutrocentric/monoplane: 2nd molar
contact if increase in compensating curve.
Balancing ramp contact if maintained true flat plane.
If no curve or ramp and have overbite, can’t balance
in protrusion.
Southasain edition, Elsevier.(Pg.no. 164)
117

CUSP-TO-CUSP
Southasain edition, Elsevier. (Pg. 163) 118

3. In lateral excursion: Working side
a) Anterior teeth: Maxillary and mandibular
anterior tooth contact.
b) Posterior teeth: The lingual inclines of buccal
cusp of maxillary posterior teeth should
contact the buccal inclines of buccal cusp of
mandibular posterior teeth. (LBBB)
Southasain edition, Elsevier.(Pg.no. 164) 119

LBBB
Rudd, Morrow, Rhoads – Dental Laboratory Procedure-Complete Denture, vol 1,
4th Southasain edition, Elsevier.(Pg.no. 164) 120

4. In lateral excursion: Balancing side
a) Anterior teeth- Maxillary and mandibular anterior
teeth contact.
b) Posterior teeth- The buccal inclines of palatal cusp of
maxillary posterior teeth should contact the lingual
inclines of buccal cusps of mandibular posterior teeth
(BPLB).
i. With monoplane balanced occlusion, usually only
2nd molar are in contact or the balancing ramp.
ii. With cusped teeth, multiple contacts of posterior
teeth are possible.
Southasain edition, Elsevier.(Pg. no. 164) 121

BPLB
Southasain edition, Elsevier.(Pg. no. 164 122

• Steep incisal guidance.
• Requirement of anatomic or semi-anatomic
for esthetic or other reason.
• Patient’s lack of achieving a repeatable centric
relation.
4th Southasain edition, Elsevier. 123
Indications
Contraindication

Monoplane articulation
• Sears – Balancing ramps or tooth at distal part of
mandibular arch which comes in contact only in
eccentric excursion.
• DeVan- Same principle without balancing ramp.
V Rangarajan – Textbook of prosthodontics, 1st edition. Elsevier, 2014. (Pg no. 150) 124

V Rangarajan – Textbook of prosthodontics, 1st edition. Elsevier, 2014. (Pg no. 150) 125
Non anatomic
tooth
Arranged as
close as mean
foundation
plane
Parallel to
ridge, fall at a
junction of
upper and
middle 3rd of
retromolar pad
No overbite
Overjet – 2mm

Steps of balancing
• Incline the mandibular 2nd
molar.
• Customized balancing ramp
placed at distal to
mandibular 2nd molar –
Tripod effect.
• Balancing ramp – improves
horizontal stability.
• Eccentric relation.
V Rangarajan – Textbook of prosthodontics, 1st edition. Elsevier, 2014.(Pg. no. 150) 126

Characteristics (No CROSS ARCH OR
CROSS TOOTH)
Southasain edition, Elsevier.
127

128
Protrusive – Christensen phenomenon

130

Indications
Abnormal closure imbalance, pathosis, trauma, neuromuscular disturbances.
Posterior displaceable mucosa.
Mutilated tortuous ridges with an excessive denture space.
Flat or knife edge ridges.
Chewing pattern is milling type with broad excursions.
Maximum vertical and minimum of horizontal force desired.
Class II and Class III jaw relations.
Southasain edition, Elsevier. 132

Advantages
More adaptable to
unusual jaw relations.
Easily used in variation
in width of maxillary
and mandibular jaw.
Impart a sense of
freedom.
Eliminate horizontal
forces.
Centric relation
developed to an area
instead of point.
Less time consuming.
Accommodate better to
negative changes in
ridge height.
133

Disadvantages
No vertical
component to
aid in shearing
during
mastication.
Lack of positive
intercuspation.
Esthetically
limited.
Occlude only in
2D.

Lingualized Occlusion
• Gysi, 1927.
• Payne, 1941.
Concepts of occlusion in prosthodontics: A literature review, part-II. J Indian
Prosthodont Soc. 2016 Jan-Mar;16(1):8-14.
135

CROSS TOOTH

138

Monoplane lingualized occlusion
140

Indications
Severe ridge
resorption
Interridge
discrepancy
Class II jaw
relationship
Implant
supported
overdenture
Free end
attachment
cases
CD opposite
to RPD
Para
functional
habit
Displaceable
supporting
tissue
141

Advantages
 Good stability
 Attributed of both anatomic and nonanatomic form are
retained.
 Vertical forces centralized on mandibular teeth.
 Reduced lateral forces.
 Good penetration of food bolus.
 Denture stability during parafunctional movements.
 Better aesthetics.
 Good for class II and class III jaw relations.
 Simpler technique.
 Ease of adjustment.

Disadvantages
Reduced interridge
distance
More wear
Less resistance of denture
base rotation than
balanced occlusion

Neutrocentric concept
• DeVan, 1954
• 5 elements Position
Proportion
Pitch
Form
Number
144

A. Position
145

B. Proportion 40% reduced
146

C. Pitch
147

D. Form
148

E. Number
149

Indications
Flat or heavily resorbed ridges
Cross bite
Class II jaw relations
Class III jaw relations
Malrelation of jaws
Uncoordinated jaw movement
150

Advantages
Simple and requires less precise
records
Lateral forces are reduced
Easier to adjust teeth
CO-CR discrepancy less destructive
151

Disadvantages
Impaired mastication
Less esthetic
152

Physiologically generated occlusion
(Mehringer)
153
CD fabrication till try in
Processing of only maxillary denture
20 conical disc – palatal region
Mandibular denture attached to plexiglass
Attaching central bearing device fitting to
upper conical disk

Functionally generated path
Lower teeth are arranged accordingly
Only 1 point contact on working side –
to stabilize and transmit force to lingual
cusp only
Prosthodont Soc. 2016 Jan-Mar;16(1):8-14
154

Linear occlusion
• Mandibular posterior teeth – straight, long,
narrow occlusal form – line.
• Maxillary posterior teeth – monoplane.
• Flat plane of occlusion.
• 0.020” VDR.
• Bilateral fulcrum of protrusive stability.
• On protrusion- blade form of mandibular 2nd
molar contacts maxillary 1st premolar bilaterally.
• Prevents anterior rotational contacts.
Prosthodont Soc. 2016 Jan-Mar;16(1):8-14
155

Summary
• Mandibular movements – Bennett shift
• Possett’s envelope of motion
• Natural v/s artificial teeth
• Requirements of complete denture
• Schemes of occlusion
• Concepts of occlusion
156

Balanced occlusion
Definition
Objectives
Mechanics
Concepts
Factors
Characteristics
Advantages
Indication
Contraindication
157

• Physiologically generated occlusion
158

Conclusion
• Many occlusal schemes have been proposed
over the years. Most schemes when correctly
used give satisfactory result. The result is
satisfactory, if the patient gets better function
esthetics and comfort without any adverse
change in denture foundation.
159

References
1. Sheldon Winkler- Essentials of Complete Denture
Prosthodontics, 3rd edition, AITBS publisher, 2017.
2. Charl M. Heartwell – Syllabus of Complete Dentures,
4th edition, K.M.Varghese company 1992.
3. Rudd, Morrow, Rhoads – Dental Laboratory
Procedure-Complete Denture, vol 1, 4th Southasain
edition, Elsevier.
4. John J Sharry- Complete Denture Prosthodontics, 3rd
edition, A. Blakiston.
5. Concepts of occlusion in prosthodontics: A literature
review, part-I. J Indian Prosthodont Soc. 2015 Jul-
Sep;15(3):200-205.
160

6. Concepts of occlusion in prosthodontics: A literature review,
part-II. J Indian Prosthodont Soc. 2016 Jan-Mar;16(1):8-14.
7. Boucher’s – Prosthodont Treatment for Edentulous Patient, 9th
edition, C.V. Mosby 1982.
8. John R. Ivanhoe – Textbook of complete denture 6th edition,
PMPH USA,2009
9. The Glossary of Prosthodontic Terms, 9th edition. J. Prosthet
Dent 2017 May; 117(5S):e1-e105.
10. Wheeler’s – Dental anatomy, physiology and occlusion, 9th
edition, Elsevier, 2012.
11. V Rangarajan – Textbook of prosthodontics, 1st edition.
Elsevier, 2014.
11. www.google.com
161

Occlusion in Complete Denture

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