Occlusion in Fixed Dental Prosthesis

Occlusion in Fixed Dental
Prosthesis
Presentation by:
Dr. Vanshree Sorathia
MDS Prosthodontist
Total no. of slides:
94

Objectivesof presentation
o Introduction
o Biomechanics of occlusion
o Effect of anatomical determinants
o Ideal occlusion
o Evolution of occlusion
o Concepts of Occlusion in FPD
o Occlusal contacts
o Occlusal Interferences
2

Objectivesof presentation
o Patient’s Adaptablity
o Pathogenic Occlusion
o Occlusal schemes
o Restoring Different Combinations
o Complete Occlusal Rehabilitation –
Philosophies of FMR
o Implant protected occlusion
o Review of literature
o Conclusion
3

Introduction
Ob+Claudre = ‘To close up’
Occlusion:
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. May 2017;
117(5S):e1-e105. 4

 Biomechanics of occlusion:
1. Anatomy of TMJ
2. Muscles of mastication
3. Mandibular movements
4. Posselt's envelope of motion
5

Idealocclusion
6
An occlusion which is compatible with
stomatognathic system providing efficient
mastication and good esthetics without
creating physiologic abnormalities.
- Hobo(1978)
Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed
prosthodontics. 5th ed. St. Louis: Elsevier 2016.

Characteristic of Ideal occlusion:
Stable Posterior contact with vertically directed resultant forces.
MIP coincident with CR along with freedom in centric.
No posterior contact in eccentric mandibular movements.
Contact of anterior teeth in harmony with functional jaw
movement.
Occlusion in Angle’s Class I.
7

Importance of ideal occlusion:
Assessment of pre-
treatment records
and examination
Correcting TMD and
occlusal interferences
For final prosthodontic rehabilitation -
confirmative or a reorganized approach
is utilized.
8

Effectof anatomicaldeterminants
9
Posterior
determinant:
• Condylar
guidance
Anterior
determinant
• Molar
disocclusion
• Anterior guidance
• Plane of occlusion
• Curve of spee
• Curve of wilson
Neuro-
masticatory
system
Herbert T. Shillinburg. Fundamentals of fixed prosthodontics. 4th edition,
Quintessence Publishing Co 2012.
Warreth A, EL-Swiah JM, Ramadan MMM, Elemam R. Fundamentals of
occlusion and restorative dentistry. Part I:Basic principles. J Irish Den Ass

A. Posterior determinant:
Influenced by:
1. Inclination of
articular eminence –
Protrusive condylar
path inclination
2. Medial wall of
glenoid fossa -
Mandibular lateral
translation
3. Shape of condyle
Herbert T. Shillinburg. Fundamentals of fixed prosthodontics. 4th
edition, Quintessence Publishing Co 2012. 10

Affected factors:
1. Vertical factors –
steepness of cusp
angle
2. Horizontal factors –
ridge and groove
direction
11
edition, Quintessence Publishing Co 2012.

1. Inclination of articular eminence: (average
angle – 30.4⁰)
2015 Oct.
12
The greater the angle of the articular
eminence, the greater the steepness of the
cuspal angle and the deeper the fossa.

2. Medial wall of glenoid fossa:
13
2015 Oct.
Greater immediate side shift.
Minimal immediate side shift.

3. Ridge and groove directions:
14
2015 Oct.
The angle between the
working (W) and
nonworking (NW) paths is
greater on teeth located
farther from the condyle.

Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics. 5th
ed. St. Louis: Elsevier 2016.
15
Posterior
Determinants
Variations Effect: Degree
of cuspal angle
Inclination of
articular eminence
Steeper More steeper
Flatter Less steep
Medial wall of
glenoid fossa
More lateral
translation
less steep
Minimal
translation
More steeper
Intercondylar
distance
Greater Smaller angle between
latertrusive and
mediotrusive movement
Lesser Increased angle
between mediotrusive
and laterotrusive
movement

B. Anterior determinant:
1. Molar disocclusion:
Measurement of disocclusion from mesiofacial cusp tip of
mandibular first molars: Hobo & Takayama 1984:
Therefore, posterior occlusion with Buffer
space.
16
Sumiya Hobo. Osseointegration and occlusal rehabilitation. Quintessence
Publishing Co.
Eccentric
movement
Molar
disocclusion
Buffer spacing
Working side 0.5mm 0.3mm
Non-working side 1.0mm 0.8mm
Protrusion 1.1mm 0.8mm

2. Anterior guidance:
17
The angle formed by the protrusive incisal path and the
horizontal reference plane.
It ranges from 50-70 degree and is often 5-10 degree
steeper than sagittal condylar guidance.
Protrusive incisal path
inclination:

18
a) A pronounced vertical overlap of the anterior teeth
permits posterior teeth to have longer cusps. (b) A minimum
anterior vertical overlap requires shorter cusps.

19
(a) A pronounced horizontal overlap of the anterior teeth
requires short cusps on the posterior teeth. (b) A minimum
anterior horizontal overlap permits the posterior cusps to
be longer.

20
While a shallow protrusive path would require short cusps
in the presence of minimal anterior guidance (a), the
posterior cusps can be lengthened if the anterior guidance is
increased (b).

21
(a) A pronounced immediate lateral translation would
dictate short cusps where there is little anterior guidance.
(b) However, the cusps can be lengthened if the anterior
guidance is increased.

Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics.
5th ed. St. Louis: Elsevier 2016. 22
Anterior
Determinants
Variations Effect: Degree
of cuspal angle
Overjet Increased Less steeper posterior
cusp
Reduced More steeper posterior
cusp
Overbite Increased More steeper posterior
cusp
Reduced Less steeper posterior
cusp

2. Plane of occlusion:
The cusp angles of posterior teeth are influenced
by the relationship between the occlusal plane and
the articular guidance.
Consequently, when the angle of the occlusal
plane is parallel or almost parallel to the condylar
guidance, the cusp height must be short and vice
versa.
23

24
3. Curve of spee:
The amount of separation (disclusion) between the
mandibular and maxillary posterior teeth is
dependent on the length of the radius of the curve
of Spee such as when the radius is short, the
separation is greater.
occlusion and restorative dentistry. Part I:Basic principles. J Irish Den Ass 2015

25
4. Curve of wilson:
A disturbance in the curve of Wilson may create an
occlusal interference. For example, when a
maxillary palatal cusp is tilted so it becomes below
the curve of Wilson, a non-working side
interference may be created and its correction is
necessary before restorative treatment can be
carried out.

Evolutionof occlusion
26
1927
Balanced
occlusion in
removable
denture
Alfred Gysi
1955
Fully balanced
occlusion in FPD
Charles Stuart
and McCollum
1960
Group function
occlusion
Schuyler
1963
Canine guided
occlusion
D’Amico

Gnathology
o First coined by Stallard in 1924.
o McCollum found the Gnathological society in
1926
o Stuart became associated with gnathological
society and published their classic “research
report” in 1955.
Definition: The fundaments of gnathology included
the concepts of CR, AG, OVD, the intercuspal
design, and the relationship of the determinants of
mandibular movements to the occlusion in fixed
dental prosthesis.
Pokorny PH, Weins JP, Litvak H. Occlusion for fixed
prosthodontics: A historical perspective of the gnathological
influence. J Prosthet Dent 2008 Apr;99:299-13.
27

Conceptsof occlusion
1. Bilaterally Balanced Occlusion
2. Unilaterally Balanced Occlusion
3. Mutually protected Occlusion
4. Organic occlusion
5. Beyron’s occlusal
6. Biologic or physiologic occlusion
28

1. Balanced occlusion
Synonyms: Bilaterally balanced occlusion
Proposed by: Ferdinand Graf Spee and
Monsoon; McCollum.
Principle: Distribute load evenly
Definition:
The bilateral, simultaneous, anterior, and
posterior occlusal contact of teeth in centric and
eccentric positions.
29
The Glossary of Prosthodontic Terms, 9th edition. J. Prosthet Dent. May
2017; 117(5S):e1-e105.

Centric position Protrusive
position
Working side Nonworking side
a) Anterior
teeth: No contact.
b) Posterior
teeth: Multiple
uniform occlusal
contacts.
a) Anterior teeth-
Maxillary and
mandibular teeth
contact.
b) Posterior
teeth- cusp to
cusp contact
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)
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).
30

1. Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed
2. Herbert T. Shillinburg. Fundamentals of fixed prosthodontics. 4th
edition, Quintessence Publishing Co 2012. 31

Drawbacks of BO for natural dentition:
a) Difficult to achieve in natural dentition.
b) Increased rate of occlusal wear.
c) Accelerated rate of periodontal
breakdown.
d) Neuromuscular disturbances.
prosthodontics. 5th ed. St. Louis: Elsevier 2016. 32

2. Group function occlusion
Synonyms: Unilaterally balanced occlusion
Proposed by: Dr Clyde Schuyler
Principle: Elimination of oblique forces on
nonworking side.
Definition:
Multiple contact relations between the maxillary and
mandibular teeth in lateral movements on the
working-side whereby simultaneous contact of
several teeth acts as a group to distribute occlusal
forces. - Glossary of
Prosthodontic Terms 9
33
117(5S):e1-e105.

Centric
position
Protrusive
position
Working side Nonworking
side
Posterior tooth
make contact.
Anterior tooth
may or may not
contact.
Canine and
posterior teeth
disocclude
Teeth contact
(most desirable
canine,
premolar,
mesiobuccal
cusp of first
premolar)
No tooth contact
34

Long Centric (Freedom in centric):
Synonyms: “Short protrusive”
Definition:
Freedom of movement in an anteroposterior direction
without any interferences and change in vertical
dimension.
- Glossary of Prosthodontic Terms 9
Ranges from: 0.5- 1.5mm.
35
117(5S):e1-e105.

Peter E Dawson:
Freedom to close the mandible either into centric
relation or slightly anterior to it without varying the
vertical dimension at the anterior teeth.
Features of long centric:
1. Involves primarily the
anterior teeth.
2. It refers from freedom
from centric, not
freedom in centric.
Peter E. Dawson, Functional Occlusion from TMJ to Smile Design,
Mosby Elsevier 2007. 36

Point centric:
o When centric occlusion coincides with centric
relation.
o Maximum intercuspation in centric relation.
37
2015 Oct.

Seen in:
1. Patients with worn out canine.
2. Class III malocclusion.
Indication:
1. Functionally generated path technique, described
by Meyer.
2. Anterior teeth with lost periodontal support.
3. Anterior open bite.
4. Increased crown : root ratio.
5. Class I malocclusion with increased overjet.
6. Missing canine
38
2015 Oct.

Contraindication:
Periodontically compromised posterior tooth.
Advantages:
1. Lateral pressure are distributed to all
working side tooth.
2. Long centric, hence allow some freedom
of movement in anteroposterior direction.
2015 Oct.
39

3. Mutually protected occlusion
Synonyms: Canine guidance occlusion
Proposed by: Stuart and Stallard and D’Amico
1963.
Principle: Minimizing horizontal loading on posterior
teeth.
Definition:
An occlusal scheme in which the posterior teeth
prevent excessive contact of the anterior teeth in
maximal intercuspal position, and the anterior teeth
disengage the posterior teeth in all mandibular
excursive movements. - Glossary of
Prosthodontic Terms 9
40
Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics.
5th ed. St. Louis: Elsevier 2016.

Centric
position
Protrusive
position
Working side Nonworking
side
Only posterior
teeth make
contact.
Anterior teeth
have a space of
minimum 30
microns.
Canine and
posterior teeth
disocclude.
Mesial inclines
of mandibular
first premolar -
buccal cusp
may contact.
Maxillary canine
guide the
mandible.
Posterior teeth
disocclude
No tooth contact
41

Why canines?
1. Stuart – higher minimal
lateral threshold.
2. Corkin & Harrison – most
sensitive intraoral
structures to blunt
stimulation.
3. Krunger & Michel – higher
concentration of neurons.
4. Siebert – movements
within physiologic limits.
5. Goldstein – periodontal
index.
42
2015 Oct.

Why canines?
6. Favourable root
anatomy
7. Lower crown : root
ratio
8. Supported by dense
and compact bone
9. Strategic position in
jaw
10.Many receptors in PDL
43
2015 Oct.

Advantages:
1. Patient’s tolerance
2. Ease of Construction
Indication:
1. Attrided posterior teeth
2. Gingival recession
3. TMD
4. Abfraction
Contraindication:
1. Periodontally weak anterior teeth
2. Missing Canine
3. Class II and Class III situation
4. Cross-bite situation

Optimum occlusion
In an ideal occlusal arrangement, the load
exerted on the dentition should be
distributed optimally.
Bakke et al - Occlusal contact influences
muscle activity during mastication.
Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics. 5th
ed. St. Louis: Elsevier 2016. 45

Features of Mutually Protected Occlusion:
1. Uniform contact of all - when the mandibular condylar
processes are in their most superior position.
2. Stable posterior tooth contacts with vertically directed
resultant forces.
3. CR = MIP.
4. No contact of posterior teeth in lateral or protrusive
movement.
5. Anterior tooth contacts harmonizing with functional
jaw movements.
46

Requirements to achieve MPO:
1. A full complement of teeth exists
2. The supporting tissues are healthy
3. There is no cross bite, and
4. The occlusion is Angle Class I
47

o Canines and incisors: effectiveness of
force exerted by muscles of mastication is
less.
o Dawson (1974): “Anterior group function”
o Theory of Nutcraker
48
Rationale:

Recap
Balanced occlusion
Groupfunctionocclusion
Mutuallyprotected occlusion
50

4. Organic occlusion
Proposed by: Thompson (1967).
Features:
1. CRP and MIP are coincident.
2. Posterior teeth are in a cusp fossa relation.
3. Each functional cusp contacts the occlusal fossa
at three points.
4. Protrusion: posterior disocclusion.
5. Lateral movements – lingual surface of maxillary
canine glides along the distal inclines of
mandibular canine and mesial ridge of 1st
premolar cusp.
Pokorny PH, Weins JP, Litvak H. Occlusion for fixed prosthodontics: A
historical perspective of the gnathological influence. J Prosthet Dent 2008
Apr;99:299-13.
51

5. Beyron’s occlusal concepts
Proposed by: Beyron
Principle:
Based on functional convenience and avoidance of
discomfort.
Advocated freedom in centric concept & canine
guided occlusion.
52
Apr;99:299-13.

6. Biologic or physiologic
occlusion
Proposed by: Becker and Kaiser 1993.
Definition:
An occlusion in which a functional equilibrium or state
of homeostasis exist between all tissues of masticatory
system.
o A physiologic occlusion - a balance between
occlusal stress and tissue resistance.
o Biologic processes and local environmental factors
are in balance.
Apr;99:299-13.
53

Occlusal contacts in MIP
A. Supporting cusp
against a flat surface
1. Single cusp tip
to fossa or
marginal ridge
contact
2. Twin cusp
stability
B. Occlusal
contacts on
inclined planes
1. A-type
2. B-type
3. C-type
Warreth A, Mo O. Fundamentals of occlusion and restorative dentistry. Part I:
occlusal contacts, interferences and occlusal considerations in implant patients. J
Irish Den Ass 2015 Oct.
54

A. Supporting cusp against a flat surface
Warreth A, Mo O. Fundamentals of occlusion and restorative dentistry. Part
II: occlusal contacts, interferences and occlusal considerations in implant
patients. J Irish Den Ass 2015 Oct.
55
A single cusp tip in contact with a flat surface (A); a twin cusp
contact when both maxillary and mandibular supporting cusps make
contact
with opposing fossae (B).

B. Occlusal contacts on inclined planes
56
Occlusal contacts on an
inclined plane surface: A, B and C
occlusal contacts.
Teeth are susceptible to
tipping when A and C contacts are
present without B contact.

Occlusal Interferences:
Interferences:
Are undesirable occlusal contacts that may
produce mandibular deviation during closure
to maximum intercuspation or may hinder
smooth passage to and from the intercuspal
position.
57

Four types of interferences:
58
Centric
Protrusiv
e
Working
Non-
working

Patient’s Adaptablity:
59
 Lowered threshold
 Raised threshold

Pathogenic occlusion
Definition:
Occlusal relationship capable of producing
pathologic changes in the stomatognathic
system. In such occlusions sufficient
disharmony exists between the teeth and
the TMJs to result in symptoms that require
intervention. – GPT 9

Signs & Symptoms of pathologic
occlusion–
61
Teeth Periodontium
Mobility Chronic Periodontal
disease
Open contacts Widened PDL Space
(Radiographically)
Abnormal wear like
fracture or chipping of
incisal edges
Tooth Movement and
A compromised C:R
Ratio.

Treatment:
62
Short Term Treatment:
Occlusal Splints/devices
Definitive treatment:
Compromising
individually or in
combination:
Deprogram the occlusion Orthodontic treatment to
correct malalignment
Act as a diagnostic tool Elimination of deflective
occlusal contacts
Beneficial in relieving
myofacial pain.
Replacement of missing
teeth

Occlusal schemes
Two
approaches
Confirmative
approach
Reorganized
approach
Warreth A, Mo O. Fundamentals of occlusion and restorative dentistry. Part
I: occlusal contacts, interferences and occlusal considerations in implant
patients. J Irish Den Ass 2015 Oct.
63

1. Confirmative approach
Indication:
1. Original occlusion is to be maintained.
2. When MIP is satisfactory.
3. Small segment of restoration.
4. Vertical stop present.
Favoured approach, because it is simple, predictable and
safe, as little or no adaptation of patient’s neuromuscular
system is needed.
64

2. Reorganized approach
Indication:
1. When construction of new occlusal scheme is
needed.
2. When MIP is not satisfactory.
3. When an increase in vertical dimension is
required.
4. Full mouth rehabilitation.
5. Long span FPD.
Provides the mutually protected occlusion.
65

Restoring Different Combinations
Prosthesis Position Articulator
and records
Occlusal
morphology
Single crown ICP Simple hinge Conform to
occlusal
morphology
FPD – one
quadrant
ICP Semi-
adjustable /
anterior
guidance
Conform to
occlusal
morphology
Several
quadrants
Long
centric
Fully adjustable
/ AG and CG
Group
function
/Cusp to
fossa 66

COMPLETE OCCLUSAL
REHABILITATION –
PHILOSOPHIES OF FMR
67

Panky-
Mann
Schuyler
philosophy
Hobo Twin
Table
philosophy
Hobo Twin
Stage
philosophy
68

Panky-Mann Schuyler
philosophy
Proposed by: Dr. L.D. Pankey and Dr. Clyde
Schuyler in 1960.
Principles:
1. Static co-ordinated occlusal contacts - centric
relation.
2. An anterior guidance
3. Disclusion - posterior teeth in protrusion.
4. Disclusion - nonworking inclines in lateral
excursions
5. Group function - working side inclines in lateral
excursions.
Mann AW, Pankey LD. Oral rehabilitation. Part I: Use of the PM-instrument in
treatment planning and in restoring the lower posterior teeth. J Prosthet Dent
1960;10:135-50.
69

Treatment sequence:
Part-1: Examination, diagnosis, treatment planning and
prognosis.
Part-2: Harmonization of the anterior guidance for best
possible esthetics, function and comfort.
Part-3: Selection of an acceptable occlusal plane and
restoration of the lower posterior occlusion in harmony
with the anterior guidance.
Part-4: Restoration of the upper posterior occlusion in
harmony with the anterior guidance and condylar guidance
by using FGPT.
70
1960;10:135-50.

Diagnose and plan
treatment - before a
single tooth is
prepared.
Well organized and
a logical procedure.
Never a need for
preparing more than
eight teeth at a time.
Divides the
rehabilitation into
separate series of
appointments.
No danger losing the
patient’s present
vertical dimension.
No need for time
consuming
techniques and
complicated
equipment.
Laboratory
procedures are
simple
71
Advantages:
treatment planning and in restoring the lower posterior teeth. J Prosthet
Dent 1960;10:135-50.

Disadvantages:
1. FGPT
2. Periodontically compromised patients.
3. P-M instrument.
Indication:
Excessive wear with loss of vertical
dimension with available space (Cat 1of TM
classification).
72
1960;10:135-50.

Hobo Twin Table philosophy
Inventor: Sumiya Hobo and Hisao Takayama in 1991.
Principle:
Anterior guidance influenced the working condylar path
and concluded that they were dependent factors.
Posterior disocclusion is dependent on angle of hinge
rotation and cusp shape factor.
Indication:
Excessive wear without loss of occlusal vertical
dimension but with space available (Cat 2 of TM
classification).
Hobo S, Twin-tables techniques for occlusal rehabilitation. Part I. Mechanism of
anterior guidance. J Prosthet Dent 1991;66:299-03. 73

Technique:
Utilizes 2 different customized incisal guide
tables
1. Incisal table without disocclusion
2. Incisal guidance with disocclusion
Hobo S. Twin table technique for occlusal rehabilitation. Part II. Clinical
procedures. J Prosthet Dent 1991;60:471-77. 74

Disadvantages:
1. Too steep cusp angle which makes
incisal table to be set an angle that was
too steep, which made patient
uncomfortable.
2. Technique sensitive as anterior guide
table was fabricated by resin molding.
Hobo S. Twin table technique for occlusal rehabilitation. Part II. Clinical
procedures. J Prosthet Dent 1991;60:471-77. 75

Hobo Twin Stage philosophy
Inventor: Sumiya Hobo and Hisao
Takayama 1997.
Principle:
The cusp angle is used as the main
determinant of occlusion because of its
reliability. Cusp shape factor and CG –
Independent factors.
Hobo S, Takayama H. Twin-Stage Procedure. Part I: A new method to reproduce
precise eccentric occlusal relations. Int J Periodont Rest Dent 1997;17:113-23. 76

Indication:
1. Excessive wear without loss of occlusal vertical
dimension but with limited space available (Cat
3 TM classification).
2. Excessive wear with loss of vertical dimension
with available space (Cat 1 of TM
classification).
Contraindications:
1. Abnormal curve of Spee
2. Abnormal curve of Wilson
3. Abnormally rotated tooth
4. Abnormally inclined tooth.
Hobo S, Takayama H. Twin-Stage Procedure. Part I: A new method to reproduce
precise eccentric occlusal relations. Int J Periodont Rest Dent 1997;17:113-23.
77

Mutually
protected
occlusion
Group function
occlusion
Balanced
occlusion
Protrusion 1.0 1.0 0.0
Non-working
side
1.0 0.5 0.0
Working side 1.5 0.0 0.0
Hobo S, Takayama H. Twin-Stage Procedure. Part II: A clinical evaluation. Int J
Periodontics Restorative Dent 1997;17:456-63. 78
Amount of disocclusion of molars for each occlusal scheme
(mm):

Condition I Condition II
Condylar path
Sagittal condylar
path inclination
Bennett angle
25
15
40
15
Anterior guide table
Sagittal inclination
Lateral wing angle
25
10
45
20
Hobo S, Takayama H. Twin-Stage Procedure. Part II: A clinical evaluation.
Int J Periodontics Restorative Dent 1997;17:456-63. 79
Articulator adjustment values for mutually protected
articulation (degrees):

Condylar path
Sagittal condylar
path inclination
Bennett angle
25
15
40
15
Anterior guide
table
Sagittal
inclination
Lateral wing angle
25
10
45
0
Periodontics Restorative Dent 1997;17:456-63. 80
Articulator adjustment values for group function

Condylar path
Sagittal condylar
path inclination
Bennett angle
25
15
25
15
Anterior guide
table
Sagittal inclination
Lateral wing angle
25
10
25
10
Periodontics Restorative Dent 1997;17:456-63.
81
Articulator adjustment values for balanced

Swaminathan Y, Rao Y. Implant protected occlusion. J Dent Med Sci 2013 Nov-
Dec;11:20-25.
82
No premature occlusal contacts or interferences ( timing of occlusal
contacts)
Influence of surface area
Mutually protected articulation
Implant body angle to occlusal load
Cusp angle of crown ( cuspal inclination )
Cantilever or offset distance
Crown height
Occlusal contact position
Implant crown contour
Implant - protected occlusion

Reviewof literature- 1
Shah SN, Khan S, Murtaza S, Ahmad A. Study of tooth wear in canine guidance
versus group function occlusion. JKCD dec 2014;5(1):29-32.
83

Abduo J ,Tennant M. Impact of lateral occlusion schemes: A systematic review. J
Prosthet Dent 2015;114:193-204. 84

What is the influence of the lateral occlusion
scheme on patient comfort, masticatory system
physiology, and prosthesis longevity?
Group 1: Evaluated the immediate response to
alteration of the lateral occlusion scheme.
Group 2: The studies investigated patient
response, restoration longevity, and
complications in situations resembling routine
clinical practice.
Miralles R. Canine-guide occlusion and group function
occlusion are equally acceptable when restoring the dentition. The Journal of
Evidence-Based Dental Practice 2016.
85

Results:
1. Some differences - parafunctional muscle
activities and the magnitude of mandibular
movement. However, physiologic function and
patient acceptance appear to be minimally.
2. CGO and GFO are equally acceptable when
restoring the dentition.
3. Similar lateral occlusion principles can be
considered for implant prosthesis.
86
Miralles R. Canine-guide occlusion and group function
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