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“Establishment of Occlusal
Relationship in Removable Partial
Dentures”
1
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
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Slide 2
Contents
•Diagnosis & treatment planning
•Articulator selection
•Jaw relation recording & interocclusal
record
•Selection of denture teeth
•Choice of Occlusal schemes & morphologies
•Objectives for establishing occlusal schemes
•Occlusal morphologies
•Plane of orientation
•Determining the occlusal scheme
•Summary & conclusion 2
Introduction
•Any partially edentulous
situation is a derailment of
occlusion
3
INTRODUCTION:
Introduction
•The natural & artificial dentition
must coexist functionally &
esthetically in a harmonious
relationship
•The knowledge, judgment,
understanding & skill of each
dentist is more important in
treating patients rather than
the techniques or concept of
occlusion
4
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Slide 5
•A review of patients
medical & dental history
Diagnosis & treatment planning:
•A complete clinical
examination
•Mounted diagnostic cast on a semi
adjustable articulator using face bow
transfer & interocclusal record.
5
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Slide 6
Preprosthetic treatment
6
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Slide 7
Analyzing & correction of occlusal plane
•Orthodontic tooth movement
•Intentional devitalization
•periodontal surgeries
•Selective occlusal adjustment
7
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Slide 8
Treatment modalities
•No prejudice
towards any
particular occlusion
•Both group function & mutually
protected articulation exists in
natural dentition
•Alteration of existing physiologic
state may create a traumatic
occlusion 8
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Slide 9
Articulator selection
•Information regarding occlusal
analysis
•Aids in diagnostic wax up
•Assists in final treatment plan
Diagnostic phase
9
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Slide 10
Treatment phase
•Fabrication of physiologic cusp
•Correct tooth positioning
•Relate casts in static relation to the
Condyle & stimulate eccentric movements
10
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Jaw relation recording
•If sufficient opposing posterior natural
teeth present, cast can be hand
articulated.
11
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•When there are sufficient natural
teeth present but the opposing teeth
cannot be occluded in a stable
position,partial record blocks are made
& an indentation of opposing natural
teeth taken
12
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Slide 13
•If there not sufficient opposing
natural teeth, jaw relation need to be
recorded with the occlusal rims &
interocclusal record as in complete
denture
13
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Slide 14
Interocclusal records
•Interocclusal orientation required to
orient the maxillary & mandibular
diagnostic & master cast
•Interocclusal relation not required if
sufficient occlusion remains to provide
stable cast to cast relation
•A record base,occlusal rim & occlusal
recording medium necessary to make
an accurate record 14
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Slide 15
Interocclusal record contd.
•Centric relation position or maximum
intercuspation
•Establishment of vertical dimension of
occlusion
•Should allow positive alignment of
cast
•Dimensionally stable
•Minimal displacement of tissues
•Easy manipulation 15
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Slide 16
Selection of denture teeth
•Acrylic resin
•Porcelain
•Metal
16
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Slide 17
Choice of occlusal schemes &
morphologies
Occlusal schemes
•Mutually protected articulation
•Canine protected articulation
•Centric occlusion coincide with
centric relation
•Group function articulation
•Neutrocentric articulation
17
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Objectives for establishing occlusal
schemes
•Tooth supported or tooth –tissue
supported situation maximum intercuspal
position should be maintained
•Bilateral simultaneous
contacts of teeth in
posterior position ,
anterior contact should
be passive in maximum
intercuspation 18
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Slide 19
•In protrusive movement anterior
clearance should be present
Objectives for establishing occlusal
schemes contd.
•If possible patients
existing occlusal scheme in
lateral movement should
not be altered
•When remaining natural canines are
present & periodontally sound ,canine
protected articulation is preferred 19
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Slide 20
Objectives for establishing occlusal
schemes contd.
•In case of missing or periodontally
weak canines, group function
articulation is preferred.
•Non working contacts on
natural teeth should not
be established
•When periodontally sound natural
anterior teeth present, no posterior
contact in protrusive movement 20
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Slide 21
Occlusal morphologies
•Zero degree or monoplane teeth
•Semianatomic (10o
– 30o
)
•Fully anatomic (30o
– 45o
)
Based on the occlusal morphologies
•Balanced articulation
•Monoplane articulation
21
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Monoplane teeth
•Seldom indicated in removable partial
unless they oppose a similar
articulation
Indications
22
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Anatomic teeth contd.
Indications
•Where esthetics is of primary concern
•Where balanced or group function
articulation is desired
•Anterior guidance due to presence of
natural teeth
•Cuspal inclination of existing natural
teeth
23
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Slide 24
Semianatomic teeth
•10o
– 30o
cuspal inclination
Plane of orientation
•Class III & class IV situation plane
of orientation determined by existing
natural dentition
24
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Slide 25
Plane of orientation contd.
•Class I & class II situation plane of
orientation determined by cusp tip of
the distal most natural teeth up to
anterior 23 of retromolar pad
•In case of inadequate interocclusal
space or weaker arch alteration in plane
of orientation required. 25
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Slide 26
Determining the occlusal scheme
Kennedy's class III situation
•Occlusal morphology of the artificial
teeth selected to match that of the
opposing teeth. 26
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Slide 27
•If existing occlusion healthy, patient
is restored to the existing occlusal
scheme
27
•Natural canine missing or periodontally
Compromised group function is indicated
28
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Slide 29
Kennedy's class III situation Contd.
•Balanced articulation recommended if
Restoration opposing complete denture
29
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Slide 30
Kennedy's class II situation
30
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Slide 31
Kennedy's class II situation contd.
•Presence of periodontally sound
canine, canine guided occlusion should
be given
31
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Slide 32
•Except opposing a complete denture
Balanced articulation should be
avoided
Kennedy's class II situation contd.
•Absent or periodontally weak canine
group function should be given
32
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Slide 33
Kennedy's class I situation
•Balanced articulation is indicated
when Canine guided articulation is
not possible
33
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Slide 34
Kennedy's class IV situation
•Passive tooth contact
in both centric
& eccentric movement
•Balanced articulation against
a complete
Denture with protrusive
contacts of the
anteriors 34
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Slide 35
Kennedy's class V situation
•Presence of periodontally sound
canine, canine guided occlusion should
be given
35
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Slide 36
Kennedy's class VI situation
•Same as class III situation
•If existing occlusion healthy,
patient is restored to the
existing occlusal scheme
•Natural canine
missing or
periodontally
Compromised, group
function is indicated 36
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Slide 37
Summary
•Selected scheme must be capable of
functioning Within the pattern of
patient’s own functional requirements
•Opposing contacting teeth should glide
Freely without cuspal interference
37
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Slide 38
•The appropriate jaw relation suitable
for the situation, whether it is centric
relation or centric occlusion should be
determined in the diagnostic phase &
attempts to create an artificial occlusal
surface should be preceded by the
elimination of any occlusal
discrepancies in the natural teeth
38
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Slide 39
•The combined occlusal pattern of
natural & artificial teeth function
harmoniously with other parts of
masticatory system
39
conclusion
•In the restoration of partial edentulousIn the restoration of partial edentulous
situations it is essential that both thesituations it is essential that both the
natural & the artificial dentition shouldnatural & the artificial dentition should
maintain a harmonious relationmaintain a harmonious relation
•There should be even contact & no
undue contact forces should be exerted
on any part of the restoration
•If possible restoration should be done
in the patients existing physiologic state
40
Thank you 41
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Slide 42
ReferencesReferences
 ““Removable Partial Prosthodontics”-Mc Cracken’sRemovable Partial Prosthodontics”-Mc Cracken’s
 ““Clinical Removable Partial Prosthodontics”-Clinical Removable Partial Prosthodontics”-
Stewart, Rudd et al.Stewart, Rudd et al.
 ““Occlusion in Removable Partial Prosthodontics”-Occlusion in Removable Partial Prosthodontics”-
JPD-2004:91:1-5JPD-2004:91:1-5
 ““Colour atlas of removable partial denture”-GeorgeColour atlas of removable partial denture”-George
grabergraber
 ““Colour atlas of removable Partial Dentures”-Colour atlas of removable Partial Dentures”-
J.C.Davenport & Basker.J.C.Davenport & Basker.
 ““Dental Laboratory Procedures” Rudd & MorrowDental Laboratory Procedures” Rudd & Morrow
 ““Removable Prosthodontics” – DCNA 2004;48:3Removable Prosthodontics” – DCNA 2004;48:3
42

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Establishment of occlusal relationship in rpd/endodontic courses

  • 1. “Establishment of Occlusal Relationship in Removable Partial Dentures” 1 INDIAN DENTAL ACADEMY Leader in continuing Dental Education
  • 2. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 2 Contents •Diagnosis & treatment planning •Articulator selection •Jaw relation recording & interocclusal record •Selection of denture teeth •Choice of Occlusal schemes & morphologies •Objectives for establishing occlusal schemes •Occlusal morphologies •Plane of orientation •Determining the occlusal scheme •Summary & conclusion 2
  • 3. Introduction •Any partially edentulous situation is a derailment of occlusion 3
  • 4. INTRODUCTION: Introduction •The natural & artificial dentition must coexist functionally & esthetically in a harmonious relationship •The knowledge, judgment, understanding & skill of each dentist is more important in treating patients rather than the techniques or concept of occlusion 4
  • 5. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 5 •A review of patients medical & dental history Diagnosis & treatment planning: •A complete clinical examination •Mounted diagnostic cast on a semi adjustable articulator using face bow transfer & interocclusal record. 5
  • 6. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 6 Preprosthetic treatment 6
  • 7. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 7 Analyzing & correction of occlusal plane •Orthodontic tooth movement •Intentional devitalization •periodontal surgeries •Selective occlusal adjustment 7
  • 8. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 8 Treatment modalities •No prejudice towards any particular occlusion •Both group function & mutually protected articulation exists in natural dentition •Alteration of existing physiologic state may create a traumatic occlusion 8
  • 9. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 9 Articulator selection •Information regarding occlusal analysis •Aids in diagnostic wax up •Assists in final treatment plan Diagnostic phase 9
  • 10. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 10 Treatment phase •Fabrication of physiologic cusp •Correct tooth positioning •Relate casts in static relation to the Condyle & stimulate eccentric movements 10
  • 11. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 11 Jaw relation recording •If sufficient opposing posterior natural teeth present, cast can be hand articulated. 11
  • 12. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 12 •When there are sufficient natural teeth present but the opposing teeth cannot be occluded in a stable position,partial record blocks are made & an indentation of opposing natural teeth taken 12
  • 13. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 13 •If there not sufficient opposing natural teeth, jaw relation need to be recorded with the occlusal rims & interocclusal record as in complete denture 13
  • 14. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 14 Interocclusal records •Interocclusal orientation required to orient the maxillary & mandibular diagnostic & master cast •Interocclusal relation not required if sufficient occlusion remains to provide stable cast to cast relation •A record base,occlusal rim & occlusal recording medium necessary to make an accurate record 14
  • 15. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 15 Interocclusal record contd. •Centric relation position or maximum intercuspation •Establishment of vertical dimension of occlusion •Should allow positive alignment of cast •Dimensionally stable •Minimal displacement of tissues •Easy manipulation 15
  • 16. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 16 Selection of denture teeth •Acrylic resin •Porcelain •Metal 16
  • 17. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 17 Choice of occlusal schemes & morphologies Occlusal schemes •Mutually protected articulation •Canine protected articulation •Centric occlusion coincide with centric relation •Group function articulation •Neutrocentric articulation 17
  • 18. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 18 Objectives for establishing occlusal schemes •Tooth supported or tooth –tissue supported situation maximum intercuspal position should be maintained •Bilateral simultaneous contacts of teeth in posterior position , anterior contact should be passive in maximum intercuspation 18
  • 19. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 19 •In protrusive movement anterior clearance should be present Objectives for establishing occlusal schemes contd. •If possible patients existing occlusal scheme in lateral movement should not be altered •When remaining natural canines are present & periodontally sound ,canine protected articulation is preferred 19
  • 20. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 20 Objectives for establishing occlusal schemes contd. •In case of missing or periodontally weak canines, group function articulation is preferred. •Non working contacts on natural teeth should not be established •When periodontally sound natural anterior teeth present, no posterior contact in protrusive movement 20
  • 21. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 21 Occlusal morphologies •Zero degree or monoplane teeth •Semianatomic (10o – 30o ) •Fully anatomic (30o – 45o ) Based on the occlusal morphologies •Balanced articulation •Monoplane articulation 21
  • 22. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 22 Monoplane teeth •Seldom indicated in removable partial unless they oppose a similar articulation Indications 22
  • 23. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 23 Anatomic teeth contd. Indications •Where esthetics is of primary concern •Where balanced or group function articulation is desired •Anterior guidance due to presence of natural teeth •Cuspal inclination of existing natural teeth 23
  • 24. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 24 Semianatomic teeth •10o – 30o cuspal inclination Plane of orientation •Class III & class IV situation plane of orientation determined by existing natural dentition 24
  • 25. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 25 Plane of orientation contd. •Class I & class II situation plane of orientation determined by cusp tip of the distal most natural teeth up to anterior 23 of retromolar pad •In case of inadequate interocclusal space or weaker arch alteration in plane of orientation required. 25
  • 26. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 26 Determining the occlusal scheme Kennedy's class III situation •Occlusal morphology of the artificial teeth selected to match that of the opposing teeth. 26
  • 27. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 27 •If existing occlusion healthy, patient is restored to the existing occlusal scheme 27
  • 28. •Natural canine missing or periodontally Compromised group function is indicated 28
  • 29. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 29 Kennedy's class III situation Contd. •Balanced articulation recommended if Restoration opposing complete denture 29
  • 30. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 30 Kennedy's class II situation 30
  • 31. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 31 Kennedy's class II situation contd. •Presence of periodontally sound canine, canine guided occlusion should be given 31
  • 32. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 32 •Except opposing a complete denture Balanced articulation should be avoided Kennedy's class II situation contd. •Absent or periodontally weak canine group function should be given 32
  • 33. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 33 Kennedy's class I situation •Balanced articulation is indicated when Canine guided articulation is not possible 33
  • 34. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 34 Kennedy's class IV situation •Passive tooth contact in both centric & eccentric movement •Balanced articulation against a complete Denture with protrusive contacts of the anteriors 34
  • 35. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 35 Kennedy's class V situation •Presence of periodontally sound canine, canine guided occlusion should be given 35
  • 36. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 36 Kennedy's class VI situation •Same as class III situation •If existing occlusion healthy, patient is restored to the existing occlusal scheme •Natural canine missing or periodontally Compromised, group function is indicated 36
  • 37. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 37 Summary •Selected scheme must be capable of functioning Within the pattern of patient’s own functional requirements •Opposing contacting teeth should glide Freely without cuspal interference 37
  • 38. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 38 •The appropriate jaw relation suitable for the situation, whether it is centric relation or centric occlusion should be determined in the diagnostic phase & attempts to create an artificial occlusal surface should be preceded by the elimination of any occlusal discrepancies in the natural teeth 38
  • 39. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 39 •The combined occlusal pattern of natural & artificial teeth function harmoniously with other parts of masticatory system 39
  • 40. conclusion •In the restoration of partial edentulousIn the restoration of partial edentulous situations it is essential that both thesituations it is essential that both the natural & the artificial dentition shouldnatural & the artificial dentition should maintain a harmonious relationmaintain a harmonious relation •There should be even contact & no undue contact forces should be exerted on any part of the restoration •If possible restoration should be done in the patients existing physiologic state 40
  • 42. © 2003 By Default! A Free sample background from www.powerpointbackgrounds.com Slide 42 ReferencesReferences  ““Removable Partial Prosthodontics”-Mc Cracken’sRemovable Partial Prosthodontics”-Mc Cracken’s  ““Clinical Removable Partial Prosthodontics”-Clinical Removable Partial Prosthodontics”- Stewart, Rudd et al.Stewart, Rudd et al.  ““Occlusion in Removable Partial Prosthodontics”-Occlusion in Removable Partial Prosthodontics”- JPD-2004:91:1-5JPD-2004:91:1-5  ““Colour atlas of removable partial denture”-GeorgeColour atlas of removable partial denture”-George grabergraber  ““Colour atlas of removable Partial Dentures”-Colour atlas of removable Partial Dentures”- J.C.Davenport & Basker.J.C.Davenport & Basker.  ““Dental Laboratory Procedures” Rudd & MorrowDental Laboratory Procedures” Rudd & Morrow  ““Removable Prosthodontics” – DCNA 2004;48:3Removable Prosthodontics” – DCNA 2004;48:3 42