This document discusses establishing occlusal relationships for removable partial dentures. It describes desirable contact relationships including simultaneous contacts in centric occlusion and working side contacts. Methods for recording occlusal relationships are outlined, including direct apposition of casts, interocclusal records, occlusal rims on record bases, and recording occlusal pathways. Considerations for establishing occlusion when opposing a maxillary complete denture are also summarized.

1. WELCOME

2. OCCLUSAL RELATIONSHIP
for
REMOVABLE PARTIAL DENTURE

3. OCCLUSAL RELATIONSHIPS
FOR
REMOVABLE PARTIAL DENTURE
DR. MD. ALIMUL RAJI
PHASE-B RESIDENT
M.S. IN PROSTHODONTICS
CHAIRPERSON
Prof. DR. MD. MAHBUBUR RAHMAN
BDS, DDS, PhD
Chairman
Dept. of Prosthodontics
BSMMU
MODERATOR
Asso. Prof. DR. MD. MASUDUR
RAHMAN
BDS, MS, FCPS
Associate Professor
Dept. of Prosthodontics
BSMMU

4. TABLE OF CONTENTS
 Abstract
 Introduction
 Objective
 Keymarks on Removable Partial Denture Occlusion
 Diserable Occlusal Contact Relationships
 Methods for Establishing Occlusal Relationships
 Some Considerations Regarding Occlusal Recording
 Establishing Jaw Relations for a Mandibular RPD opposing a Maxillary
CD
 Summary

5. ABSTRACT
After the mouth preparation and abutment preparation , the next
procedure in the fabrication of Removable Partial Denture is
determining and Establishing a occlusal relation for a balanced,
functional and stable prosthesis .
For a satisfactory occlusion, this we need to know about the
occlusal concepts for removable prosthesis, the desirable contact
relationships for removable partial dentures and also the methods
for establishing this. We’ll discuss over this through the time .

6. Occlusal Relationship is an area of
Removable Partial Prosthodontics where
stability under function is the major
concern, and where knowledge must be
applied to create a functional and
harmonious occlusion. It is the fourth
phase in the treatment of patients with
removable partial dentures.

7. Regarding occlusion, Thompson has written,
“Observing the occlusion with the teeth in static
relations and then moving the mandible into various
eccentric positions is not sufficient. A dynamic concept
is necessary to produce an occlusion that is in functional
harmony with the facial skeleton, the musculature, and
the TMJ.”
By adding “and with the remaining natural teeth,” the
requirements for removable partial denture occlusion
are more completely defined.

8. OBJECTIVE
• To establish harmony between the denture and the
natural teeth and surrounding tissue.
• Maintenance of vertical dimension.
• Preservation of the health of the surrounding
structures .
• Occlusal balance and harmony in eccentric
positions.

9. KEY MARKS
of
REMOVABLE PARTIAL
DENTURE OCCLUSION

10. • In establishing occlusion on a removable partial
denture, the influence of the remaining natural
teeth is usually such that the occlusal forms of the
teeth on the removable partial denture must be
made according to an already established occlusal
pattern. Occlusal adjustment or restoration may
have altered this pattern.
• The pattern present at the time the RPD is made
dictates the Occlusion.
Influence of the remaining natural teeth :

11. (Cont'd)
• Exceptions :
- opposing complete denture
or, anterior teeth remain in both arches
- in these situations, jaw relation
record & arrangement of teeth is done as like in
complete denture and same general principles

12. • With all other types of removable partial
dentures, the remaining teeth dictate the
occlusion.
• The dentist should strive for planned contacts
in centric occlusion and no interferences in
lateral excursions.
(Cont'd)

13. Establishment of a satisfactory occlusion for the
removable partial denture patient :
(1)analysis of the existing occlusion;
(2) correction of existing occlusal disharmony;
(3) recording of centric relation or an adjusted centric occlusion;
(4) harmonizing of eccentric jaw movements for a functional eccentric
occlusion; and
(5) correction of occlusal discrepancies created during processing of the
removable partial denture.

14. Failure to Provide and maintain adequate Occlusion :
1. Lack of support for the denture base
2. The fallacy of establishing Occlusion to a
single static jaw relation record
3. Unacceptable Occlusal plane

15. DESIRABLE OCCLUSAL
CONTACT RELATIONSHIPS
for
REMOVABLE PARTIAL
DENTURES

16. 1. Simultaneous bilateral contacts of opposing
posterior teeth must occur in centric occlusion.
2. Occlusion for tooth-supported removable
partial dentures,similarly to the occlusion seen
in a harmonious natural dentition.
Here, stability of such dentures results from
the effects of direct retainers at both ends of
the denture base.

17. 3. Bilateral balanced occlusion in
eccentric positions should be
formulated when a Maxillary
complete denture (Figure A) opposes
the removable partial denture to
promote the stability of the complete
denture. However, simultaneous
contacts in a protrusive relationship
do not receive priority over
appearance, phonetics, and/or a
favorable occlusal plane

18. Figure 1: Posterior occlusion of a maxillary complete denture
opposing a Class I mandibular removable partial denture. The
stability of the maxillary complete denture can be promoted
by developing balanced occlusion as shown.

19. 4. Working side contacts should be
obtained for the mandibular distal
extension denture (Figure 2). These
contacts should occur simultaneously
with working side contacts of the
natural teeth to distribute the stress
over the greatest possible area.
Masticatory function of the denture is
improved by such an arrangement.

20. Figure 2 : Bilateral distal extension mandibular removable partial
denture opposed by natural dentition in the maxillary arch. Working
contacts are achieved, balancing contacts are purposefully avoided
because they would not enhance the stability of the restoration

21. 5. Simultaneous working and balancing
contacts should be formulated for the
maxillary bilateral distal extension
removable partial denture whenever
possible (Figure 3.1). Such an arrangement
will compensate in part for the
unfavorable position of the maxillary
artificial teeth which is usually lateral to
the crest of the ridge. (Figure 3.2)

22. Figure 3.1 : Opposing Class I partially
edentulous arches arranged to allow
working side contacts of opposing
posterior teeth (A) with balancing contact
(B) arranged to minimize tipping of the
maxillary removable partial denture and to
broadly distribute forces to its supporting
structures (abutments and residual ridges).

23. Figure 3.2 : The position of the maxillary
molar is lateral to the supporting crest of
the residual ridge. This position is
functionally unfavorable because of the
potentially unstable leverage effects;
however, stability can be improved by
arranging simultaneous working and
balancing contacts in the occlusal
scheme

24. 6. Only working contacts need to be
formulated for the maxillary or
mandibular unilateral distal extension
removable partial denture (Figure 4).
Balancing side contacts would not
enhance the stability because it is
entirely tooth supported by the
framework on the balancing side.

25. Figure 4: In Class II removable partial denture (maxillary or mandibular), only
working side contacts are necessary, because the cross-arch framework stability
gained from tooth engagement provides resistance to movement. Balancing
side contacts do not enhance stability beyond that.

26. 7. In the Kennedy Class IV configuration, opposing
anterior teeth contact in the planned ICP is desired
to prevent continuous eruption of the opposing
natural incisors, unless they are otherwise prevented
from extrusion.
Contact of the anterior teeth in eccentric positions
can be developed to enhance incisive function but
should be arranged to permit balanced occlusion
without excursive interferences.

27. 8. Artificial posterior teeth should not be
arranged farther distally than the
beginning of a sharp upward incline of
the mandibular residual ridge or over
the retromolar pad (Figure 5). To do so
would have the effect of shunting the
denture anteriorly.

28. Figure 5: Mandibular posterior teeth should not be arranged
distal to the upward incline (ascending ramus) of the residual
ridge. The molar tooth has been placed just anterior to a mark
on the cast land area designating the beginning incline.

29. • Bilateral eccentric contact of the
mandibular distal extension
removable partial denture need not
be formulated to stabilize the
denture. The buccal cusps, however,
must be favorably placed to direct
stress toward the buccal shelf.
• A harmonious relationship of
opposing occlusal and incisal
surfaces alone is not adequate. In
addition, the relationship of the
teeth to the residual ridges must be
considered.

30. METHODS FOR
ESTABLISHING
OCCLUSAL
RELATIONSHIPS

31. • Five Methods are there.
• Before any of these being described,
The use of a facebow mounting of the Maxillary
Cast
be considered.
- any of the common type of facebow for mounting
in relation to the condylar axis in the articulator is acceptable for
RPD
• Horizontal Jaw Relation - Planned ICP or CR
- restoration is to be fabricated in this
( Mouth preperation including Occlusal Adjustments done
maintaining this determination )

32. one of the following conditions should exist:
• CR and planned ICP - coincide - no evidence of occlusal pathologic
conditions;
Fabricate the Denture in CR
• If, not coincide, but the planned ICP is clearly defined
Fabricate the restoration in ICP
• If not coincide - ICP not clearly defined
Fabricate the Denture in CR
• If posterior teeth not present in one or both arches
Fabricate the restoration in CR
(Cont’d)

33. METHODS FOR RECORDING OCCLUSAL RELATIONSHIPS
 Direct Apposition of Casts
 Interocclusal Records with Posterior Teeth Remaining
 Occlusal Relations Using Occlusion Rims on Record Bases
 Jaw Relation Records Made Entirely on Occlusion Rims
 Recording of Occlusal Pathways

34.  When sufficient opposing teeth remain in contact,
 Only a few teeth replacement on short denture bases
and no evidence of occlusal abnormality
 Opposing casts may be occluded in apposition by hand
 Attached with Sticky Wax to the base of the cast ,Then
Mounted securely in the articulator
 This method can only perpetuate the existing occlusal
vertical dimension of the natural teeth
DIRECT APPOSITION TECHNIQUE

35. Interocclusal Records with Posterior Teeth Remaining
• A second method, which is a modification of the first.
• Used when sufficient natural teeth remain to support the
RPD (Kennedy Class III or IV) but do not permit the
occluding of casts by hand.
• In such situations, jaw relations must be established as for
fixed restorations with some type of interocclusal record.
• The least accurate of these methods is the interocclusal wax
record. -
- The bulk, consistency, and accuracy of the wax will influence
the successful recording of centric relation after chilling the wax record
- Distortion during or after removal

36. Definitive procedure for making interocclusal record:
• Metal reinforced Wafer of base plate or set-up wax placed
between teeth.
• Pt is guided to close in CR (Correct closure is rehearsed
before)
• Removed and chilled in room temp. water and then
replaced second time to correct the distortion from chilling.
• All excess wax be removed with sharp knife and make sure
that no contact of excess wax with soft tissue
• It can be further corrected by with freely flowing
occlusal reg material, such as metallic oxide paste.
Opposing teeth should be lightly coated with
petroleum jelly before that..

37. Occlusal Relations Using Occlusal Rim on Record Bases
• Indications:-
1. When one or more distal extension areas are
present.
2. When a tooth- supported edentulous space is large.
3. When opposing teeth do not meet.
• In these instances occlusion rims on accurate bases are used where
the occlusal surface of a rim opposes standing teeth, a layer of
modelling wax approximately 2mm depth is added to occlusal
surface of the rim, and the wax is thoroughly softened by using a
hot wax knife. The rim is seated in the mouth and the mandible
guided carefully into closure until maximal intercuspal contact for
natural teeth occurs.

38. Jaw Relation Record made Entirely on Occlusal Rim
• Indications:-
1. When an opposing maxillary complete denture is to be made concurrently
with a mandibular removable partial denture.
2. Rare situation in which the few remaining teeth do not occlude and will not
influence eccentric jaw movements.
3. When either arch has only anterior teeth present.
• In any of these situations, jaw relation records are
made entirely on occlusion rims. The occlusion rims
must be supported by accurate jaw relation record
bases. Here, the choice of method for recording jaw
relations is much the same as that for complete
dentures.
• Either direct interocclusal method or stylus tracing

39. Establishing Occlusion by the
Recording of Occlusal Pathways
• The registration of occlusal pathways and the use of an occluding
template rather than a cast of the opposing arch.
• Some of the methods described previously may be applied to the
fabrication of removable partial dentures in both arches
simultaneously, whereas the registration of occlusal pathways
necessitates that an opposing arch be intact or restored to the
extent of planned treatment.

40. • When a functional occlusal record is used,
the teeth are modified to accept every
recorded eccentric jaw movement. On the
other hand, specific concept of occlusion is
followed in static jaw relation record. These
movements are made more complicated by
the influence of the remaining natural
teeth
• Regardless of the method used, when one
arch is completely restored first, that arch is
treated as an intact arch even though it is
wholly or partially restored by prosthetic
means.

41. Step-by-Step Procedure for Registering Occlusal
Pathways :
• Denture Base made of VLC or Autopolymerising Acrylic
resin. Wax occlusal rim – hard inlay wax , suitable
• Inform the patient – Rim must be worn Constantly for 24 hrs or longer even at the night
time except for removal during meal
• Instruct the patient - removal and placement of the denture that support the occlusal rim
. - occasional cleaning of accumulated wax particles from the opposing
teeth
• With wearing and biting into a hard wax occlusion rim, a record is made
of all extremes of jaw movement.
• The wax occlusion rim must maintain positive contact with the opposing
dentition in all excursions. Extreme jaw positions and habitual
movements during sleep should also be recorded.

42. • After a second 24- to 48-hour period of wear, the
registration should be complete and acceptable
• The remaining teeth that serves as a vertical stops should
be in contact and the rim should show intact glossy surface
representing each cusp in all extreme movements.
• After 24 hours, the occlusal surface of the wax rim should
show a continuous gloss, indicating functional contact with
the opposing teeth.
• Any area deficient in contact should be added this time and
after that be reseated for the second time in pt’s mouth
• The occlusal paths, thus recorded, will represent each tooth
in its three-dimensional aspect

43. • Schuyler has emphasized the importance of establishing first
the anterior tooth relation and incisal guidance before
proceeding with any complete oral rehabilitation.
• Others have shown the advantages of establishing canine
guidance as a key to functional occlusion
Canine teeth serve to guide the mandible during eccentric movements
when the opposing teeth come into functional contact.
• If removable partial dentures are planned for both arches, the
mandibular arch is restored first and the maxillary removable
partial denture is occluded to that restored arch.
Some Considerations regarding Occlusal Recording

44. • When the mandibular removable partial denture replaces all posterior
teeth and the anterior teeth are noninterfering
- a central bearing point tracer may be mounted in the
palate of the maxillary denture, and centric relation
recorded by means of an intraoral stylus tracing against a
stable mandibular base.
• If an existing maxillary complete denture is satisfactory and the
occlusal plane is oriented to an acceptable anatomic
- the complete denture need not be replaced and the
opposing arch is treated as an intact arch as though natural
teeth were present.
MANDIBULAR REMOVABLE PARTIAL DENTURE OPPOSING A MAXILLARY COMPLETE DENTURE

45. • When an existing complete denture is opposing the arch on which a
removable partial denture is fabricated
- a cast of the complete denture may be used during the fabrication
procedures.However, when the occlusion is corrected after
processing ,the complete denture should be retrieved and mounted
on the articulator with a centric relation record at the desired
vertical dimension of occlusion
• If the mandibular removable partial denture will be tooth supported (a
Kennedy Class III arch accommodating a bilateral removable
prosthesis)
- the mandibular arch is restored first, and jaw relations are
established, as they would be to a full complement of
opposing teeth. Thus, the maxillary complete denture is
made to occlude with an intact arch.

46. SUMMARY
Occlusion is a dynamic part in our dentoalveolar system,
with time it changes. Occlusal concepts in case of
Removable Partial Denture is a complex one and,it’s quite
challenging for every clinician to restore the occlusal
relation of natural teeth and provide harmonious
occlusion . Failure to maintain this will result in instability
of the prosthesis. So having complete knowledge about
Occlusal relationships is a must for every Prosthodontists.

47. References:
• McCracken’s REMOVABLE PARTIAL PROSTHODONTICS -13th Edition
Alan B. Carr, David T. Brown
• Thompson JR: Temporomandibular disorders: diagnosis and dental
treatment in the temporomandibular joint
• www.Slideshare.net