The document presents an in-depth exploration of occlusion in fixed partial dentures, emphasizing its importance for the long-term success of dental restorations and the maintenance of stomatognathic health. It covers the evolution of occlusion concepts, types of occlusion like ideal, optimal, and various occlusal schemes, while detailing occlusal determinants and methods for evaluation. Additionally, it describes factors such as centric occlusion, maximum intercuspation, and different occlusal contacts essential for effective dental treatment planning.

2. OCCLUSION IN FIXED PARTIAL
DENTURES
PRESENTER:
DR. KRUTIKA CHIKORDE.
2nd
YEAR POSTGRADUATE
DEPT. OF PROSTHODONTICS,
AND CROWN AND BRIDGE
COLLEGE OF DENTAL SCIENCES,
DAVANGERE .
STAFF INCHARGE:
DR. VEENA PRAKASH MAM.
PROFESSOR,
DEPT. OF PROSTHODONTICS
AND CROWN AND BRIDGE,
COLLEGE OF DENTAL SCIENCES,
DAVANGERE .

3. CONTENTS :
• Introduction
• Definitions and Terminologies
• Evolution of Occlusion
• Ideal occlusion
• Optimal occlusion
• Organization of occlusion
• Occlusal determinants
• Occlusal schemes

4. • Planning of Occlusion
• Methods to evaluate occlusal relationship.
• Normal versus pathogenic occlusion
• Occlusal interferences
• Occlusion development by different techniques
• Summary
• Conclusion
• References

5. INTRODUCTION-
• Long- term success of a restoration is dependent on maintenance
of occlusal harmony between the various components.
• In health, the occlusal anatomy of the teeth functions in harmony
with structures controlling the movements patterns of the mandible.
• Stomatognathic system is designed to dissipate the forces of
mastication to the supporting structures.
• Requirements of ideal occlusal contact relationships-
a) It should be within the adaptive capacity of the patient.
b) To restore and maintain heath and function of the
stomatognathic system.
c) Simultaneous bilateral contact of opposing posterior teeth must
occur in centric occlusion.

6. • Most dentists are aware of the importance of the good marginal adaptation of
their crowns and bridges.
• Many dentists do not appreciate the potential consequences of poor occlusal
contacts.
• To maintain an occlusion that will function in harmony with the other components of
masticatory mechanism, thereby preserving their health at the same time providing
optimum masticatory function.

7. DEFINITIONS AND TERMINOLOGIES-
• OCCLUSION (GPT-9)
-The act or process of closure or of being closed or shut off.
-The static relationship between incising or masticating surfaces of the
maxillary or mandibular teeth or tooth analogues.
• ARTICULATION (GPT-9)
- The static and dynamic contact relationship between the occlusal
surfaces of the teeth during function.

8. • CENTRIC RELATION (GPT-9)
- The maxillomandibular relationship in which the condyles articulate with
the thinnest avascular portion of their respective disks with the complex
in the anterior-superior position against the slopes of the articular
eminencies.
- This position is independent of tooth contact.
- This position is clinically discernible when the mandible is directed
superiorly and anteriorly.

9. • CENTRIC OCCLUSION (GPT-9)
-The occlusion of opposing teeth when the mandible is in centric relation.
-This may or may not coincide with the maximum intercuspation.

10. • MAXIMUM INTERCUSPATION (GPT-9)
-The complete intercuspation of the opposing teeth
independent of condylar position , sometimes referred
to as the best fit of the teeth regardless of the
condylar position - called also maximal intercuspation.
• Normal Occlusion
-Normal occlusion implies a situation commonly found in the absence of disease.
-It should include not only a range of anatomically acceptable values but also
physiological adaptability.
-It is always a range never a point.
• Physiologic Occlusion
-A static and dynamic relationship of the teeth combining minimum stress on TMJ,
optimal function of the orofacial complex, stability and esthetics of the dentition
and protection and health of periodontium.

11. • Traumatic Occlusion
-An occlusion judged to be causative factors in the formation of
traumatic lesions of disturbances in the orofacial complex.
• Therapeutic Occlusion
-It is a treated occlusion employed to counteract structural inter-
relationship related to traumatic occlusion.
• Pathogenic Occlusion
-A pathogenic occlusion is defined as an occlusal relationship capable of
producing pathologic changes in the stomatognathic system.

12. EVOLUTION OF OCCLUSION-
• Bonwill (1858) - Concept of Bilateral Balanced
occlusion and developed an
articulator that applied his 4-inch
triangular theory.
• Balkwill (1866) - The translating condyle moved
medially during lateral jaw
movement.
• Von Spee (1890) - Occlusal plane of the teeth
followed a curve in the sagittal plane.

13. • Christensen (1901) - Observed the opening of the
posterior teeth in mandibular
protrusion (Christensen phenomenon).
• Bennet (1908) - Described the immediate side
shift (Bennet movement).
• Alfred Gysi (1927) - Balanced occlusion on a
Removable Denture.
• Stuart and McCollum (1955) - Fully Balanced Occlusion
on fixed partial dentures.

14. • Mann and Pankey (1960) - Group function occlusion
• D’Amico (1961) - Cuspid Guidance
• Gutierrez MF, - Preservation of Natural
Cavada G, Valenzuela S (2010) Occurring Occlusion.
• Frank Spear (2013) - Occlusion defined by
Patient’s Physiologic
Capability of Compensation

15. IDEAL OCCLUSION-
• Ideal Occlusion - Hobo (1978)
-Ideal occlusion can be defined as an occlusion which
is compatible with stomatognathic system providing
efficient mastication and good esthetics without
creating physiologic abnormalities.
• Importance of Ideal Occlusion-
1. Use it as a benchmark for the assessment of pre-treatment records and
examination (diagnostic cast).
2. Correcting the TMD and occlusal interferences (if they exist) before commencing
restorative procedures.
3. For final prosthodontic rehabilitation – a confirmative and re-organized approach.

16. OPTIMAL OCCLUSION-
• In the placement of restorations, one must strive to produce for the
patient an occlusion that is as nearly optimum as his or her skills and the
patient’s oral condition will permit.
• The criteria for such an occlusion have been described by Okeson-,
1. In closure , the condyles are the most
super-anterior position against the discs on
the posterior slopes of the eminences of
the glenoid fossa.

17. 2. The posterior teeth are in solid and even
contact and the anterior teeth are in
slightly light contact.
3. Occlusal forces are in the long axes of the
teeth.
Shillinberg HT, Hobo S, Whitsett LD, Fundamentals of FPD.3rd
ed.Chicago;1997.p.85-86

18. 4. In the lateral excursions, working side contacts (preferably on canines)
disocclude or separate the non- working teeth instantly.
5. In protrusive excursions,
anterior tooth contacts will
disocclude the posterior teeth.
6. In an upright posture,
posterior
teeth contact more heavily than
do anterior teeth.

19. ORGANIZATION OF OCCLUSION-
Three recognized concepts-
A. Bilateral Balanced Occlusion
B. Unilateral Balanced Occlusion
C. Mutually protected Occlusion
Rosenstiel, Land, Fujimoto .Contemporary Fixed prosthodontics.5th
ed.
• However, since restorative treatment requirements vary, the clinician should
understand possible combinations of occlusal schemes and their advantages, dis
advantages and indications.

20. A. BILATERAL BALANCED OCCLUSION
• In 1935 ,Schuyler developed the first detailed technique for occlusal
adjustment. By 1953 he began to observe failure of natural dentition
restored with balance. His observations and suggestions effectively
signaled the end of BALANCE as an acceptable treatment approach for
the dentulous patient.
• Stuart and Stallard (1960) noted that balanced occlusion in reconstructed
natural dentitions
1.Often required injudicious increase in occlusal vertical dimension to achieve
balance.
2. Often led to instability of occlusion.
3. Frequently showed increased wear of teeth and restorations
• Thus the concept of a unilateral balanced occlusion (group
function) evolved.

21. B. UNILATERAL BALANCED OCCLUSION
• 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.
• Here excursive contact occurs between all opposing
posterior teeth on the laterotrusive (working) side only.
On the mediotrusive (non-working) side, no contact
occurs until the mandible has reached centric relation.
Glossary of Prosthodontic Terms, Edition Nine, J Prosthet Dent 2017;117 (5S):e1-e105
(GROUP FUNCTION OCCLUSION)

22. ADVANTAGES:
• Group function of the teeth on the working
side distributes the occlusal load.
• The absence of contact on the nonworking
side prevents those from getting subjected
to destructive ,obliquely directed forces
found in nonworking interferences.
• It also saves centric holding cusps that is
mandibular buccal cusps and maxillary
palatal cusps from excessive wear.
• In the presence of anterior bone loss or
missing canines, mouth should be restored
to group function.

23. C. MUTUALLY PROTECTED OCCLUSION
(CANINE GUIDED OCCLUSION)
Rosensteil SF, Land MF, Fujimoto J. Contemporary fixed
prosthodontics. 3rd
ed.St.Louis: Elsevier;2000.p.110-144
• During the early 1960s, an occlusal scheme called
as mutually protected occlusion was advocated by
Stuart and Stallard, based on the earlier work by
D’Amico.
• In this arrangement, centric relation coincides with
maximum intercuspation position.
• The six anterior maxillary teeth, together with six
anterior mandibular teeth, guide excursive
movements of mandible, and no posterior occlusal
contacts occurs during any lateral or protrusive
excursions.

24.  Advantages-
• Patients tolerance
• Ease of construction
Disadvantages-
• Periodontally weak anterior teeth
• Missing canine
• Class II and class III situations
• Cross-bite situations.

25.  Features of mutually protected occlusion-
• Uniform contact of all teeth around the arch when the mandibular condylar
processes are in their most superior position.
• Stable posterior tooth contacts with vertically directed resultant forces.
• Centric relation coincident with maximum intercuspation (intercuspal postion).
• No contact of posterior teeth in lateral or protrusive movements.
• Anterior tooth contacts harmonizing with functional jaw movements.

26.  Anterior teeth are suited for guidance by the
virtue of –
• Canines having longest, strongest roots.
• Good crown to root ratio
• The load being reduced by distance from the fulcrum as
the lever arm increases.
• Location is far from the TMJ thus receiving less stress.
• The proprioceptive threshold and concomitant reflexes reducing the load.
• Surrounded by dense compact bone which tolerates forces better.
• It has many receptors in the periodontal ligament so it controls lateral
pressure by directing vertical masticatory movements.
Dawson P. Evaluation and Diagnosis of Occlusion.St.Louis:Mosby Elsevier;2007
The farther anterior a tooth is
located, the less the influence of the
TMJ and the greater the influence of
the anterior guidance (AG).

27. D. OTHER CONCEPTS OF OCCLUSION
• Gnathological concept (1960)
• Organic Occlusion by THOMPSON (1967)
• BEYRON’S Occlusal Concepts
• Biologic or Physiologic Occlusion
• Neuromuscular concept or Myocentric Concept

28. OCCLUSAL DETERMINANTS
1. Posterior controlling factor (CONDYLAR GUIDANCE)
2. Anterior controlling factor (ANTERIOR GUIDANCE)
• The anatomic determinants of mandibular movements i.e., anterior
guidance and condylar guidance have a strong influence on the
occlusal surface morphology of the teeth being restored.

29. 1. CONDYLAR GUIDANCE / POSTERIOR DETERMINANT-
• The angle at which the condyle moves away
from a horizontal reference plane is referred
to as the CONDYLAR GUIDANCE ANGLE.
• As the condyle moves out of centric relation
it descends along the articular eminence.
• The condylar movements depends on the
steepness of eminence.
• If the articular eminence is steep, the
condyle describes a steep vertically inclined
path and if flatter, the path is less vertically
inclined.

30. • Right & left TMJ & associated structures.
Posterior determinants of occlusion-A) Angle of the articular eminence (condylar guidance
angle). 1. Flat; 2. average; 3. steep.
- B) Anatomy of the medial walls of the mandibular fossae.
1. Greater than average; 2. average; 3. minimal sideshift.

32. Mandibular lateral translation -
• Immediate mandibular lateral translation
• Gradual mandibular lateral translation
• In immediate lateral translation (side shift),the
cuspal height is shorter or the fossa width wider.
• In gradual lateral translation (no side shift),the
cuspal height is longer or the fossa be narrower.
• Ridges and groove direction are affected by
the condylar path, particularly the lateral
translation. Working Condyle

33. 2. ANTERIOR GUIDANCE / ANTERIOR DETERMINANT-
PROTRUSIVE INCISAL PATH-
• The track of the incisal edges from the maximum
intercuspation to edge- edge occlusion is termed as
PROTRUSIVE INCISAL PATH.
• It ranges from 50-70 degrees and is often 5-10
degrees steeper than the sagittal condylar guidance.

34. • Anterior guidance which is linked to the combination of vertical and
horizontal overlap of the anterior teeth, can affect the occlusal
morphology of the posterior teeth.
• a) Vertical Overlap and cuspal height
• b) Horizontal Overlap and cuspal height

36. • The occlusal scheme can be classified by the location of the occlusal
contact made by the functional cusp on the opposing tooth in the centric
relation.
• They are mainly four types -
 Cusp- fossa
 Cusp –Marginal ridge
 Surface-surface contact
 Tripod contacts
OCCLUSAL SCHEMES

37. CUSP FOSSA OCCLUSAL
SCHEME
CUSP-MARGINAL RIDGE
OCCLUSAL SCHEME

38. SURFACE -TO-SURFACE CONTACT TRIPODIZATION

39. CLASSIFICATION OF OCCLUSAL SCHEMES-
CUSP-FOSSA CUSP –MARGINAL
RIDGE
LOCATION OF OCCLUSAL
CONTACT ON OPPOSING TEETH
Occlusal fossae only Marginal ridges and occlusal
fossae
RELATION WITH OPPOSING TEETH Tooth-to- tooth Tooth-to-two teeth
Advantages Occlusal forces are directed
parallel with the long axis of the
tooth; these forces are near the
centre of the tooth.
Most natural type of occlusion and
is found in 95 % of all adults ; it can
be used for single restorations.
Disadvantages Used only when restoring several
contacting teeth and the tooth
opposing them.
Food impaction and the displacement
of the teeth may arise if the functional
cusps wedge into lingual embrasure.
Application Full –mouth rehabilitations Most Cast Restorations

40. PLANNING OF OCCLUSION
Whether to take - Centric occlusion
(or)
MIP
(or)
Long centric (Freedom from centric) ??
• Centric occlusion (CO) is the position of choice:
 When there are insufficient occlusal contacts to relate the mandible to the
maxilla (to relate the diagnostic casts) in a stable consistent relationship.
 When eccentric contacts are to be made.

41. • MIP is the position of choice:
 When stable, the maximal occlusal contacts exist with no evidence of
pathosis.
 After any anterior or mediolateral deflection from centric relation have
been adjusted.
• Long centric (Freedom from centric)
 According to Peter Dawson “ it is the freedom to close the mandible either
into centric relation or slightly anterior to it without varying the vertical
dimension at the anterior teeth”.

42. ASSESSMENT OF OCCLUSION -
 Clinical examination-
• This is done to reveal signs and symptoms
of occlusal pathosis.

43.  Radiographic Survey -
• There are certain radiographic
signs that are indicative of
pathologic changes that may be
caused by the occlusion.
• Radiographic signs of occlusal pathosis are :
a) Widening of PDL space
b) Angular bony defects Thickening
c) Changes in lamina dura
Thinning

44.  Mounted Diagnostic casts -
• Occlusal plane and occlusal contacts study
to facilitate and aid in the designing the
Occlusal scheme of FPD.
• Factors to be studied on the Mounted
diagnostic Casts -
1. Centric occlusion(CO),MIP and initial tooth contacts.
2. Plane Of Occlusion.

45. Plane of Occlusion -
• The plane of occlusion of the natural dentition
can be visualized as an imaginary curved plane
that connects the incisal edges of the anterior
teeth with the cusp tips of the posterior teeth.
• The curvatures of anterior teeth are determined by:
 Esthetically correct smile line.
 The relationship of the mandibular incisal edges to the anterior
guidance & phonetics.

46. The curvatures of posterior
plane of occlusion are
divided into:
an Anteroposterior curve 
Curve of Spee
Mediolateral curve  Curve
of Wilson
Together, the composite of
the curve of Spee, the curve
of Wilson, and the curve of
the incisal edges is properly
referred to as the curve of
occlusion.

47.  Anteroposterior curve (curve of spee) –
• First described by Ferdinand Spee, in 1890
• The anatomic curve established by the occlusal
alignment of the teeth, as projected onto the
median plane, beginning with the cusp tip of
the mandibular canine and following the buccal
cusp tips of the premolar and molar teeth,
continuing through the anterior border of the
mandibular ramus, ending with the anterior
most portion of the mandibular condyle.
• Assists in obtaining protrusive balance.

48.  Mediolateral curves –
1. Curve of Wilson:
• George Wilson , in 1911.
• The curve that is convex downwards.
• The lower teeth are inclined lingually, giving
prominence to the buccal cusps and bringing them
into heavy occlusal contact with the upper buccal
cusp during lateral movements on the working side.
2. Reverse curve or anti-Monson curve:
• A curve of occlusion that is convex upwards.
• This is usually used to arrange the first premolars.

49. 3. Curve of monson:
• George S. Monson
• 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 centre in the
region of the glabella.
• Combination of ‘curve of spee and curve of Wilson.
4. Pleasure curve:
• In excessive wear of the teeth, the obliteration of
the cusps and formation of either flat or cupped-out
occlusal surfaces, associated with the reversal of the
occlusal plane of the premolar, first and second molar
teeth, (the third molars being generally unaffected),
whereby the occlusal surfaces of the mandibular teeth
slope facially instead of lingually and those of the
maxillary teeth incline lingually.
• Combination of monson and anti-monson curves

50. NORMAL OCCLUSION V/S PATHOLOGIC OCCLUSION
• A pathogenic occlusion is defined as an occlusal relationship capable of
producing pathologic changes in the stomatognathic system.
(GPT-9)
• In such occlusions sufficient disharmony exists between the teeth and the
TMJs to result in symptoms that require intervention.
• Signs and symptoms of pathogenic occlusion:
 Teeth
• Mobility
• Open contacts
• Abnormal wear like fracture or chipping of incisal edges.

51.  Periodontium
• Chronic periodontal diseases
• Widened PDL space (radiographically)
• Tooth movement and a compromised C:R ratio.
 Musculature
• Acute and chronic muscular pain due to the bruxism
• Trismus due to no relaxation of elevator muscle
 TMJ
• Pain, clicking or popping due to muscular origin or internal derangement
of joint.
• Unilateral clicking with midline deviation due to displaced disc
Shillingburg HT, Hobo S, Whitsett LD, Jacobi R, Brakett SE. Shillinburg's Fundamentals
Of Fixed Prosthodontics.4th ed. Chicago: quintessence;2012

52.  Short term treatment-
 Occlusal splints /devices
• Serve to deprogram the occlusion such that future restoration in centric
relation is easily accomplished.
• Acts as a diagnostic tool determining if a proposed change in the occlusal
scheme tolerated by patient.
 Definitive treatment-
 Compromising individually or in combination.
 Elimination of deflective occlusal contacts through elective grinding of interfering
inclines.
 Replacement of missing teeth to produce a more favourable distribution of
force.
PATHOGENIC OCCLUSION TREATMENT -

53. OCCLUSAL INTERFERENCES
• Working interferences
• Non-working interferences
• Centric interferences
• Protrusive interferences
Shillinberg HT, Hobo S, Whitsett LD, Fundamentals of FPD.3rd
ed.Chicago;1997.

54. (a)There may be an occlusal disharmony (shaded bar) that is not ideal
but is tolerated by the patient because it is below his or her
threshold of perception and discomfort.
(b) If the threshold is lowered, the disharmony that had been previously
tolerated may produce symptoms in the patient.
(c)Treatment is then rendered by first raising the patient’s threshold
and then decreasing or eliminating the disharmony.
Shillinberg HT, Hobo S, Whitsett LD, Fundamentals of FPD.3rd
ed.Chicago;1997.
PATIENTS ADAPTABILITY -

55. EQUILIBRATION PROCEDURES -
Reduction of
interferences in
Centric Relation
Selective
reduction of
interferences in
lateral
excursions
Elimination of all
posterior
interferences
during protrusive
excursions
Harmonization
of anterior
guidance

56. Dawson E.P. Functional Occlusion From TMJ To Smile Design.1st Ed. St. Louis:
Elsevier;2009. p. 189-198
Selective Grinding for Occlusal Equilibration

57. CENTRIC RELATION INTERFERENCES CAN
BE DIFFERENTIATED INTO TWO TYPES:
1. Interference to the arc of closure
2. Interference to the line of closure
1.Interference to the arc of closure -
As the condyles rotate on their
centric relation axis, each lower
tooth follows an arc of closure
Any interference  condyles
displaced downward and forward 
anterior slide

58. Basic grinding rule to correct anterior slide -
MUDL

59. 2.Interference to the line of closure -
Primary interferences that cause the mandible
to deviate to left or right from first point of
contact in CR to most closed position.

60. 1. If the interfering incline causes the
mandible to deviate off the line of closure
toward the cheek, grind the
Basic grinding rules-
BULL

61. Basic grinding rules-
2. If the interfering incline causes the
mandible to deviate off the line of
closure toward the tongue, grind the
LUBL

62. LATERAL EXCURSION INTERFERENCES:
 Dictated by two determinants:
1. The border movements of the condyles
2. The anterior guidance
• When lateral excursions are being equilibrated, the
mandible must be guided with firm upward pressure
through the condyles to ensure that all
interferences are recorded and eliminated through
the uppermost ranges of motion that can occur at
true border paths for both the condyles and the
anterior guidance.

63. ELIMINATING EXCURSIVE INTERFERENCES
 Protrusive interferences,
 Interferences of the working side
 Interferences of the balancing side

64. PERFECTED OCCLUSION
DOTS IN BACK...
LINES IN FRONT...
• This is the ideal result of marking
with a red ribbon while the patient
grinds the teeth together in all
excursions.

65. • Note the posterior interferences prevent any excursive
contact on the anterior teeth.
• Grind all red marks on posterior teeth. Do not touch
any black marks.
• Marks that might look insignificant can be
potent triggers for activating muscle
hyperactivity and can prevent the turning
off of the elevator muscles that occurs
when posterior disclusion is complete.

66. DUML: Grind the Distal inclines of the Upper
or, in some instances, the Mesial incline of the
Lower teeth.
PROTRUSIVE INTERFERENCES:
DUML

67. VERIFICATION OF COMPLETION -
Clench Test
Anterior
Deprogramming
Splint
Ask the patient to clench the teeth together
and squeeze firmly (empty mouth). If the
patient can feel any discomfort in any tooth,
the equilibration is not complete.
To confirm whether the problem is or is not
related to occluso-muscle pain. If the anterior
splint completely separates all the posterior
teeth, all discomfort will dissipate if the cause
of the discomfort is totally related to
occlusion.

68. METHODS TO EVALUATE OCCLUSION
1) Quantitative method -
Sequence and density of contacts can be differentiated.
a) Virtual dental patient
b) T-Scan system
2) Qualitative method -
Density of the contacts can be evaluated.
a)Wax, articulating paper
b) Shimstock foils
c) Silk strips
d) Occlusal tapes
Ramakrishna Rajan Babu, Sanjna Vibhu Nayar. Occlusion indicators: A review. J
Indian Prosthodont Soc. 2007;7(4):170-174.

69. Articulating paper -
• Articulating papers are the most frequently used
qualitative indicators to locate the occlusal contacts
intraorally.
• They differ in terms of width, thickness and the
type of the dye impregnated.
• They are hydrophobic in nature.

70. • On occlusal contact, the coloring agent is
expelled from the film and the bonding
agent binds it on to the tooth surface.
• The characteristic marking is observed as a
central area that is devoid of the colorant
and surrounded by a peripheral rim of the
dye.
• This region is called “target” or “iris” owing
to their appearance, and it denotes the
exact contact point.

72. OCCLUSAL DEVELOPMENT
1) Functionally generated path technique by Meyers (1933)
2) Pankey-Mann-Schulyer Philosophy by L.D.Pankey.
3) Hobo’s Twin Table Philosophy by Sumiya Hobo

73. Pankey –Mann Schyuler Philosophy by LD Pankey -
Shetty Et al . PHILOSOPHIES IN FULL MOUTH REHABILITATION – A SYSTEMATIC REVIEW.
IJDCR 2013; 3(3): 30-39.

74. Hobo’s Twin Table philosophy by Sumiya Hobo -
Shetty Et al . PHILOSOPHIES IN FULL MOUTH REHABILITATION – A SYSTEMATIC REVIEW.
IJDCR 2013; 3(3): 30-39.

75. Shetty Et al . PHILOSOPHIES IN FULL MOUTH REHABILITATION – A SYSTEMATIC REVIEW.
IJDCR 2013; 3(3): 30-39.

76. DIAGNOSTIC WAX-UP
PRINCIPLE - The diagnostic wax-up is the
process of converting a programmed treatment
plan into a three-dimensional visualization.
Steps in the diagnostic wax-up -
Step 1: Mount upper and lower casts with centric relation
bite record and facebow.
Step 2: Verify the accuracy of the mounting.
Step 3: Examine the occlusal relationship on the casts.

77. Step 4: Lock the centric latch when observing the casts and
determine the correct vertical dimension
Step 5: Return the condyles to centric relation and lock the
centric lock.
Step 6: Observe the teeth that were reshaped, Remove
unsavable teeth from the casts.
Step 7: Equilibration is the first treatment option to explore.
Step 8: Examine the plane of occlusion.
Step 9: Establish stable holding contacts on the anterior teeth.
Step 10: Correct lower incisal edges if needed.
Step 11: Re-evaluate the total occlusion with the upper cast to
see how it can be adapted to occlude with the lower arch.

78. SUMMARY
RESTORING DIFFERENT COMBINATIONS
PROSTHESIS POSITION
ICP /CR
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
/anterior guidance
and condylar
guidance
Group function is
desired /cusp to
fossa

79. CONCLUSION
• Occlusion is the integrated relationship of the tooth, periodontium ,TMJ and neuro
musculature, and not merely the interdigitation of the tooth.
• There is a complex interaction of many components of masticatory system.
• Changes in one component would affect the entire system.
• One who practices the restorative dentistry should appreciate their significance for
the long term successful restorations by maintaining the occlusal integrity.
• There is no one answer to occlusal problems, the dentist should use the philosophy
that works best in his own hands and at the same time do the most good, or better
yet, the least harm to the patient.”

80.  Dawson; Functional occlusion From TMJ To Smile Design – 1st
edt.
 Dawson; Evaluation, diagnosis & treatment of occlusal problems
 Okeson; Management of temporomandibular disorders and occlusion – 8th
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 Shillingburg, Hobo, Whitsett, Jacobi, Brackett; Fundamentals Of Fixed
Prosthodontics – 3rd
edt.
 Takayama and hobo; Oral rehabilitation: Clinical determination of occlusion.
 Rosensteil, Land, Fujimoto; Contemporary Fixed Prosthodontics – 5th
edt.
REFRENCES
TEXTBOOKS -

81. SCIENTIFIC JOURNALS-
 Ogawa, Ogimoto. Pattern Of Occlusal Contacts In Lateral Position: JPD 1998;80:67-
74.
 Schuyler. Factors of Occlusion As Applicable To Restorative Dentistry; JPD 1953;3:
772-15.
 Pokorny, Wiens, Litvak. Occlusion For Fixed Prosthodontics – A Historical Perspective
of the Gnathological Influence; JPD 2008;99:299-313.
 Johnson. Variations in Organic Occlusion ; JPD 1979;41:625-629.
 Clark JR, Evans RD. Functional Occlusion: A Review; JO 2001;28(1):76-81.
 Babu RR, Nayar SV. Occlusion indicators: A review. J Indian Prosthodont Soc.
2007;7(4):170-174.

82. THANK YOU