(Replace) 15.concepts of complete denture occlusion
The document discusses concepts of complete denture occlusion including the differences between natural dentition and dentures, goals of denture occlusion, types of occlusion including bilateral balance and monoplane, factors affecting occlusion balance, and considerations for posterior tooth forms including anatomic versus lingualized teeth. Bilateral balance aims to limit denture tipping during parafunctional movements and can be achieved with anatomic or non-anatomic posterior teeth using techniques like balancing ramps.
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(Replace) 15.concepts of complete denture occlusion
- 1. Concepts of Complete Denture Occlusion This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.
- 2. Differences between Naturaland Complete Denture Occlusion Natural Dentition Denture “Dentition” n Retained in PDL n Mobile bases on mucosa n Units move n Teeth move as an unit independently n Malocclusion affects n Malocclusion effects not entire base immediately immediate n Non-vertical forces affect n Non-vertical forces all teeth and is traumatic affect only teeth involved and usually n Incising affects all teeth well tolerated attached to base n Incising doesn’t affect n Bilateral balance is often posteriors desired for base stability n Bilateral balance is rare n Decreased tactile sense n Tactile sensitivity
- 3. Goals of CompleteDenture Occlusion n Minimize trauma to the supporting structures n Preserve remaining structures n Enhance stability of the dentures n Facilitate esthetics and speech n Restore mastication efficiency to a reasonable level
- 4. Types of CompleteDenture Occlusion n Bilateral balance n Neutrocentric We prefer bilateral balance because this type of occlusal arrangement limits tipping of the dentures during parafunctional movements,
- 5. Bilateral Balanced DentureOcclusion The stable simultaneous contact of opposing upper and lower teeth in centric relation position with a smooth bilateral gliding contact to any eccentric position within the normal range of mandibular function, developed to lessen or limit tipping or rotation of the denture bases in relation to the supporting structures.
- 6. Bilateral Balanced DentureOcclusion n Traditionally bilateral balance was achieved with anatomic posterior denture teeth. However, it can be achieved with nonanatomic teeth using balancing ramps or by manipulating the compensating curve.
- 7. Bilateral Balanced DentureOcclusion with Anatomic Posterior Denture Teeth Protrusive Balancing Working n Bilateral Posterior Centric Contact n Centralized Forces n “Balanced” Occlusion to minimize tipping Centric
- 8. Monoplane with BalancingRamps Working Balancing Bilateral balanced occlusion can Protrusive also be obtained with nonanatomic posterior teeth if balancing ramps are employed. In all lateral excursions you should observe at least three points of contact bilaterally if bilateral balance is to be achieved.
- 9. Lingualized Opposing Monoplanewith Balancing Ramps Working Balancing n A similar concept is used when lingualized maxillary teeth oppose nonanatomic teeth in the mandible.In all lateral excursions you should observe at least three points of contact bilaterally to maintain bilateral balance.
- 10. Monoplane Occlusion (Neutrocentric Concept) This concept of occlusion assumes that the anterior- posterior plane of occlusion should be parallel to the denture foundation area and not dictated by condylar inclination. The plane of occlusion is completely flat and level. There is no curve of Wilson or Curve of Spee (compensating curve) incorporated into the set up. There is no vertical overlap of the anterior teeth. When using this concept of occlusion the patient is instructed not to incise the bolus. With this tooth
- 11. Monoplane Occlusion (Neutrocentric Concept) Centric Balancing At balancing and protrusive positions there is separation of the denture teeth in the posterior regions leading to tipping of the dentures. This may be disadvantageous in the patients exhibiting parafunctional grinding habits
- 12. Hanau’s Quint n Five Factors Affecting Occlusal Balance • Condylar Inclination • Incisal Guidance • Occlusal Plane Inclination • Compensating Curve • Cuspal Inclination
- 13. Hanau’s Quint n Inter-relationship of these five factors may be described by Theilman’s Formula n In order to maintain a balanced occlusion: Condylar Inclination x Incisal Guidance C= OccPlane x Cuspal Inclination x CompCurve
- 14. Hanau’s Quint Factors controlled by the dentist n Of these five factors, the patient presents you with Condylar Inclination n Occlusal Plane cannot be altered substantially since functional requirements dictate its position and orientation n The remaining three factors can be controlled by the dentist Condylar Inclination x Incisal Guidance C= OccPlane x Cuspal Inclination x CompCurve
- 15. Hanau’s Quint Factors controlled by the dentist n Of these five factors, the patient presents you with Condylar Inclination n Occlusal Plane cannot be altered substantially since functional requirements dictate its position and orientation n The remaining three factors can be controlled by the dentist Condylar Inclination x Incisal Guidance C= OccPlane x Cuspal Inclination x CompCurve
- 16. Hanau’s Quint n Within the confines of esthetics and phonetics, minimize Incisal Guidance in Complete Dentures to minimize inclined tipping forces n Adjust remaining factors to maintain balance Condylar Inclination x Incisal Guidance C= OccPlane x Cuspal Inclination x CompCurve
- 17. Posterior Tooth Forms Lingualized Monoplane– neutrocentric Monoplane with balancing ramps Lingualized opposing monoplane Semi-anatomic Anatomic (30 degree)
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- 22. Goals of CompleteDenture Occlusion n Minimize trauma to the supporting structures n Preserve remaining structures n Enhance stability n Esthetics, Speech and Mastication n Enhance mastication In addition we would like to decrease lateral forces to the residual ridges.
- 23. General Concepts ofDenture Occlusion n Common Features • Functional anatomy is the main determinant of denture tooth position • Simultaneous, bilateral posterior contact in centric relation (centric occlusion) • Centralization of centric occlusal forces over the mandibular residual ridges n Buccal-Lingually
- 24. Is “Balance” necessary? Protrusiveposition Protrusive position Balanced vs Non-balanced occlusion occlusion
- 25. Is “Balance” Necessary? “Bolus in” “Balance out”
- 26. Is “Balance” Necessary? “Societyis made up of happy neurotics, unhappy neurotics, and a few psychotics, and some of each become partially or totally edentulous.” Theodore Berg, Jr., D.D.S. * Balance is for Parafunctional Movements
- 27. Is “Balance” Necessary? Tests of Balanced and Non-balanced Occlusions Trapozzano, V. R.: JPD 10: 476-487, 1960. 1) No patient preference 2) Balanced slightly more efficient 3) Percentage of patients using eccentric movements during mastication is small
- 28. Is “Balance” Necessary? “Simplificationof Occlusion in Complete Denture Practice: Posterior Tooth Form and Clinical Procedures” Dale Smith: DCNA 14: No. 3; July, 1970. 1) Advocates cuspless teeth primarily for ease of use 2) May use balanced occlusion but can’t prove that it is necessary
- 29. Balance and theMonoplane Occlusion Minimize vertical overlap within the dictates of esthetics and phonetics
- 30. Balance and MonoplaneOcclusion Minimize vertical overlap within the dictates of esthetics and phonetics
- 31. Bilateral Balance n Anatomic posterior teeth vs Lingualized
- 32. Bilateral balance withanatomic denture teeth Balancing side
- 33. Lingualized Occlusion Centric Occlusion Conventional Lingualized Theoretically, there should be less lateral displacement of the denture and less lateral forces during function when using lingualized posterior denture teeth.
- 34. Setting the MaxillaryPosteriors The lingual cusp tips should be in contact with the central fossae of the opposing mandibular teeth. The cuspal inclines of the mandibular teeth are relatively flat, resulting in potentially less lateral forces and displacement during function.
- 35. Lingualized Occlusion Working Side Centric Occlusion Balancing Side
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- 37. Lingualized Occlusion Indications for use Advantages n High esthetic demands n Good esthetics n Severe mandibular ridge n Freedom of non-anatomic atrophy teeth n Displaceable supporting n Potential for bilateral tissues balance n Malocclusion n Centralizes vertical forces n Previous successful denture n Minimizes tipping forces with Lingualized Occlusion n Facilitates bolus penetration (mortar and pestle effect)
- 38. Complete Denture Occlusion n Investigators have not shown one type of denture occlusion to be : • superior in function • safer to oral structures • more acceptable to patients
- 39. Complete Denture Occlusion n Neuromuscular control may be the single most significant factor in the successful manipulation of complete dentures under function n Tongue function and denture wearing experience
- 40. v Visit ffofr.org for hundreds of additional lectures on Complete Dentures, Implant Dentistry, Removable Partial Dentures, Esthetic Dentistry and Maxillofacial Prosthetics. v The lectures are free. v Our objective is to create the best and most comprehensive online programs of instruction in Prosthodontics