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Lingualized Occlusion for Removable Prosthodontics.

Lingualized occlusion is an attempt to maintain the esthetic & food penetration advantages of the anatomic form while maintaining the mechanical freedom of the non anatomic form. The lingualized concepts utilizes anatomic teeth for the maxillary denture and modified non anatomic or semi anatomic teeth for the mandibular denture. Lingualized occlusion should not be confused with placement of the mandibular teeth lingual to the ridge crest.

Indications for Lingualized Occlusion.

Lingualized occlusion can be used in most denture combinations. It is particularly helpful in when the patient places a high priority on aesthetics but a non anatomic occlusal scheme is indicated by the oral conditions such as: evere resorption. !lass II "aw relationship. #isplaceable supporting tissue.

If the non$anatomic occlusal scheme is used% aesthetics in the premolar region is compromised. &ith lingualized occlusal concept% the aesthetic result is greatly improved while maintaining the advantages of a non$anatomic system. Lingualized occlusion also can be used effectively when a complete denture opposes a removable partial denture. The goal for bilateral balanced occlusion with lingualized occlusion should be to achieve smooth bilateral contact with excursive movements of '$(mm. away from the centric relation. )sually the desired range of balanced occlusion can be achieved before the anterior teeth ma*e contact. In situations where the anterior teeth would contact before achieving the desired range of bilateral balanced occlusion% the vertical overlap of the anterior teeth can be reduced to approach an incisal guidance of zero. + slight compensating curve will be necessary to achieve continuous posterior contacts anterior to the centric relation.

,rinciples of Lingualized Occlusion.

-. +natomic posterior teeth .(( or (/ degree0 are used for the maxillary denture. Tooth forms with prominent lingual cusps are useful. '. 1on$anatomic or semi$anatomic teeth are used for the mandibular denture. 2ither a shallow or flat cusp form is used. + narrow occlusal table is preferred when severe resorption of the residual ridge has occurred. (. 3odification of the mandibular posterior teeth is accomplished by selective grinding which is always necessary regardless of specific tooth material. elective grinding smoothes the fossae of the mandibular teeth% lowers marginal ridges% and forms slight buccal and lingual inclines. This create a slight concavity in the occlusal surface. 4. 3axillary lingual cusps should contact mandibular teeth in centric relation. The mandibular buccal cusps should not contact the upper teeth in centric relation% as is customary with usual anatomic tooth placement. It is helpful to slightly rotate the maxillary posterior teeth buccally to allow for slight clearance of the buccal cusps in the wor*ing position and to reduce the need for selective grinding. 5. 6alancing and wor*ing contacts should occur only on the maxillary lingual cusps. Then posterior teeth are arranged and ad"usted to establish bilateral balanced occlusion in lateral mandibular excursions for a range of '$( mm. around centric relation. selective grinding of the maxillary buccal cusps may be needed to create a small clearance between the maxillary and mandibular buccal cusps on the wor*ing side when excursive movements are initiated. The maxillary lingual cusps remain in contact on the wor*ing side. This helps to reduce lateral movement of the lower denture placing occlusal forces more lingual to and toward the centre of the mandibular teeth. On the balancing side% the maxillary lingual cusps contact the mandibular buccal cusps as is customary with anatomic tooth arrangement. 7. ,rotrusive balancing contacts should occur only between the maxillary lingual cusps and the lower teeth. 8eduction of the antero$posterior interferences on the mandibular teeth may be needed in order to provide a range of balanced occlusion in the protrusion position. lective grinding for the protrusive

movements should be done on the mandibular teeth only so that the lateral balancing contacts and the vertical dimension of occlusion are not changed.

+dvantages of Lingualized occlusion.

-. 3ost of the advantages are attributed to both the anatomic and non anatomic forms are retained. '. !usp form is more natural in appearance compared to non$anatomic tooth form. (. 9ood penetration of food bolus is possible. 4. 6ilateral balanced occlusion is readily achieved for a region around centric relation. 5. :ertical forces are centralized on the mandibular teeth.