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International Journal of
CODEN: IJRSFP (USA)
Recent Scientific
International Journal of Recent Scientific Research Research
Vol. 10, Issue, 09(D), pp. 34784-34787, September,
ISSN: 0976-3031 2019 DOI: 10.24327/IJRSR
Case Report
LINGUALIZED OCCLUSION- A CASE REPORT
Surbhi Jain1, Rajeev Singh2, Gaurang Mistry3 and Omkar Shetty4
1Indira Vishnu Smruti Bldg, 2nd Floor, Mahavir MARG, Pen- Raigad 402107, Maharashtra, India
2,3,4D. Y. Patil School of Dentistry, Nerul, Navi-Mumbai

DOI: http://dx.doi.org/10.24327/ijrsr.2019.1009.3972

ARTICLE INFO ABSTRACT

Article History:
Received 10th June, 2019
Received in revised form 2nd July, 2019
Accepted 26th July, 2019
Published online 28th September, 2019
Key Words:
Complete denture occlusion
Occlusion is a very fine and complex topic to be taken into consideration while fabricating a
complete denture. Various occlusal schemes are proposed for various ridge relationships and ridge
morphologies. In patients with comparatively resorbed ridges special care is to be taken while
fabricating a complete denture occlusion, as there is poor retention, support and stability from the
lower residual alveloar ridge and the denture bases may not be stable and does not provide the basic
masticatory satisfaction. The practitioner should choose the occlusal scheme to determine the pattern
of occlusal contacts and the direction of forces via theses contacts through the denture. So the
success of a stable denture depends more on the occlusal scheme given on the denture.

Copyright © Surbhi Jain et al, 2019, this is an open-access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is
properly cited.

INTRODUCTION of the mandibular posteriors. The upper posteriors are placed

Numerous concepts, techniques and philosophies have been
documented concerning about complete denture occlusal
schemes. There are several schools of thoughts on occlusal
schemes in complete denture and some clinician believe there
should be cusps on the teeth and must be in complete harmony
with the stomatognathic system.1 A lot of discussion was
carried out regarding which ideal occlusion provides the best
esthetic, retention, stability, support and masticatory efficiency,
without causing any problem to the health of the underlying
hard and soft tissues of the edentulous arch. The clinician aims
to fulfil these above mentioned qualities and provide retention,
stability, support and masticatory efficiency to the denture
wearer. Various techniques and philosophies about complete
denture occlusion like balanced occlusion (unilateral or
bilateral), monoplane balanced occlusion, lingualized occlusion
have been documented. Some researchers believe that the cusps
on the teeth should be in complete harmony with the oral
system and create the minimal horizontal forces generated to
seat the denture base. In this type of occlusion the palatal cusps
of maxillary posterior teeth articulate with the fossa of the
mandibular shallow teeth without any buccal inter-digitation of
the maxillary and mandibular cusps. The upper palatal cusps
contact in the area 2-3 mm in diameter around the centric stop
with slight tilt in palatal direction so the teeth are placed more
buccally and it in turn provides facial muscles support. The
palatal cusps provide the vertical force n the middle of the
lower ridge which gives superior stability to the tipping forces
of the mandibular denture base.2
The importance of this type of occlusion is it provides better
chewing efficiency and leads to better geriatric health of our
patient. It is the most simplified type of occlusion and it is easy
to adjust as the number of contact points are greatly reduced.
This case reports provides us with one of the simplest of the
way to provide stable dentures in a resorbed mandibular ridge3.
CASE REPORT
A 58 year old male reported to the Dept of Prosthodontics with
the chief complaint of inability to eat due to upper and lower
missing teeth since 8 months and wanted the replacement of the
same. On intraoral examination, the maxillary and mandibular
ridges are completely edentulous with well rounded maxillary
ridge and severely resorbed mandibular ridge. The extra-oral
examination showed hollow cheeks and lack of facial muscular
support. Esthetics was not the prime concern for the patient.
Different treatment options like neutral zone, monoplane
occlusion were discussed and out of which lingualized occlusal

*Corresponding author: Surbhi Jain

Indira Vishnu Smruti Bldg, 2nd Floor, Mahavir MARG, Pen- Raigad 402107, Maharashtra, India
 International Journal of Recent Scientific
Scientif Research Vol. 10, Issue, 09(D), pp. 34784-34787
34787, September, 2019

scheme was finalized. The treatment planned for the patient

was maxillary
axillary and mandibular complete denture fabrication
with the occlusal philosophy of lingualized occlusion.

Fig 4 maxillary wash impression

Fig 1 Primary impressions were made using impression compound cake

Fig 5 Hanau facebow recorded

Primary impressions were made using impression compound

cake (Fig.1) in a non-perforated
perforated stock metal tray and casts were
poured with dental plaster. For the maxillary arch, the special
tray
ay was fabricated using a single spacer and border moulding
was performed using type I impression compound green sticks,
the final wash impression was made with the light body
material. (Fig.2) A tertiary impression was planned to be made
for the mandibularr arch due to its resorbed condition and
achieving greater surface details. A second tray was fabricated
and impression was made using admixed technique (Fig.3). A
special tray was then made and a convention border moulding
and wash impression was made usi using light body impression
Fig 2 maxillary wash impression
material (F4). The final casts were poured and models were
retrieved. A permanent denture base with wax occlusal rims
was fabricated and jaw relation was carried out using
conventional method. A hanau facebow transfer was made and
casts were mounted in centric relation (Fig.5) Teeth selection
according to the patients skin tone and facial shape was
carefully done and we selected an ovoid mould anatomic teeth
set and semi-anatomic
anatomic mandibular posteriors of shade A3, as
the scheme of occlusion
cclusion planned is lingualized occlusion.
Anterior try-in
in was done to assess the aesthetics, phonetics of
the patient. Once the anterior try
try-in is approved by the dentist
and the patient, posteriors were arranged accordingly in such a
way that palatal cuspsps of the maxillary posteriors fall on the
central fossae of the mandibular posteriors with no buccal
contact (Fig. 6). Series of articulating paper of various
thickness were used to achieve the cuspal markings on the
Fig 3 admixed technique impression
posteriors (Fig. 7). Set-up
up trial arra
arrangement was done, centric
relation and lingualized occlusal scheme was verified intra intra-
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Surbhi Jain et al., Lingualized Occlusion- A Case Report
orally. Denture was finished, polished and delivered to the
patient (Fig. 8). Post denture delivery instructions were given
and recall visit was planned post 24 hours, 1 week and 6
months after delivery.
Fig 6 Showing trial arrangement
Fig 7 Showing articulating point contacts
Fig 8 Showing occlusion during denture delivery
Fig 9 Post denture delivery
DISCUSSION
Arranging teeth in the lingualized occlusion is an attempt to
maintain the aesthetics and food penetration advantages of the
anatomic form while maintaining the mechanical freedom of
the semi-anatomic
anatomic form. This form utilizes semi semi-anatomic
teeth for maxillary denture while non non-anatomic or semi-
anatomic teeth for mandibular denture with slight modification
of the mandibular posterior teeth accompanied by selective
grinding of the central fossa of the mandibular teeth, lowering
marginal ridges. Arranging teeth in lingualized occlusion
shouldd not be confused with placing mandibular teeth lingually
to the crest ridge.4-8 In normal class I jaw relationship, with a
conventional denture made with anatomical occlusion concept,
the denture during lateral excursions; both the buccal and
lingual cuspss of the upper and lower denture on the working
side come in contact, that indicates a large number of
articulating contacts during eccentric jaw movements seen on
the denture. In comparison with the lingualized occlusion
concept, the number of occlusal contacts is highly reduced
considerably, it’s only in centric relation that the lingual cusps
of the posterior teeth in the upper denture make contact in the
central fossa of the lower posteriors and buccal cusps are not in
contact.9 It is helpful to slightly
tly rotate the maxillary posteriors
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 International Journal of Recent Scientific Research Vol. 10, Issue, 09(D), pp. 34784-34787, September, 2019
bucally to achieve slight clearance of the buccal cusps and
reduce the need for extensive grinding. A carborundum is used
to recontour the mandibular teeth.
Various advantages of choosing lingualized occlusion is use of
both anatomic and non-anatomic teeth forms, good penetration
of food bolus possible, bilateral mechanical balanced occlusion
obtained around centric relation region, vertical forces are
centralized on the mandibular arch.
Lingualized occlusion is indicate in patients with high demand
esthetics but a semi- anatomic occlusal scheme is suggested
because of severe ridge resorbtion, in class II jaw relationship
or highly unstable or displaceable supporting tissues, used
when complete denture opposes a removable partial denture or
in patients with para-functional habits.10
The goal for bilateral balanced occlusion with lingualized
occlusion should be to achieve smooth bilateral contact with
excursive movements of 2 to 3 mm away from centric relation.
CONCLUSION
Lingualized occlusion has been in practice since past 60 years.
The cuspal relationship as seen with the lingualized occlusion
is achieved with variety of moulds and anatomy of teeth that
seem to provide the minimal occlusal adjustments and greater
benefits to the patients. This occlusal scheme provides greater
support to the denture base area as the forces are well directed
to the centre of the ridge hence a happy patient.
How to cite this article:
Surbhi Jain et al., 2019, Lingualized Occlusion- A Case Report. Int J Recent Sci Res. 10(09), pp. 34784-34787.
DOI: http://dx.doi.org/10.24327/ijrsr.2019.1009.3972
*******
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