OCCLUSION IN COMPLETE

DENTURES
Dr Ayesha Sadaf
 DENTURE SURFACES
WILFRED FISH described 3 denture surfaces

1) IMPRESSION SURFACE
2) POLISHED SURFACE
3)OCCLUSAL SURFACE
 IMPRESSION /INTAGLIO SURFACE

IMPRESSION SURFACE RESTS ON THE RESIDUAL

RIDGES AND TRANSMITS FORCES DIRECTLY TO THE
DENTURE BEARING TISSUE
 OCCLUSAL SURFACE

OCCLUSAL SURFACES THAT CONSISTS OF TEETH ‘S ARTICULATING

SURFACES THAT COME IN CONTACT DURING FUNCTIONAL AND
PARAFUNCTIONAL ACTIVITIES.
 POLISHED SURFACE

POLISHED SURFACE MADE UP OF LABIAL, BUCCAL, PALATAL

AND LINGUAL SURFACE OF THE DENTURE TOGETHER WITH THE
NON-ARTICULATING PARTS OF THE PROSTHETIC TEETH
Complete Denture Workflow
PRIMARY IMPRESSION

SECONDARY IMPRESSION

MAXILLOMANDIBULAR JAW
RELATION

DENTURE FOLLOW -
TRIAL DELIVERY UP
 OCCLUSAL PLANE
One of the important factors that help us in the establishment of ideal
occlusion is the orientation of the occlusal plane.

Occlusal plane is the average plane established by the incisal and

occlusal surfaces of the teeth;
Biometric guidelines For Occlusal Plane
ORIENTATION

RETROMOLAR
Biometric guidelines For Occlusal Plane
ORIENTATION
MANDIBULAR OCCLUSAL PLANE

Middle / 2/3rd of the height of retromolar pad

Biometric guidelines For Occlusal Plane
ORIENTATION

Posterior mandibular occlusal

plane at the level of lateral
border of tongue
ORIENTATION OF MAXILLARY
OCCLUSAL PLANE

INTERPUPILLARY ALA-TRAGAL
LINE LINE
Occlusion
The static relationship between the incising or
masticating surfaces of the maxillary and mandibular
teeth, or tooth analogs

Articulation
the contact relationship between the occlusal surfaces
of teeth during function
Centric occlusion maximum intercuspation when condyle is in
superior and anterior position

Eccentric occlusion
Protrusive occlusion
Lateral occlusion
Working side
the side toward which the mandible moves in a lateral
excursion

Non working (balancing) side

that side of the mandible that moves toward the median
line in a lateral excursion.
• COMPLETE DENTURE OCCLUSION

CR/CO= Maximum intercuspation

Occlusal Schemes / Theories For CD

• Bilateral Balanced articulation

• Non-balanced articulation ( Neutrocentric or monoplane articulation)
• Lingualized articulation
• Functionally generated occlusal scheme
Bilateral Balanced Occlusion/Articulation

• Balanced Occlusion is defined as the bilateral, simultaneous,

anterior, and posterior occlusal contact of teeth in centric and
eccentric positions. Balanced occlusion in complete dentures is
unique, as it does not occur with natural teeth.
Bilateral Balanced Occlusion/Articulation
Requirements
• Bilateral simultaneous contact between anterior & posterior teeth
during all centric and eccentric positions

• There should be no interferences during movement from centric

position to eccentric positions

• The movements should be in harmony with TMJ & neuromuscular

control
BILATERAL BALANCED OCCLUSION
Advantages of Balanced Occlusion
• To improve Stability & Retention

• To distribute the occlusal load evenly across the arch therefore helps
to improve the stability of the denture during centric, eccentric or
parafunctional movements.

• To improve oral comfort of the patient

DISADVANTAGES OF BILATERAL BALANCED
OCCLUSION
• More occlusal disharmony during setting of teeth and difficult to
correct by adjustment.

2- Stable bases and precise jaw closure is required.

3- Increased horizontal forces due to the presence of incline plane of the

cups.

4- Difficult to adapt in jaw relation other than class l.

BILATERAL BALANCED
OCCLUSION IS ABSENT IN
NATURAL DENTITION
 CHRISTENSON’S PHENOMENON

In natural teeth when the mandible is protruded so that the incisal edges
of the upper & the lower teeth contact, there is a gap between the upper
& lower posterior teeth, this is termed as “Christensen’s phenomenon”.
Curvatures OF Natural Dentition
Curve Of Monson
A proposed ideal curve of
occlusion in which each
cusp and incisal edge
touches or conforms to a
segment of the surface of a
sphere 4 inches (102mm)
in radius with its centre in
the region of the glabella.
Mechanics Of Balanced Occlusion
Christensen’s phenomenon
Condylar Guidance*
Mandibular guidance
generated by the condyle and
articular disc traversing the
contour of the glenoid fossae

The posterior determinent of

mandibular movement
Condylar Guidance Angle
The angle formed by an
imaginary horizontal line at
the superior head of the
condyle and the path that the
condyle will pass through
during function

Varies from individual to

individual because of
anatomical differences
Factors That Affect Occlusal Balance
• Hanau’s Quint
• Condylar Guidance
• Incisal Guidance
• Plane of occlusion
• Cuspal inclination
• Compensating curve

If Increased Incisal Guidance Angle For CD?

 Incisal Guidance
It’s the influence of the contacting
surfaces of the mandibular &
maxillary anterior teeth on mandibular
movement

Incisal Guidance Angle

The angle formed by the intersection of the plane of occlusion
and a line within the sagittal plane determined by the incisal
edges of the maxillary and mandibular central incisors when the
teeth are in maximum intercuspation
Incisal Guidance Angle
This angle varies directly with the vertical overbite and inversely with
the horizontal overjet
This angle is set to 10˚ in CD and not exceeding 20˚

↓ Incisal Guidance Angle by ↑ horizontal overlap

Incisal Guidance
For CD, the incisal guidance should be as shallow as esthetics and
phonetics will permit when arrangement of anterior teeth to reduce
protrusive displacing forces
↓ Incisal Guidance Angle by either:*
↑ horizontal overlap
↓ vertical overlap

If Increased Incisal Guidance Angle For

CD? During protrusion:

Upper denture drops at the back

Lower denture slides backward

Plane Of Occlusion
Its inclination can be altered slightly
It is not as important as other factors

Cusp Height & Angulation

It is the smooth gliding of the cusp tips along the cusp inclines
of the opposing teeth to provide balanced articulation
• Anatomic teeth are easier to balance than nonanatomic
teeth
• Cuspal inclines should not be too steep as it can increase
lateral forces
• It is possible to decrease cuspal height by using
compensating curves
Compensating Curves
Artificial curves introduced into complete denture occlusion to achieve
balanced occlusion
Are among the most important determinents of occlusal balance
The anteroposterior curving (in the median plane) and the mediolateral
curving (in the frontal plane) within the alignment of the occluding
surfaces and incisal edges of artificial teeth that is used to develop
balanced occlusion
Curvatures OF Natural Dentition

Curve of Spee
An arc of a circle 65mm to
70mm radius that touches
the tips of all the mandibular
teeth when the skull is
viewed laterally; when
continued it touches the
anterior surface of the
condyles
Compensating Curves

Anteroposterior Mediolateral curve

curve
Compensating Curves
 The steepness of the curve necessary to achieve balance is the result
of guiding influence of angle of condylar guidance and angle of
incisal guidance

 It is functionally and mechanically advantageous to keep

compensating curve as modest as possible → This is accomplished
by setting as shallow an incisal guidance as phonetics, esthetics
permit
 LINGUALIZED OCCLUSION
The lingualized occlusion concept is a variation of the bilaterally
balanced occlusion concept
CHARACTERISTICS OF LINGUALIZED
OCCLUSION
• The premolars and molars are arranged so that only the lingual cusps
of the upper posterior teeth make contact with the central fossae of the
lower posterior teeth.
• This type of occlusion involves:
• - The use of a large upper palatal cusp against wide lower central
fossa,

- The buccal cups of the upper and lower teeth do not contact each other.
Lingualized Occlusion
• Max. lingual cusps
contact central
fossae/marginal ridge

• ~ 1mm space
between buccal
cusps
Lingualized Occlusion
• Forces directed toward lingual side
• Maxillary lingual cusps articulate with the
mandibular central fossae
• Elimination of contacts on the buccal
cusps in both centric and eccentric
• The aim is to provide greater masticating
efficiency and the elimination of lateral
interferences
Lingualized Occlusion
• Verify centric
• No max. buccal cusp
contacts in:
• Centric
• Lateral excursions
Contraindications Of Balanced Occlusion & Lingualized
Occlusion

Extreme cases of the following:

Difficulty in obtaining repeatable centric record (incoordination, jaw

malrelations)

Severe ridge resorption (lateral forces displace the denture) may more
easily be handled with a monoplane scheme
MONOPLANE / NEUTROCENTRIC
OCCLUSION
• Monoplane or None balanced Articulation
It is also called Neutrocentric occlusion. This type of occlusion
assumes that the anterior-posterior plane of occlusion should be parallel
to the denture foundation area and not dictated by condylar inclination.
 CHARACTERISTICS OF MONOPLANE
OCCLUSION
• The plane of occlusion is completely flat.

• There is no curve of Wilson or curve of Spee (no compensating curve) incorporated into the set up.

• - There is no vertical overlap of the anterior teeth.

- When setting these teeth the horizontal and lateral condylar guidance should be set at zero.

• - Non-anatomical cuspless teeth (zero degree) are used.

-The occlusal plane flat and parallel to the upper and lower residual ridges.
- The teeth are set flat with no medial or lateral inclination, elimination of inclined plane therefore more stability,
- The patient is instructed to avoid incising with anterior teeth to avoid displacement of the denture.
-The buccolingual width of the teeth is reduced.
- The number of teeth is reduced (removing the second molar teeth) to direct the forces in the 1st molar and bicuspid
areas of support.
Monoplane Articulation (Neutrocentric
Concept)
• Cuspless teeth (0°) on a flat plane with 1.5-2.0 mm overjet
• No cusp to fossa relationship
• No anterior contacts in centric position

• Eliminate cusps
• lateral forces reduced
• improves stability
• Simplifies tooth arrangement
Monoplane Articulation
Excursions - may
• No overbite (would or may not contact
cause tilting) on balancing sides
• Overjet of 2 mm is
used to create an
illusion of overbite
Monoplane Articulation
Monoplane Articulation
Advantages Disadvantages
Technically easier to achieve • Poorer appearance
Use when: • Can be unstable if
• Difficulty obtaining repeatable condylar guidance is
centric records (muscle steep (posterior teeth
incoordination) separate, leaving only
• Skeletal malocclusion (Class II, III) the anteriors in
• Severe residual ridge resorption contact)
• Reduces horizontal forces
• Knife edge Ridges
Monoplane Articulation
Contraindications:
• The patient has high expectations for improved appearance
• Very steep condylar guidance may make a monoplane scheme less
stable, unless modifying ramps or compensating curves are used.
• Young patients
• When 1.5-2.0mm of overjet can be set, a lingualized occlusion (left)
can have overbite set. Monplane occlusion (right) should normally
have no overbite set.
Characteristic Balanced Lingualized Neutrocentric
Better esthetics
Ease of penetration
(decreased vertical
stress)
Denture stability
during
parafunctional
movement.
Simpler technique,
less precise records
Decreased lateral
forces
Ease of adjustment
Good for Classll
and Class III jaw
relation
Forces centralized
and neutralized