Complete Denture

Occlusion

Rola M. Shadid, BDS, MSc

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

• 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.
Occlusal Schemes For CD

Balanced articulation
Nonbalanced articulation
(linear or monoplane
articulation)
Lingualized articulation
Functionally generated
occlusal scheme
Balanced Occlusion/Articulation

• Bilateral simultaneous contact

betw. 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
 Advantages of
Balanced Occlusion

• To improve stability &

retention

• To decrease soreness &

resorption of residual ridge

• To improve oral comfort of

the patient
 Mechanics Of
Balanced Occlusion

Christensen’s phenomenon*
How Could You Achieve
Balanced Occlusion In
CD?
Factors That Affect
Occlusal Balance
Factors Affecting Balanced
Occlusion (Hanau’s Quint) *

1. Condylar Guidance
2. Incisal Guidance
3. Plane of occlusion
4. Cuspal inclination
5. Compensating curve.
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
 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

↓ 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

↓ 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
Cusp Height & Angulation

• 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
Compensating Curves
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
The Curvatures In 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
The Curvatures In 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.
Compensating Curves

Anteroposterior
curve *

Mediolateral
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
Theilmann’s Formula

IGxCG = CHxOPxCC
According To The Formula

• To achieve balanced occlusion: For

high condylar guidance we need to
have high compensating curve,
occlusal plane and cuspal height.

• To achieve balanced occlusion: For

high incisal guidance we need to
have high compensating curve,
occlusal plane and cuspal height.
According To The Formula

To achieve balanced occlusion,

the steeper the condylar
guidance, the greater the
cusp height toward the
posterior or the steeper the
compensating curves
According To The Formula

To achieve balanced occlusion,

the steeper the compensating
curves, the less the cusp
height toward the posterior
 Question
Q) Suppose that the incisal guidance is set and the condylar
guidance is steeper than your chosen 20 degree teeth. To
obtain balanced occlusion in your complete denture, what
should you do?
a. steepen the compensating curves in both sagittal and
frontal planes
b. steepen the compensating curves in only sagittal but not
frontal plane
c. decrease the inclination of occlusal plane
d. decrease the steepness of compensating curves in both
sagittal and frontal planes
e. steepen the condylar guidance
f. none of the above
Occlusal Schemes For
CD
Philosophies of Denture Occlusion
• Many philosophies of arranging denture
occlusion
• No definitive scientific studies prove one
occlusal scheme clearly superior
Occlusal Schemes

Balanced articulation
Nonbalanced articulation
(linear or monoplane
articulation)
Lingualized articulation
Functionally generated
occlusal scheme
Lingualized Occlusion

Max. lingual cusps

contact central
fossae/marginal ridge

~ 1mm space
between buccal
cusps
Lingualized Occlusion

• Lingualized
occlusion is a type of
bilaterally balanced
occlusal schemes *

• Anatomic teeth are

used in the maxilla
opposing a flat-
cusped, or shallow
cusped mandibular
tooth.
 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

• Maxillary anatomic (33°)

• Mandibular Teeth
• Steep Condylar Guidance
• Shallow cusped
Lingualized (lingual contact)
(Anatoline)
• Shallow Condylar Guidance
• Non-anatomic (Portrait
0°)
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 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
Monoplane Articulation

• Eliminate cusps
• lateral forces reduced
• improves stability
• Simplifies tooth arrangement
Monoplane Articulation

• No overbite (would
cause tilting)
• Overjet of 2 mm is
used to create an
illusion of overbite
Monoplane Articulation

• Excursions - may or may

not contact on balancing
sides
• Depends on condylar
inclination and other
aspects of the tooth
arrangement
Monoplane Articulation

• Anterior teeth make

contact in excursions
• Modifications have been
proposed to minimize
the tilting potential:
• Compensating curves
Monoplane Occlusion
without condylar influence
Monoplane Occlusion
Monoplane Articulation

Advantages
• Technically easier to achieve
• Use when:
– Difficulty obtaining repeatable
centric records (muscle
incoordination)
– Skeletal malocclusion (Class II,
III)
– Severe residual ridge resorption
– Reduces horizontal forces
Monoplane Articulation
Disadvantages
• Poorer appearance
• Can be unstable if condylar
guidance is steep (posterior
teeth separate, leaving only
the anteriors in contact)
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.
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.