Manuals_files/CD Manual 12.pdf - Removable Prosthodontics

Selecting & Setting Teeth - 50
Philosophies of Denture Occlusion:
There are many philosophies of arranging the denture occlusion, but no definitive scientific
studies have proven one type of occlusion to be clearly superior to another. Clinicians
have developed some principals, based on experience, to make it easier to determine which
type of occlusal scheme to use. We will learn two occlusal schemes (there are others):
1. Lingualized Occlusal Scheme
Lingualized occlusion is a type of bilaterally balanced occlusal schemes. The philosophy
of a balanced occlusal scheme is to improve denture stability by maintaining contacts on
both sides of the denture in excursions during function. Patients feel more confident and
have less discomfort when dentures are more stable. There is indirect evidence that
balanced occlusion may reduce ridge resorption and allow for increased functional forces
in excursions. Lingualized occlusion differs from traditional fully balanced schemes by
having only the lingual cusp of the maxillary tooth contacting the mandibular teeth to
maintain this contact.
a) Centric position contacts are set maxillary lingual cusp to fossae of the mandibular
posterior teeth. No anterior contacts should be present in the centric position.
b) Anatomic teeth are used in the maxilla opposing a flat-cusped, or shallow cusped
mandibular tooth.
c) Overbite is incorporated into the anterior setup to improve esthetics, and eccentric
contacts.
d) In eccentric movements there are contacts on both the working and balancing sides
of the denture, whether excursions are protrusive or lateral in nature. Anterior teeth
make grazing contact in excursions.
e) The condylar guidance, incisal guidance, angle of the occlusal plane, cusp angle of
the denture teeth, and compensating curves placed during the posterior tooth setup
all affect the ability to achieve these contacts.