The Importance of Lingualized Occlusion - JDT Unbound

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The Importance of 

Lingualized Occlusion 

By T.G. Hornischer, CDT 

ell it’s difficult to sit down with technicians today, especially 

denture technicians, and not have the subject of lingualized 

occlusion come up. Everyone has an opinion, some think this occlusal 

philosophy is the only answer, some feel it can be used occasionally and 

some think it makes no difference. The entire subject of occlusion is 

very broad and varied. I feel there is no one answer for every situation, 

but when it comes to dentures, occlusion lingualized is certainly my 

number one choice for many reasons: 

1. It is very efficient for mastication, and this 

leads to much better intake of nutrients for 

the patient. 

2. This form of occlusion is much easier to 

manage clinically because the number 

of contact points to control it is greatly 

reduced compared to a functional type of 

arrangement. 

3. Once understood, it is much easier to 

produce in the laboratory. 

For me, this is a win for all parties concerned. 

And remember all of these factors and more are 

extremely critical in dealing with dental implants. 

Lingualized occlusion is quite simple and can 

be used in both fixed and removable prostheses. In 

their British Dental Journal article, Good Occlusal 

Practice in the Provision of Implant Borne Prostheses, 

20 Journal of Dental Technology November/December 2009

authors S.J. Davies, R.J.M. Gray and M.P.J. Young 

write of lingualized occlusion: 

“The key feature is the arrangement of the 

posterior teeth so that only the maxillary palatal 

cusps (hence: ‘lingualized’ occlusion; or should it 

have been called ‘palatalised’ occlusion) occlude 

with shallow mandibular central fossae. There is 

no contact between the mandibular buccal cusp 

and palatal maxillary cusps which might result 

in a inclined (non-axial) contact. Laboratory 

fabrication time is reduced and this scheme 

represents a posterior occlusion that can be more 

readily observed in both the laboratory and clinical 

environments thereby enabling any unfavorable 

occlusal contacts to be identified and corrected 

more easily.” 

This type of occlusal philosophy has been 

advocated for quite some time. Many of the great 

dental giants (Gerber, Pound, Frush, Trubyfield, 

Massad and others) have advocated this type of 

denture occlusion. It is interesting when you 

study the writings of these dentists that the 

arrangement of the occlusion is only a part of the 

whole treatment, most of the steps leading to the 

posterior set are concerned with proper occlusal 

registration and positioning of the anterior teeth, 

lip support, incisal edge position, phonics and arc 

of closure. All of these things must be addressed 

well before we can determine how and where the 

posterior teeth are set. Despite all the time we, 

as technicians, spend setting articulation, setting 

teeth, waxing the gingival contours, processing and 

polishing, it is all in vain without the foundation 

of proper occlusal records and precise models. In 

most cases without proper occlusal records and 

precise models, the restoration will be ground 

endlessly by the dentist or not worn by the patient. 

This article will mainly focus on a simple 

lingualized set up and will touch on the anterior 

function leading up to it. This certainly is not an 

exhaustive study but simply the basics. 

OK let’s begin. 

At all possible costs, try and use a semiadjustable 

articulator and hopefully with a face 

bow, these are inexpensive today. The Whip Mix 

Ulti-Mate (Figure 1) is a good example of this 

type of articulator. Even without the face bow, if 

properly mounted, this type of articulator will be 

much better than the old hinge type as you can 

Figure 2 

Figure 1 

Figure 3 

Figure 4 

November/December 2009 Journal of Dental Technology 21

Figure 5 

Figure 7 

Figure 6 

Occlusal plane is the line between 

the incisal edge position and the 

middle of the retromolar pad. 

set the models more in a proper relationship to 

the TMJ. In Figure 2 we set the maxillary anterior 

according to the approved or contoured wax rim. 

Figures 3 and 4 demonstrate the appropriate 

inscial edge and facial contour as dictated by the 

established rim. Also, note that the teeth are placed 

in a more natural arrangement and not perfectly 

straight so that we do not get the denture look. 

Figures 5 and 6 illustrate the relationship of the 

maxillary incisal edge position to help determine 

the occlusal plane. 

At this point some technicians will complete 

the maxillary set up, which is my choice, or set the 

mandibular anteriors followed by the mandibular 

posteriors. Either way works, as long as the 

principals are followed. Figure 7 shows the facial 

view of the lower set up, while Figure 8 illustrates 

again the natural appearance arrangement. One 

Figure 9 

Figure 10 

Figure 8 


thing to remember is that function is king, so 

following the guidance of the TMJ we can set 

the anterior teeth in functional harmony and 

natural esthetics at the same time. In Figure 9, 

the facial appears very natural, the placement of 

the teeth does not look as different as in previous 

figures. And, in Figures 10 and 11 you can see the 

function in lateral excursion and protrusive are 

quite functional. We have a nice balance in lateral 

from central, lateral and cuspid. In protrusive we 

have nice balance again with the upper and lower 

anteriors. So, with function we also have esthetics! 

Now, to the mechanics of lingualized 

occlusion. Figure 12 illustrates the mandibular 

posteriors set. The thing to note here is the curve 

of Spee originating from the incisal edge of the 

cuspid to two-thirds the height of the retro-molar 

pad, our occlusal plane. This is very important for 

the correct function in our lingualized posterior 

set up. Now, before we set our maxillary posteriors 

let’s look at the contacts we need. Figures 13A 

and 13B illustrate the upper and lower contact 

points. On the upper, there are contacts only on 

the lingual cusp tips. On the lower, the contact 

points are in the central groove. It is important 

that we must not have any balancing contacts on 

the upper posteriors in lateral movements. As you 

can see from a side view there is no buccal contact 

in centric occlusion (Figure 14) and the case 

looks very natural from the facial (Figure 15). Also 

important to note, is that the anterior function 

Figure 12 

Figure 14 

Figures 13A 

and 13B 

Figure 11 

Figure 15 

November/December 2009 Journal of Dental Technology 23

Figure 16 

facilitates the disclusion of the buccal cusps (Figure 

16). 

Reviewing this case occlusally (Figures 17 and 

18), note the tooth rotations in the anterior and 

how they function very nicely while being esthetic. 

Figure 19 shows the facial view of the completed 

case. All that is left now is a nice processing job 

and you will have a wonderful result. 

I hope that I have shed a bit of light on the 

concept of lingualized occlusion, although this 

barely uncovers all that this great concept can be. 

Remember that proper jaw relations are essential 

to a successful case and that beauty and function 

can go hand in hand. We are very fortunate today 

to have manufacturers producing teeth specifically 

for this purpose. In the not too distant past we 

technicians had to adjust the occlusals of posterior 

teeth to achieve this occlusal scheme, luckily this is 

no longer true. 

My suggestion to anyone who wishes to add 

lingualized occlusion to your repertoire is to attend 

hands-on training and market your newly-learned 

skills. One can never know too much or be too 

successful! 

Figure17 Figure 18 

Figure 19 

Author’s Note: 

I would like to give special thanks to 

Candulor USA and to Vident for their support and 

contribution to this article. 

About the Author: 

Hornischer is the 

recipient of the NADL’s 

2006 Excellence in 

Education Award. He is the 

general manager of Centric 

Dental Laboratory, CDL, 

a 25-person, full-service 

laboratory in Bullard, Texas. 

QUIZ: 

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The Importance of Lingualized Occlusion - JDT Unbound

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