The Importance of Lingualized Occlusion - JDT Unbound

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