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‫بسم هللا الرحمن الرحيم‬

‫‪11/04/21‬‬ ‫‪Dr Mohammed M Fuad‬‬ ‫‪1‬‬


BASICS OF COMPLETE
DENTURE OCCLUSION

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DEFINITIONS

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Occlusion
“The static relationship between the
incising or masticating surfaces of the
maxillary and mandibular teeth when
they are in contact in either centric or
eccentric jaw relation.”
“Static tooth contact”

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Centric occlusion
• It is the maximum intercuspation
between upper and lower teeth (cusp
to fossa relation)
• It is a tooth‑to‑tooth relation.
• In complete dentures, ideally,
CR=CO.

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Articulation
“The contacting of teeth as the
mandible moved to and from
centric and eccentric relation
(dynamic)”.
“Dynamic tooth contact”

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Centric relation
• Most posterior retruded unstrained
position of mandible in relation to
maxilla at established vertical
dimension from which any eccentric
movement can be done at a given
degree of jaw separation.
• Called horizontal jaw relation.
• It is bone to bone relation.

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Eccentric occlusion
• “It is the occlusion of opposing
teeth when the mandible is in any
other relation than centric
relation”.
• The contacting of teeth on
eccentric occlusion can occur with
the jaws in a static relation .

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Gliding occlusion
• “ It is the contacting of teeth in
motion”.
• It occurs when the occlusal
surfaces of the teeth make contact
when the mandible is moving to
and from eccentric and centric jaw
relations.

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Basic mandibular movements.
1) Hinge axis movement
2) "Translation"
• The max opening in hinge
movement=25 mm (measured from
incisal edges).
• The average opening of hinge and
translation together is in the area of
50mm.
• The three main categories of
mandibular positions:
1. MI
2. CR
3. Eccentric positions or movements
• Condylar guidance refers to
angulations and curvature of the bony
structures of TMJ (fixed ).

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What happens if you have a greater
degree of condylar guidance? Lesser?

• The greater/lesser degree of posterior


tooth disocclusion

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What happens with an overbite?

• That is a greater
vertical overlap,
therefore the
greater the amount
of disengagement

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What happens with a greater
horizontal overlap (overjet)?
• The further the lower
incisors will have to
travel before contacting
the lingual surfaces of
the upper incisors
• A later and lesser
disocclusion of the
posterior teeth.

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What is vertical dimension?
1) the height of the
lower third of the face
2) 2) the distance
between the upper
and the lower arches.

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what are the types of vertical
dimension?
1)Vertical dimension of Occlusion: Distance
between maxilla and mandible when teeth
are in MI
2)Vertical Dimension at Rest: Distance
between the maxilla and mandible when in
physiological rest position.

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What is physiological rest position?
• PR represents the normally relaxed state
of the lower jaw. It hangs open 2-3 mm.
• Force of gravity is equal to the
neuromascular tonality of muscles of
mastication

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What is "Freeway space"?
• That is the difference in distance between
VDO and VDR

2-4 mm

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What is Canine guidance?

• The canines will guide


the lateral protrusive
movement and
DISOCCLUDE all
other teeth and guide
the teeth back into
occlusion

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Differences between natural and
artificial occlusion

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Natural occlusion Artificial occlusion
1. Periodontal • The teeth are retained by periodontal • All the teeth are on bases seated
tissues. on slippery tissues
tissues
2. Malocclusion • May be uneventful. • Evokes an immediate response
and involves all of the teeth and
the base.
• Affect only the teeth involved • The effect involves all of the teeth
3. Nonvertical forces • and are usually well tolerated, on the base. It is usually traumatic
to the supporting structures.

4. Incising • Does not affect the posterior teeth. • Affects all of the teeth on the
base.

5. The favored area • The second molar region. • Heavy pressures of mastication in
the second molar region with
for masticating artificial dentition will tilt the
hard foods. base and ship it, if it is on an
inclined foundation.
• Rarely found; if present it is • Considered necessary for base
6. Bilateral balance
considered balancing side stability.
interference.

7. Properioception • Gives the neuromuscular system • Not present and the mandible in
control during function. function will end its chewing
stroke in the most favorable
physiologic position, which is
very close to centric relation.
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Objectives of restored occlusion

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Objectives of restored occlusion:
1. An acceptable interocclusal distance.
2. A stable jaw relationship with bilateral
tooth contacts in retruded closure.
3. Stable tooth quadrant relationships,
providing axially directed forces.
4. Multidirectional freedom of tooth contacts
throughout a small range of mandibular
movements.
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Requirements of complete denture
occlusion

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Requirements of complete denture
occlusion:
1. Stability of occlusion at centric relation
position and in an area forward and
lateral to it.
2. Balanced occlusal contacts bilaterally for
all eccentric mandibular movements.
3. Unlocking the cusps mesiodistally to
allow for gradual settling of

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Requirements of complete denture
occlusion:
4. Control of horizontal force by
buccolingual cusp height reduction
according to residual ridge resistance
form and interarch distance.
5. Functional lever balance by favorable
tooth‑to‑ridge crest position.
6. Anterior incisal clearance during all
posterior masticatory function and
bruxing activity.
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Requirements of complete denture
occlusion:
7. Minimum occlusal contact areas for
reduced pressure in comminuting food
(lingual contact occlusion).
8. Cutting, penetrating, and shearing
efficiency of occlusal surfaces.
9. Sharp ridges or cusps and generous
sluice­ways to shear and shred food with
the minimum of force necessary.
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The occlusion of complete denture is
divided into three distinct units:

(a) Incising Units,


(b) Working occlusal Units, and
(c) Balancing occlusal units.

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Requirement for Incising Units:
1. These units should be sharp in order to cut
efficiently.
2. They should not contact during mastication.
3. They should have as flat incisal guidance as
possible considering esthetics and
phonetics.
4. They should have horizontal overlap to allow
for base settling without interference.
5. They should contact only during protrusive
incising function.

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Requirements for working
occlusal Units:
1. They should be efficient in cutting and grinding.
2. They should have decreased buccal‑lingual
width to minimize the work force directed to the
denture foundation.
3. They should function as a group with
simultaneous harmonious contacts at the end of
the chewing cycle and during eccentric excur­
sions.
4. They should be over the ridge crest in the
masticating area for lever

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Requirements for working
occlusal Units:
5. They should have a surface to receive
and transmit the force of occlusion
essentially verti­cally.
6. They should center the workload near the
anteroposterior center of the denture.
7. They should present a plane of occlusion
as parallel as possible to the mean
foundation plane.
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Requirements for balancing
occlusal units:
1. They should contact on the second
molars when the incising units contact in
function.
2. They should contact at the end of the
chewing cycle when the working units
contact.
3. They should have smooth gliding contacts
for lateral and protrusive excursions.
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Theories of occlusion:

1. The Bonwill theory of occlusion.


2. The conical theory of occlusion.
3. The spherical theory of
occlusion (by Monson in 1918).

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The Bonwill theory of occlusion:
(The theory of the equilateral triangle)

• Proposed that the teeth move in


relation to each other as guided by
the condylar controls and the
incisal point. There is a 4‑inch (10-
cm) distance between the condyles
and between each condyle and the
incisor point.
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The conical theory of occlusion:
• Proposed that the lower teeth move
over the surfaces of the upper teeth as
over the surface of a Cone, generating
an angle of 45 degrees with the central
axis of the cone tipped 45 degrees to
the occlusal plane.
• It should be noted that teeth having
45‑degree Cusps are necessary when
dentures are made on this instrument.

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The spherical theory of
occlusion (by Monson in 1918):
• showed the lower teeth moving over the
surface of the upper teeth as over the
surface of a sphere with a diameter of 8
inches (20 cm). The center of the sphere
was located in the region of the glabella,
and the surface of the sphere passed
through the glenoid fossae along or
concentric with the articulating
eminences.
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COMPANSATING CURVES

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Definition:
• Compensating curves are the artificial curves
introduced into dentures in order to facilitate
the production of balanced occlusion; they
are artificial counterparts of the curves of
Spee (anteroposterior) and Monson (lateral)
which are found in the natural dentition.
• The compensating curves may be increased
or decreased in artificial dentition to help
achieve balanced occlusion.
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Curve of Spee
• This curve follows an
imaginary line
touching the buccal
cusps of all the lower
teeth from the lower
canine backwards.
This curve forms an
arc of a circle 14 cm
in diameter with its
center behind the
crista lacrimalis.
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Curve of Monson
• The curve of
occlusion in which
each cusp and incisal
edge touches or
conforms to a
segment of the
surface of a sphere
20 cm in diameter
with its center in the
region of the glabella.
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All teeth
and cusps
contact the
compensat
ing curve

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CONCEPTS OF OCCLUSION

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• A concept is a general belief
representing a class of ideas or
objects.
• Occlusal scheme for complete
dentures fall into two general
concepts:
1. Balanced occlusion, and
2. Nonbalanced occlusion.

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Balanced occlusion

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Definition of balanced occlusion
• “ It is the bilateral, simultaneous,
anterior, and posterior occlusal
contact of teeth in centric and
eccentric positions (static
positions)”.
• Teeth can be arranged in these static positions
and observed on positional, semi adjustable
and adjustable articulators; and assuming that
the maxillo­mandibular relation records are
accurate, the contacts will be repeated in the
mouth.
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Definition of balanced gliding
occlusion
• “ It is the even contacting of teeth
as the mandible moves to and
from eccentric and centric max­
illomandibular relations (dynamic
positions)”.
• The teeth can he arranged in these dynamic
positions and observed on positional and
adjustable articulators, but the contacting in
the mouth will not be the same.

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• The concept of balanced
occlusion does not occur in the
natural dentition.
• A stable base is the ultimate
goal.
• Total stability is not possible
because of the yielding nature
of the supporting structures
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PRINCIPLES OF BALANCE AS
RELATED TO COMPLETE
DENTURE OCCLUSION

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Principles of balance as related to
complete denture occlusion :
• The wider and larger the ridge and the
closer the teeth are to the ridge, the
greater the lever balance.
• Conversely, the narrower and smaller the
ridge and the farther the teeth from the
ridge, the poorer the lever balance.
• The wider the ridge and the narrower the
teeth buccolingually, the greater the
balance.
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Principles of balance as related to
complete denture occlusion :
• Conversely, the narrower the ridge and
the wider the teeth, the poorer the
balance.
• The more lingual (inside) the teeth are
placed in relation to the ridge crest, the
greater the balance.
• The more buccal (outside) the teeth are
positioned, the poorer the balance.
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Principles of balance as related to
complete denture occlusion :
• The more centered the force of occlusion
anteroposteriorly, the greater the stability of
the base.
• The smaller the area of occlusal surface acting
on food, the smaller will be the crushing force
on food transmitted to the supporting
structures.
• Vertical force applied to an inclined occlusal
surface causes nonvertical force on the
denture base.

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Principles of balance as related to
complete denture occlusion :
• Vertical forces applied to inclined-
supporting tissues will cause nonvertical
forces on the denture base.
• Vertical force applied to a denture base
supported by yielding tissue causes the
base to teeter when the force is not
centered on the base.

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Methods of producing occlusal
balance:
• Adjustable articulator techniques
• Average articulator techniques
• Hinge articulator with generated
occlusal curvature techniques
• Hinge articulator and average curve
techniques

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Adjustable Articulator Techniques

• Sufficient data are obtained to adjust the


articulator to the individual condyle paths
of the patient. In addition to the usual jaw
relation records is an occlusal record of
the patient's protrusive position. A
face‑bow registration is also taken to
relate the casts to the retruded hinge axis.

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Average articulator techniques
• These articulators have been designed to
produce average mandibular movements, and
the teeth are usually set to an average curvature
of about a 100-mm radius.
• Their use has the advantage of requiring only
the minimum of clinical information.
• The standard of eccentric occlusion achieved is,
of course, not perfect, and a certain amount of
error must be accepted in the finished denture.

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Hinge articulator with generated
occlusal curvature techniques
• The objective of 'grind‑in' and 'chew‑in' techniques is to modify the
surface form of record blocks to harmonize with the mandibu­lar
movements.
• For the grind‑in technique, the blocks are made of two parts of
powdered pumice and one part of plaster of Paris mixed with water.
Soft wax blocks covered with tin foil are used for the chew‑in
technique.
• In both techniques a template of the patient's occlusal curvature is
produced, the casts are mounted on a hinge articulator, and the
technician sets cuspless teeth to duplicate the curved occlusal
Surface. The bases that carry the record blocks should be rigid and
should fit well, because any movement of the record blocks will spoil
the result.
• The degree of balanced articulation depends on the original form of
the record blocks and the care given to the grinding in techniques at
the chairside.
• In general, it is best to start with an occlusal surface that repre­sents
a segment of a 100-mm radius sphere. This is then modified by the
mandibular movements of the patient.
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Hinge Articulator and 'Average
Curve’ 'Techniques
• These techniques do not give such good results
as the other methods and their only virtue is their
simplicity. All that is necessary is to supply the
technician with a metal template of an average
occlusal curvature to which he sets the teeth
after the retruded contact registration has been
made. Several different 'average' templates are
but the 100-mm radius curve based on
Monson’s work (1932) is most commonly used.

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Factors that affect occlusal balance
1. Condylar guidance.
2. Incisal guidance angle.
3. Angulation of the occlusal plane.
4. Compensating curves.
5. Cusps on teeth or the inclination of cuspless teeth
• Under the dentist’s control makes it is possible to
achieve simultaneous gliding occlusal contacts
from centric occlusion to eccentric occlusal
positions both on the articulator and in the
patient's mouth.

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Non Balanced occlusion
Philosophy
Occlusal scheme
1.Neutrocentric concept
2.Reverse lateral curve
3.Organized occ.
4.Occlusal pivots
5.Lingualized occ.

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QUESTIONS

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Right or Fault? Correct the fault:
1. Centric occlusion is "the static relationship between the
incising or masticating surfaces of the maxillary and
mandibular teeth when they are in contact in either cen­tric or
eccentric jaw relation.”
2. Centric relation is the most posterior retruded unstrained
position of mandible in relation to maxilla at established vertical
dimension from which any eccentric movement can be done at
a given degree of jaw separation.
3. Gliding occlusion is a static contact of teeth.
4. The greater/lesser degree of condylar guidance, the
greater/lesser degree of posterior tooth disocclusion
5. The difference in distance between VDO and VDR is called the
"interarch space”
6. Incising with the artificial teeth does not affect the posterior
teeth.
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