Complete dentures

Occlusion as reked to co
prosthodontics
refrtow~e
H. 0. Beck, D.D.S., MS.*
The University of Texas Dental Branch at Houston,, Texas
0 cclusion of complete dentures has been a concern since ancient times when
attempts were made to replace lost teeth. Teeth carved from ivory and fastened to
gold plate have been found in mummies dating back more than 2,400 years.
Others found were made of bone and wood. Although those who practiced this
art of carving possessed certain degrees of skill the occlusal surfaces may be said
to be nondescript or unclassifiable and often of several forms in the same series of
carvings.
Among the principal contributors in the development of posterior denture teeth
of different occlusal forms in the last 50 years have been Sears,l Gysi,2 Hal&:
French,4 Kurth,5 and Hardy.G Many other occlusal forms appear to be modifications
of the original patterns.
The designs of posterior teeth generally have been based on the morphology of
the natural teeth and the temporomandibular joints, observation of movements of
the mandible, clinical observations of wear facets on the natural teeth, chewing
efficiency, and/or empirical and subjective values assigned by the the designers based
on clinical experience and judgment. Other contributions have been made in other
continents. Thus, a variety of occlusal forms have been accepted for complete
dentures without long-term investigations and statistical analyses of the advantages
which may be attributed to each form.
Woelfelt recently reported on a five-year clinical study of a comparison of three
occlusal forms, i.e., 0, 20, and 33 degree teeth in complete dentures. He suggests as
one result of his study that the selection of 0 and 20 degree teeth should be based
on other factors than an attempt to maintain the supporting structures of the
dentures. Another long-term study of a different nature relates tooth form to two
different techniques. It was begun several years ago and hopefully will disclose
further statistical s&nificance after the ten-year period of study is completed. Progrrss
of the study has been reported by Hickey, Henderson, and Straus7
Read before the Academy of Denture Prosthetics, Detroit, Mich.
*Professor and Chairman, Removab!e Prosthodontics.
TWoelfel, J. B.: Personal communication.
246
Volume 27
Number 3
Occlusion and removable prosthodontics 247
Paynes listed definable guidelines for the selection of occlusal patterns based on
anatomic oral tissue conditions and jaw positions in centric relation. A chart which
outlines the selections has been exceedingly helpful for dentists who do not strictly
subscribe to one tooth form and concept for all patients.
In the broadest sense, complete dentures should fulfill the requirements of ( 1)
esthetics, (2) harmonious function, and (3) maintenance of hard and soft tissues
of the edentulous arches. Important contributions enabling the dentist to attain these
goals have been made by the Academy of Denture Prosthetics through periodic pub-
lications.g-ll Important information and suggestions have been detailed in statements
covering various phases of prosthodontic treatment including conditioning and prep-
aration of the patient for dentures, the making of impressions, the recording of jaw
positions, the transfers of records, and the use of articulators, as well as provisions
for an esthetic denture. Very little guidance is given for the selection and arrange-
ment of one or more occlusal forms of denture teeth, except in stating that bilateral
balance is desirable and that teeth should allow for unlocking in centric occlusion.
ESTHETICS
One of the factors in developing an esthetic denture is dependent upon the re-
action of the patient and the dentist to the color (shade) of the teeth to be chosen.
Color is a three-dimensional entity consisting of hue, chroma, and value.* Hue is
the designated color such as red, yellow, or green. Chroma is the strength or purity
of the color, and value is the lightness or darkness of the color as compared to a
gray scale ranging from white to b1ack.S
Another factor to be considered in esthetics is the arrangement of anterior and
posterior teeth. Judicious proximal spacing between the teeth will result in depth
perception. Tinting of the bases where they are visible will add to depth perception
by the observer.
HARMONIOUS FUNCTION
Harmonious function of complete dentures is the requirement which exhibits
harmonious occlusal contacts in centric and eccentric maxillomandibular relations
and which is in harmony with the neuromuscular mechanism and the temporo-
mandibular joints in the functional ranges of speaking, chewing, and swallowing,
and with parafunctional movements including exploratory or nonfunctional move-
ments.$ In narrowing the part of function applicable to the occlusal and incisal
areas of the denture teeth, occlusal balance is defined as, . . . a condition in which
there are simultaneous contacts of the occluding units on both sides of the opposing
dental arches.12 This definition can be applied to centric occlusion as well as eccentric
occlusal contacts.
Occluding units in complete dentures under functional contacts away from cen-
tric occlusion are referred to as being in a balanced occlusion or in a nonbalanced
occlusion.
A balanced occlusion is defined as . . . the simultaneous contacting of the upper
*Munsell Color Order System, Munsell Color Company, Inc., Baltimore, Md.
+Sproul, R. C.: Personal communication.
SLarkin, J. D.: Personal communication.
24% Beck
J. Prosthet. Dent.
March. 1972
and lower teeth on the right and left sides and in the anterior and posterior occlusal
areas of the jaws. This occlusion is developed to prevent a tipping or rotating of the
denture base in relation to the supporting structures.12 It must follow that a non-
balanced occlusion would not fulfill the conditions of simultaneous contacting of the*
upper and lower teeth in eccentric positions. The question of immediate concern is
how far from centric occlusion do teeth contact in their functional ranges and how
far should potential deflective contacts be avoided to eliminate tilting or rotating
actions on the denture bases?
Jankelson, Hoffman, and Hendronl suggested that there were not enough factual
reports in the literature to substantiate a balanced occlusion. They further suggested,
as evidenced by cinefluorographic studies, that centric occlusion is the only tooth
rontact of any significance. They stated that, There was no evidence that balance
of teeth in eccentric positions is a physiologic necessity, or that lack of eccentric.
balance is less conducive to masticatory function. The cusp angulation in six pa-
tients who had 0 to 45 degree cusp teeth in dentures appeared to have no influc,nct*
on the manner of incision. Occlusal balance was not observed as long as the bases
remained in contact with the supporting tissues. The influence of the tongue in rt-
taining the dentures, however, was obvious.
Yurkstas and Emerson reported that twelve patients with nonanatomic teeth
(0 degree) in dentures had considerable contact of teeth on the working sides. and
nearly 100 per cent had contact on the balancing sides. Dentures made with post-
molar ramps exhibited no contact on the working sides but did show some contact
on the balancing sides. Their investigation was comparable in method to part of that
of Jankelson, Hoffman, and Hendron.13
Brewer and Hudsonlj used radio signals to record chewing contacts of teeth. This
procedure was the first to eliminate direct wiring out of the mouth to the recording
unit. This pilot study on two patients showed that chewing contacts occur on thr
cusp heights as well as in centric occlusion. A later report by BrewerI indicated that
the type of cusp form and harmony of balanced occlusion caused variation in the
number and type of contacts.
Experiments with natural teeth by other investigators disclosed contacts in the
intercuspal position. increasing in frequency toward the end of mastication. Lat-
eral tooth contacts did occur although less frequently than in the intercuspal po-
sition, and they occurred before and after the centric occlusal contacts were
reached.lR
MAINTENANCE OF HARD AND SOFT TISSUES
The maintenance of hard and soft tissues of the dental arches is difficult to re-
late to occlusal patterns and occuding concerns alone. Other factors, such as (1 :
properly fitted bases, (2) correct jaw relation records and transfers to an instrument
capable of holding what is recorded, and (3) the arrangement of teeth for the best
stability, and other procedures have an influence on tissue maintenance. Cn-
doubtedly, occlusal patterns and the types of occlusions developed must exert con-
siderable influence on the soft and hard tissues. When more long-term independent
studies with statistical evidences are completed, guidelines for the selection of oc-
Volume ?i
Number 3
Occlusion and removable prosthodontics 249
OCCLUSAL PLANE
-
U
OVERLAPS CENTRIC OCCLUSION
HORIZONTAL 33 - 30 - 20 - 12
VERTICAL
OCCLUSAL PLANE
RIGHT
OCCLUSAL PLANE
-
., RIGHT
STABILIZED
OCCLUSAL PLANE
..
RIGHT
Fig. 1. (A) Diagram of anatomic or semianatomic cusp teeth in centric occlusion with overlaps
in the anterior region. The composites of the contact forces are directed toward the ridges.
(B) From a right lateral movement, cusps glide on opposing inclines. Although bilateral con-
tacts stabilize the dentures, the contact forces are directed away from the ridges. (C) In a
condition of deflective occlusal contact on the balancing side, the contact force is directed out-
side of the ridges. (D) In strong working-side contacts on both cusp inclines, contact forces are
also directed outside of the ridges.
clusal patterns may be forthcoming. Investigations as designed by Woelfel* and by
Hickey and associates have stimulated further research in depth and scope. The
Academy of Denture Prosthetics should then be in the position to include definable
guidelines for occlusal concerns in its pub1ications.l
Ten contemporary occlusal concerns will be reviewed by schematic drawings,
several of which appear to be used more than others. Of these, the first five are in
the balanced occlusion concept, and the remaining five are in the nonbalanced cate-
gory in eccentric occlusal positions. Undoubtedly, more exist, but they should be
in one of the ten categories by virtue of being modifications. Detailed techniques and
procedures, efficiency and mastication performances will not be evaluated. However,
forces exerted by tooth contacts which could be transmitted to the basal seat areas
are illustrated in the diagrams. The directions of these forces are usually perpendicu-
*Woelfel, J. R.: Personal communication.
250 Beck
,I. Prosthet. Dent.
March. 1972
OCCLUSAL PLANE OCCLUSAL PLANE
------ .
OVERLAPS CENTRIC OCCLUSION
HORIZONTAL
VERTICAL
RIGHT
Fig. 2. (A) In centric occlusion, half of the width of lower posterior teeth helps to direct the
occlusal contact forces on the lingual side of the ridges in a buccal direction to the lower
ridge. (B) From a right lateral position toward centric occlusion, the contact forces are di-
rected toward the ridges on the working side (W) and away from the ridges on the balancing
side (B) (Frenchs posterior teeth).
lar to the opposing surfaces in gliding contacts. Small frictional forces present would
alter the directions by small unknown amounts, and variations in the positioning of
the teeth to obtain a balanced occlusion would also alter the directions of these con-
tact forces.
BALANCED OCCLUSIONS
( 1) The definite cusp form which represents anatomic and semianatomic con-
figurations dates back to 1909 when twentieth-century anatomical bicuspids and
molars were introduced by the Dentists Supply Company.* This culminated in the
33 degree cusp form in 1914 as advocated by Gys? (Fig. 1, A) . A classical lateral
movement is shown where cusps contact bilaterally to enhance the stability of the
dentures (Fig. 1, B) . Fig. 1, C and D, depicts deflective contacts in extreme lateral
positions which may cause tilting actions of the bases.
(2) Fig. 2, A and B, illustrates the reduction of the occlusal table of the lower
posterior teeth to increase the stability of the dentures as advocated by French.4 The
upper posterior teeth have slight lingual occlusal inclines of 5 degrees for the first
bicuspids, 10 degrees for the second bicuspids, and 15 degrees for the first and second
molars, so that a balanced occlusion could be developed laterally as well as an-
teroposteriorly by the arrangement of the teeth on a curved occlusal plane.
(3) Sear? was one of the greatest exponents of the nonanatomic tooth forms. He
introduced his chewing members in 1922 and his channel type posterior teeth in
1927. These teeth had a restricted acceptance at first. Modified nonanatomic tooth
patterns from the early types have been accepted much more extensively since then.
A balanced occlusion can be developed by a curved occlusal plane anteroposteriorly
and laterally or with the use of the second molar ramp (Fig. 3, A and B)
(4) The next occlusal concern employs a posterior reverse lateral curvature
except for the second molar which is set with the customary lateral curvature (Wil-
son curve) to provide a balanced occlusion (Fig. 4, A and B) . Pleasurels rational-
ized that the occlusion should be of special design due to the instability of the lower
*Densply International, York, Pa.
Occlusion and removable prosthodontics 251
OCCLUSAL PLANE
HORIZONTAL WITH RAMP
OCCLUSAL PLANE
/
HORIZONTAL WITH RAMP-
OVERLAPS CENTRIC 2nd
HORIZONTAL OCCLUSION
MOLAR
:. RIGHT
MOLAR
VERTICAL CONTACT
CONTACT
Fig. 3. (A) Nonanatomic teeth will exert contact forces toward the ridges in centric occlusion.
(B) From a right lateral position toward centric occlusion, gliding surfaces will direct contact
forces toward the ridge on the working side (W) but will direct contact forces toward the
buccal side of the ridge on the balancing side (B), depending on the degree of lateral inclina-
tion of the second mo!ars.
OCCLUSAL PLANE OCCLUSAL PLANE
I
HORIZONTAL WITH RAMP
HORIZONTAL WITH RAMP
WT
B STABILIZED
RIGHT
WITH
RAMP
OVERLAP
CENTRIC OCCLUSION 2nd
LA
HORIZONTAL REVERSE MOLARS
VERTICAL
LATERAL
CURVE
Fig. 4. (A) An arrangement of teeth with a reverse lateral curve through the first molars will
direct contact forces toward the lingual side of the lower ridge and toward the buccal side of
the ridge at the second molar ramp. (B) Gliding surfaces will direct contact forces toward the
lingual side of the lower ridge on the working side (W) and toward the buccal side of the
ridge on the balancing side (B), depending on the inclination of the second molar ramp.
denture. Resultant forces should be directed vertically and/or lingually. He further
envisioned that research should result in a machine which could test, . . . (1) the
forces encountered in closing through food; (2) the number of chewing cycles re-
quired; (3) the amount of lateral displacement induced in the tooth support during
a normal chewing cycle against resistant food. He stressed that forces of cutting and
shear with a reduction in the displacement of bases are more important than the
triturating efficiency to evaluate posterior tooth form in terms of maintaining the
supporting structures.
(5) The last occlusal design in the balanced category employs an arbitrary ar-
ticulator balance, followed by intraoral corrections to obtain balance, and it illus-
trates a linear occlusion which is intended to give a one-dimensional contact be-
tween the opposing posterior teeth as advocated by Frush20 (Fig. 5, A and B) . A
blade on the lower posterior teeth contacts essentially flat surfaces of the upper
252 Beck
OCCLUSAL PLANE OCCLUSAL PLANE
6
6
A
=t
_- 6===-
=-6
OVERLAPS CENTRIC OCCLUSION
HORIZONTAL
VERTICAL
Fig. 5. (A) In a linear occlusal concept the contact force would be directed toward the ridges
and slightly toward the buccal side at the given inclination of 6 degrees. (A) From a right
lateral movement, the directions of contact forces would be maintained toward the ridges
and slightly toward the buccal side of the lower ridge.
OCCLUSAL PLANE OCCLUSAL PLANE
- -
OVERlAPS CENTRIC OCCLUSION
1 - 1 J2 mm. ~~ RIGHT
HORIZONTAL 33 UPPERS
2 - 3 mm.
20 LOWERS
VERTICAL
Fig. 6. (A) One of several combinations of posterior tooth designs is illustrated in which upper
lingual cusps make contact in lower fossae and in which the contact forces are directed toward
the ridges. Gold occlusal inlays help maintain the occlusal vertical dimension. (B) From a
right lateral position, only the upper lingual cusps glide on low opposing inclines into enlarged
fossae in the lower teeth. The buccal cusps on the working side are out of contact, and there
are no balancing-side contacts. The contact forces on the working side are directed toward
the lingual side of the lower ridge. Accurate retentive bases are indicated. This concept also
uses phonetic sounds of F, V, and 3 for the placement of the anterior teeth before the
posterior teeth are arranged.
teeth set at a slight angle to the horizontal. The intent in this concern is to elim-
inate occlusal deflective contacts and, thus, provide greater stabilization of the den-
tures.
NONBALANCED OCCLUSlONS
(6) Fig. 6, A and B, depicts a concept as advocated by Poundr which stresses
the positions of the anterior teeth to preserve or re-establish the phonetic values
of the patient in harmony with increased denture stability and efficiency with the
chewing cycle. Several characteristics of this concept are the incorporation of sharp
Volume 27
Number 3
Occlusion and remouable prosthodontics 253
OCCLUSAL PLANE OCCLUSAL PLANE
CUSPID Wf
B
OVERLAPS CENTRIC OCCLUSION
GUIDANCE i,
HORIZONTAL
RIGHT
VERTICAL
Fig. 7. (A) A concept which uses deep vertical overlaps, when indicated phonetically and
esthetically, and anatomic posterior teeth with full gold occlusal surfaces is illustrated. The
upper hngual cusps and lower buccal cusps contact opposing fossae, and the composite direc-
tions of contact forces are exerted toward the ridges. (B) From a right lateral position to
centric occlusion, cuspid guidance disoccludes the posterior teeth until occlusal contact is made
in centric occlusion. Accurate retentive denture bases are a requirement in this concept.
upper lingual cusps in opposing widened fossae of the lower teeth in centric oc-
clusion, the reduction of the buccal cusps of the lower posterior teeth, and the elim-
ination of deflective contacts by the use of occlusal adjustment wax on the completed
dentures. In effect, the occlusion is lingualized by the elimination of contacts on
the buccal cusps and by the anteroposterior arrangement of the lower posterior
teeth so that their lingual surfaces are on or within the lingual side of a triangle
from the mesial area of the lower cuspid to the sides of the retromolar pad. Partial
occlusal metal inlays may be used to minimize wear on teeth and, thus, help main-
tain the vertical dimension of occlusion.
(7) Another concept utilizes a 33 degree cusp form with full occlusal gold sur-
faces (Fig. 7, A and B) .* The anterior teeth are set to the requirements of phonetic
values. Extreme vertical overlaps producing cuspid guidance are frequently used,
resulting in disocclusion of the posterior teeth away from centric occlusion. Charac-
teristic of this concept is the use of pantographic tracings and the transfer of these
recordings to an instrument to eliminate all potential deflective contacts in the ar-
rangement of the posterior teeth.
(8) A contemporary occlusal design which is used extensively utilizes nonan-
atomic teeth in a straight occlusal plane, usually horizontal, when the casts are
mounted horizontally in an instrument (Fig. 8, A and B) . All-porcelain or all-plastic
posterior teeth may be used, or combinations of posterior teeth of porcelain upper
and plastic lower teeth, or metal shearing blades may be incorporated in a block of
the upper posterior teeth occluding against lower porcelain teeth as advocated by
Hardy.
(9) Occlusal pivots were advocated by Sear? (Fig. 9, A and B) . The primary
concerns are that the mandible be placed in equilibrium by maintaining the load
in the molar regions, that the procedure protects the temporomandibular joints
*Aull, A. E.: Personal communication.
254 Beck
J. Prosthet. Dent.
March, 1972
OCCLUSAL PLANE
OCCLUSAL PLANE
HORIZONTAL HORIZONTAL
OVERLAP CENTRIC OCCLUSION
HORIZONTAL
RIGHT
Fig. 8. (A) Nonatomic posterior teeth in a flat plane with a minimal vertical overlap in the
anterior region is a widely used concept. The contact forces are directed toward the ridge
bilaterally in centric occlusion. (B) From a right lateral position to centric occlusion, only the
buccal cusps on the working side (W) contact if the path of the condyle is not parallel to the
occlusal plane. Tilting of the bases and shear lateral forces may result if extreme gliding OC-
clusal contacts are made (B).
OCCLUSAL PLANE
HORIZONTAL WITH PIVOTS
OCCLUSAL PLANE
*~ - DIVERGENT
HORIZONTAL WITH PIVOTS
OVERLAP CENTRIC OCCLUSION
HORIZONTAL AT PIVOT
? 2nd
RIGHT MOLARS
Fig. 9. (A) Pivoting in the posterior region of a flat occlusal plane has been used to alleviate
temporomandibular joint symptoms. Contact forces are directed toward the ridges in centric
occlusion. (B) From a right lateral position to centric occlusion, only the working-side pivot
will contact if the path of the condyle on the balancing side (B) is not parallel to the occlusal
plane.
against injury, and that the stresses are also reduced in the anterior regions of the
ridges in anticipation of tissue maintenance.
(10) A reverse lateral curvature in the occlusal arrangement is used infrequently
(Fig. 10, A and B) . The mounted casts and the occlusal plane are on a horizontal
plane in the instrument without a posterior ramp which results in a nonbalanced oc-
clusion in eccentric positions. One type of this occlusal ,pattern was developed by
Kurth5 and consisted of posterior tooth blocks in series of four teeth which were
arranged on a flat anteroposterior occlusal plane with a reverse lateral curve
(reverse of Wilson curve) .
CONCLUSIONS
( 1) Ten occlusal concepts with different occlusal arrangements for complete
dentures have been reviewed.
p"l;;;ry
OCCLUSAL PLANE
HORIZONTAL
A
b
-- --
a
=--=
Occlusion and removable prosthodontics 255
OCCLUSAL PLANE
HORIZONTAL
OVERLAP CENTRIC OCCLUSION TW
B
HORIZONTAL REVERSE
LATERAL CURVE
,, RIGHT
Fig. 10. (A) A concept which utilizes a flat anteroposterior occlusal plane and a reverse lateral
curve is not used extensively. Contact forces are directed toward the lingual side of the lower
ridge in centric occlusion. (B) 0cc1~sa.l contact is maintained in a movement from a right
lateral position to centric occlusion on the working side (W) only, with contact forces directed
toward the ridges. (B, balancing side.)
(2) Five of these designs are in the balanced concept, and five in the non-
balanced concept.
(3) Contact forces which are transmitted to the basal seat areas of dentures
vary with different occlusal patterns and designs.
(4) Efficiency of the teeth in triturating food in mastication is a factor which also
needs evaluation relative to maintenance of supporting tissues.
(5) A few long-term investigations are in progress to evaluate statistically (a)
several tooth forms and compare them and (b) the use of one tooth form with dif-
ferent clinical procedures.
(6) It is conceivable that more than one occlusal design can provide satisfac-
tory denture service and fulfill the requirements of esthetics, function, and main-
tenance of supporting tissues.
SUMMARY
Occlusal designs and their resulting functions are of concern to the dentist so
that loss of the remaining tissues of the mouth, which may be attributed to the oc-
clusion, can be minimized. This is difficult to assess since living tissues change and
physiologic tolerances vary. More long-term statistical investigations are necessary
to compare the various occlusal designs so that more definable guidelines may evolve.
Until such guidelines are available, the dentist must rely on his clinical experience
and clinical judgment to select the occlusal design or designs of his choice in the
treatment of complete denture patients.
References
1. Sears, V. H.: Thirty Years of Nonanatomic Teeth, J. PROSTHET. DENT. 3: 596-617, 1953.
2. Gysi, A.: Research in Denture Construction, J. Am. Dent. Assoc. 16: 199-223, 1929.
3. Hall, R. E.: Full Denture Construction, J. Am. Dent. Assoc. 16: 1157-1158, 1929.
4. French, F. A.: The Problem of Building Satisfactory Dentures, J. PROSTHET. DENT. 4:
769-781, 1954.
5. Kurth, L. E.: Balanced Occlusion, J. PROSTHET. DENT. 4: 150-167, 1954.
256 Beck
.I. Prosthet. I)ent
March, 1Yi
6. Hardy, I. R.: The Developments in the Occlusal Patterns of Artificial Teeth, J. PROSTHK
DENT. 1: 14-28, 1951.
7. Hickey, J. R., Henderson, D., and Straus, R.: Patient Response to Variations in Denture
Technique. Part I. Design of a Study, J. PROSTET. DENT. 22: 158-170, 1969.
8. Payne, S. H.: Selective Occlusion, J. PROSTHET. DENT. 5: 301-304, 19.?5.
9. Schuyler, C. H., Jordan, L. G., and Sears, V. II.: Report of the Committee on Principlcr.
Practices and Nomenclature, J. PROSTHE?. DENY. 2: 573-574, 19j2, and J. PROS~XXUI.
DENT. 3: 595, 1953.
10. The Academy of Denture Prosthetics: Principles, Concepts and Practices in Prostho-
dontics, J. PROSTHET. DENT. 13: 283-294 ,1963.
11. Lytle, R. B., Atwood, D. A., and Beck, H. 0.: Minimum Standards of Adequate Prosthr+
dontic Service, J. PROSTHET. DENT. 19: 108-109, 1968.
12. Boucher, C. 0.: Current Clinical Dental Terminology, St. Louis, 1963, The C. V. Mosby
Company.
13. Jankelson, B., Hoffman, G. M., and Hendron, J. A., Jr.: The Physiology rlf the
Stomatognathic System, J. Am. Dent. Assoc. 46: 375-386, 1953.
14. Yurkstas, A. A., and Emerson, W. H.: A Study of Tooth Contact During Mastication With
Artificial Dentures, J. PROSTHET. DENT. 4: 168-174, 1934.
15. Brewer, A. .4., and Hudson, D. C.: Application of Miniaturized Electronic Devices to
the Study of Tooth Contact in Complete Dentures. J. PROSTHET. DENT. 11: 62-72, 1961.
16. Brewer, A. A.: Prosthodontic Research in Progress at the School of .4erospace Medicine.
J. PROSTHET. DENT. 13: 49-69, 1963.
17. Anderson, D. J., and Picton, D. C. A.: Tooth Contact During Chewing, J. Dent. Res.
36: 21-26, 1957.
18. Adams, S. H., and Zander, H. A.: Functional Tooth Contacts in Lateral and in Centric
Occlusion, J. Am. Dent. Assoc. 69: 465-473, 1964.
19. Pleasure, M. A.: Anatomic Versus Nonanatomic Teeth, J, PROSTHET. DENT. 3: f47-i.54.
1953.
20. Frush, J. P.: Linear Occlusion, Swissedent Foundation, June, 196;.
21. Pound, E.: Utilizing Speech to Simplify a Personalized Denture Service, J. PROSTHEF.
DENT. 24: 586-600, 1971.
22. Sears, V. H.: Occlusal Pivots, J. PROSTHET. DENT. 6: 332-338, 1956.
UNIVERSITY OF TEXAS DENTAL BRANCH AT HOUSTON
P. 0. Box 20068
HOUSTON TFXAS 77023
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