DEPTT.

OF PROSTHODONTICS & CROWN & BRIDGE

CONCEPTS OF OCCLUSION
SEMINAR

VIKAS AGGARWAL

INDEX
1. INTRODUCTION
2. NORMAL HUMAN DENTITION
3. THEORITICALLY IDEAL OCCLUSION
4. PHYSIOLOGICAL OCCLUSION
5. NON PHYSIOLOGICAL OCCLUSION
6. THERAPEUTIC OCCLUSION
7. DEVELOPMENT OF CONCEPT OF OCCLUSION
8. BILATERAL BALANCED OCCLUSION
9. UNILATERAL BALANCED OCCLUSION (GROUP FUNCTION)
10.LONG CENTRIC
11.PANKEY-MANN-SCHUYER PHILOSOPHY
12.MUTUALLY PROTECTED OCCLUSION
13.CANINE PROTECTED OCCLUSION
14.GENERAL OBJECTIVES OF ESTABLISHING OCCLUSAL
SCHEMES
15.OCCLUSAL CONSIDERATIONS IN FIXED PARTIAL DENTURE
16.OCCLUSAL CONSIDERATIONS IN REMOVABLE PARTIAL
DENTURE
17.OCCLUSAL CONSIDERATIONS IN SINGLE COMPLETE
DENTURE
18.OCCLUSAL CONSIDERATIONS IN IMPLANT SUPPORTED
PROSTHESIS
19.CONCLUSION:

INTRODUCTION
The study of occlusion and its relationship to the masticatory system has been a
topic of interest in dentistry since many years.
One of the chief aims of Preventive and Restorative dentistry has been to
maintain an occlusion that will function in harmony with the other components

of masticatory mechanism, thereby preserving their health at the same time

providing optimum, if not maximum masticatory function.
CONCEPTS APPLIED TO NATURAL DENTITION:

Although early anatomists such as Andreas Versalius and John Hunter

described the static relationships of the natural dentition, these issues
were not directly addressed until the dentists began to evolve the
concepts related to the replacement of the natural dentition by artificial
complete dentures.

Development of concept of occlusion--Three periods:

1. Fictional period (prior to 1900)
2. Hypothetical period (1900-1930)
3. Factual period (1930 to present)

EARLY CONCEPTS:

BONWILL:

Prior to Bonwills law, concepts of occlusion were based on the idea

of a single, centrally located static hinge. This was embodied in the simple
hinged articulators of the middle and late 19 th century. Bonwill analyzed
the mandible and described in terms of an equilateral triangle with 10cm
sides connecting both condyles and the mesio-incisal angles of the
mandibular central incisors.

His concept of geometric ideal was for the purpose of bringing into
contact the largest amount of grinding surface of the bicuspids and
molars, and , at the same time, to have the incisors all come into action
during lateral movements(1885). The resulting balanced occlusion would
be for equalizing the action of muscles on both sides simultaneously, and
getting the greatest amount of grinding surface at each movement which

helps to equalize the pressure and force on both sides or parts of the
dental arches.

Bonwill introduced equilateral anatomical articulator with 2

independent condylar elements. This instrument is considered the first
example of the application of mathematical principles to the problems of
occlusion (Butler and Zander, 1968). Bonwills instrument did not allow
provision for condylar inclination. Walker in 1893 recognised this and
designed an articulator with an adjustable condylar path mechanism and
a complex extaoral tracing device to record the inclination of this path for
each patient. This forerunner of later gnathological concepts and
instrumentation gave impetus to the idea that the creation of a balanced
occlusion required the recording of the patients condylar inclination
during protrusion and lateral excursion.

FERDINAND GRAF SPEE :

The concept of balanced occlusion itself is often credited to Ferdinand Graf

Spee. He proposed that
1. The contacting occlusal surfaces of all natural mandibular teeth
glide against those of maxillary teeth.
2. These area of contact lie on the same cylindrical surface , and
3. The horizontal axis of the cylinders curvature pass through the
middle of the medial surface of the orbit behind the medial surface
of the lacrimal duct.
Spee suggested that the occlusion functions like grinding millstones
and that the mandibular movement occurs in circular paths just as the
pendulum moves around an axis. The term curve of Spee derives from his
observation that when viewed laterally, the masticatory surfaces of the
molars are aligned in an downward convex curve along the upper jaw and
in an upward concave curve along the lower jaw (1890). He also believed
that a posterior continuation of this curvature would pass along the
anterior surface of the condyle, which also moves on a circular path with
the same length of radius on the occlusal surfaces of the molars, that is,
on the same cylindrical surface.

Spee concluded that, as forward and backward gliding of the

mandible takes place in a path of circular motion, such displacement can
occur over long distances without any need for the arches to separate
from each other. Thus, masticatory efficiency is guaranteed. A separation
of occlusal surface is only evitable in order to overcome the contact of
strongly protruding upper and lower canineds. But this can also be
eliminated by wear.this ought to be considered in construction of the
dentures, not only to enable better mastication but also in order to avoid
lever effects during chewing.
Thus, the balanced occlusion organization was born particularly for
complete denture occlusion.

EDWARD HARTELY ANGLE(1900)

Gave his famous classification- Angle Class I , II, and III in 1900.
Drawback: it deals with the static occlusal relationships in centric
occlusion. Thus angles concepts, although very valuable, did not directly
deal with the issues of balanced occlusion, mutual protected occlusion or
occlusal organization associated with eccentric positions of the mandible.

CHRISTENSEN(1902)

He was the first to describe an intraoral method for recording a static

protrusive record to determine the condylar inclination, and he produced
an adjustable condylar guide articulator, the rational articulator, to
promote this technique. From his description came what Ulf Posselt coined
Christensen phenomenon, or the posterior separation of the occlusal
rims that occur when the mandible moves from a centric to a protrusive
position.

ALFRED GYSI(1910)

He criticized the continued use of the simple up and down hinge

articulator. He developed simpler methods to more accurately record the

pathway of the condyle as it translates anteriorly and inferiorly on the

articular eminence. Gysi built several new articulators and extraoral
tracings during this period.
He contended the condyle path does not form a straight as stated
by Walker and Christensen , but follows a curved line or a S-shaped curve.
He believed that mandibular movement is dependent on incisal as well as
condylar inclination. Also, these points of rotation are not fixed points but
results from diverse contraction of the masticatory muscles, and happens
to coincide only now and then with the condyles.

GEORGE S MONSOON

Proposed Spherical theory, which was based, on the concept hat the
mandibular teeth move over the occlusal surface of the maxillary teeth, as
over the external surface of a segment of an 8 inch sphere, and the radius
( or the common center) of the sphere is located in the region of crista
galli.

Monsoon disregarded the Bonwill horizontal excursion. However, he

adapted the 10cm equilateral triangle that formed the basis of Bonwill
theory, and added it to the occlusal curvature- fixed central axis of
rotation concept of Spee. His conclusion produced the 10-cm radius
sphere, a geometric embodiment of the function, form, and beauty of the
masticatory system.

According to Monsoon, elongated teeth must be reduced in their

length and teeth that have been in excessive function built up to their
proper occlusion, bringing the occlusion of all teeth to conform to the
surface of the sphere having proper interlocking cusps to maintain them in
their alignment. The teeth are then ground into the full range of occlusion.
He did recognize two schools of thoughts for mandibular movement.
The first believes that the shape and movement of the condyles govern
the occlusion of the teeth, while the 2 nd contends that the occlusion of the
teeth is the dominant guiding factor, which determines the shape and
movements of the condyles in the glenoid fossa. Monsoon followed the 2 nd
group as reflected in his articulators(maxillo-mandibular instrument) he

utilized a single midline pivot 10cm above the occlusal plane, and no
condylar mechanism whatsoever.

These divergent theoretical approaches to understand and

reproduce the mandibular movement shared one essential therapeutic
objective: a completely balanced occlusion for full denture prosthesis.
Denture stability was a paramount, and as a result the cross-arch, crosstooth, and protrusive elements of balance were accepted.

CROSS ARCH BALANCE: simultaneous contact of working and non-working

teeth.
CROSS TOOTH BALANCE: simultaneous contacting inclines of buccal-tobuccal and lingual-to-lingual cusps of working side teeth.
PROTRUSIVE BALANCE: provided simultaneously contacting inclines of
both anterior and posterior teeth during protrusion.

RUPERT HALL(1914)

To explain his theory of mandibular movement, Hall envisioned that if two

equilateral triangles ( constructed on Bonwills principles) were placed
back to back, they would share a common base that represented the
condylar axis. The vertex of the anterior triangle would be located at the
incisor point, and the posterior vertex would be located at the external
occipital protuberance.
Hall believed that an angle of 45 degrees would produce cusp of the
highest efficiency in mastication. In natural teeth this is found
predominantly in the maxillary first bicuspids. Hall chose the 45 degree
angle as the generating angle for the cone.

Three occlusal concepts:

1.The Gnathological
2.The Freedom-in-centric
3.European conceptual model

GNATHOLOGY:

HISTORY:
Dr. Beverly B. McCollum is considered the "Father of Gnathology." Dr.
Harvey Stallard, an orthodontist, proposed the word Gnathology. It is
derived from "Gnathos," meaning jaw and "ology," meaning study of, or
knowledge of.
In 1924, Dr. McCollum discovered the first positive method of locating the
Hinge Axis, a milestone in dental research. He founded the Gnathological
Society in 1926. McCollum and the Gnathological Society's definition of
Gnathology: Gnathology is the Science that treats the biologics of the
masticating mechanisms; that is, the morphology, anatomy, histology,
physiology, pathology and the therapeutics of the oral organ, especially
the jaws and teeth and the vital relations of the organ to the rest of the
body." McCollum and his associates developed their concept of occlusion
on what was considered the immutable and ideal nature of the
relationship between the condyle and the fossa, which in turn was
responsible for guiding the mandible in its correct relationship to the
maxilla. They believed that if an articulator could absolutely duplicate jaw
relations and condylar movement, it would be possible to make the teeth
that occlude ideally.

McCollum introduced the hinge axis locator, which could precisely

pinpoint the transverse axis of condylar rotation. He embraced the idea of
a completely balanced occlusion for the natural dentition that was totally
consistent with his notion of an idealized biomechanical mechanism. The
presumed objectives were

1.To maintain idealized occlusal contact throughout all excursions,

coordinated in function with the stable condylar-fossa relationship,

thereby eliminating potential tooth interferences during the ideal condyle

positions and movements.
2. To distribute occlusal contacts among as many teeth as possible,
resulting in reduced loading to the individual teeth and curtailment of
periodontal
breakdown.
In 1927, Harvey Stallard recognized that the teeth dictate the arc of closure and the occluded
position of the mandible. If articulators were to be used to reveal mal-occluded teeth, then
"interocclusal records" would be needed to mount the casts in the centric relation position.
Proprioceptors from the teeth were dictating to the muscles, and this feedback had to be dealt
with. Interocclusal registrations solved the problem. Since these registrations were taken at a
slightly opened position, the Hinge Axis of the mandible must have been accurately located.
In 1930, Dr. Charles Stuart and Dr. McCollum developed the first semi-adjustable articulator
called the McCollum Gnathoscope.
By 1933, Stuart invented a frictionless jaw-writing device for recording
mandibular movement with styli on plates outside the face. In 1934, with
the aid of Dr. Stuart, McCollum produced the first mandibular movement
recorder known as the McCollum Gnathograph.
It differed from today's recorder in that it anteriorly had a sagittal plate
with a horizontal stylus. It would record the entire capacity of mandibular
movements. These movements were later described by Posselt, as the
"Envelope of Motion."

Dr. Stuart and Dr. Stallard worked together to teach "organic occlusion."
They gave us the determinants of occlusal morphology and renewed an
interest in Gnathological principals. Dr. Stuart often said that he had
stolen the wax-addition technique from Everitt Payne and the cusp-fossa
occlusion from the Good Lord to come up with Organic Occlusions. Peter K.
Thomas, who taught the principles of Gnathology to study groups all over
the world, was considered the "Ambassador of Excellent Dentistry."

THE PHILOSOPHY OF ARNE G. LAURITZEN

Direction of occlusal stresses-long axis of teeth.

Centric relation=centric occlusion
(condyles in uppermost and rearmost position)
Simultaneous occlusal loads fall on as great number of teeth.

 Optimal tooth-to tooth occlusion should reach terminal hinge axis

intercuspation without interferences.
Terminal hinge axis intercuspation should occur from an adequate
interocclusal freeway space.
Lateral excursion may be free.
Canine guided occlusion.
Group contact between upper and lower anterior teeth during
straight protrusive movement.

DE AMICO S CONCEPT

His conclusions had a direct impact on the thinking of the dentists with
regard to concepts of occlusion. He developed the view that
1. The flattened edge-to-edge occlusion seen in aboriginal dentitions were
due to excessive attrition and are abnormal.
2. A lateral ruminating type of mandibular function in humans is not
typical.

3. Steeply cusp teeth are entirely appropriate

4. The maxillary incisors and canines are meant to exhibit overbite so as
to disclude the posterior teeth during eccentric positions of mandible.

De Amico particularly emphasized the maxillary canines having the

principal occlusal contact in lateral excursion and serving to guide the
closing movement of the mandible in the centric occlusion. This idea has
been termed CANINE PROTECTION.

NILES GUICHET AND GNATHOLOGY

Tried to explain the advantages of canine guidance by means of

biomechanics.
Optimal occlusion (1966)

Canine guided occlusion- biomechanics

Occlusion must be in harmony with the mandibular movements of
each patient.
Introduced modification of gnathological extra oral device of graphic
registration called Gnathograph to be used with a Pantograph, which
were adjusted to Denar articulator.
In regard to vertical stresses, he incorporated the factors of an
interocclusal relationship in order to reduce them.
In regard to horizontal stresses CO=CR. This eliminates the
horizontal stress potential induced by patients when guiding their
food in the retrusive range of the centric contacts. There is
horizontal movement of the mandible from the maximal intercuspal
position and teeth are capable of standing that horizontal stress in
function.
He utilized D Amicos findings -canines withstands eight times
stresses than on the 2nd premolars.
Bennet movement: lateral shift increases as occlusion becomes
tight.

THE

VISION OF TRANSOGRAPHIC CONCEPT

PAGE HL being a layman conceived transographic theory.

Four principles:
1.Opening axis
2.Cranial plane
3.Bennett movement
4.Envelope of motion

1. Opening axis: 12 to 15 of rotation.

Transverse hinge axis reproducible.
2.Cranial planes: No translatory condyles, so no practical support for
horizontal plane.
3.Bennett movement: such a movement is because of mouth opening to 2
noncolinear axes, Page did not concede to the existence of the Bennett
side shift.
4. In the discussions conceding the envelope of motion, when one takes
the motions to a narrow functional terminal orbit, raised a great number of
questions in the oral rehabilitation.

INFLUENCE OF PHYSICAL ANTHROPOLOGY

Many anthropological studies had great influence over occlusal concepts.

SPEE had emphasized the ruminant like grinding action of the human
dentition, which strongly implied laterally directed excursive-incursive
shearing movements of the mandible.

Examination of the flattened edge-to-edge occlusion and reverse

curve of Wilson found in aboriginal societies seemed to bear witness to

the importance of lateral component of the chewing cycle and to the

maximum shearing of multiple inclined planes- an idea seemingly
compatible with both the geometrical ideal and early gnathological
concepts. In studies of the dentitions of Australian aborigines Begg (1964)
noted severe interproximal and occlusal attrition and concluded that
attritional process produced the only anatomical correct occlusion.

Jones observed in humans mastication is from lateral to medial and

is unilateral, the teeth of opposite side being definitely not in contact.

OCCLUSAL CONCEPTS OF SCHUYLER

Like many gnathologists Clyde H Schuyler believed in harmony between

centric relation and centric occlusion for natural dentition. He did not
impose a set of rigid standards on the occlusion that, if lacking, was
tantamount to pathology. This concept when applied to natural teeth was
called FUNCTIONALISM.

Schuyler observed that all principles of occlusion pertaining to full

denture prosthesis does not hold good for natural dentition. The termbalanced occlusion is most applicable to restorations supported by soft
tissues. He believed there was a relationship between functioning occlusal
inclines and potential stress to the periodontium, and his occlusal
adjustment were to ameliorate these stresses. He suggested reducing the
contact areas during maximum intercuspation and described a division of
labor between inclines, cusp tips and occluding surfaces of teeth.

He favoured point contacts opposite flat planes during lateral

excursions. In 1953, he stated, in the natural dentition I fail to see the
real value of contacts on the non-functioning side, as they do not reduce
the application of stress being applied to the teeth on the working side,
and their contact may be a contributing factor to traumatic injury.
His observation effectively signaled the end of BALANCE as an acceptable
treatment approach to the dentulous patient. Schuyler also emphasizes
the importance of incisal guidance as the predominating factor
determining posterior occlusal morphology. Although the muscles and

TMJs control the direction of movement of the mandible when the

dentition is out of occlusion.

When the opposing teeth of the natural dentition come into contact
the guiding planes of the teeth immediately assume almost complete
control of the direction and the extent of movement of the mandible. His
concepts thus included the importance of canine guidance and canine
protected occlusion that was used for the desired relief of stress upon the
balancing inclines of posterior teeth.

Anterior guidance Purpose: permit a condylar motion without restrictions

along with the prevention of posterior contacts, during lateral excursions

FREEDOM IN CENTRIC
According to Schuyler,
Freedom in centric is a maxillomandibular position where maximum
intercuspation and centric relation coincide to a certain degree of freedom
for eccentric excursions without the influence of occlusal inclines. (Figure)

Variation in centric relation recording not a point area in relation to

horizontal plane.

Concepts that form this large occlusion group, freedomincentric, dealt

initially with denture construction. Posselt was first to describe its
principles.

Supporters of Functional occlusion developed the principles of this

philosophy.
This concept basically deals with functional occlusion. Functional occlusion
takes
into
consideration
fundamentals
of
neurophysiological,
psychological states, muscular functions, articular mechanisms and
biomechanical knowledge. Rationale of this concept
1. To adapt itself to all maxillomandibular relationship patterns.
2. Fulfill the requirements of physiologic relations such as mandibular
guidance, occlusal stability, mastication and swallowing.

According to this concept,

Maximum intercuspation and centric relation are coincident but flat areas
on the depth of the fossae, on which opposing cusps occlude, will allow for
a certain degree of freedom in both centric and eccentric movements
without the guiding influences of occlusal inclines.

Vertical dimension of occlusion in maximum intercuspation and centric

relation might be the same when all the interferences for closing in centric
relation are eliminated.

STUART AND STALLARD CONCEPT

Stallard and Stuart: organic or organised occlusion.

They noted that balanced occlusion in reconstructed natural
dentitions leads to
1. Injudicious increase in occlusal vertical dimension to achieve
balance.
2. Often led to instability of occlusion.
3. Frequently showed increased wear of teeth and restorations.
4. Provided poor group usage of teeth.
5. Extraordinary technical demands.
6. Esthetic character of the restored balanced occlusions, which
often required severe reduction of anterior overbite, was found to be
far from adequate.

 Thus, some parallel ideas evolved in the concepts of both the

gnathologists and the functionalists, and both groups came to speak
of the mutually protection concept of occlusion. This concept is
based on the premise that the teeth should act as a specialized
groups so that in centric or eccentric positions of the mandible
certain teeth or groups of teeth are best able to withstand the
occlusal loads and, in doing so, will protect other teeth or groups of
teeth from unfavorable forces.

BEYRONS OCCLUSAL CONCEPTS

Based on functional convenience and avoidance of discomfort. An

optimal occlusion would be one that requires less muscular activity and is
harmony with the neuromuscular system and TMJ guidance. Such
occlusion might not be considered as static entity and might not be
evaluated as having what he called instantaneous occlusion. Most
physiological inter-relationship between morphology and function might
be the most natural one. Beyron revealed that he majority of the subjects
had anteroposterior slide, in the mandibular central position, in the range
of 0 to 2 mm. Only 10% of them presented a coincidence of CO=CR. He
also advocated freedom in centric concept & canine guided occlusion.

PANKEY MANN PHILOSOPHY

Monsons sphere (occlusal line and plane) + Meyers concepts of a

functionally generated path; some principles of occlusion and establishing
Incisal guidance from Schuyler.

Pankey Mann Philosophy oral rehabilitation

Objectives: - optimal health, masticatory efficiency, comfort and esthetics

Pankey Mann Schuyler concept (based on group function). Rationale

about this group function is that a certain quantity of lateral stress on the
posterior teeth might provide, during function and within a physiological

tolerance, the necessary periodontal stimulus and might even spread the
occlusal load to a certain number of teeth. The fundamental principles of
this philosophy are as follows:

Stable and Static contacts - greatest number of teeth

Long centric Occlusal harmony with an anterior slide between
centric relation and maximum intercuspation (1mm) and a small
amount of lateral freedom for accommodation of the Bennett
movement on the horizontal plane.
Group function during lateral excursion (working side)
Balancing side - No contacts
Protrusion Immediate disocclusion

DAWSONS CONCEPT

Peter Dawson introduced Bimanual technique for the manipulation

of the jaw in centric relation and for
recording the border movements according to modification of functionally
generated path technique. (In this colossal scheme, the maxillary teeth
carve out a path in the wax placed on the lower colossal table. This is
known as functionally generated path. Later, the wax containing this
path is replaced with cast gold or cobalt-chromium alloy).

Group function during lateral excursion (working side)

Balancing side - No contacts
Protrusion Immediate disocclusion

Theory of Nutcracker

When establishing an ideal occlusion, he assumed that he anterior

guidance would have a key role. He defended the ideas that the
anterior teeth are more capable of supporting stresses than are the
posteriors because of the anteriors mechanical position in relation to
the fulcrum(TMJ) and force( masticatory muscles), and because of
higher density of bone surrounding the anteriors long roots, with a
better crown root ratio. Dawson presented his theory of nutcracker. The
farther the nut (anterior teeth) was from the fulcrum (condyles), the

lesser would be the force exerted on the nut. Making the nut as strong
as possible by means of a correct interdental contact would make the
role of protection of the anterior teeth better.

The condylar path is not supposed to dictate how the anterior

guidance works, and so there is no advantage or necessity in trying to
make the anterior guidance duplicate the condylar one. As a final
consideration, the condyle path dictate where the external limits of the
mandibular motion (envelope of motion) are and, in a free moving joint,
the action of the muscles is responsible for both their functions and
dysfunctions.

Nutcracker theory

GERBERS CONDYLAR DISPLACEMENT THEORY

EUROPEAN CONCEPT
His theory is influenced from Gysis philosophy.
The normal or ideal occlusion proposed by Gerber was one in which the
teeth would be in maximum intercuspation, with the condyles centered in
the articular surfaces in the median and uppermost position. Any
deviation related to this mandibular centralization constitutes a condylar
displacement.

CANINE PROTECTED OCCLUSION A form of mutually protected

occlusion in which the vertical and horizontal overlap of the canine teeth
disengage the posterior teeth in the excursive movements of the
mandible (ANTERIOR PROTECTED ARTICULATION/ CUSPID PROTECTION).
The concept of the cuspid protection mechanism which is diametrically
opposed to the balanced occlusal concept began in 1919 with the work of
Nagao. This was reinforced by Shaw in 1924 and then gained most of its
following after the extensive work of DAmico in 1958. This theory
suggests that the only tooth contact in all positions of the mandible
except CR should be between maxillary cuspids and mandibular cuspids or
first premolars. DAmico also claimed that proprioceptors of the
periodontal ligament associated with the canine teeth are far more
responsive than those of any other teeth. Consequently the proprioceptors
associated with the periodontal ligament of the canine teeth transmit
desirable impulses to the muscles of mastication by way of central
nervous system. Occlusal trauma to the canine teeth is thus prevented by
the reduced muscular tension and magnitude of the applied force.

Canine-guided occlusion

GROUP FUNCTION OCCLUSION

A form of mutually protected occlusion in which multiple contact

relation between the maxillary and mandibular teeth in lateral movements
on the working side whereby simultaneous contact of several teeth acts
as a group to distribute occlusal forces (UNILATERAL BALANCED
OCCLUSION).

SCHUYLER -1961.

Clinically, distinctions between canine protection and group function

are often difficult to make, but the differences in the rationale underlying
each is quite clear. The modern gnathological concept of canine protection
is based on the assumption that tooth blades and cusps are arranged for
vertical chewing (Stuart and Stallard, 1960), and that cusp-fossa-groove
position and form must be strictly integrated with the condylar and
mandibular movements so that minimal tooth contacts occur during
function. From this perspective, the canines help to prevent the lateral
enmeshment of working side posterior teeth, which is considered not only
superfluous, but potentially damaging as well.

Alexander P.C (1967) did clinical evaluation of the canine function

theory and balanced occlusion theory. The evidence presented showed
that canine teeth were incapable of supporting excessive functional
forces. Vertical bone loss, with accompanying infrabony pocket formation
occurred. He concluded from the periodontal point of view, the dentition
should be treated according to the principles of balanced occlusion
therapy.

Studies on the incidence of the canine protected occlusion have

produced equivocal results. This is probably due to the use of different
criteria, amounts of lateral excursion, age groups, cultures, and other
variables among the studies. Collectively, however, the data tend to
support the premise that the relative incidence of canine protection and
group function is related to the age of the subject and the amount of

attrition on the canines and other teeth, as well as on the basic structural
features of occlusion.

Butler and Zander (1968) found a difference in the tooth contact

pattern in two test subjects rehabilitated with two types of fixed partial
dentures. Such observations indicate adaptability in the masticatory
system to changes in the occlusal pattern.

MUTUALLY PROTECTED (Organized / Organic) OCCLUSION

An occlusal scheme in which the posterior teeth prevent excessive contact

of the anterior teeth in maximum intercuspation, and the anterior teeth
disengage the posterior teeth in all mandibular excursive movements.

STUART AND STALLARD 1960. - Organized disclusion.

Despite the continued dual perceptions of the canine protection

versus group function, the development of mutual protection concept
represent an embodiment of both gnathological and functionalist ideas,
and is compatible with each. Functionalisms most crucial contribution
may have been the understanding of the variability and impreciseness of
mandibular function and the intercuspation of the teeth. Gnathology has
provided a biomechanical model and rationale for understanding function
and occlusal morphology. Mutual protection in the broadest sense, can
embrace both perspectives, and provides a basis for arranging teeth that
takes into account these apparently contradictory approaches.

The aim of the organized occlusion is to relate the occlusal elements

of the teeth, so that the teeth will be in harmony with the muscles and
joints in function. The muscles and joints should determine the mandibular
position of occlusion without tooth guidance. The ridges and groove
directions of posterior teeth are determined as a result of the movements
of the condyles.

The following organizational scheme and functional relationships of the

natural dentition are derived from such a perspective:
1. In the intercuspal position, primary occlusal loading, axially directed,
is absorbed by contact-supporting areas on posterior teeth only.
Anterior teeth contact very lightly and should not bear these
potentially heavy forces.
2. In protrusion, the overbite-overjet relations of the incisors produce
an incisal guidance that is steep enough to cause disclusion of all
posterior teeth.
3. In lateral excursion, the overbite-overjet relationship of the
contacting teeth of the working side should be sufficiently steep to
cause disclusion of all non-working side teeth. The question of
whether the working side canine alone should be in contact (canine
guided), whether the premolars should also be in contact, or
whether all working side posterior teeth should be in contact (group
function) is probably best determined on an individual case-by-case
basis, depending on such clinical factors as preexisting
relationships, root-crown ratios, and the degree of mobility or
fremitus of the teeth involved.

OCCLUSION IN NATURAL DENTITION

Occlusion for the natural teeth is the integrated relationship of the teeth,
periodontium, temporomandibular joints and neuromusculature, not merely the
interdigitation of teeth.
THEORITICALLY IDEAL OCCLUSION / OPTIMUM OCCLUSION
It is preconceived view of structural and functional relationship. It does not
represent the norm in strict sense and only occasionally represents the
characteristics of a given individual. This concept is used as series of idealized
parameters against which variations may be compared.
According to this concept, occlusion and masticatory system should ideally be
such that: (Norman. D.Mohl 1988)
1. All components of masticatory system are present.
2. Classical anatomical relationship exist between maxillary and mandibular
teeth

3. In centric occlusion the supporting cusp of all posterior teeth should

occlude with marginal ridges except DB cusp of mandibular molars and
ML cusp of maxillary molars which occlude with central fossa of their
opposing tooth.
4. Dentition is in harmony with basal bone and with craniofacial structures.
5. Long axes of teeth are aligned so that functional occlusal forces act
through or close to these axes.
6. Periodontium is intact and there is no clinically detectable fremitus or
tooth mobility
7. The occlusion is stable that do not migrate other than slow physiological
compensatory movements.
8. Teeth do not exhibit attritional wear beyond what would be expected for
the age of individual.
9. Muscular contact position should be coincident with the intercuspation
position that is individual can voluntary control to close the mandible into
centric occlusion accurately and consistently with head erect.
10.Centric occlusion is in harmony with centric relation; that is, the two
positions are coincident, or centric occlusion is a short distance (within 1
mm) to the anterior of centric relation in the mid-sagittal plane.
11.During protrusion, the posterior teeth disclude so as not to interfere with
the ability of the opposing incisor teeth to occlude and function properly.
12.During lateral movements, the teeth on the nonworking side disclude so
as not to interfere with the ability of the opposing working side teeth to
contact and function properly.
13.During lateral movements, there is occlusal contact between the opposing
canines on the working side, either alone or together with one or more
-pair of adjacent posterior teeth.
14.A postural rest position that provides for an adequate interocclusal
distance.
15.All masticatory, deglutition, speech articulation, esthetic, and respiratory
requirements are met and are satisfactory to the patient.
16.Tonic activity of the masticatory muscles can be reduced to low levels at
times of repose.

17.Minimal parafunctional activity that is little phasic muscle activity is

present
18.Self-perpetuating structural and functional adaptation to ageing and to
altered conditions can be achieved.
19.Multi directional masticatory function can be accomplished satisfactorily
with wide variety of food.
20.No sign or symptom of pain or dysfunction from any component of
masticatory system can be detected.
21.The patient has an aura of unawareness of the occlusion and masticatory
system.

According to Dawson 1974 there are 5 criteria for optimal occlusion:

1. Stable stops on all teeth when condyles are in most superior posterior
position (centric relation).
2. An anterior guidance that is in harmony with the border movements of
the envelope of function.
3. Disclusion of all posterior teeth in protrusive movement.
4. Disclusion of all posterior teeth on balancing side.
5. Non-interference of all posterior teeth on working side with either the
lateral anterior guidance or the border movements of the condyles.

PHYSIOLOGICAL OCCLUSION
Physiologic occlusion, usually found in adults, deviates in one or more ways
from the theoretically ideal yet is well adapted to its particular environment, is

aesthetically satisfactory to the patient, and has no pathological manifestations

or dysfunctional problems. It represents a state of harmony, and does not require
therapeutic intervention.
In physiologic occlusion, either static or functional occlusal relationships may
be at variance from the classical characteristics of an occlusion. Although it may
be a malocclusion, it is a malocclusion in a state of health. It may demonstrate
maxillomandibular relationships different from theoretical criteria, but no
untoward effects are observed. Parafunctional activity may be present, but all
components of the masticatory system are responding well, and no pain or
dysfunctional signs or symptoms can be demonstrated.
The system has adapted and continues to adapt to the unique structural and
functional circumstances of that individual.
Criteria of physiological occlusion
1. Occlusal stability :
Teeth should stay in position without a tendency to extrude, drift, rotate, or
otherwise migrate within a dentition, The slow, compensatory, physiological
movement or adaptation that accompanies wear at contact areas in order to
maintain the continuity of the arch, or passive eruption to maintain occlusal
contact in the presence of a normal rate of attrition, are to be expected and are
acceptable. Migration beyond this (i.e., occlusal instability) is not acceptable.

2. Masticatory function

It should be satisfactory to the patient. This is a subjective assessment on the

part of the patient. If a patient can meet his or her own masticatory and dietary
needs, the situation is considered physiological.
3. Speech articulation
It should be acceptable to the patient. This is also a subjective assessment. An
impaired speech sound resulting from a malocclusion may be considered
physiological if the patient has no concern about this situation. An anterior open
bite accompanied by faulty sibilants, for example, need not be treated if the
patients assessment is neutral and no other unfavourable conditions exist.
4. Esthetic considerations
This is obviously a completely subjective assessment and must be left entirely
to the patient. For Example, a diastema between the maxillary central incisors
may be absolutely unacceptable to one patient and completely acceptable to
another.
5. Freedom from signs and symptoms
involving periodontal attachment apparatus that are related to functional
loading. Clinical detectable fremitus or mobility not directly attributable to
inflammatory process should be regarded as functional in nature, but if the
mobility is progressive it should not be considered physiological occlusion
6. Freedom from signs and conditions involving the teeth themselves
those are attributable to functional activity. Thus, a physiological occlusion
would preclude such conditions as excessive attritional patterns from parafunctional activities or from a very abrasive diet.

7. Freedom from signs and symptoms involving the temporomandibular joint

or the musculature associated with mandibular function
NON PHYSIOLOGICAL OCCLUSION
A non-physiologic occlusion is one in which there are signs or symptoms of
pathology, dysfunction, or inadequate adaptation of one or more components of
the masticatory system that can be attributed to faulty structural relationships or
to mandibular functional or parafunctional activity. The concept also includes
patient none acceptance of occlusally related speech articulation, or masticatory
parameters. A non-physiologic occlusion necessarily implies that the existing
maxillomandibular relationships are the cause of signs or symptoms.
In addition to the subjective criteria for treatment as expressed by the patients
concerns over esthetics, speech articulation, or masticatory function, there are
objective criteria. These are signs or symptoms of
1. Periodontal conditions attributable to functional loading,
2. Pathological conditions of the teeth that can be attributed to mandibular
functional or parafunctional activity.
3. Temporomandibular disorders.

THERAPEUTIC OCCLUSION
It is the one that has been modified by appropriate therapeutic modalities in
order to change non physiological occlusion to one that, at least fall within the
parameters of physiological occlusion. Examples include freedom in centric or
cusp to fossa posterior occlusal relationship instead of cusp to marginal ridge
relationship.

DEVELOPMENT OF CONCEPT OF OCCLUSION

Prior to Bonwills law, concepts of occlusion were based on the idea of a single,
centrally located static hinge.
This was embodied in the simple hinged articulators of the middle and late 19th
century. Bonwill (1885) analysed the mandible and described it in terms of an
equilateral triangle with 10cm sides connecting both condyles and the mesioincisal angles of the mandibular central incisors.
In 1890 Ferdinand Graf Spee proposed concept of balanced occlusion based on
his observation on natural teeth.
1926 McCollum and a group of dental colleagues founded Gnathological
society of California. They coined the term Ganathology which has been
defined as study of temporomandibular joints movements, their selective
measurement, reproduction and use as determinants in the diagnosis and
treatment of occlusion. McCollum embraced the idea of completely balanced
occlusion for natural dentition.
1929 Schuyler observed that balancing contact in natural dentition were more
destructive to periodontal structures. Thus he put forward the theory of
unilateral balanced occlusion.
Beyron in 1954 has listed characteristics of this type of occlusion.Weinberg in
1964 also supported this concept.Group function occlusion has broad support
from Mann and Pankey 1960, Ramjford and Ash 1966, Posselt 1968 observed
that this type of occlusion is commonly seen in natural dentition.
Schuyler in 1959 put forward the concept of long centric or freedom in centric.
DAmico in 1961 gave the concept of Canine protected occlusion

Harvey and Stallard 1960 found anterior teeth protect posterior teeth and
posterior teeth protect anterior teeth. This concept of mutually protected
occlusion was based on this observation.
In 1967 term mutually protected occlusion was changed to Organic occlusion by
Stallard, Stuard and Thomas in 1967.
In 1974 Dawson stated that when canines cannot be used as guide for lateral
movement, posterior disclusion can be produced by anterior teeth. He called this
anterior group function.

Historically the study of occlusion and articulation has undergone an evolution

of concepts. These can be broadly classified as
1. Bilateral balanced occlusion
2. Unilateral balanced or group function
3. Mutually protected articulation
Bilateral balanced occlusion
The concept of balanced occlusion itself is often credited to Ferdinand Graf
Spee
It was one of the earliest proposed theories -Bilateral Balanced Occlusion.
Although earlier applied to natural dentition ,it is now limited to complete
denture
Bilateral, Simultaneous, Anterior and Posterior Occlusal Contact of Maxillary
and Mandibular Teeth in Centric and Eccentric Position

When the principles of bilateral balanced occlusion were introduced in Fixed

Prosthodontics, there was a high rate of failure even with specific attention to
detail and use of sophisticated articulators. Failure was due to increased occlusal
wear, Increased/accelerated periodontal breakdown, TMJ and neuromuscular
disturbances
In 1935 ,Schuyler developed the first detailed technique for occlusal adjustment
based on careful grinding of specific occlusal inclines
He believed that there was relationship between functioning occlusal inclines
and potential stress to periodontium and occlusal adjustment was a way to
reduce this stress.
By 1953 he began to observe failure of natural dentition restored with balance.
He said that he failed to see the value of non-functional contacts as they did not
reduce the application of stress on the working side rather their contact may be
contributing factor for traumatic injury.

Stuart and Stallard (1960) noted that balanced occlusion in reconstructed natural
dentitions
1. 1 Often required injudicious increase in occlusal vertical dimension to
2.
3.
4.
5.
6.

achieve balance.
Often led to instability of occlusion.
Frequently showed increased wear of teeth and restorations
Provided poor group usage of teeth.
Extraordinary technical demands
Esthetic character of the restored occlusions was not satisfactory.

SCHUYLER (1961) stated that an ideal occlusion has coincident Maximum

intercuspation position and Centric Relation position but this rarely occurs in
clinical situations.

2) UNILATERAL BALANCED OCCLUSION (GROUP FUNCTION)

Definition:Multiple contact relations between maxillary and mandibular teeth, in lateral
movements on the working side, whereby simultaneous contact of several teeth
acts as a group to distribute occlusal forces-GPT 8
In this type of occlusal arrangement the load is distributed among the
periodontal support of all posterior teeth on working side. This can be
advantageous if for instance periodontal support for canine is compromised.
While on the working side, occlusal load is distributed during excursive
movement, and the posterior teeth on the nonworking side do not contact. In the
protrusive movement, no posterior tooth contact occurs.
The most desirable group function consists of canine,premolar and mesiobuccal
cusp of first molar
Any laterotrusive contact more posterior than mesial portion of first molar are
not desirable because of the increased amount of force that can be created as the
contact gets closer to the fulcrum (TMJ).
Horizontal pressures during lateral movements are distributed to one half of the
arch on the working side.

The functionally generated path technique, originally described by Meyer

(1938) is used for producing restorations in unilateral balanced occlusion. It has
been adapted by Mann and Pankey (1960) for use in complete-mouth occlusal
reconstruction.
Advantages:
Group function of the teeth on the working side distributes the occlusal
load
The absence of contact on the nonworking side prevents those from
getting subjected to destructive, obliquely directed forces found in
nonworking interferences.
It also saves centric holding cusps that is mandibular buccal cusps and
maxillary palatal cusps from excessive wear
Group function was felt to be goal for occlusal adjustments and has easy
application
In the presence of anterior bone loss or missing canines, mouth should be
restored to group function
Long centric
As the concept of unilateral balance evolved, it was suggested that allowing
some freedom of movement in an anteroposterior direction is advantageous.
This concept is known as long centric
. Schuyler was one of the first to advocate such an occlusal arrangement. He
thought that it was important for the posterior teeth to be in harmonious gliding
contact when the mandible translates from centric relation forward to make
anterior tooth contact. Other have advocated long centric because centric
relation only rarely coincides with the maximum intercuspation position in
healthy natural dentitions.

However, its length is arbitrary. At given vertical dimensions, long centric

ranges from 0.5 to 1.5 mm in length have been advocated.
This theory presupposes that the condyles can translate horizontally in the
fossae over a commensurate trajectory before beginning to move downward. It
also necessitates a greater horizontal space between the maxillary and
mandibular anterior teeth (deeper lingual concavity), allowing horizontal
movement before posterior disocclusion (separation of opposing teeth during
eccentric movements of the mandible).

PANKEY-MANN-SCHUYER PHILOSOPHY
It used in complete occlusal rehabilitation
Objectives:

Optimal Health
Masticatory Efficiency
Comfort
Esthetics

Principles include
1.

Static coordinated occlusal contact of maximum number of teeth when

2.
3.
4.
5.

mandible is in centric relation

An anterior guidance in harmony with lateral eccentric positions
In protrusion dsclusion of posterior teeth
In lateral excursions ,dsclusion of all non -working teeth
Group function of all working side inclines in lateral excursion

MUTUALLY PROTECTED OCCLUSION

It is an occlusal scheme in which the posterior teeth prevent excessive contact
of the anterior teeth in maximum intercuspation, and the anterior teeth
disengage the posterior teeth in all mandibular excursive movements.

Alternatively, an occlusal scheme in which the anterior teeth disengage the

posterior teeth in all mandibular excursive movements and the posterior teeth
prevent excessive contact of the anterior teeth in maximum intercuspation.
(Rosenstiel 4th ed)
Angelo D. Amico, (1958) using anthropologic and evolutionary studies
discarded the balanced occlusion and stressed on the function of the canines.
The ideas of Stuart, Stallard, Lucia, DAmico (1963) and the members of the
gnathologic society lead to the development of the concept of organic occlusion
or mutually protected occlusion.
In this arrangement, centric relation coincides with the maximum intercuspation
position. The six anterior maxillary teeth, together with the six anterior
mandibular teeth, guide excursive movements of the mandible, and no posterior
occlusal contacts occur during any lateral or protrusive excursions.
The relationship of the anterior teeth, or anterior guidance, is critical to the
success of this occlusal scheme. The anterior teeth either contact lightly or are
very slightly out of contact (approximately 25 microns), relieving them of the
obliquely directed forces that would be the result of anterior tooth contact.
In a mutually protected articulation, the posterior teeth come into contact only
at the very end of each chewing stroke, minimizing horizontal loading on the
teeth. Concurrently, the posterior teeth act as stops for vertical closure when the
mandible returns to its maximum intercuspation position. Posterior cusps should
be sharp and should pass each other closely without contacting to maximize
occlusal function.
CANINE PROTECTED OCCLUSION

According GPT-8 the canine-protected occlusion is a form of mutually

protected occlusion in which vertical and horizontal overlap of canines
disengages posterior teeth in excursive movement of mandible.
This concept of occlusion is also known as canine guidance, canine disclusion
or canine rise from the Gnathology School of occlusion.
This theory suggests that the only tooth contact in all positions of the mandible
except CR should be between maxillary cuspids and mandibular cuspids. Thus
canine are called as NATURES STRESS BREAKER.
WHY CANINE
The canines have a good crown root ratio capable of tolerating high
occlusal forces.
Surrounded by dense compact bone which tolerates forces better.
Location is far from the TMJ thus receiving less stress.
It has many receptors in the periodontal ligament so it controls lateral
pressure by directing vertical masticatory movements.
The shape of the palatal surface of canine is concave and is suitable for
guiding lateral movements.
Canine protected Occlusion is an important concept, especially for people who
have

Excessive wear on their teeth,

Erosion of their roots,
Gingival recession,
And suffer from TMD (Temporomandibular joint dysfunction).

Limitations:

Controversy arises whether or not the canine should be the only

tooth to bear the pressures during lateral excursion

Missing canine and prosthetic canine

Periodontium is compromised.
In Class III and cross-bite cases mutually protected occlusion is
contraindicated.

Dawson (1974) stated that,

When canines cannot be used ,lateral movements have

posterior dsclusion guided by anterior teeth on the working

side, instead of canine alone

He called this Anterior Group Function

He defended the ideas that the anterior teeth are more capable of supporting
stresses than are the posteriors because
1) Of the anteriors mechanical position in relation to the fulcrum (TMJ) and
force( masticatory muscles)
2) With a better crown root ratio.
Stuart and Stallard (1961) modified features of mutually protected occlusion
and coined the term ORGANIC OCCLUSIONin which Centric relation and
maximum intercuspal position coincide.
The aim of the Organized Occlusion is to relate the teeth to be in harmony with
the muscles and joints in function.
The muscles and joints should determine the mandibular position of occlusion
without tooth guidance.

Its features as described by THOMPSON (1967) are:

CRP and MIP are coincident

Posterior teeth are in a cusp fossa relation, one tooth to one tooth contact

Each functional cusp contacts the occlusal fossa at three points

In protrusion maxillary incisors guide the mandible and disocclude the

posteriors

In lateral movements lingual surface of maxillary canine glides along

the distal inclines of mandibular canine and mesial ridge of 1st premolar cusp.

GENERAL OBJECTIVES OF ESTABLISHING OCCLUSAL SCHEMES

In determining correct occlusal scheme for particular patient several factors
must be considered
1.
2.
3.
4.

Should the restoration be made in CO or CR

Will CO and CR be coincidental
What is correct lateral guidance
What is the character of occlusal contact

Centric Occlusion Centric Relation

Maintain the patients centric occlusal position if a physiological state exists. An
anterior harmonious slide of 1.5mm or less, from centric relation to centric
occlusion with no lateral deviation is acceptable
When centric occlusion must be re-established, it should be coincidental with
centric relation.

Lateral guidance
1. Maintain the patients existing occlusal scheme in lateral excursion, providing
there are no signs of occlusal pathology. Both cuspid- protected and group
function occlusions are commonly found in natural physiologic dentitions and
should not be arbitrarily altered.

2. When re-establishing lateral guidance, cuspid protected occlusions is

preferable when the remaining natural cuspids are present and not periodontally
compromised. Cuspid guidance reduces occlusal wear and horizontal forces on
posterior teeth
3. Establish group function or unilateral- balanced occlusion for patients with
missing or periodontally compromised cuspids

Occlusal contacts:
1.

Multiple equal intensity contacts on each tooth in CR at correct vertical.

2.

Occlusal forces directed parallel to the long axis of each tooth.

3.

Non-interference with any border path of the condyles or the anterior

guidance.
In determining the type of CR contacts there are further more choices to
be made:
1. Cusp to marginal ridge contact/ one tooth opposing two teeth.
2. Cusp to fossa contact/one tooth opposing one tooth.

Cusp to marginal ridge contact/ one tooth opposing two teeth.

The relation between the upper and lower teeth is such that one stamp cusp fits
in a fossa and another stamp cusp of the same tooth fits into the embrasure area
of two of the opposing teeth. This cusp-ridge arrangement is called a tooth-totwo-teeth occlusion, or acusp-embrasure occlusal pattern

Cusp to fossa contact/one tooth opposing one tooth.

In this scheme stamp cusps fit into fossae. The cusp -fossa relationship
normally produces an interdigitive relation of the cusps and fossae of one tooth
with the cusps and fossae of only one opposing tooth. This pattern may also be
called tooth -to-one-tooth occlusion

Advantages of Cusp-Fossa over Cusp-Marginal Ridge Pattern of occlusion:

A cusp fossa relationship produces an interlocking of the upper and lower teeth,
thus giving maximum support in centric occlusion. The forces are closer to the
long axis of each tooth, giving a more efficient chewing apparatus. The occlusal
forces are along the long axes of teeth thus less tipping. There is elimination of
food impaction between marginal ridges. The teeth are more stable, with more
stable occlusion.

.OCCLUSAL CONSIDERATIONS IN FIXED PARTIAL DENTURE

When majority of occlusal surfaces are restored with fixed restoration,
pre-existing centric occlusion cannot be preserved .therefore planned
restoration is restored in CO which is coincidental with CR(repeatable
position
Cusp fossa occlusion scheme is prescribed to enhance stability and reduce
food impaction

 Occlusal tables are narrowed to maintain forces within the confines of

root system and to minimize non-working contact.
Lateral working position may be canine guided or group function, group
function is prescribed if canine is compromised and cannot support the
entire eccentric load.
Non-working contacts are eliminated in lateral excursion.

OCCLUSAL CONSIDERATIONS IN REMOVABLE PARTIAL

DENTURE
1.

Simultaneous bilateral contacts of opposing posterior teeth must occur

2.

in centric occlusion.
Occlusion for tooth-supported removable partial dentures may be
arranged similar to the occlusion seen in a harmonious natural

3.

dentition.
Bilateral balanced occlusion in eccentric positions should be used
when a maxillary complete denture opposes the removable partial
denture. This is accomplished primarily to promote the stability of the

4.

complete denture.
Working side contacts should be obtained for the mandibular distal
extension denture .These contacts should occur simultaneously with
working side contacts of the natural teeth to distribute the stress over
the greatest possible area. Masticatory function of the denture is

5.

improved by such an arrangement.

Simultaneous working and balancing contacts should be formulated
for the maxillary bilateral distal extension removable partial denture

6.

whenever possible.
Only working contacts need to be formulated for either the maxillary

7.

or mandibular unilateral distal extension removable partial denture.

In the Kennedy Class IV removable partial denture configuration,
contact of opposing anterior teeth in the planned intercuspal position

is desired to prevent a continuous eruption of the opposing natural

incisors .Contact of the opposing anterior teeth in eccentric positions
can be developed to enhance incisive function but should be arranged
8.

to permit balanced occlusion without excursive interferences.

Balanced contact of opposing posterior teeth in a straight forward
protrusive relationship and functional excursive positions is desired
only when an opposing complete denture or bilateral distal extension

9.

maxillary removable partial denture is placed.

Whenever possible eccentric load should be borne by natural teeth

10.

with disclusion of artificial teeth.

Maintain a narrow short occlusal table to minimize unfavourable
movement.

OCCLUSAL CONSIDERATIONS IN SINGLE COMPLETE DENTURE

The position of the remaining natural teeth in these examples may create
interferences in excursive movements of the single complete denture and create
instability that would not be a problem in a patient with natural dentition in both
arches and with anterior guidance. Correcting these interferences may be as
simple as an occlusal adjustment or as severe as extraction of the offending
tooth.
Presence of natural teeth in opposing arch increases the forces on complete
denture.Complete balanced occlusion should be given in such cases.
OCCLUSAL CONSIDERATIONS IN IMPLANT SUPPORTED
PROSTHESIS
The choice of an occlusal scheme for implant-supported prostheses is broad and
often controversial. Almost all concepts are based on those developed with
natural teeth, and are transposed to implant support systems with almost no
modification. No controlled clinical studies have been published comparing the
various implant occlusal theories.

The occlusion should distribute the forces evenly among the implants. The
occlusion chosen for implant-supported complete dentures or overdentures
should be a balanced occlusion ensuring that there is no interference with jaw
movements into eccentric positions. A lingualized occlusion provides an
excellent alternative to a fully balanced scheme. According to Carl E Misch a
medial positioned lingualized occlusion is a consistent approach for implant
occlusal schemes.
Canine guided occlusal scheme or group function can be given for single tooth
or implant supported FPD depending upon the patient occlusal status.
CONCLUSION:
Many occlusal schemes have been proposed over the years. Most schemes when
correctly used gives satisfactory results. The result is satisfactory, if the patient
gets better function, esthetics & comfort without any adverse changes in denture
foundation.

REFERENCES:
1. A Text book of occlusion Norman .D.Mohl 1988 1st edn
2. SHILLINGBURG- Fundamentals of Fixed Prosthodontics (3RD ED.)
1996
3. ROSENSTEIL-Contemporary Fixed Prosthodontics (4TH ED.)2006
4. OKESON-Management of Temporomandibular Disorders and
Occlusion (6TH ED) 2008
5. RAMJFORD & ASH- Textbook On Occlusion(2th Ed) 1979
6. PETER E.DAWSON- Evaluation,diagosis and Treatment of Occlusal
Problems(2ND ED) 1989

7. Carr, McGivney, Brown: McCrackens Removable Partial

Prosthodontics 12TH ED 2011
8. Tylman Theory And Practice Of Fixed Prosthodontics 8th Ed 1989
9. Thorton .J.L (1990) Anterior guidance group function/canine
guidance. A literature review . J Prosthet Dent. 64, 479-481
10.Pasricha N, Sidana V, Bhasin S, Makkar M.(2012) Canine protected
occlusion. Indian J Oral Sci 3:13-8.