Concept of

occlusion
Terminology
Occlusion is each static contact between one or more
lower teeth with one or more upper teeth.

Occlusion
The occlusal contacts of the maxillary and mandibular
teeth during function

Speech
Mastication
Swallowing

Functional occlusion
Intercuspal position is the occlusal position with the
teeth in maximum intercuspation.

The term intercuspal position (ICP) is synonymous
with many other terms, including centric occlusion,
habitual occlusion, acquired occlusion, and habitual
centric.

Intercuspal Position
centric relation is the mandibular jaw position in which
the head of the condyle is situated as
far anteriorly and superiorly as it possibly can within
the glenoid fossa. It is restricted to a purely rotary
movement about the transverse horizontal axis

It is a physiologic position that is used for reproducibility.

Centric Relation
Working side is the side that the mandible moves
towards in a lateral excursion.

Non-working side is the side that the mandible moves
away from during a lateral excursion.

Working and Non-working Side
Occlusal Concepts
Four major different types of occlusal relationships
can occur during lateral excursion of the mandible.

Mutually protected occlusion
Group function
Canine protected occlusion
Balanced occlusion
Occlusal Concepts
The anterior teeth bear all the load and the posterior
teeth are disoccluded in any excursive position of the
mandible.

In the intercuspal position, the posterior teeth
contact and relieve the anterior teeth
Mutually Protected Occlusion
During the entire lateral movement the buccal cusps
of the posterior teeth on the working side are in
contact. There is no tooth contact on the non-
working side.
Group Function
During the lateral excursion contact occurs only
between the upper and lower canine, and/or first
premolar on the working side. There is no contact
between the teeth on the non-working side.
Canine Protected Occlusion
The theory of canine protected occlusion is attributed
to Nagao (1919), Shaw (1924) and D'Amico (1958), and
is based on the impression that the canine tooth is
the most appropriate tooth to guide the mandibular
excursion
Canine Protected Occlusion
The canine has a good crown:root ratio,
capable of tolerating high occlusal forces;
The canine root has a greater surface area
than adjacent teeth, providing greater
proprioception;
The shape of the palatal surface of the upper
canine is concave and is suitable for guiding
lateral movements.

Canine Protected Occlusion
During the entire lateral movement posterior teeth
on both the working side and the non-working side
are in contact.
Early workers in the field of occlusion
assumed that this type of occlusal
construction was necessary to achieve the
best results for both complete dentures and
the natural dentition

(Monson, 1932 ; Schuyler, 1935)
Balanced Occlusion
Present day thinking has completely
dismissed this concept for restoring the
natural dentition, although it is still
useful in complete denture
construction.

Balanced Occlusion
Concept of occlusion of
removable partial denture
Occlusal relationships for RPD
Establishment of a satisfactory occlusion for RPD should
include


1. Analysis of the existing occlusion
2. Correction of existing occlusal disharmony
3. Recording of centric relation or an adjusted
centric occlusion
4. Harmonizing of eccentric jaw movements for a
functional eccentric occlusion
5. Correction of occlusal discrepencies
Desirable occlusal contact relationships for
RPD
1. Simultaneous bilateral contacts of opposing
posterior teeth must occur in centric occlusion

Desirable occlusal contact relationships for
RPD
2. Occlusion for tooth-supported RPD (class III RPD)
similar to occlusion in a harmonious
natural dentition

Desirable occlusal contact relationships for
RPD
3. CD opposes RPD
Bilateral balanced occlusion

Desirable occlusal contact relationships for
RPD
4. Mandibular class I RPD opposes natural teeth
Working contacts

Desirable occlusal contact relationships for
RPD
5. Maxillary class I RPD opposes natural teeth
Working and balancing contacts

Desirable occlusal contact relationships for
RPD
6. Maxillary or mandibular class II RPD
Working contacts

Desirable occlusal contact relationships for
RPD
7. Class IV RPD

Contact of opposing anterior
teeth in centric occlusion
Contact of the opposing
anterior teeth in eccentric
position an can be developed
to enhance incisive function
Concept of occlusion
of complete denture
Requirements of complete
denture occlusion
Stability of occlusion at centric relation and in an area
forward and lateral to it

Balanced occlusal contacts bilaterally

Control of horizontal force by buccolingual cusp reduction
according to residual ridge resistance form and interarch
distance

(JPD., 1971)


Requirements of complete
denture occlusion
Functional lever balance by favorable tooth-to-crest ridge
position

Cutting, penetrating, and shearing efficiency of occlusal
surfaces (proper sluice-way of occlusal surfaces)

Anterior incisal clearance during all posterior masticatory
movement


(JPD., 1971)

Types of posterior teeth
1. Anatomic tooth : designed to simulate the natural tooth
form. The standard anatomic tooth has inclines of
approximately 33 degree or more.



Types of posterior teeth
2. Semi-anatomic tooth : the cusp incline is less steep than the
anatomic tooth. They articulate in three dimensions.



Types of posterior teeth
3. Non-anatomic tooth : flat and no cusp heights and has sulci
to enhance its comminuting effect on food. They articulate in
only two dimensions.
Type of occlusion
Complete denture occlusion can be of three types
namely

Balanced occlusion

Monoplane occlusion (non-balanced occlusion)

Lingualized occlusion

(Deepak et.al., 2003)
Anatomic teeth usually are selected for balanced occlusion

Non-anatomic teeth are generally the choice for monoplane
occlusion

For the lingualized occlusal concept, a combination of
upper anatomical and lower non-anatomical teeth.


Type of occlusion and
Types of posterior teeth
Balanced
occlusion
It is defined as, The simultaneous contacting of the
maxillary and mandibular teeth on the right and left
and in the posterior and anterior occlusal areas in
centric and eccentric positions, developed to lessen or
limit tipping or rotating of the denture bases in relation
to the supporting structures GPT.
Balanced Occlusion
Ref :Textbook of Prosthodontics By Nallaswamy
Balanced occlusion can be described as the position
of the teeth such that they have simultaneous
contact in centric relation and provide a smooth
sliding motion to any eccentric position.
Balanced occlusion is absent in natural dentition.
Balanced Occlusion
Ref :Textbook of Prosthodontics By Nallaswamy
http://www.ffofr.org/education/lectures/complete-dentures/concepts-of-complete-
denture-occlusion/
All the teeth of the working side (central
incisor to second molar) should glide
evenly against the opposing teeth

No single tooth should produce any
interference or disocclusion of the other
teeth.
Characteristic Requirements of
Balanced occlusion
There should be contacts in the balancing
side,but they should not interfere with the
smooth gliding movement of the working
side.

There should be stimultaneous contact
during protrusion.
Characteristic Requirements of
Balanced occlusion
The following points should be considered while
developing balanced occlusion:
wide and large ridges, with teeth arranged close to the
ridge.
Teeth that have a narrow buccolingual width and those
that rest on wide ridges provide ideal balanced occlusion.
General consideration
for balance occlusion
The following points should be considered while
developing balanced occlusion:
arranging the teeth slightly on the lingual side of the
crest of the ridge.
If the teeth are set outside the ridge the denture may
elevate on one side during tooth contact.
General consideration
for balance occlusion
The teeth should be placed
over the ridge to provide lever
balance to the denture
The following points should be considered while
developing balanced occlusion:
The complete denture should be designed in such a
way that the forces of occlusion are centred
anteroposteriorly in the denture.

General consideration
for balance occlusion
Balanced occlusion can be classified as
Unilateral balanced occlusion
Bilateral balanced occlusion
Protrusive balanced occlusion
Lateral balanced occlusion
Classifications
This is a type of occlusion seen on occlusal surfaces of
teeth on one side when they occlude simultaneously
with a smooth, uninterrupted glide.
This is not followed during complete denture
construction. It is more pertained to fixed partial
dentures.

Unilateral balanced occlusion
This is a type of occlusion that is seen when simultaneous
contact occurs on both sides in centric and eccentric
positions. Bilateral balanced occlusion helps to distribute the
occlusal load evenly across the arch and therefore helps to
improve stability of the denture during centric, eccentric or
parafunctional movements
Bilateral balanced occlusion
For minimal occlusal balance, there should be at least
three points of contact on the occlusal plane. More
the number of contacts, better the balance. Bilateral
balanced occlusion can be protrusive or lateral
balance.

Bilateral balanced occlusion ()
Present when mandible moves in a forward direction and the
occlusal contacts are smooth and simultaneous anteriorly and
posteriorly.
There should be at least three points of contact in the occlusal
plane.(Two of these should be located posteriorly and one
should be located in the anterior region.)



This is absent in natural dentition
Protrusive balanced occlusion
In lateral balance,there will be a minimal simultaneous
three point contact (one anterior, two posterior)
present during lateral moment of the mandible.


Lateral balanced occlusion
Monoplane occlusion
(non-balanced occlusion)
Monoplane occlusion
Neutrocentric monoplane

Conventional monoplane


Neutrocentric monoplane
In 1954, De Van formalized guidelines for using flat teeth in
his neutrocentric concept

occlusal surfaces should have
Flat planes in all directions with no inclination at all in respect to
the underlying denture foundation.
Balance was considered unnecessary and undesirable, as the
resulting inclines would create instability of the dentures.
1. Position of teeth
2. Decrease proportion
3. Plane of occlusion
4. Flat Tooth form
5. Decrease number of teeth
Neutrocentric monoplane
Neutrocentric monoplane
Occlusal concept
Centric relation jaw only record
Simple articulator
Set 12 anterior teeth with overjet but no overbite
Set lower teeth in flat plane to middle of retromolar pad
Set upper to match; no attempt on contact on excersions
Neutrocentric monoplane
Advantage
Simplest recording and articulator
Quick arrangement of teeth
Wide range of posterior tooth positions possible
No lateral stress on mucosa with parafunction
Easier for patients with cross bite and low ridge
No lock occlusion
Neutrocentric monoplane
Disadvantage
Flat premolar and no overbite may less esthetic
Reported as less efficient in chewing tests
christensens phenomena
Discomfort

Neutrocentric monoplane
Neutrocentric monoplane
Conventional monoplane
Occlusal concept
Centric relation jaw record
Semi adjustable articulator
Anterior teeth with over jet and slight overbite
Posteriors set to contact on at least 1 point on
nonworking or balancing contact
Conventional monoplane
Advantage
more esthetic overlap of anterior teeth
The posterior point contact maintains denture-base
stability on excursions or parafunction.
Conventional monoplane
Disadvantage
Slightly more laboratory setup time than flat teeth
Premolar appear flat if visible
Conventional monoplane
Indications of the monoplane occlusion
Flat ridge
Class II jaw relations
Class III jaw relations
Maxillofacial patients
Cross bite
Doubtful or without any perfect centric relation
records

Lingualized occlusion


Lingualized occlusion was developed in an attempt to
simplify denture occlusion while Maintaining the advantages
and eliminating the disadvantages of both balanced and
monoplane type occlusions.

Lingualized occlusion
Opposing anatomic or semi-anatomic denture teeth are
selected when creating a balanced lingualized occlusion.

Anatomic teeth opposing non-anatomic teeth are selected
for a non-balanced lingualized occlusion.

Lingualized occlusion
Lingualized occlusion
The maxillary teeth for both occlusions are arranged
so that the lingual cusps are in contact with the
mandibular teeth

The buccal cusps lie slightly above the occlusal plane


Lingualized occlusion
Lingualized occlusion
Balancing side contact and Working side contact is
limited to maxillary lingual cusps.

Maxillary buccal cusps do not contact mandibular
teeth in centric or eccentric positions.
1. In patients having the priority on esthetics but a non-
anatomic occlusal scheme is indicated by oral conditions
such as severe alveolar resorption, a Class II jaw
relationship, or displaceable supporting tissue.

2. In patients with implant supported overdenture.


Indications for lingualized
occlusion
3. In patients having parafunction habits. So that
reduced amount of horizontal forces are transmitted
to the supporting tissues.

4. Lingualized occlusion also can be used effectively
when a complete denture opposes a removable
partial denture and bilateral balanced occlusion is
desirable.



Indications for lingualized
occlusion

anatomic and non-anatomic


Mono-plane
Bilateral-balance occlusion
Advantages






Class II III cross bite
nonanatomic


Advantages
Concept of occlusion
of fixed
prosthodontics
Two reference positions are commonly used in
prosthodontics
Maximum intercuspal position (MIP)
Centric relation (CR)
Concept of occlusion of fixed
prosthodontics
Maximum intercuspal position
If the existing MIP is satisfactory and only local
changes are being planned, then it is the treatment
position of choice
Concept of occlusion of fixed
prosthodontics
Criteria for an acceptable MIP
Comfort
Appearance
The quality of the end-stop
Concept of occlusion of fixed
prosthodontics
Centric relation
CR has been advocated as a treatment position when
the current MIP is not available or suitable
Concept of occlusion of fixed
prosthodontics
Occlusal objectives in making crowns and bridges
There are two main objectives
To leave the occlusion with no additional occlusal
interferences, i.e. harmonious
To leave the occlusion stable
Concept of occlusion of fixed
prosthodontics