Maintaining occlusal stability by selecting the most appropriate occlusal scheme in complete removable prosthesis

Abstract

The search of an adequate occlusal scheme that maximizes dentures’ stability and patients’ satisfaction is an ultimate objective in every complete prosthodontic treatment. Many studies compared occlusal schemes in terms of retention, comfort and masticatory performance. The purpose of this article is to review literature about different occlusal schemes related to complete dentures’ stability and edentulous patients’ satisfaction, in order to select the most appropriate occlusal scheme. Thus, an electronic search was performed from PubMed (MEDLINE), Scopus, Cochrane, Google Scholar and Sciencedirect databases. 65 articles were identified of which 56 were selected to compose the present article. Within the limitations of this review, it has been concluded that edentulous patients prefer anatomic occlusal schemes to non-anatomic teeth. Furthermore, canine guidance seems to be efficace in terms of chewing comfort and dentures’ retention, as well as lingualized occlusion. However, bilateral balanced occlusion does not confer a long-term masticatory performance and satisfaction to edentulous patients.

Comparison of Canine-Guided Occlusion with Other Occlusal Schemes in Removable Complete Dentures: A Systematic Review

“…The present systematic review compared various aspects of the canine-guided occlusion with other types of occlusal schemes in complete denture wearers. The selection of an adequate occlusal scheme in removable complete dentures is challenging [27,36]. Achieving all the objectives of complete denture making in edentulous patients involves the successful integration of patients' functional needs and psychological acceptance [37].…”

“…BBO is one of the earliest occlusion concepts advocated for the construction of complete dentures and involves the continuing contacts of as many maxillary and mandibular artificial teeth as possible at the centric relation and all eccentric mandibular movements [43]. Proponents of this scheme claim that dentures fabricated with BBO are more stable, with multiple point contacts in all excursive movements, particularly for edentulous patients with compromised ridges and neuromuscular skills [36,43]. In contrast, with CGO, the posterior teeth disengage during all excursive movements of the mandible, with the canine teeth making a vertical and horizontal overlap [14].…”

“…In centric occlusion, both types of schemes have simultaneous occlusal contacts; however, they differ in occlusal contacts during excursive/eccentric movements [44,45]. The selection of the optimal or appropriate occlusal scheme for edentulous patients has economical and clinical significance [36,43,45]. The construction of the occlusal scheme with BBO is more complex and time-consuming compared to the canine-guided scheme [1].…”

The Relationship between Dental Occlusion and “Prosthetic Occlusion” of Prosthetic Restorations Supported by Natural Teeth and Osseointegrated Dental Implants

“…Scientific studies comparing balanced and non-balanced occlusion schemes of complete dentures regarding variables such as retention, stabilization, masticatory efficiency of complete dentures, comfort of wearing complete dentures, resorption of the alveolar ridge (load transfer) and quality of life of edentulous patients also come to contradictory results. Some studies [53, 54] favor non-balanced occlusal concepts (e.g., canine guidance) over balanced occlusions and vice versa [55], others emphasize the advantages of balanced occlusions per se and over non-balanced schemes [38,47,[56][57][58][59][60][61][62][63], and third studies record no differences between balanced and non-balanced occlusal concepts for complete dentures [64][65][66][67][68][69] and consider them clinically equivalent in the context studied.…”

Oclusión balanceada bilateral aplicada en un paciente con prótesis total inmediata

“…8 Por lo tanto un tratamiento protésico debe cumplir con parámetros tanto estéticos como funcionales. 9 El objetivo de este reporte de caso es describir los procedimientos realizados a un paciente de sexo masculino, con enfermedad periodontal, ausencias dentales y caries tratado mediante una rehabilitación oral con prótesis totales inmediatas para devolverle su aspecto estético, fonético y funcional en la misma sesión en la cual se realizaron las extracciones dentales; utilizando los principios básicos de la oclusión balanceada bilateral y otros como: soporte, estabilidad y retención.…”