Masticatory afficiency in denture wearers with bilateral balanced occlusion and canine guidance

Abstract

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.

A prospective cross-over study to evaluate the effect of two different occlusal concepts on the masseter muscle activity in implant-retained mandibular overdentures

“…The results also coincide with Grunert et al, [20] who found no difference in muscle activity between bilateral balanced occlusion and canine guidance occlusion in complete dentures. These results were also similar to Neto AF et al, who stated that bilateral balanced occlusion did not improve masticatory efficiency when compared with canine guidance [11]. Abd Elmonem evaluated masticatory efficiency in complete denture wearers with bilateral balanced occlusion and canine guidance using the colorimetric method and also found no statistical significant difference between them [35].…”

“…For more than a hundred years, textbooks and undergraduate teaching have stated that canine guided dentures should be avoided, since they would result in denture instability and impaired muscle function; however, recent research has shown that conventional complete dentures can function successfully without balanced occlusion [11]. …”

Oclusión terapéutica: Desde las escuelas de oclusión a la Odontología Basada en Evidencia

“…Clark (2001) recomienda el montaje en articulador en casos de deslizamientos en céntrica mayor a 2 mm, de inestabilidad oclusal por pérdida de piezas dentarias, indicación de cirugía ortognática y por último, pre y post tratamiento ortodóncico, más por razones legales que científicas (50) . Se ha responsabilizado a las interferencias oclusales y a la asimetría de contactos oclusales de causar movilidad dentaria, trauma oclusal, deflexión mandibular, bruxismo, migraciones dentarias y desbalance en la actividad muscular causando alteraciones en la función muscular, de las ATMs, y por consiguiente TTM (7,47,52,54,76) . Para responder a esto, Ciancaglini (2001) estudió la distribución de contactos oclusales en sujetos sanos y con síntomas de TTM y observó que la simetría en el número de contactos ocurre solamente en el 4% de los pacientes con TTM, respecto al 8% en sujetos sanos.…”

“…Aunque los estudios no muestran diferencias significativas en cuanto a estos factores, la mayoría de los clínicos postula que debe haber contactos en todos los dientes posteriores en OC (7,74) . Farías (2010) comparó la eficiencia masticatoria en prótesis completas entre un esquema oclusal de guía canina y uno de balanceada bilateral, y no encontró diferencias estadísticamente significativas (52) .…”

Masticatory Efficiency of Complete Dentures Constructed by different Denture Base Materials

“…[1] Furthermore, a reduction in the physiological secretion of gastric acid is characteristic of the aging human process which reinforces the importance of efficient mastication to start food digestion processes. [2] One of the primary function of the complete denture is to restore masticatory function in the people who have lost their natural teeth, studies have reported that the values for maximum biting force in patient wearing complete dentures were only one-fifth to one-sixth the values reached by dentate subjects. [3] However, problems such as discomfort and difficulty in chewing certain foods are generally reported by its wearers as a result of a reduced masticatory efficiency, which ranges from 16% to 50%, when compared to dentate subjects.…”