Occlusal assesment/ dental courses

OCCLUSAL ASSESSMENT
AND
ADJUSTMENTS
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

CONTENTS
• INTRODUCTION
• PROBLEMS DUE TO ERROR IN OCCLUSION
• DEFINITIONS
• OCCLUSAL CONCEPTS
• OCCLUSAL SCHEMES
• CAUSES OF ERROR IN OCCLUSION
• CHECKING FOR ERRORS IN OCCLUSION
• TIMING OF CORRECTION
• REMOUNTING
• OCCLUSAL ADJUSTMENTS AND SELECTIVE
GRINDING
• SUMMARY AND CONCLUSION
• REFERENCES

INTRODUCTION
• Occlusion is an anatomic and physiologic complex
present when the opposing teeth are in contact. It
consists of the positional relations, the stresses directed
to the supporting structures, their resistance to stresses,
the form and arrangement of teeth, the influencing
factors of the TMJ, and neuromuscular mechanism
responsible for mandibular movements.
• Perpetual preservation of what remains is better than the
meticulous reconstruction of what is lost. Hence, the
occlusion must satisfy the physiologic requirements and
be acceptable to the patient, otherwise………

PROBLEMS DUE TO ERROR IN OCCLUSIONPROBLEMS DUE TO ERROR IN OCCLUSION
1. DENTURE INSTABILITY
• last lower tooth too posteriorly placed
• orientation of occlusal plane not parallel to ridge
• uneven initial contact
• intercuspal position and centric relation not coincident
• excessive vertical overlap of anterior teeth
• lack of balanced occlusion
• lack of freedom in intercuspal position
2. DISCOMFORT
• Pain on eating in the presence of occlusal imbalance
• Pain and/or ulceration lingual to lower anterior ridge
• Pain and/or ulceration on labial aspect of lower ridge
• Pain at the periphery of dentures, in the depth of sulci
• Cheek/lip biting
• Tongue biting
• Soreness on the crest of ridgewww.indiandentalacademy.com

TO AVOID:
• Selection of proper occlusal concept and occlusal
scheme
• Proper teeth arrangement
• Remounting of dentures
• Occlusal adjustment by selective grinding

DEFINITIONS
OCCLUSAL ADJUSTMENT
1. Any adjustment in the occlusion intended to alter
occlusal relation
2. Any alteration of the occluding surface of the teeth or
restoration
OCCLUSAL RESHAPING
Intentional alteration of the occlusal surfaces of teeth to
change their form
OCCLUSAL EQUILIBRATION
The modification of occlusal form of teeth with the intent
of equalizing occlusal stress producing simultaneous
occlusal contacts or harmonizing cuspal relations

OCCLUSAL HARMONY
A condition in centric and eccentric jaw relation in which
there are no interceptive deflective occlusal contacts of
occluding surfaces
OCCLUSAL DISHARMONY
A phenonmenon in which contacts of opposing occlusal
surfaces are not in harmony with other tooth contacts
and/or anatomic and physiologic components of the
craniomandibular contacts
OCCLUSAL INTERFERENCES
Any tooth contact that inhibits the remaining occluding
surfaces from achieving stable and harmonious contacts
OCCLUSAL PREMATURITY
Any contact of opposing teeth that occurs before the
planned intercuspation

OCCLUSAL CONCEPTS
• Balanced occlusion
• Lingualised occlusion
• Spherical occlusion
• Organic occlusion
• Neutrocentric occlusion
• Transiographics

Theories of occlusion
• Spherical theory
• Equilateral triangle theory
• Conical theory

Equilateral Triangle Theory
This theory was proposed by Bonewill
Average 4inch between each condyles and incisal
guidance form the shoulder of the equilateral triangle
Conical theory
This theory was proposed by Hall
Lower teeth move over the surfaces of the upper teeth
as over the surfaces of cone with a generating angle
of 45 degree and with the central axis of cone tip
opened at 45 degree angle to the degree of occlusal
plane. www.indiandentalacademy.com

Spherical theory of occlusion
 This was given by Monson(1918) and the concept
was derived from an idea by Von spee.
 Positioning of teeth with antero-posterior and
medio-lateral inclines in harmony with a spherical
surface. Some times referred to as having Monson
curve.
 Lower teeth moves over the surface of upper teeth
as over the surface of sphere with a diameter of
8inches(20cm).
 Centre of sphere is in gabella.
 Surfaces of the sphere passes through glenoid
fossa along the articular eminences.www.indiandentalacademy.com

• According to Russell C. Wheeler,”Nothing anatomic may
be reduced to the mathematical exactitude of
geometrical terms.”
• Reliable observations has shown repeatedly that
although the lower teeth may appear to conform to the
segment of an 8 inch sphere , the teeth definitely do not
move along the surface of such a sphere.
• The contention that movements of the mandible will
readily adapt themselves to this pattern of occlusion is
fallacious since condyles are generally inadaptable
• Individual anteroposterior and lateral movements are not
encompassed within spherical machine
• The disharmonies introduced in such an occlusion would
exert a deleterious effect on the underlying bone and
tissues

Organic occlusion
 Based on the work of Angelo D Amico (Gnathological Society)
 It is that concept where in any jaw movement away from centric
occlusion will result in separation of all posterior teeth.
 The ridge and groove directions of the posterior teeth are determined
as result of the movements of the condyles. The cusp height, fossa
depth of posterior teeth and the proper concavity at the lingual
surfaces of the maxillary anterior teeth are determined as a result of
mandibular movements.
 The aim of this occlusion is to relate the occlusal elements of teeth so
that the teeth will be in harmony with the muscles and joints in
function.

 In organic occlusion three phases of mutually interdependent
protection are present.
 The posterior teeth should protect the anterior in the centric
occlusal position.
 The maxillary incisors should have vertical overlap
sufficient to provide separation of the posterior teeth when
the incisors are in edge to edge contact.
 In lateral mandibular position outside the masticatory
movements, the cuspids should prevent contact of all other
teeth.

Transographic Occlusion
• Given by Shwelzer
• Eccentric balancing contacts are not considered since they are
believed to be outside the mandible
• This theory is dependant on Split Theory where each condyle is
considered to be independent
• According to Schweitzwer this theory agreed in principle with tenets
of gnathology, but differed in its concept of the problem.

Neutrocentric concept
Proposed by DeVan(1954)
Key objectives: -Neutralization of inclines
-Centralization of forces
Features :
• Arrangement of teeth on a plane parallel to basal support and without
compensating curves.
• Not dictated by horizontal condylar guide
• Bucco-lingual direction teeth are set flat without B-L inclination
• Horizontal condylar guidance and lateral condylar set zero
• Reduced bucco-lingual width of teeth
• Second molar is eliminated
• Patient advised to avoid incising in anterior teeth
• No cusp in posterior teeth
Advantages: -simple and less precise records are required
-lateral forces are reduced
-easy to adjust

Balanced Occlusion:
It is defined as “The simultaneous contact of opposing upper and
lower teeth in centric relation position and a continuous smooth
bilateral gliding from this position to any eccentric position with
in normal range of mandibular function”-GPT

LINGUALISED OCCLUSION
• GYSI in 1927 introduced this type of concept.
• POUND used it for non balanced articulation.
• PAYNE in 1941 used it for balanced articulation.
Lingualised occlusion uses the maxillary lingual cusp as a dominant
functional element, against the corresponding portion of the mandibular
teeth

Indications for Lingualised occlusion:
• Lingualised occlusion can be used in most denture combinations.
• It is particularly helpful when the patient places high priority on
esthetics but non-anatomic occlusal scheme is indicated by oral
conditions such as severe alveolar resorption, a Class II jaw
relationship, or displaceable supporting tissue.
• If the non-anatomic occlusal scheme is used, esthetics in the premolar
region are compromised.
• With Lingualised occlusion, the esthetic result is greatly improved
while still maintaining the advantages of a non-anatomic system.
• Lingualised occlusion also can be used effectively when a complete
denture opposes a removable partial denture.www.indiandentalacademy.com

Principles of Lingualised occlusion
• Anatomic posterior (30 or 33°) teeth are used for the maxillary
denture. Tooth forms with prominent lingual cusps are helpful.
• Non-anatomic or semi-anatomic teeth are used for the mandibular
denture. Either a shallow or flat cusp form is used. A narrow occlusal
table is preferred wherever resorption of the residual ridges has
occurred.
• Modification of the mandibular posterior teeth is accomplished by
selective grinding which is always necessary regardless of specific
tooth or material.
• Upper lingual cusps should contact lower teeth in centric occlusion.
• Balancing and working contacts only on maxillary lingual cusps.
• Protusive contacts only between upper lingual cusps and lower teeth.

Advantages of Lingualised occlusion
– Most of the advantages attributed to both the anatomic and
non-anatomic forms are retained.
– Cusp form is more natural in appearance compared to non-
anatomic tooth form.
– Good penetration of the food bolus is possible.
– Bilateral mechanical balanced occlusion is readily obtained
for a region around centric relation.
– Vertical forces are centralized on the mandibular teeth.

OCCLUSAL SCHEMES
3 TYPES-
• Anatomically shaped teeth in upper and lower dentures
• Non-anatomically shaped teeth in both dentures
• A combination of both types,usually anatomically shaped
teeth in upper

Occlusal form
• 330
bucco-lingual inclines of
anatomic teeth for patients
with strong, well formed
ridges
• 200
bucco-lingual inclines of
semi-anatomic teeth for
patient with ridge contour is
reduced by resorption
• 00
non-anatomic teeth for
patient with flat, knife edge
ridges

CAUSES OF ERROR IN OCCLUSION
• Change in state of health of TMJ
• Inaccurate maxillomandibular records made by the
dentist
• Errors made in the transfer of the maxillomandibular
records to the articulator
• Failure to seat occlusal rims correctly on the cast
• Ill fitting temporary bases
• Failure to use facebow and subsequently changing the
vertical relation on the articulator
• Incorrect arrangement of posterior teeth
• Failure to close flasks completely
• Use of too much pressure in closing the flask

• Changes in supporting structures since the impression
were made
• Unavoidable changes due to denture base material
itself-
-greatest amount of warpage occurs when dentures
are removed from the casts
-Warpage of dentures by overheating them in
polishing operations
-resin absorbs water in use and this will expand the
resin

CHECKING FOR ERRORS IN OCCLUSION
- By feeling the touch and slide

TIMING OF CORRECTION
• Occlusal errors must be eliminated before dentures are
worn by the patient
• Postponing this important step will lead to-
-deformation of underlying soft tissue
-discomfort
-destruction of supporting bone
• Later, the occlusal errors may be concealed and
impossible to locate and correct because of distorted
and swollen tissues.

REMOUNTING
• “Any method used to relate restoration to the articulator
for analysis and/or to assist in development of a plan for
occlusal equilibration or reshaping.”
• 2 types-
lab remounting
clinical remounting

LAB REMOUNTING
• Replacement of casts with the processed dentures still
on them on their original mountings on the articulator.
• Eliminates part of error in occlusion
• Eliminates error due to processing changes
• Corrections are done by selective grinding

CLINICAL REMOUNTING
• Remounting of dentures on the articulator by means of
new interocclusal records made in the patients mouth at
the time of denture insertion.
• Most accurate procedure
• The lab remount procedures will not correct for clinical
errors :
-in recording jaw relation records
-in mounting the cast on the articulator

Causes of errors in recording jaw relation records
• Record bases that do not fit accurately
• A shifting of record bases over displaceable tissue
• Excessive pressure exerted by the patient during the
registering of maxillomandibular relations
• Unequal distribution of stress during the registering of
maxillomandibular relations
• record bases placed on soft tissues that have been
deformed by ill-fitting dentures
• Factors beyond the control of dentist--

Causes of errors in mounting the cast on the
articulator
• Record bases that are not properly seated and secured
to casts during mounting procedures
• Occlusal rims not being definitely locked or keyed for
correct orientation during mounting on the articulator
• Interferences of casts in the posterior region during
mounting
• Articulator not maintaining horizontal and vertical
relationship of casts.
• Inaccuracies introduced by changes in the plaster used
to mount the casts

Procedure of clinical remounting
1. Preparation of remounting jig
2. Construction of remounting casts
3. Making of interocclusal records of centric relation and
protrusive relation
4. Remounting of mandibular denture with the help of
interocclusal record
5. Adjust the articulator

Advantages of remounting
• It reduces the patient participation
• It permits the dentist to see the procedure better
• It provides a stable working foundation
• The absence of saliva makes possible more accurate
marking with articulating paper
• Correction can be made away from the patient, thus
preventing occasional objections when patient sees their
dentures being ground

Methods of correcting occlusal disharmony
1. Articulating paper
2. Carbon paper
3. Central bearing devices
4. Occlusal wax
5. Abrasive paste

OCCLUSAL ADJUSTMENTS

IDEALS OF OCCLUSAL HARMONY AS PUBLISHED BY
SCHUYLER
1. Maximum distribution of stress in centric
maxillomandibular relation
2. Retention of the maxillomandibular opening
3. Harmony of guiding inclines, thereby distributing
eccentric occlusal stresses
4. Reduction of the incline of guiding tooth surfaces, that
occlusal stresses may be more favourably applied to
the supporting tissues.
5. Retention of sharpness of cutting cusps
6. Increase of food exits.
7. Decrease of contact surfaces

SELECTIVE GRINDING
Definition: The modification of the occlusal forms of the teeth
with the intend of equilibrating occlusal stress, producing
simultaneous occlusal contacts/ harmonizing cuspal relations.
Rational :
• Eliminate occlusal interferences
• Achieve balanced occlusion
• Contacts in harmony with TMJ and neuromuscular system
• Failure to achieve it
-soreness
-loss of supporting bone
-TMJ problems

ANATOMIC TEETH IN BALANCED OCCLUSION
In centric occlusion-
• articulating paper of minimum thickness
• When 2 points strike prematurely in centric, one of the
points must be ground to equalize contacts on all points
of the arch
• To select which point should be ground---------

• Hence ,
a) If the cusp is high in the centric and in the eccentric
position, reduce the cusp.
b) If the cusp is high in centric and not in eccentric
position, deepen the fossa or marginal ridge
• Grinding is done by means of mounted chayes stone
• The marking procedures are repeated until practically
all teeth have contact in centric occlusion
• incisal pin is relieved of contact on the incisal
guidance table

Working side
• Incisal pin is placed in contact with incisal guide table
• Articulating paper is placed
• Marking shows contacts of a maxillary and mandibular
buccal and lingual cusps and the maxillary and
mandibular incisors on working side
• If the pin rises away from the incisal guide table:
• Reduce the inner inclines of the
a) buccal cusps of the maxillary
teeth
b) lingual cusps of the mandibular
teeth
• This is called as BULL LAW

Balancing side
•Marks are shown on lingual cusps of the maxillary
teeth and on the buccal cusps of the mandibular teeth
•Reduce the inner inclines of mandibular buccal cusp
•If it is necessary to eliminate a centric cusp to correct
balancing prematurities, eliminate the mandibular
buccal cusp because---

Protrusive balancing
• Reduce the distal inclines of maxillary cusps and mesial
inclines of mandibular cusps

• After completing the selective grinding procedure
-refine the occlusal anatomy using mounted inverted
cone points
-polish all the ground surfaces with wet powdered
pumice on a wet rag wheel
Carborundum paste
• Should not be used for cusped teeth
Disadvantages:
-decrease in vertical dimension
-increases area of tooth surface contact
-stresses of mastication will be distributed improperly
-loss of sharpness of cusps and hence decrease in
size and no. of food exits
• If used at all -smoothness of minute irregularities by 1 or
2 gliding movements of articulator.www.indiandentalacademy.com

Types of occlusal errors and their correction
• In centric-3 types
1. Any pair of opposing teeth can be too long and hold
other teeth out of contact
2. The upper and lower teeth can be too nearly end to
end.
3. The upper teeth can be too far buccally in relation to
the lower teeth

• Working side errors
1. both the upper buccal cusp and the lower lingual cusp
are too long
2. Buccal cusps make contact but the lingual cusps donot
3. lingual cusps make contact but the buccal cusps donot
4. The upper buccal or lingual cusps are mesial to their
intercusping positions
5. The upper buccal or lingual cusps are distal to their
intercusping positions
6. The teeth on working side may not contact

• Balancing side errors
1. Heavy balancing contacts preventing working side
teeth contact
2. No balancing contacts

NONANATOMIC TEETH IN BALANCED
OCCLUSION
• Gross premature contacts in centric relation are removed
by grinding
• small ares of contact uniformly dispersed over the
occlusal surface of all posterior teeth
• The same procedures are used to locate and remove all
occlusal interferences in the lateral and protrusive
occlusion
• The grinding is done on the occlusal surfaces of teeth
that appear to have been tipped or elongated in
processing
• In eccentric occlusion, no grinding is done on the
distobuccal portion of the occlusal surface lower of 2nd
molar
• All balancing side grinding is done on the lingual portion
of the occlusal surface of upper 2nd
molar

Striping method for non anatomic teeth
• Carborundum stripping technique
• Originally published by Dr Grunas in 1970
• Maintains the previously established flat occlusal
scheme
• TECHNIQUE
1. Adjustments for centric-
a) locate the premature contacts with articulating paper.
Any grossly tipped tooth is reduced with the stone.
b) Check the eccentric movements and remove the
premature contacts with with a stone or bur
c) Place a caborundum strip against the teeth and gently
close the articulator in centric relation

d) Apply light pressure to the upper member of the
articulator and pull the strip briskly between the teeth
e) Reduction of the contacts with the strips is continued by
stripping an equal number of times with the abrasive
side alternated up and down until uniform bilateral
contacts on the posterior teeth are obtained
2 . Adjustments for eccentric occlusion-
Check each eccentric position and remove any
premature contact with a flat stone while maintaining a
flat occlusal scheme

ANATOMIC TEETH IN LINGUALISED
OCCLUSION AND CLASS1 JAW RELATION
FOR STATIC CENTRIC CONTACTS
• Premature contacts are removed---
• Difference-any contact on buccal cusps should be
ground
• Complete M-D unlocking of cusped teeth by grinding the
transverse ridges
• Only the upper lingual cusp should articulate with the
lower posterior
• The final result should be stable contacts with all the
upper lingual cusps in the common lower central fossa.

FOR WORKING AND BALANCING CONTACTS
• Working side- upper lingual cusps should contact the
lower lingual cusps.
• Balancing side -the upper lingual cusp should contact
the lower buccal cusps
• Ideal contacts should be:
-5 working cusp contacts
-5 balancing cusp contacts
-no upper buccal cusp contacts
• Grind the marked premature contacts on the lower teeth.
• Do not grind the upper lingual cusps
• Any contact on upper buccal cusps should be ground.

• FOR PROTRUSION
• The upper right and left 2nd
molar cusps should ride up
the distal inclines of the lower right and left 2nd
molars
• There should be no interference between the buccal
cusps of the upper teeth and any of the lower buccal
cusps

ANATOMIC TEETH IN LINGUALISED OCCLUSION
AND
CLASS II JAW RELATION
FOR STATIC CENTRIC CONTACTS
• The buccal cusps of lower premolars and lingual cusps
of upper premolars are flattened to horizontal table
• Selectively grind all contacts on lower teeth until all of
the upper lingual cusps contact

FOR WORKING AND BALANCING CONTACTS
• Same as class I
• Difference-premolars do not make balancing contacts
because of the buccal overlap which takes them out of
range during lateral excursion on the balancing side
• Selectively grind the interfering cusps or inclines until the
desired working and balancing contacts are established
• The centric occlusion contact that establish the occlusal
vertical dimension should not be ground

FOR PROTRUSION
• large range in this direction
• Intermediate protrusive positions just forward of centric
occlusion are used for light chewing
• smooth bilateral contact of the posterior teeth from
centric to an intermediate protrusive position
• Articulating paper is used
• Never grind the upper lingual cusps or the lower central
fossa in this procedure
• The anterior teeth should be out of contact for this range
of intermediate protrusive positions
• Modest class II ridge relation….
• severe classII ridge relation……

NON ANATOMIC TEETH IN LINGUALISED OCCLUSION
AND
CLASS II RIDGE RELATION
• Used when the lower ridge is severely resorbed in case
of classII
• 2 schemes-Reverse occlusal scheme or pleasure curve
-Revised occlusal scheme or
Revised pleasure curve

BALANCING FOR REVERSE OCCLUSAL SCHEME
• No Balancing contacts because of absence of buccal
cusp rise
• only working side contacts and these should be smooth
gliding multiple contacts
• acheived by selective grinding of premature contacts
• selective grinding is restricted to the lower teeth

BALANCING FOR REVISED OCCLUSAL SCHEME
• Premolars-working side contacts because of the lingual
rise of the bucally inclined occlusal surface
• 1st
molar -only centric occlusal contact
• 2nd
molars- Balancing contacts ; upper lingual on the
lower buccal
• selectively grinding of premature inclines on the lower
occlusal surface.

LINGUALISED OCCLUSION AND
CLASS III JAW RELATION
• Cross-bite occlusion
• Buccal cusp of upper is in lower central fossa
• May occur unilaterally or bilaterally depending upon
posterior upper and lower ridge relationship
• The crossing point of this occlusion depends on
buccolingual vertical relation of each case
• Done either with modified anatomic or non anatomic
teeth
• Grinding modifications-buccal and lingual cusps of tooth
that initiates crossing over are flattened to establish a
static centric occlusal contact and upper buccal cusp of
tooth in cross bite relation must be rounded to occlude in
modified central fossa of the lower

BALANCING
Centric contacts:
Anterior to crossing point- upper lingual cusps in lower
central fossa
At crossing point- upper buccal and lingual cusps
on lower buccal and lingual
cusps
Posterior to crossing point- upper buccal cusp in the lower
central fossa
working side contacts
Anterior to crossing point- upper lingual opposing lower
lingual
At crossing point- no contacts
Posterior to crossing point- upper buccal cusp opposing
lower lingual cusp

Balancing contacts:
Anterior to crossing point- upper lingual cusps opposing
lower buccal cusp
At crossing point- No balancing contact
Posterior to crossing point- upper buccal cusp opposing
lower buccal cusp
Protrusive contacts
Anterior:
Anterior teeth edge to edge- no protrusive excursion
Anterior teeth with slight horizontal overlap-
protrusion brings anterior teeth edge to edge
Posterior-the upper 2nd
molar buccal cusps on lower 2nd
molar distal inclines

• Articulating paper will identify the interferences that
prevent the desired working and balancing side contacts.
• Harmony of upper working cusps on lower buccal and
lingual inclines can be obtained by proper selective
grinding procedure

COMBINATION ANATOMIC- NON ANATOMIC
POSTERIOR SETUP
• A variation of lingualised occlusion
• Anatomic teeth for upper posteriors and nonanatomic
teeth for lower posterior
• Penetrating efficiency of cusped teeth and the favourable
control of occlusal forces by non cusped teeth
• flat scheme of occlusion
• flat incisal guidance or an adequate horizontal overlap to
avoid anterior interference during function
• No special indications
• Increase the masticatory efficiency of complete denture
occlusion in compromised ridges
• Effective with various ridge relationships

• BALANCING THE OCCLUSION
• Flat scheme of occlusion modified by a compensating
curve for a balanced occlusion apply to this combination
• A stable non-deflective contact bilaterally for the centric
occlusion is the primary requisite for a balanced
occlusion
• Centric contacts-upper lingual cusps occluding with the
opposing flat occlusal surface
• Working contacts-upper lingual cusps occluding with the
lingual area of the opposing flat lingual occlusal surface
• Balancing contacts-lingual cusps of upper 2nd
molars on
the buccal slope of the lower 2nd
molars
• protrusive contacts-lingual cusps of upper 2nd
molars on
the distal slope of the lower 2nd
molars

SUMMARY AND CONCLUSION
• No one occlusal scheme can be best for all the patients
• Clinical remounting is the best procedure for remounting
• Occlusal adjustments and Selective grinding are very
important procedures for the development of proper
occlusion

REFERENCES
• Boucher’S Prosthodontic Rx for edentulous patient 10th
edition.
• Syllabus of complete dentures by Charles M. Heartwell
4th
edition 5th
edition.
• Essentials of complete Denture Prosthodontics by
Sheldon Winkler-2nd
edition.
• Prosthodontic Rx for edentulous patients by Zarb
Bolender 12th
edition.
• Ramjford S. and Ash: Occlusion
• Sharry J.J.: Complete Denture Prosthodontics; 1962
McGraw-Hill Book Company.
• Gregory R.P., Gerald H.L.: The Occlusal Spectrum and
Complete Dentures.www.indiandentalacademy.com

• Complete prosthodontics-Problems, Diagnosis and
Management by Alan A Grant
• Identification of complete denture problems:a
summary,BDJ, vol-189, no.3, 2000
• An effective pattern of occlusion in complete artificial
dentures by Samuel Friedman , JPD 1951, vol-1,p-402-
413
• Dental physiology for dentures, JPD 1952, vol 2, p 3-11
• Swensons complete dentures, st. louis,1940
• Colour Atlas of Dental medicine,complete denture and
overdenture prosthetics by martin, charles and kelsy

THANK YOU

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