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OCCLUSION
IN
PROSTHODONTICS
OCCLUSION
The static relationship between the
incising or masticating
surfaces of the maxillary or mandibular
teeth or tooth
analogues.
Ideal Occlusion: Synonym: Optimal Occlusion,
Therapeutic Occlusion.
Purpose: To permit good oral health, function, comfort and esthetics.
Clinical characteristics:
Classical dental relations in intercuspal position based on multiple contact
pointsand major occlusal load sustained by posrerior tooth.
Coincidence between intercuspal position and myocentric position.
Axial occlusal forces during intercuspal position with regard to the tooth
axis of posterior tooth.
Centric occlusal stability that avoids tooth migrations.
Physiological occlusion. Synonym: Normofunctional
occlusion.
Physiological occlusion is characterized by the existence of a
functional balance or a physiological adaptation condition of a proper
contact relation between teeth, with regard to the other physiological
components of the stomatognathic system (articular, neuromuscular,
and periodontal).
Clinical characteristics
Without marked parafunctional tooth manifestations ( attritions,
fractures,rhizolysis, pulpar hyperemia)
Normal functional activity during mastication, swallowing, speech and
breathing.
Relatively healthy periodontium in relation to parafunctionalactivities.
Contd.
Relative occlusal stability without apparent tooth migrations.
Absence of dysfunctional musculo-articular symptomatology related to
parafunctional activities during function and rest.
Nonphysiological occlusion. Synonyms: Traumatic occlusion or
functional malocclusion.
Nonphysiological occlusion is characterized by the rupture of balance or
functional adaptation of the contact relation between teeth with respect
to the other physiological components of the stomatognathic system
(articular, neuromuscular, and periodontal).
Clinical characteristics
It is associated with centric occlusal instability
It is associated with an occlusion showing premature contacts and
/occlusal interferences.
Contd.
Presence of marked centric and eccentric
bruxofacets
Presence of dysfunctional symptomatology
associated with temporomandibular disorders
Presence of gingival recessions and cervical
abfractions
Clinical characteristics:
Harmonic intercuspal position with centric physiological relation
(coincident or small distance of ICP not more than 1-2mm anterior
to RCP).
During protrusion and laterotrusion, anterior teeth must disoclude
the posterior ones( anterior guidance).
Healthy periodontium in relation to parafunctions(without occlusal
trauma, marked gingival retraction or recession)
Absence of marked parafunctional tooth manifestations( attrition,
coronary fracture,rizalisis, pulpar hyperemia).
Normal functional activity during mastication, swallowing, speech
and breathing.
Absence of dysfunctional symptomatology in relation to
parafunctions.
MUTUALLY PROTECTED
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.
MUTUALLY PROTECTED
OCCLUSION
CENTRIC POSITION PROTRUSIVE
POSITION
LATERAL
POSITION
Working Nonworking
Only posterior tooth make
contact.
Anterior tooth have a
space of minimum 30
microns.
Canine and
posterior teeth
disclude .
Mesial inclines of
mandibular first
premolar buccal
Maxillary
canine
guide the
mandible.
Posterior
teeth
No tooth
contacts.
Criteria
MUTUALLY PROTECTED
OCCLUSION
In lateral position, working side In protrusive position
ADVANTAGES OF MUTUALLY
PROTECTED OCCLUSION
1. Minimum amount of tooth contact is involved
and this makes for better penetration of the
food.
2. The force is closer to the long axis of each
tooth.
3. The arrangement of the marginal, transverse
and oblique ridges so that they have a
shearing action, which makes for a much
more chewing apparatus.
GROUP FUNCTION
Multiple contact relations 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.
• Criteria
GROUP FUNCTION
CENTRIC POSITION PROTRUSIVE
POSITION
LATERAL POSITION
Working Nonworking
Posterior tooth make
contact.
Anterior teeth may or
may not contact.
Canine and
posterior teeth
disclude .
Teeth contact
(mostly
desirable
canine,
premolar,
mesiobuccal
cusp of 1st
molar)
No tooth
contacts.
GROUP FUNCTION
ADVANTAGES OF GROUP
FUNCTION OCLUSION
1) Lateral pressure are distributed to all working
side tooth.
2) Long centric, so allow some freedom of
movement in an anteroposterior direction.
BALANCED OCCLUSION
The bilateral, simultaneous, anterior, and
posterior occlusal contact of teeth in centric
and eccentric positions.
• The bilateral, simultaneous, anterior, and
posterior occlusal contact of teeth in centric
and eccentric positions.
BALANCED OCCLUSION
CENTRIC POSITION PROTRUSIVE POSITION LATERAL POSITION
Working Nonworking
Anterior and posterior
teeth contact
All maxillary and
mandibular teeth
contact
Posterior teeth
make contact
Posterior
teeth make
contact.
BALANCED OCLUSION
In lateral position, working side In lateral position, balancing side
ADVANTAGES OF BALANCED
OCCLUSION
1. Help to seat the denture in a stable position
during function.
2. Patients do not upset the normal static, stable,
and retentive position of their dentures.
3. In balanced occlusion, the denture bases are
stable during bruxing activity.
OCCLUSION IN NATURAL
DENTITION
• Posterior disclusion on protrusion
• Disclusion on non working side during lateral
movement.
• Occlusion on working side (either canine
guided/group function) during lateral
movement.
DESIRABLE OCCLUSION FOR COMPLETE
DENTURE
1. Stability of occlusion in centric relation.
2. Balanced for all eccentric contacts bilaterally for all
eccentric mandibular movements
The balancing arrangement
in centric occlusion, buccal
view.
In working occlusion,
buccal view.
In balancing position,
buccal view
3. Control of horizontal forces by buccoligual
cusp height reduction according to the residual
ridge resistance form and interarch distance.
4. Functional lever balance by favorable tooth to
ridge crest position
Occlusion in complete denture
5. Unlocking the cusp mesiodistally to allow for
gradual but inevitable settling of the bases due
to tissue deformation and bone resorption.
6. Cutting and shearing efficiency of the occlusal
surface (sharp cusps or ridges).
7. Anterior clearance of teeth during mastication.
Minimum occlusal contact between the upper
and lower teeth to reduce pressure during
function.
DESIRABLE OCCLUSION FOR
RPD
**Simultaneous bilateral contacts of opposing posterior
teeth must occur in centric occlusion.
1. Kennedy class-I-
>>> Mandibular RPD opposed by natural dentition.
Contact on working side
No contact on balancing side.
>>>Maxillary RPD opposing natural dentition or
mandibular bilateral distal extension RPD
Simultaneous contact on working and non
working side.
In lateral position, nonworking sideIn lateral position, working side
>>>Mandibular RPD opposed by maxillary complete denture-
During lateral movement, both working and balancing
side make contact.Not necessarily balanced in protrusion.
In lateral position, nonworking side
In lateral position, working side
In protrusive position
2. Kennedy class-II
Contact on working side
No contact on balancing side.
In lateral position, nonworking sideIn lateral position, working side
3. Kennedy class-III
similar to occlusion in harmonious natural
dentition
4. Kennedy class-IV
Contact in intercuspal position
No contact in eccentric position
DESIRABLE OCCLUSION FOR FPD
**Similar as occlusion in natural dentition
Either mutually protected or group
function occlusion.
**In the following cases, desirable occlusion should
be group function
-Periodontally compromised supporting
anterior teeth.
-Missing canine
-Angle class-II and class-III malocclusion
-Crossbite
DESIRABLE OCCLUSION FOR
OSSTEOINTEGRATED PROSTHESIS
1) Full-arch fixed prosthesis
Bilateral balanced occlusion with opposing complete
denture
Group function occlusion or mutually protected
occlusion with shallow anterior guidance when opposing
natural dentition
Freedom in centric (1–1.5mm)
2) Overdenture
Bilateral balanced occlusion using lingualized
occlusion
Monoplane occlusion on a severely resorbed ridge
3) Posterior fixed prosthesis
Anterior guidance with natural dentition
Group function occlusion with compromised
canines
Centered contacts, narrow occlusal tables, flat cusps
Cross bite posterior occlusion when necessary
4) Single implant prosthesis
Anterior or lateral guidance with natural dentition
Light contact at heavy bite and no contact at light
bite
Centered contacts (1–1.5mm flat area)
Increased proximal contact
Centric relation: that yields Condylar Stability in Centric.
Intercuspal position: that confers Occlusal Stability in Centric.
Miocentric position: that gives Muscular Stability in centric.
References:
1) JUNHEI FUJIMOTO: CONTEMPORARY FIXED PROSTHODONTICS.
2) HERBERT T. SHILINBURG, FUNDEMENTAL OF FIXED
PROSTHODONTICS.
3) SUMAIYA HOBO: OSSEOINTEGRATION AND OCCLUSAL
REHABILITATION
4) SHELDON WINKLER: ESSENTIALS OF COMPLETE DENTURE
PROSTHODONTICS.
5) DEEPAK NALLASWAMY VEERAIYAN: TEXTBOOK OF
PROSTHODONTICS
6) SOME INFORMATION FROM INTERNATE
MUTUALLY PROTECTED OCCLUSION
In lateral position, working side In protrusive position
ADVANTAGES OF MUTUALLY
PROTECTED OCCLUSION
1) Minimum amount of tooth contact is
involved and this makes for better
penetration of the food.
2) The force is closer to the long axis of each
tooth.
3) The arrangement of the marginal, transverse
and oblique ridges so that they have a
shearing action, which makes for a much
more chewing apparatus.
GROUP FUNCTION
Multiple contact relations 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.
CENTRIC POSITION PROTRUSIVE POSITION LATERAL POSITION
Working Nonworking
Posterior tooth make
contact.
Anterior teeth may or
may not contact.
Canine and posterior
teeth disclude .
Teeth contact
(mostly desirable
canine, premolar,
mesiobuccal cusp
of 1st molar)
No tooth
contacts.
GROUP FUNCTION
ADVANTAGES OF GROUP FUNCTION
OCLUSION
1) Lateral pressure are distributed to all working
side tooth.
2) Long centric, so allow some freedom of
movement in an anteroposterior direction.
BALANCED OCCLUSION
The bilateral, simultaneous, anterior, and
posterior occlusal contact of teeth in centric
and eccentric positions.
CENTRIC POSITION PROTRUSIVE POSITION LATERAL POSITION
Working Nonworking
Anterior and posterior
teeth contact
All maxillary and
mandibular teeth
contact
Posterior teeth
make contact
Posterior
teeth make
contact.
BALANCED OCLUSION
In lateral position, working side In lateral position, balancing side
Ideal Occlusion: Synonym: Optimal Occlusion, Therapeutic Occlusion.
Purpose: To permit good oral health, function, comfort and esthetics.
Clinical characteristics:
Classical dental relations in intercuspal position based on multiple contact
pointsand major occlusal load sustained by posrerior tooth.
Coincidence between intercuspal position and myocentric position.
Axial occlusal forces during intercuspal position with regard to the tooth axis of
posterior tooth.
Centric occlusal stability that avoids tooth migrations.
Physiological occlusion. Synonym: Normofunctional occlusion.
Physiological occlusion is characterized by the existence of a
functional balance or a physiological adaptation condition of a proper
contact relation between teeth, with regard to the other physiological
components of the stomatognathic system (articular, neuromuscular,
and periodontal).
Clinical characteristics
Without marked parafunctional tooth manifestations ( attritions,
fractures,rhizolysis, pulpar hyperemia)
Normal functional activity during mastication, swallowing, speech and
breathing.
Relatively healthy periodontium in relation to parafunctionalactivities.
Contd.
Relative occlusal stability without apparent tooth migrations.
Absence of dysfunctional musculo-articular symptomatology related to
parafunctional activities during function and rest.
Nonphysiological occlusion. Synonyms: Traumatic occlusion or
functional malocclusion.
Nonphysiological occlusion is characterized by the rupture of balance or
functional adaptation of the contact relation between teeth with respect
to the other physiological components of the stomatognathic system
(articular, neuromuscular, and periodontal).
Clinical characteristics
It is associated with centric occlusal instability
It is associated with an occlusion showing premature contacts and
/occlusal interferences.
Contd.
Presence of marked centric and eccentric
bruxofacets
Presence of dysfunctional symptomatology
associated with temporomandibular disorders
Presence of gingival recessions and cervical
abfractions
Clinical characteristics:
Harmonic intercuspal position with centric physiological relation
(coincident or small distance of ICP not more than 1-2mm anterior
to RCP).
During protrusion and laterotrusion, anterior teeth must disoclude
the posterior ones( anterior guidance).
Healthy periodontium in relation to parafunctions(without occlusal
trauma, marked gingival retraction or recession)
Absence of marked parafunctional tooth manifestations( attrition,
coronary fracture,rizalisis, pulpar hyperemia).
Normal functional activity during mastication, swallowing, speech
and breathing.
Absence of dysfunctional symptomatology in relation to
parafunctions.
Centric relation: that yields Condylar Stability in Centric.
Intercuspal position: that confers Occlusal Stability in Centric.
Miocentric position: that gives Muscular Stability in centric.
ADVANTAGES OF BALANCED
OCCLUSION
1. Help to seat the denture in a stable position
during function.
2. Patients do not upset the normal static, stable,
and retentive position of their dentures.
3. In balanced occlusion, the denture bases are
stable during bruxing activity.
OCCLUSION IN NATURAL
DENTITION
• Posterior disclusion on protrusion
• Disclusion on non working side during lateral
movement.
• Occlusion on working side (either canine
guided/group function) during lateral
movement.
DESIRABLE OCCLUSION FOR COMPLETE
DENTURE
1. Stability of occlusion in centric relation.
2. Balanced for all eccentric contacts bilaterally for all
eccentric mandibular movements
The balancing arrangement
in centric occlusion, buccal
view.
In working occlusion,
buccal view.
In balancing position,
buccal view
3) Control of horizontal forces by buccoligual cusp
height reduction according to the residual ridge
resistance form and interarch distance.
4) Functional lever balance by favorable tooth to
ridge crest position
5) Unlocking the cusp mesiodistally to allow for
gradual but inevitable settling of the bases due to
tissue deformation and bone resorption.
6) Cutting and shearing efficiency of the occlusal
surface (sharp cusps or ridges).
7) Anterior clearance of teeth during mastication.
Minimum occlusal contact between the upper
and lower teeth to reduce pressure during
function.
DESIRABLE OCCLUSION FOR RPD
**Simultaneous bilateral contacts of opposing posterior
teeth must occur in centric occlusion.
1)Kennedy class-I-
>>> Mandibular RPD opposed by natural dentition.
Contact on working side
No contact on balancing side.
>>>Maxillary RPD opposing natural dentition or
mandibular bilateral distal extension RPD
Simultaneous contact on working
and non working side.
In lateral position, nonworking sideIn lateral position, working side
>>>Mandibular RPD opposed by maxillary complete denture-
During lateral movement, both working and balancing
side make contact.Not necessarily balanced in protrusion.
In lateral position, nonworking side
In lateral position, working side
In protrusive position
2)Kennedy class-II
Contact on working side
No contact on balancing side.
In lateral position, nonworking sideIn lateral position, working side
3) Kennedy class-III
similar to occlusion in harmonious natural
dentition
4) Kennedy class-IV
Contact in intercuspal position
No contact in eccentric position
DESIRABLE OCCLUSION FOR FPD
**Similar as occlusion in natural dentition
Either mutually protected or group
function occlusion.
**In the following cases, desirable occlusion should
be group function
-Periodontally compromised supporting
anterior teeth.
-Missing canine
-Angle class-II and class-III malocclusion
-Crossbite
DESIRABLE OCCLUSION FOR
OSSTEOINTEGRATED PROSTHESIS
1) Full-arch fixed prosthesis
Bilateral balanced occlusion with opposing complete
denture
Group function occlusion or mutually protected
occlusion with shallow anterior guidance when opposing
natural dentition
Freedom in centric (1–1.5mm)
2) Overdenture
Bilateral balanced occlusion using lingualized
occlusion
Monoplane occlusion on a severely resorbed ridge
3) Posterior fixed prosthesis
Anterior guidance with natural dentition
Group function occlusion with compromised
canines
Centered contacts, narrow occlusal tables, flat cusps
Cross bite posterior occlusion when necessary
4) Single implant prosthesis
Anterior or lateral guidance with natural dentition
Light contact at heavy bite and no contact at light
bite
Centered contacts (1–1.5mm flat area)
Increased proximal contact
References:
1) JUNHEI FUJIMOTO: CONTEMPORARY FIXED PROSTHODONTICS.
2) HERBERT T. SHILINBURG, FUNDEMENTAL OF FIXED
PROSTHODONTICS.
3) SUMAIYA HOBO: OSSEOINTEGRATION AND OCCLUSAL
REHABILITATION
4) SHELDON WINKLER: ESSENTIALS OF COMPLETE DENTURE
PROSTHODONTICS.
5) DEEPAK NALLASWAMY VEERAIYAN: TEXTBOOK OF
PROSTHODONTICS
6) SOME INFORMATION FROM INTERNATE
THANK
YOU

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Occluion in prosthodontics lec 16 04-'13

  • 2. OCCLUSION The static relationship between the incising or masticating surfaces of the maxillary or mandibular teeth or tooth analogues.
  • 3. Ideal Occlusion: Synonym: Optimal Occlusion, Therapeutic Occlusion. Purpose: To permit good oral health, function, comfort and esthetics. Clinical characteristics: Classical dental relations in intercuspal position based on multiple contact pointsand major occlusal load sustained by posrerior tooth. Coincidence between intercuspal position and myocentric position. Axial occlusal forces during intercuspal position with regard to the tooth axis of posterior tooth. Centric occlusal stability that avoids tooth migrations.
  • 4. Physiological occlusion. Synonym: Normofunctional occlusion. Physiological occlusion is characterized by the existence of a functional balance or a physiological adaptation condition of a proper contact relation between teeth, with regard to the other physiological components of the stomatognathic system (articular, neuromuscular, and periodontal). Clinical characteristics Without marked parafunctional tooth manifestations ( attritions, fractures,rhizolysis, pulpar hyperemia) Normal functional activity during mastication, swallowing, speech and breathing. Relatively healthy periodontium in relation to parafunctionalactivities.
  • 5. Contd. Relative occlusal stability without apparent tooth migrations. Absence of dysfunctional musculo-articular symptomatology related to parafunctional activities during function and rest. Nonphysiological occlusion. Synonyms: Traumatic occlusion or functional malocclusion. Nonphysiological occlusion is characterized by the rupture of balance or functional adaptation of the contact relation between teeth with respect to the other physiological components of the stomatognathic system (articular, neuromuscular, and periodontal). Clinical characteristics It is associated with centric occlusal instability It is associated with an occlusion showing premature contacts and /occlusal interferences.
  • 6. Contd. Presence of marked centric and eccentric bruxofacets Presence of dysfunctional symptomatology associated with temporomandibular disorders Presence of gingival recessions and cervical abfractions
  • 7. Clinical characteristics: Harmonic intercuspal position with centric physiological relation (coincident or small distance of ICP not more than 1-2mm anterior to RCP). During protrusion and laterotrusion, anterior teeth must disoclude the posterior ones( anterior guidance). Healthy periodontium in relation to parafunctions(without occlusal trauma, marked gingival retraction or recession) Absence of marked parafunctional tooth manifestations( attrition, coronary fracture,rizalisis, pulpar hyperemia). Normal functional activity during mastication, swallowing, speech and breathing. Absence of dysfunctional symptomatology in relation to parafunctions.
  • 8. MUTUALLY PROTECTED 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.
  • 9. MUTUALLY PROTECTED OCCLUSION CENTRIC POSITION PROTRUSIVE POSITION LATERAL POSITION Working Nonworking Only posterior tooth make contact. Anterior tooth have a space of minimum 30 microns. Canine and posterior teeth disclude . Mesial inclines of mandibular first premolar buccal Maxillary canine guide the mandible. Posterior teeth No tooth contacts. Criteria
  • 10. MUTUALLY PROTECTED OCCLUSION In lateral position, working side In protrusive position
  • 11. ADVANTAGES OF MUTUALLY PROTECTED OCCLUSION 1. Minimum amount of tooth contact is involved and this makes for better penetration of the food. 2. The force is closer to the long axis of each tooth. 3. The arrangement of the marginal, transverse and oblique ridges so that they have a shearing action, which makes for a much more chewing apparatus.
  • 12. GROUP FUNCTION Multiple contact relations 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.
  • 13. • Criteria GROUP FUNCTION CENTRIC POSITION PROTRUSIVE POSITION LATERAL POSITION Working Nonworking Posterior tooth make contact. Anterior teeth may or may not contact. Canine and posterior teeth disclude . Teeth contact (mostly desirable canine, premolar, mesiobuccal cusp of 1st molar) No tooth contacts.
  • 15. ADVANTAGES OF GROUP FUNCTION OCLUSION 1) Lateral pressure are distributed to all working side tooth. 2) Long centric, so allow some freedom of movement in an anteroposterior direction.
  • 16. BALANCED OCCLUSION The bilateral, simultaneous, anterior, and posterior occlusal contact of teeth in centric and eccentric positions.
  • 17. • The bilateral, simultaneous, anterior, and posterior occlusal contact of teeth in centric and eccentric positions. BALANCED OCCLUSION CENTRIC POSITION PROTRUSIVE POSITION LATERAL POSITION Working Nonworking Anterior and posterior teeth contact All maxillary and mandibular teeth contact Posterior teeth make contact Posterior teeth make contact.
  • 18. BALANCED OCLUSION In lateral position, working side In lateral position, balancing side
  • 19. ADVANTAGES OF BALANCED OCCLUSION 1. Help to seat the denture in a stable position during function. 2. Patients do not upset the normal static, stable, and retentive position of their dentures. 3. In balanced occlusion, the denture bases are stable during bruxing activity.
  • 20. OCCLUSION IN NATURAL DENTITION • Posterior disclusion on protrusion • Disclusion on non working side during lateral movement. • Occlusion on working side (either canine guided/group function) during lateral movement.
  • 21. DESIRABLE OCCLUSION FOR COMPLETE DENTURE 1. Stability of occlusion in centric relation. 2. Balanced for all eccentric contacts bilaterally for all eccentric mandibular movements The balancing arrangement in centric occlusion, buccal view. In working occlusion, buccal view. In balancing position, buccal view
  • 22. 3. Control of horizontal forces by buccoligual cusp height reduction according to the residual ridge resistance form and interarch distance.
  • 23. 4. Functional lever balance by favorable tooth to ridge crest position
  • 24. Occlusion in complete denture 5. Unlocking the cusp mesiodistally to allow for gradual but inevitable settling of the bases due to tissue deformation and bone resorption. 6. Cutting and shearing efficiency of the occlusal surface (sharp cusps or ridges). 7. Anterior clearance of teeth during mastication. Minimum occlusal contact between the upper and lower teeth to reduce pressure during function.
  • 25. DESIRABLE OCCLUSION FOR RPD **Simultaneous bilateral contacts of opposing posterior teeth must occur in centric occlusion. 1. Kennedy class-I- >>> Mandibular RPD opposed by natural dentition. Contact on working side No contact on balancing side.
  • 26. >>>Maxillary RPD opposing natural dentition or mandibular bilateral distal extension RPD Simultaneous contact on working and non working side. In lateral position, nonworking sideIn lateral position, working side
  • 27. >>>Mandibular RPD opposed by maxillary complete denture- During lateral movement, both working and balancing side make contact.Not necessarily balanced in protrusion. In lateral position, nonworking side In lateral position, working side In protrusive position
  • 28. 2. Kennedy class-II Contact on working side No contact on balancing side. In lateral position, nonworking sideIn lateral position, working side
  • 29. 3. Kennedy class-III similar to occlusion in harmonious natural dentition
  • 30. 4. Kennedy class-IV Contact in intercuspal position No contact in eccentric position
  • 31. DESIRABLE OCCLUSION FOR FPD **Similar as occlusion in natural dentition Either mutually protected or group function occlusion. **In the following cases, desirable occlusion should be group function -Periodontally compromised supporting anterior teeth. -Missing canine -Angle class-II and class-III malocclusion -Crossbite
  • 32. DESIRABLE OCCLUSION FOR OSSTEOINTEGRATED PROSTHESIS 1) Full-arch fixed prosthesis Bilateral balanced occlusion with opposing complete denture Group function occlusion or mutually protected occlusion with shallow anterior guidance when opposing natural dentition Freedom in centric (1–1.5mm) 2) Overdenture Bilateral balanced occlusion using lingualized occlusion Monoplane occlusion on a severely resorbed ridge
  • 33. 3) Posterior fixed prosthesis Anterior guidance with natural dentition Group function occlusion with compromised canines Centered contacts, narrow occlusal tables, flat cusps Cross bite posterior occlusion when necessary 4) Single implant prosthesis Anterior or lateral guidance with natural dentition Light contact at heavy bite and no contact at light bite Centered contacts (1–1.5mm flat area) Increased proximal contact
  • 34. Centric relation: that yields Condylar Stability in Centric. Intercuspal position: that confers Occlusal Stability in Centric. Miocentric position: that gives Muscular Stability in centric.
  • 35. References: 1) JUNHEI FUJIMOTO: CONTEMPORARY FIXED PROSTHODONTICS. 2) HERBERT T. SHILINBURG, FUNDEMENTAL OF FIXED PROSTHODONTICS. 3) SUMAIYA HOBO: OSSEOINTEGRATION AND OCCLUSAL REHABILITATION 4) SHELDON WINKLER: ESSENTIALS OF COMPLETE DENTURE PROSTHODONTICS. 5) DEEPAK NALLASWAMY VEERAIYAN: TEXTBOOK OF PROSTHODONTICS 6) SOME INFORMATION FROM INTERNATE
  • 36.
  • 37. MUTUALLY PROTECTED OCCLUSION In lateral position, working side In protrusive position
  • 38. ADVANTAGES OF MUTUALLY PROTECTED OCCLUSION 1) Minimum amount of tooth contact is involved and this makes for better penetration of the food. 2) The force is closer to the long axis of each tooth. 3) The arrangement of the marginal, transverse and oblique ridges so that they have a shearing action, which makes for a much more chewing apparatus.
  • 39. GROUP FUNCTION Multiple contact relations 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. CENTRIC POSITION PROTRUSIVE POSITION LATERAL POSITION Working Nonworking Posterior tooth make contact. Anterior teeth may or may not contact. Canine and posterior teeth disclude . Teeth contact (mostly desirable canine, premolar, mesiobuccal cusp of 1st molar) No tooth contacts.
  • 41. ADVANTAGES OF GROUP FUNCTION OCLUSION 1) Lateral pressure are distributed to all working side tooth. 2) Long centric, so allow some freedom of movement in an anteroposterior direction.
  • 42. BALANCED OCCLUSION The bilateral, simultaneous, anterior, and posterior occlusal contact of teeth in centric and eccentric positions. CENTRIC POSITION PROTRUSIVE POSITION LATERAL POSITION Working Nonworking Anterior and posterior teeth contact All maxillary and mandibular teeth contact Posterior teeth make contact Posterior teeth make contact.
  • 43. BALANCED OCLUSION In lateral position, working side In lateral position, balancing side
  • 44. Ideal Occlusion: Synonym: Optimal Occlusion, Therapeutic Occlusion. Purpose: To permit good oral health, function, comfort and esthetics. Clinical characteristics: Classical dental relations in intercuspal position based on multiple contact pointsand major occlusal load sustained by posrerior tooth. Coincidence between intercuspal position and myocentric position. Axial occlusal forces during intercuspal position with regard to the tooth axis of posterior tooth. Centric occlusal stability that avoids tooth migrations.
  • 45. Physiological occlusion. Synonym: Normofunctional occlusion. Physiological occlusion is characterized by the existence of a functional balance or a physiological adaptation condition of a proper contact relation between teeth, with regard to the other physiological components of the stomatognathic system (articular, neuromuscular, and periodontal). Clinical characteristics Without marked parafunctional tooth manifestations ( attritions, fractures,rhizolysis, pulpar hyperemia) Normal functional activity during mastication, swallowing, speech and breathing. Relatively healthy periodontium in relation to parafunctionalactivities.
  • 46. Contd. Relative occlusal stability without apparent tooth migrations. Absence of dysfunctional musculo-articular symptomatology related to parafunctional activities during function and rest. Nonphysiological occlusion. Synonyms: Traumatic occlusion or functional malocclusion. Nonphysiological occlusion is characterized by the rupture of balance or functional adaptation of the contact relation between teeth with respect to the other physiological components of the stomatognathic system (articular, neuromuscular, and periodontal). Clinical characteristics It is associated with centric occlusal instability It is associated with an occlusion showing premature contacts and /occlusal interferences.
  • 47. Contd. Presence of marked centric and eccentric bruxofacets Presence of dysfunctional symptomatology associated with temporomandibular disorders Presence of gingival recessions and cervical abfractions
  • 48. Clinical characteristics: Harmonic intercuspal position with centric physiological relation (coincident or small distance of ICP not more than 1-2mm anterior to RCP). During protrusion and laterotrusion, anterior teeth must disoclude the posterior ones( anterior guidance). Healthy periodontium in relation to parafunctions(without occlusal trauma, marked gingival retraction or recession) Absence of marked parafunctional tooth manifestations( attrition, coronary fracture,rizalisis, pulpar hyperemia). Normal functional activity during mastication, swallowing, speech and breathing. Absence of dysfunctional symptomatology in relation to parafunctions.
  • 49. Centric relation: that yields Condylar Stability in Centric. Intercuspal position: that confers Occlusal Stability in Centric. Miocentric position: that gives Muscular Stability in centric.
  • 50. ADVANTAGES OF BALANCED OCCLUSION 1. Help to seat the denture in a stable position during function. 2. Patients do not upset the normal static, stable, and retentive position of their dentures. 3. In balanced occlusion, the denture bases are stable during bruxing activity.
  • 51. OCCLUSION IN NATURAL DENTITION • Posterior disclusion on protrusion • Disclusion on non working side during lateral movement. • Occlusion on working side (either canine guided/group function) during lateral movement.
  • 52. DESIRABLE OCCLUSION FOR COMPLETE DENTURE 1. Stability of occlusion in centric relation. 2. Balanced for all eccentric contacts bilaterally for all eccentric mandibular movements The balancing arrangement in centric occlusion, buccal view. In working occlusion, buccal view. In balancing position, buccal view
  • 53. 3) Control of horizontal forces by buccoligual cusp height reduction according to the residual ridge resistance form and interarch distance.
  • 54. 4) Functional lever balance by favorable tooth to ridge crest position
  • 55. 5) Unlocking the cusp mesiodistally to allow for gradual but inevitable settling of the bases due to tissue deformation and bone resorption. 6) Cutting and shearing efficiency of the occlusal surface (sharp cusps or ridges). 7) Anterior clearance of teeth during mastication. Minimum occlusal contact between the upper and lower teeth to reduce pressure during function.
  • 56. DESIRABLE OCCLUSION FOR RPD **Simultaneous bilateral contacts of opposing posterior teeth must occur in centric occlusion. 1)Kennedy class-I- >>> Mandibular RPD opposed by natural dentition. Contact on working side No contact on balancing side.
  • 57. >>>Maxillary RPD opposing natural dentition or mandibular bilateral distal extension RPD Simultaneous contact on working and non working side. In lateral position, nonworking sideIn lateral position, working side
  • 58. >>>Mandibular RPD opposed by maxillary complete denture- During lateral movement, both working and balancing side make contact.Not necessarily balanced in protrusion. In lateral position, nonworking side In lateral position, working side In protrusive position
  • 59. 2)Kennedy class-II Contact on working side No contact on balancing side. In lateral position, nonworking sideIn lateral position, working side
  • 60. 3) Kennedy class-III similar to occlusion in harmonious natural dentition
  • 61. 4) Kennedy class-IV Contact in intercuspal position No contact in eccentric position
  • 62. DESIRABLE OCCLUSION FOR FPD **Similar as occlusion in natural dentition Either mutually protected or group function occlusion. **In the following cases, desirable occlusion should be group function -Periodontally compromised supporting anterior teeth. -Missing canine -Angle class-II and class-III malocclusion -Crossbite
  • 63. DESIRABLE OCCLUSION FOR OSSTEOINTEGRATED PROSTHESIS 1) Full-arch fixed prosthesis Bilateral balanced occlusion with opposing complete denture Group function occlusion or mutually protected occlusion with shallow anterior guidance when opposing natural dentition Freedom in centric (1–1.5mm) 2) Overdenture Bilateral balanced occlusion using lingualized occlusion Monoplane occlusion on a severely resorbed ridge
  • 64. 3) Posterior fixed prosthesis Anterior guidance with natural dentition Group function occlusion with compromised canines Centered contacts, narrow occlusal tables, flat cusps Cross bite posterior occlusion when necessary 4) Single implant prosthesis Anterior or lateral guidance with natural dentition Light contact at heavy bite and no contact at light bite Centered contacts (1–1.5mm flat area) Increased proximal contact
  • 65. References: 1) JUNHEI FUJIMOTO: CONTEMPORARY FIXED PROSTHODONTICS. 2) HERBERT T. SHILINBURG, FUNDEMENTAL OF FIXED PROSTHODONTICS. 3) SUMAIYA HOBO: OSSEOINTEGRATION AND OCCLUSAL REHABILITATION 4) SHELDON WINKLER: ESSENTIALS OF COMPLETE DENTURE PROSTHODONTICS. 5) DEEPAK NALLASWAMY VEERAIYAN: TEXTBOOK OF PROSTHODONTICS 6) SOME INFORMATION FROM INTERNATE