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Occlusion in complete denture

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					Occlusion in complete
denture

               ทพ. ดนัย ยอดสุวรรณ
               danai@kku.ac.th
BASIC OCCLUSAL FORMS
   1. Anatomic, balanced occlusion.
   2. Semi-anatomic, balanced occlusion.
   3. Nonanatomic, balanced occlusion.
   4. Neutrocentric occlusion.
   5. Lingualized occlusion.
       : Balanced or
       : Non-balanced
Advantages of Anatomic Occlusion
   1. Esthetics.
   2. Better penetration of food bolus,
   3. Decrease of vertical stresses.
   4. Harmony with muscles of mastication and
        TMJ during functional and non-functional
        movements.
Disadvantages of Anatomic Occlusion
   1. precise technique required.
   2. greater lateral forces
   3. more time, not long-lasting, require occlusal
         adjustment
   4. difficult to tooth position in class II, III, X-
         bite
SEMI-ANATOMIC, BALANCED
OCCLUSION
Advantages of Semi-anatomic Cusp Teeth
   1. Esthetics
   2. Good chewing efficiency
   3. Balanced occlusion
   4. Less lateral forces
   5. Functional occlusal balance
Disadvantages of Semi-anatomic Cusp
Teeth
   1. Same as for anatomic teeth.
   2. More difficult to achieve cross arch, cross
        tooth balance.
   3. Esthetics reduced somewhat by decreasing
        the incisal guidance of anterior teeth.
NONANATOMIC, BALANCED
OCCLUSION
    Balanced occlusion for non-anatomic teeth
    may be accomplished by:
   1.compensating curve
   2.tilting the second molar
   3.placing the balancing ramp
NONANATOMIC, BALANCED
OCCLUSION




       compensating curve
NONANATOMIC, BALANCED
OCCLUSION




  tilting the second molar   placing the balancing
                             ramp
Advantages of Nonanatomic
Occlusion
   1. Slightly more esthetic than neutrocentric
    occlusion.
   2. patients with poor neuromuscular coordination,
         difficult to obtain precise, repeatable jaw relation
         records.
Advantages of Nonanatomic
Occlusion
   3. Less time involved in set up and articulation..
   4. patients with cross bite or Class III relationships
         and particularly for patients with Class II
         relationships who move the mandible far
         forward in functional relationships.
Disadvantages of Nonanatomic Occlusion
   1. Use of a compensating curve may cause
        the same damaging effects as cuspal
        inclines.
   2. Occlusal adjustments are more difficult to
        accomplish.
NEUTROCENTRIC OCCLUSION
   "neutralizing cuspal inclines and centralizing
    occlusal forces".
   Position
   Proportion
   Pitch
   Form
   Number
Advantages of Neutrocentric Occlusion
   1. simple and less time consuming.
   2. less precise jaw relation records.
   3. lateral forces are reduced by eliminating
         (neutralizing) cuspal inclines.
Advantages of Neutrocentric Occlusion
   4. simpler and easier occlusal adjustments
   5. occlusion is not locked
   6. good for patients with Class II (Retrognathic),
         Class III (Prognathic) and crossbite ridge
         relations.
   7. for the geriatric patient
Disadvantages of Neutrocentric Occlusion
   1. least esthetic
   2. poor bolus penetration
   3. disclusion of the posterior teeth in Class II
         patients.
   4. can not be balanced in eccentric
         excursions.
LlNGUALIZED OCCLUSION
   A lingualized occlusal scheme can be:
   1. Bilaterally balanced.
   2. Non-balanced
LlNGUALIZED OCCLUSION




    Balanced lingualized class I arrangement
    Tooth- to- tooth
    Max. Li cusp to central fossa
LlNGUALIZED OCCLUSION




    A 20-degree occlusal template being used
    to generate the occlusal plane
LlNGUALIZED OCCLUSION




 Cross-arch contacts during an excursive movement
LlNGUALIZED OCCLUSION




   Balanced lingualized class II arrangement
   Narrower mand. anterior
   Drop mand. first premolar
LlNGUALIZED OCCLUSION




    Balanced lingualized class III arrangement
    Wider mand. Anterior
    Drop max. first premolar
LlNGUALIZED OCCLUSION




     Cross-bite, Li cusp plays no role at all
LlNGUALIZED OCCLUSION




  Nonbalanced lingualized class I
  Blunt max. Li cusp and mand. limited occlusal anatomy
Advantages of Lingualized Occlusion
   1. Esthetics
   2. Better penetration of the food bolus
   3. Decrease of vertical and lateral forces
   4. Simpler technique. less precise CR records
   5. Useful in a wide variety of patients
Advantages of Lingualized Occlusion
   6. Added stability is gained during
        parafunctional movements with a
        balanced occlusion.
   7. Easier to adjust occlusion
   8. May be used in Class II, Class III and
        crossbite
   9. may be used to incorporate many of the
        advantages but few of the disadvantages
        of other occlusal schemes.
SUMMARY AND CONCLUSIONS
   There is no one ideal occlusal scheme to fit
    all the variety of patient situations and
    requirements.
   There is not clear cut research in occlusion to
    support one occlusal scheme over another
การสบฟันได้ดุล (Balanced Occlusion)




         Christensen’s phenomenon
แสดงวิธีขากรรไกรที่มี
จุดหมุนเกิดจากเส้นที่
ลากตั้งฉากกับแนวนา
คอนดายล์และแนวนา
ปลายฟันหน้าตัดกัน
แสดงวิธีขากรรไกร
ขณะสบยื่น
แนวนาปลายฟันหน้าที่มีค่า
มากขึ้นจะทาให้วิธีขากรรไกร
ชันมากขึ้น
เส้น AB แทนวิธีขากรรไกรขณะเป็น
ด้านดุล
เส้น CB แทนวิธีขากรรไกรด้าน
เดียวกันแต่ทาหน้าที่เป็นด้านใช้งาน
ปัจจัยที่มีผลต่อการสบได้ดุล
   แนวนาคอนดายล์ (Condylar guidance)
   แนวนาปลายฟันหน้า (Incisal guidance)
   ระนาบสบ (Plane of occlusion)
   โค้งชดเชย (Compensating curve)
   ความลาดเอียงของฟัน (Inclination of the teeth)
Hanau’ Quints


          HCG x IG
       CC x CA x OOP   = K
ขอบคุณครับ

				
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posted:11/2/2011
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