philosophies of occlusion for implants
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Philosophies of Occlusion for Implants. Implant Occlusion. Single Crown Fixed Partial Dentures Full arch prostheses (screw retained) Overdentures. M any Philosophies of Occlusion. No definitive scientific studies to prove: one type of tooth form one type of occlusal scheme

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implant occlusion
Implant Occlusion
  • Single Crown
  • Fixed Partial Dentures
  • Full arch prostheses (screw retained)
  • Overdentures
m any philosophies of occlusion
ManyPhilosophies of Occlusion

Nodefinitivescientificstudies to prove:

  • one type of tooth form
  • one type of occlusal scheme
  • to be clearly preferred by patients
  • to be more efficient than another
tooth forms occlusal schemes

Non Anatomic

Canine Guidance (Mutually Protected)

Group Function

Lingualized (Balanced)


Tooth Forms Occlusal Schemes
occlusion implants
Occlusion & Implants
  • Evidence Based Review

Taylor, Wiens et al. J Prosthet Dent 2005;94:555-560

  • No Preferred occlusal scheme
  • Clinicians advocate axial loading of implants,

but no evidence, at present,

demonstrating benefits

occlusion implants7
Occlusion & Implants
  • Evidence Based Review

Taylor, Wiens et al. J Prosthet Dent 2005;94:555-560

  • No evidence at present that
    • progressive occlusal loading of implant is beneficial
    • occlusal overload is detrimental to implants
absence of scientific evidence

Absence of Scientific Evidence

Not proof against!

Follow best available clinical principles

Do not build in heavy non-axial loading or overloading

clinical principles for occlusion

Clinical Principles for Occlusion

Based on Clinical Experience

Not Scientific Evidence

general principles
General Principles

Improve denture stability or axial loading of single teeth

  • Centric contacts on flat surfaces, not inclines
general principles11
General Principles

Posterior Overjet to Avoid Cheek Biting

general principles12
General Principles

Improve denture stability or single tooth loading

  • Center occlusal contacts over ridge
  • Simultaneous posterior contacts in centric
general occlusal principles
General Occlusal Principles

For overdentures or full arch prostheses opposing a CD:

  • No anterior contacts in centric
    • Minimizes anterior resorption
  • Grazing anterior contacts in excursions
    • Incising
occlusal schemes
Occlusal Schemes
  • Canine Guidance
  • Group Function
  • Lingualized
  • Monoplane

Single Teeth



crowns or fpd s
Crowns or FPD’s
  • Either canine guidance or group function works - no preference
  • Use what the patient has
  • Use what would be easiest
overdentures or full arch prostheses

Overdentures or Full Arch Prostheses

ALL Occlusal Schemes Devised to Maximize Denture Stability

lingualized occlusion
Lingualized Occlusion
  • Maxillary cusped tooth
  • Mandibular cuspless or shallow cusped tooth
  • Maxillary lingual cusp balanceslike a mortar in a pestle
lingualized occlusion18
Lingualized Occlusion
  • Lingual cusp contacts opposing central fossae
  • Mandibular cuspal inclines are shallow (0°, 10°)
  • Less lateral displacement
lingualized occlusion how stability is improved
Lingualized OcclusionHow Stability is Improved
  • Simultaneous bilateral anterior and posterior in all excursions
  • Tilting forces theoretically neutralized
enter bolus exit balance
Enter Bolus Exit Balance?
  • Many patients chew bilaterally
  • Biting forces maximum close to intercuspation (where balance most effective)
  • Non-functional aspects (swallow)
point of loading affects stability






Point of Loading Affects Stability
  • Browning, 1986
    • Loaded centrally, M, D, L,B
    • B caused unseating
    • Central loading better than distal loading
lingualized contacts
Lingualized Contacts
  • Only buccal cusp contact is inner incline of mandibular teeth (balancing)

Working Side

Balancing Side

iif rule
‘IIF’ Rule
  • IIF you have contacts on the Inner Inclines of Functional cusps they are balancing contacts
rules for balancing contacts
Rules for Balancing Contacts
  • Balancing contacts should be lines, not points
  • Balancing contacts should never be heavier than working contacts
balanced occlusion lingualized
Balanced Occlusion (Lingualized)
  • Indirect evidence that balanced occlusion may:
    • reduce ridge resorption (Maeda & Wood, 1989)
    • allow for increased functional forces in excursions (Miralles et al, 1989)
lingualized cusp angles
Lingualized Cusp Angles
  • Always use steep cusped maxillary tooth (33°)
  • When condylar guidance is steeper use more cusp angle in mandible (10°)
lingualized occlusion28
Lingualized Occlusion
  • Balance cannot be set without an articulator
  • Clinical remount on an articulator - fewer adjustments
condylar inclination
Condylar Inclination
  • Posterior teeth separate as working condyle moves forward (and downward)
  • Anterior teeth contact
  • Closer to condyle, more separation
  • More anterior separation of Premolars if steep anterior guidance
maintaining balancing contacts
Maintaining Balancing Contacts
  • Change occlusal plane angle
  • Increase compensating curves
  • Increase cusp angles or effective cusp angles
checking for balance
Checking for Balance

Feels Smoooooothin excursions

  • - Fingers on max. canines
  • - Check on articulator
assess contacts
Assess Contacts:
  • Centric Stops
  • Excursions
improving denture occlusion
Improving Denture Occlusion
  • Most important cusp - maxillary lingual
  • Mandibular buccal cusps more lateral - more tipping
when not to balance
When Not to Balance
  • Difficulty in obtaining repeatable centric record
    • incoordination,
    • muscle splinting
  • Dramatic malocclusions
  • Severe ridge resorption
    • lateral forces displace the denture
    • Implants tend to negate this factor
monoplane occlusion
Monoplane Occlusion
  • Cuspless teeth set on a flat plane with 1.5- 2 mm overjet
  • No cusp to fossa relationship
  • No anterior contacts present in centric position
  • No overbite
monoplane occlusion how stability is improved
Monoplane OcclusionHow Stability is Improved
  • Elimination of cusps
    • Lateral forces reduced, improving stability
    • Simplifies denture tooth arrangement
ensure teeth set over ridge
Ensure Teeth Set Over Ridge
  • Minimize tilting/tipping
  • Maximize stability
  • Minimize contacts on buccal of flat cusps
monoplane occlusion41
Monoplane Occlusion
  • Functional, but unesthetic
  • Not balanced - flat
  • Zero degree teeth can be balanced if condylar inclinations are shallow
monoplane occlussion when
Monoplane Occlussion - When?
  • Jaw size discrepancies, malocclusions
    • cross-bite, Cl II, III
  • Minimal ridge
    • reduces horizontal forces
    • implants help
  • Uncoordinated jaw movements


No definitive studies to show one type of occlusion is best

Follow established clinical principles

Assess each case - adapt to clinical situation

Continue to read the literature