Balanced Occl PDF

Balanced occlusion
Occlusion:
The static relationship between the incising or masticating
surfaces of the maxillary and mandibular teeth.
Balanced occlusion
“The bilateral, simultaneous, anterior and posterior
occlusal contact of the maxillary and mandibular teeth
in centric and eccentric positions.”
The balanced occlusion developed to limit tipping or rotating
of denture bases in relation to the supporting structure.
Balanced occlusion can be described as the position of the teeth
such that they have simultaneous contact in centric relation and
provide a smooth sliding motion to any eccentric position.
For minimal protrusive occlusal balance, there should be at
least three points of contact on the occlusal plane (one anterior,
two posterior). The more the number of contacts the better the
balance.
Balanced occlusion in complete denture is unique and man-
made. It does not occur in natural teeth, and indeed is not
needed, since each tooth is supported independently.
Should bilateral occlusal contact occur in natural teeth it is
considered a premature contact on the non-working side and is
considered pathologic.
The advantages of balanced occlusion:
1. It produces improved occlusal contact which distributes
occlusal forces over a wide area of the oral tissues.
2. There is reduced trauma to the oral tissues.
3. Denture stability is improved.
4. Masticatory efficiency is improved
5. Chair-side time required to fit dentures is reduced.
Centric Occlusion:
The occlusion of opposing teeth when the mandible is in centric
relation. In complete denture construction, centric occlusion and
centric relation should coincide.
Theories of occlusion
1- Bonwill Theory:
According to this theory, the teeth move in relation to each
other guided by the condylar and incisal guidance.
It is also called as theory of equilateral triangle according to
which there was a 4-inch (10 cm) distance between the condyles
and between each condyle and mid-point of mandibular
incisors.
Bonwill articulator was designed according to this theory, allow
lateral movement in the horizontal plane.
Bonwill Triangle
2- Conical Theory:
RE Hall proposed that the lower teeth move over the surfaces
of the upper teeth as over the surface of cone, generating an
angle of 45º degree with the central axis of the cone tipped 45º
to the occlusal plane
3- Spherical Theory:
G. Monson proposed that lower teeth move over the surfaces
of the upper teeth as over a surface of sphere with a diameter
of 8 inches (20 cm), and the center of the sphere was located
in the region of glabella. The surface of the sphere passed
through the glenoid fossa and along with the articular
eminences.
“Slide” In Centric
MI POSITION
CR POSITION
Protrusive Balanced Occlusion
This type of balanced occlusion is present when mandible moves
in a forward direction and the occlusal contacts are smooth and
simultaneous anteriorly and posteriorly.
When the patient protrudes the mandible, the mandibular denture
glides along the maxillary denture until the anterior teeth make light
contact. The protrusive balance is obtained as a result of maxillary
posterior distal inclines of the buccal cusps coming into contact with
the mesial inclines of the mandibular posterior buccal cusps.
In centric occlusion, the mandibular buccal cusps tips occlude
in the central fossa and marginal ridge areas of the maxillary
teeth. And the maxillary lingual cusps occlude in the central
fossae and marginal ridge areas of the mandibular teeth.
Working-side occlusion:
The occlusal contacts of teeth on the side toward which the
mandible is moved. The buccal cusps of maxillary posterior teeth
oppose the buccal cusps of mandibular posterior teeth, and the
lingual cusps of maxillary teeth oppose the lingual cusps of the
mandibular teeth. Note that the relationship is not cusp tip to cusp
tip, but cusp tip into the opposing groove.
Non-working side (balanced) occlusion:
The occluding surfaces of dentures on the balancing side
developed for the purpose of stabilizing dentures. It occurs
when the maxillary posterior lingual cusps contact the lingual
inclines of the mandibular posterior buccal cusps. It occurs
simultaneously with working side occlusion to maintain the
dentures in position during lateral excursive movements.
Excursive Movements
(Laterotrusive and Mediotrusive)
B L L B
Non-working Side Working-Side

(Mediotrusive) (Laterotrusive)
An illustration of laterotrusive and mediotrusive sides in a lateral
excursion. The lower jaw moves towards the right, which is the
working or laterotrusive side. The left side is the balancing side, or
non-working side, or mediotrusive side (these are all synonomous).
Factors affecting balanced occlusion Condylar guidance (B)
Incisal guidance (A)
Compensating curves (D)
Cusp height (C)
Plane of occlusion (E)
1. Condylar guidance
The mechanical device on an articulator which is intended to
produce similar guidance in articulator movements as are
produced by the path of the condyles of the cranio-mandibular
joints.
The condylar path should be determined on the patient and set on
the articulator, so that the working pattern of the patients CMJ is
in harmony with the occlusion as programmed on the articulator.
2. Incisal guidance
It is the influence of the contacting surfaces of the
mandibular and maxillary anterior teeth on mandibular
movements. Also the influence of the contacting surfaces
of the guide pin and guide table on the articulator
movements.
If the incisal guidance is steep, it requires steep cusps, a
steep occlusal plane, or steep compensating curve, to effect
an occlusal balance.
For complete dentures, the incisal guidance should be as flat
as aesthetics and phonetics permit.
When arranging anterior teeth that require vertical overlap,
a horizontal overlap should be set to prevent anterior
interference.
The incisal guide angle can be made flatter by increasing the
horizontal overlap (HO). It can be made less steep by reducing the
vertical overlap (VO)
3. Plane of occlusion
 The occlusal plane is established in the anterior by the height
of the lower cuspid, which nearly coincident with the
commissure of the mouth and in the posterior by height of
retro-molar pad. It is parallel to ala-tragus line (Camper’s
plane).
4. Compensating curves
Compensating curves are artificial curves introduced into
dentures in order to produce balanced occlusion. They
are artificial counter-parts of the curve of Spee, Wilson’s
curve and Monson’s curve associated (found) only with
natural dentition.
The curve introduced in the construction of complete
dentures to compensate for the opening influences
produced by the condylar and incisal guidances during
lateral and protrusive mandibular excursive movements.
There are two components to a compensating curve;
antero-posterior curve is useful in obtaining balance in
protrusive movements, while the cross-arch curves
(mediolateral curves) involved in providing fbalance in
lateral movements.
Antero-posterior Compensating Curve
This curve first described by Ferdinard Graf Spee, a (German
prosector of anatomy) 1855-1937.
This curve follows an imaginary line touching the buccal cusps
of all lower teeth from the lower canine backwards, following
the buccal cusps tips of the premolar and molar teeth, continuing
through the anterior border of mandibular ramus ending with the
anterior most portion of mandibular condyle.
Curve of Spee
Significance of Antero-posterior Compensating Curve:
1. Required for efficient masticatory system.
2. To avoid Christensen’s phenomenon.
3. Maximize muscular efficiency during chewing.
One of the importance of antero-psterior compensating curve is
that, when the patient moves his/her mandible forward, the
posterior teeth set on this curve will continue to remain in contact.
If the teeth are not arranged according to this curve, there will be
dis-occlusion during protrusion of the mandible (Christensen’s
phenomenon).
Posterior separation will Incorporating the curve of
occur during protrusion if Spee will produce tooth
the curve of Spee is not contact during protrusion
incorporated into the
artificial teeth arrangement
Mediolateral compensating curves
 These curves run transversely from one side of arch to the other.
Curve of Wilson:
- Adopted by George H Wilson, from Cleveland, Ohio (1855-1922),
used in setting of artificial posterior teeth in balanced occlusion for
complete denture.
- The arc of this curve is concave for mandibular posterior teeth and
convex for maxillary posterior teeth.
- The buccal cusps of the lower posterior
teeth are slightly higher than the lingual
cusps, and a line drawn through the buccal
and lingual cusps of the teeth on the other
side forms curve of Wilson.
Curve of Wilson
The lower teeth are inclined lingually, giving prominence to the
buccal cusps and bringing them into occlusal contact with the
upper cusps during lateral movement on the working side.
Significance:
1- Enables efficient mastication.
2- Prevents interferences of posterior teeth to occur during
mandibular excursion
Compensating Curve for Monson Curve:
 Adopted by George S. Monson from Minnesota 1869-1933
 Monson’s curve is defined as “The curve of occlusion in which
each cusp and incisal edge touches or conform to a segment of
a sphere of 20 cm.(8 inches) in diameter with its center in the
region of the Glabella”.
 This curve in 3-dimensions is a combination of curve of Spee
and Curve of Wilson.
 Only if the teeth are set following Monson’s curve, there will
be lateral balance of occlusion.
Monson’s sphere
Monson’s sphere
5. Cusp height
Cusp height:
The perpendicular distance between the tip of a cusp
and its base plane.
Cusp angle:
The angle made by the average slopes of a cusp with a
cusp plane measured mesiodistally or buccolingually.
Cusp height on the teeth is an important determinant
of occlusion:
Shallow cusp teeth allow the

opposing members to slide during
mastication
Higher cuspal angle lock the teeth

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Balanced occlusion

Non-working Side Working-Side

Shallow cusp teeth allow the

Higher cuspal angle lock the teeth

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