Balanced Occlusion In Complete Denture

 Balanced Occlusion In Complete Denture

Explain the various concepts proposed to attain balanced occlusion in complete dentures.
Answer:

Concepts Proposed To Attain Balanced Occlusion In Complete Dentures

1. Gypsy’s concept
2. French’s concept
3. Sear’s concept
4. Pleasure’s concept
5. Hanau’s concept
6. Trapozzano’s concept
7. Boucher’s concept
8. Lott’s concept
9. Levin’s concept.

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1. Gysi’s Concept

Gysi proposed the concept in 1914. For complete denture arrangement, 33° anatomic teeth were
used to enhance the stability of the denture.

2. French Concept

The mandibular cuspal plane was lowered to increase the stability of the dentures along with balanced occlusion. The individual tooth was designated a particular inclination such as:

• Maxillary 1st Premolar – 5° inclination
• Maxillary 2nd Premolar – 10° inclination
• Maxillary 1st Molar – 15° inclination.

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3. Sear’s Concept

He proposed balanced occlusion for non-anatomical teeth using posterior balancing ramps or an occlusal plane that curves anteroposteriorly and laterally. The use of the second molar ramp provided the tooth contacts for the balanced occlusion.

4. Pleasure Concept

• This concept was proposed by Max Pleasure in 1937 in which a pleasure curve or the posterior reverse lateral curve was used to align and arrange the posterior teeth in order to increase the stability of the denture.
• This was achieved by modifying lower posterior teeth to a reverse curve by tilting teeth buccally. This curve runs from the palatal cusp of the 1st PM to the distobuccal cusp of the 2nd molar which provides occlusal balance and second premolar provides lever balance.

The reverse curve was set as:

• 2nd PM (Premolar)—buccally tilted
• 1st M (Molar)—horizontally
• 2nd M—lingually tilted.

5. Hanau’s Concept

The nine factors involved in balanced articulation are:

1. Horizontal condylar inclination
2. Compensating curve
3. Protrusive incisal guidance
4. Plane of orientation
5. Buccolingual inclination tooth axes
6. Sagittal condylar guidance
7. Sagittal incisal guidance
8. Tooth alignment
9. Relative cusp height.

He combined the 9 factors into 5, such as:

1. Condylar guidance
2. Compensating curve
3. Relative cusp height
4. Incisal guidance
5. Plane of orientation.

He showed how they affected one another by a diagram called “The articulation quint”.

6. Trapozzano’s Concept

The 3 factors were:

1. Condylar guidance
2. Relative cusp height
3. Incisal guidance.

Reasons for eliminating the other two factors

• The plane of orientation was eliminated as its location is highly variable within the available interridge space. The length of the cusp inclines is sufficient to permit the teeth to maintain contact within the limits of eccentric functional movements.
• The compensating curve was eliminated as the cuspal angulations which produce the balanced occlusion is determined, and a compensating curve of varying concavity or convexity is created.

7. Boucher’s Concept

1. Factors in balanced occlusion
   1. Orientation of occlusal plane
   2. The incisal guidance
   3. The condylar guidance
2. The angulations of the cusp are more important than the cusp height
3. The compensating curve enables one to increase the effective cusp height without changing the form of the teeth

8. Lott’s Concept

The laws of occlusion were related to the posterior separation that is the result of guiding factors. The greater the separation of posterior teeth, the greater or higher must be the compensating curve.

9. Levin’s Concept

The plane of orientation was eliminated as it was considered that the patients have an adaptive capacity for a slight change in the plane of occlusion (1–2 mm at most).

Levin’s Quad

1. The condylar guidance is fixed and recorded by the patient. The balancing condylar guidance includes the Bennett movement, which may or may not affect lateral balance.
2. The incisal guidance is obtained from the patient’s esthetic and phonetic requirements.
3. The compensating curve is the most important factor for obtaining balance. Monoplane or low cusp teeth must employ the use of a compensating curve.
4. Cusp teeth have the inclines necessary for obtaining balanced occlusion but nearly always are used with a compensating curve.