Dr.

Amal Fathy Kaddah

, Prof. of Prosthodontic

, Faculty of Oral & Dental Medicine

Cairo University
Occlusion in complete denture must
be developed to function efficiently
and with the least amount of
. trauma to the supporting tissues
Objectives
 Preservation of the remaining tissues
 Proper masticatory efficiency
Enhancement of denture stability,
retention and support
 Enhancement of phonetics and esthetics
The determinants of occlusion

Anterior
Posterior determinants determinants of
of occlusion occlusion
1. The condylar guidance

2. The incisal guidance

3. The inclination of plane

of occlusion

4. The compensating
curve and

5. cusp angle of teeth

(Cuspal inclination)
The movements of the condyle in the
glenoid
Rotationfossa
occurs are
wheneither:
the
mandible makes a hinged
movement. (the head of the
condyle rotates around an
imaginary axis )

Translation occurs when the

mandible moves into a
protrusive or lateral position, or
a combination of the two
(bodily movement of the head of
the condyle)
No Translation
A- Rotation occurs when the head of the
condyle rotates around an imaginary
axis
Translation

B. Translation is the bodily movement of the head of the condyle

 1- Condylar inclination

The angle formed by the steepness of the

articulator surface of the Temporal bone as
related to a horizontal plane
The condylar guidance is the only factor
given by the patient
Condylar Guidance
Angle
The angle formed by an
imaginary horizontal line
at the superior head of
the condyle and the path
that the condyle will
pass through during
function

Varies from individual to

individual because of
anatomical differences
The inclination of the condylar paths varies in
different individuals and from side to side in
the same person. It depends upon
1. The shape of the glenoid
fossa.
2. The variation of the
thickness of the
articular disc in its
different parts.
3. The relation of the
condyle to the disc
during movement.
4. The extent of
mandibular protrusion
Condylar path inclination varies according
to the amount of protrusion. a-b Sagittal condylar path
inclination. Centric relation position of the condyle.
4-P. 4 mm protrusion.8P. 8 mm protrusion
 Balancing side. Working side.
Condyle has downward path Condyle pivots.

The condylar guidance: refers to the

path of the condyle follows in the
temporomandibular joint when the
mandible moves into protrusive or lateral
 Bennett Angle
The angle formed by the
.Balancing side .Working side
sagittal plane (assumed
straight protrusive path)
and the path of the
advancing (orbiting)
condyle during lateral
mandibular movements
as viewed in the
horizontal plane.
• Working side: (Mandible moving
toward the cheek)

• Balancing side: (Mandible moving

toward the tongue)
• Working side condyle pivots within the
socket and is better supported.
• Balancing side condyle has a downward
orbiting path. It is traveling a greater
distance in ‘space’ and is more prone to
injury or damage.
If the condylar angle is
steep, its difficult to
produce balance
occlusion because when
the condyle travel
downward and forward;
large space is created
posteriorly when the
anterior teeth are edge
to edge. So,
compensation should be
made by altering the
other factors to obtain
Sagittal Christensen phenomenon

Means that when the patient produce a

protrusion with well adapted occlusal
rims, there will be a v- shaped gap
between the rims in the molar region.
 The Transversal Christensen
phenomenon
Means that when the patient
produce a lateral excurtion
with well adapted occlusal
rims, there will be a v shaped
gap between the rims in the
molar region on the balance
side. On the working side there
will be contact between the
upper and the lower rims.
 Protrusive Records
To Set Condylar Inclination

 Ease of determination
 Used to set condylar
guidance
 Helps setting teeth
for best occlusal
contacts
 Protrusive Records
To Set Condylar Inclination

 Material must interdigitate

with the opposing “V-
shaped” notches
 Record should cover entire
rim surface.
 Condylar elements are released from hinge
position (unlocked).
 Instrument protruded, and the rims closed into
Horizontal condylar
guidance
Prior to Mounting

• Ensure
– Only wax-rim to wax-rim contact
– Casts should not contact
– Record bases should not contact
– If other contacts, mounting will be
incorrect
Adjust Protrusive Guide for
Maximal Interdigitation
 The C.G. of articulator is an appropriated duplication of
the C.G. in the patient and is obtained by means of a
protrusive record. So that the patient's
temporomandibular joint is in harmony with the occlusion
as programmed on the articulator
The occlusion rims are reestablished and checked for 3mm.
Clearance in a protrusive excursion
Right and left lateral relation

After protrusive record

making the same procedure
is followed, however the
patient is asked to move his
mandible to left and right
and getting
him to bite on wax wafer, two records are made,
one for left and one for right. These records are
used to adjust the lateral condylar inclination.
In Hauau
articulator
Hanan equation
can be used
L = H/ 8+ I2
 2-The incisal guidance
It is the path taken by the
lower anterior teeth as it
move in protrusive
movements against the
palatal surface of upper
anteriors till become edge
to edge.
It’s the influence of the contacting surfaces
of the mandibular & maxillary anterior teeth
on mandibular movement
The incisal guidance of the
articulator
The influence
of the
contacting
surfaces of the
guide pin and
guide table on articular
movement.
 Relation
between the
incisal path of
patient and
incisal
guidance of
articulator
 Incisal Guidance Angle

The angle formed by the

intersection of the plane of
occlusion and a line within
the sagittal plane
determined by the incisal
edges of the maxillary and
mandibular central incisors HO
when the teeth are in
maximum intercuspation
The incisal inclination is
called the incisal
guide angle and the
influence that this angle
has on mandibular
movements is termed

incisal guidance .
Incisal Guidance Angle

This angle varies directly with the

vertical overbite and inversely with
the horizontal overjet

This angle is set to 10˚ in CD and

not exceeding 20˚
 Incisal Guidance

↓ Incisal Guidance Angle

by either:

↑ Horizontal overlap
↓ Vertical overlap
 The incisal guide angle can be controlled
when developing a balanced occlusion. With a given
amount of vertical overlap (VO) the incisal guide angle
can be made flatter by increasing the horizontal overlap (HO)
 B

It can also be made less steep by reducing VO

A- Steep incisal guidance

B. Medium incisal guidance

C. Zero incisal guidance

 Incisal Guidance

• For CD, the incisal

guidance should be as
shallow as esthetics
and phonetics

will Permit when arrangement of anterior teeth

to reduce protrusive displacing forces
 A) The esthetic factor dictated a steep vertical
overlap with little horizontal overlap. Therefore,
steeper posterior cuspal inclines had to be selected.
(B) In eccentric movements the inclinations of the
posterior cusps must be sufficient to prevent
anterior interference
A- The esthetic factors allowed for an adequate
amount of horizontal overlap, so the shallow
cuspal inclines could be selected.

B- In eccentric movement the shallow

posterior inclines are sufficient to prevent
anterior interference
I.G. should be either equal to or less than C.G.

I.G. SHOULD NEVER BE GREATER THAN C.G .

X

I.G. GREATER THAN C.G

Anterior interference
 Excursive Movements
Protrusive

Centric
occlusion

The mandible moves essentially forward and the occlusal

contacts are smooth and simultaneous in the posterior
both on right and left sides and on the anterior teeth.
 Excursive Movements
Protrusive

Centric
occlusion

Anterior
interference
• I.G. can be set by the
dentist according to
esthetics and phonetics
requirements.

but in no case should

I.G. exceed that

of the C.G .
 If Increased Incisal
Guidance Angle For
? CD
During
protrusion:

Upper denture drops at

the back

Lower denture slides

backward
 C.C. to effect an occlusal
balance.
• This type of occlusion is
detrimental to the stability
and equilibrium of the denture
base.
Steep I.G. results in harmful
inclined planes with their
harmful risk to the supporting
tissues
3- The Plane of Occlusion
(Plane of Orientations)
O. P. is formed
by lines
connecting tips
of incisor teeth
and distobuccal
cusps of the
most posterior
teeth on each
side of arch
 3- The Plane of Occlusion

The occlusal plane The occlusal plane

is parallel to the is parallel to the
ear nose plane interpupillary line
 3- The Plane of Occlusion
(Plane of Orientations)

Its inclination can be altered slightly to a maximum of 10o

It is established anteriorly by the height of the lower

canine, which nearly coincides with the commisure of
the mouth and posteriorly by the height of the retro
molar pad. It is usually parallel to
Camper’s line.

It is not as important as
other factors
Determination of the occlusal plane

: Factors must be considered

1- Aesthetic base

2- Functional base (chewing and speech)

3- Physical and mechanical (leverage

action and parallelism).
O.P. At (a) is the
ala-tragus plane
obtained from the
patient. At (b) is a
compromise plane
midway between
ridges. At (c) is a
low plane
necessary to favor
weak lower ridges
 •The orientation of the occlusal
3- The
plane Plane of
becomes Occlusion
a fixed factor of
occlusion
•Any necessary alteration for
balancing the occlusion must
therefore be made on other factors
affecting the occlusion (that is,
the cuspal inclination or the
prominence of the compensating
curve)
Effect of plane of occlusion on cusp height
 Effective Cusp angle
Tilt Tilt
5o 5o • CA: Cusp Angle
• ECA: Effective Cusp angle
= CA 20o+ Angle of plane of
occlusion (5o) = (25o)
CA
CA
20o
20o Plane of occlusion
5o Angle of O. plane
ECA 25o
ECA 25o horizontal
When we select a tooth with a certain cusp height or angle, it
doesn’t mean anything until the tooth is positioned in the
denture. For example, a particular tooth may be manufactured
with a 20 degree inclination. However, by tilting the tooth in
relation to the mean occlusal plane, one may create an
effective inclination of greater or less than 20 degrees.
4- Compensating curves
Artificial curves introduced into
complete denture are among the
most important determinants in
establishing a balanced occlusion so
that the occlusal surface results in a
curve that is in harmony with the
movement of the mandible as guided
posteriorly by the condylar path
 5- Compensating curves
1- Spee’s curve

The anatomic curvature of the occlusal alignment

of the lower teeth beginning at the tip of the
lower cuspid and following the buccal cusps of
the natural bicuspids and molars continuing to the
2- Wilson’s curve
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 a lateral
 3- Monson’s curve
A proposed ideal curve of occlusion the curve of occlusion
in which each cusp and incisal edge of upper and lower
teeth of right and left sides touches or conforms to a
segment of the surface of a sphere eight inches in diameter
its center in the region of the Glabella
The compensating curve of the
artificial occlusion corresponds
to a combination of these curves
in natural teeth.
It is considered one of the most
important factors in establishing
balanced occlusion
Compensating Curves
•The steepness of the curve necessary to
achieve balance is the result of guiding
influence of angle of condylar guidance and
angle of incisal guidance.
•A lesser compensating curve for the same
condylar guidance would result in a steeper
incisal guidance (anterior interference), which
would cause loss of molar balancing contacts.
Compensating Curves

•It is functionally and mechanically

advantageous to keep compensating
curve as modest as possible → This
is accomplished by setting as
shallow an incisal guidance as
phonetics, esthetics permit
4- Cusp Height (inclination of cuspless
teeth) It is measured by
the angle formed
by the
mesiobuccal
cuspal incline to
the horizontal plan
when the long axis
of the tooth is
Cusp Angle vertical to the
plane
A steep condylar guidance necessitates teeth with steep cusps.
Cusp height is therefore an important determinant as it modifies
the effect of occlusal plane and compensating curves.
• Steep I.G. calls for steep cusps, steep
O.P. or a steep C.C. to effect an occlusal
balance. The angle of this movement is
governed by the cusp angles and hence
the lower incisors will move at the same
angle as the lower molars
Cusp Angle
 Hanau’s articulation Quint

Arrow pointing
away from center
indicates increasing
values
Arrow pointing
toward center
indicates decreasing
values
Hanau in 1926 formulated laws of balanced
(.articulation (called Hanau’s quint
Hanau’s Quint (1926)

C= Condylar Inclination x Incisal Guidance

Occ. Plane x Cuspal Inclination x Comp. Curve

• The five factors of balanced occlusion related to one

another on a balance beam.
• To keep the occlusion in balance is a simple procedure
once the factors are related this way
• Within the confines of esthetics and phonetics, minimize
Incisal Guidance in Complete Dentures to minimize
inclined tipping forces
 The five factors of balanced occlusion
related to one another on a balance
beam. To keep the occlusion in balance
is a simple procedure once the factors
are related to this way

Condylar Incisal Occlusal Cusp Compensating

guidance guidance Plane Height curve

Theilmann’s Formula
* The incisal guidance and inclination of the plane
of occlusion: can be altered within a small range
according to esthetic and phonetic and anatomical
factors.

Condylar Incisal Occlusal Cusp Compensating

guidance guidance Plane Height curve

Theilmann’s Formula
As the mandible is protruded its position is
controlled by the incisal guidance and the
condylar path. The center elements
affecting balance, namely the plane of
occlusion, the cusp inclines, and the
compensating curve, can be adjusted to
harmonize. Their relationship to one
another is easily recognized if this diagram
is reproduced as a cutout for actual
manipulation.
The dentist can only
control four of five
factors .
* The condylar guidance: can be completely
fixed and is not his to change.

* The incisal guidance and inclination of the

plane of occlusion: can be altered within a
small range according to esthetic and physiologic
(phonetic)and anatomical factors.

* Cusps on the teeth and tooth inclination of

cuspless teeth and compensating curve: are the
real working tools of balanced occlusion.
According To The Formula
• Steep I.G. calls for steep cusps,
steep O.P. or a steep C.C. to
effect an occlusal balance.
• This type of occlusion is
detrimental to the stability and
equilibrium of the denture base.
Steep I.G. results in harmful
inclined planes with their
harmful risk to the supporting
tissues
According To The Formula

• To achieve balanced occlusion: For

high condylar guidance we need to
have high compensating curve,
occlusal plane and cuspal height.

• To achieve balanced occlusion: For

high incisal guidance we need to have
high compensating curve, occlusal
plane and cuspal height.
According To The Formula

To achieve balanced occlusion,

the steeper the condylar
guidance, the greater the cusp
height toward the posterior
or the steeper the
compensating curves
According To The Formula

To achieve balanced
occlusion, the steeper the
compensating curves,
the less the cusp height toward
the posterior
 Bilateral Balanced Lingualized Occlusion
Centric Occlusion Protrusive

Working Side Balancing Side

a b

Two figures with the same condylar inclination but

different incisal guide inclinations. A, Steep vertical

overlap, with resultant steep cusp inclines. B, Less

incisal angle, with resultant flatter cusp inclines

 X

a b

The condylar guidance has great influence in the second molar region and
progressively less till the incisor region.

Two figures with different condylar inclinations and different incisal guide
inclinations. a, Less condylar inclination with Steep vertical overlap, with
resultant flatter cusp inclines. b, Steep condylar inclination with Less
incisal angle, with resultant steep cusp inclines or Steepen the
compensating curves
 Question
Q) Suppose that the incisal guidance is set and the condylar
guidance is steeper than your chosen 20 degree teeth. To
obtain balanced occlusion in your complete denture, what
should you do?
a. Steepen the compensating curves in both sagittal and
frontal planes
b. Steepen the compensating curves in only sagittal but not
frontal plane
c. Decrease the inclination of occlusal plane
d. Decrease the steepness of compensating curves in both
sagittal and frontal planes
e. Steepen the condylar guidance
f. None of the above
Next lecture
Concepts of
Occlusion for
complete denture
 Everything is
okay in the end
If it's not okay,
then it's not
the end
 N K
A
TH
O U
Y