Complete Denture Occlusion: Best Evidence Consensus Statement

Abstract

Purpose: The occlusal scheme required for an edentulous patient is controversial. The purpose of this Best Evidence Consensus Statement was to evaluate the existing complete denture literature related to occlusal schemes.

Materials and methods: A literature search was limited to Meta-analyses, Systematic Reviews (SR), Randomized Controlled Studies (RCT) and Clinical Trials. Key Words were: Complete dentures, occlusion, harm; Complete dentures, occlusion alveolar bone loss; Complete dentures, occlusion, stability; Complete dentures, occlusion. Additional related articles were culled from the authors' library and reference lists in the articles found in the PubMed searches.

Results: Of the 165 articles that met the initial search criteria, 34 related to the focus questions and were evaluated and rated.

Conclusions: There is strong support that the average denture patient, with good residual ridges and no neuromuscular problems, will function adequately with a properly fabricated complete denture regardless of the occlusal scheme. There is neither strong support for or against bilateral balanced occlusal schemes as it relates to patient satisfaction, preference or chewing ability. There is some support for increased alveolar bone loss with complete dentures that have a non-balanced occlusion. There is a need for bilateral balanced occlusal schemes for patients presenting with loss of stability and retention as a result of their presenting conditions (PDI III and IV).

Keywords: Anterior disclusion; bilateral balance; buccalized occlusion; canine guidance; denture occlusion; lingualized occlusion.