Quest for ideal occlusal patterns for complete dentures

Concepts of occlusion in prosthodontics: A literature review, part II

This series of articles describes about concepts of occlusion in the complete denture, fixed partial denture, and implants. This article discusses about the evolution of different concepts of nonbalanced occlusion and occlusal schemes in complete denture occlusion.

WITHDRAWN: Interventions for replacing missing teeth: denture chewing surface designs in edentulous people

The Cochrane Oral Health Group withdrew this review as of Issue 12, 2015. The review is out of date and does not meet current Cochrane methodological standards.

The editorial group responsible for this previously published document have withdrawn it from publication.

A randomized clinical trial comparing anatomic, lingualized, and zero-degree posterior occlusal forms for complete dentures

STATEMENT OF PROBLEM

There is a lack of evidence to recommend a particular type of posterior occlusal form for conventional complete dentures.

PURPOSE

The purpose of this study was to compare subject satisfaction with 3 types of posterior occlusal forms for complete dentures in a randomized cross-over controlled trial.

MATERIAL AND METHODS

For each participant (n=45), 3 sets of complete dentures were fabricated, each of which had a different posterior occlusal form (0-degree, anatomic, and lingualized). Each set was worn for 8 weeks in a randomized order. Subjective data were collected using the Oral Health Impact Profile 20-EDENT (OHIP-EDENT). The Wilcoxon statistical test was used to compare differences between the groups (alpha=.05).

RESULTS

Lingualized posterior occlusal forms were perceived to be significantly superior in terms of painful aching in the mouth (P=.01), sore spots (P<.001), eating ability (P=.02), and meal interruptions (P=.008), compared with 0-degree posterior occlusal forms. Subjects with anatomic posterior occlusal forms had significantly fewer problems eating (P=.05) compared with 0-degree posterior occlusal forms. There was no significant difference found between the lingualized and anatomic posterior occlusal forms.

CONCLUSIONS

Participants provided with complete dentures having lingualized or anatomic posterior occlusal forms exhibited significantly higher levels of self-perceived satisfaction compared to those with 0-degree posterior occlusal forms.

Interventions for replacing missing teeth: denture chewing surface designs in edentulous people

BACKGROUND

When constructing complete dentures for edentulous patients, ultimately patient satisfaction is key. Complete dentures can be produced with different types of occlusal schemes (chewing surfaces) and it is widely accepted that the occlusal scheme for complete dentures has a direct influence upon their success.

OBJECTIVES

To assess the relative effectiveness of differing occlusal schemes for complete dentures with regard to patient satisfaction. The null hypothesis is that there is no difference in terms of patient satisfaction between different designs of chewing surfaces for complete dentures.

SEARCH STRATEGY

Several electronic databases were searched in order to identify relevant trials: Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 2, 2004), MEDLINE (1966 to week 2 April 2004), OLDMEDLINE (1953 to 1965), EMBASE (1980 to week 16 2004),Zetoc (1993 to December 2003), SIGLE (1980 to December 2003), SCI (Science Citation Index) (1945 to 04 April 2004 ). Reference lists of identified, relevant trials and review articles were scanned. Unpublished data were sought through personal contact with experts in the field. There was no language restriction.

SELECTION CRITERIA

Randomised or quasi-randomised controlled clinical trials (RCTs), recruiting edentulous adults, and comparing complete dentures produced with different occlusal schemes with regard to patient satisfaction and masticatory function.

DATA COLLECTION AND ANALYSIS

The quality assessment of the included trials was undertaken independently and in duplicate by two reviewers based initially on what was written in the articles. Data were extracted by two reviewers independently. Disagreements were discussed and a third reviewer consulted as necessary. Authors were contacted for clarification or missing information. Data were excluded until further clarification if agreement could not be reached.

MAIN RESULTS

1076 titles and abstracts were identified through the electronic searches. Thirteen trials were thought to be potentially relevant. Ten of these studies were subsequently excluded following further analysis. Two trials require further information from the author before being considered eligible for inclusion. Only one cross-over trial (n = 30), comparing lingualised teeth and zero-degree teeth, fully met the review's inclusion criteria. Twenty patients preferred the lingualised denture, five the zero-degree denture and five patients had no preference. There was a statistically significant difference in favour of the lingualised denture with an odds ratio of 10 (95% confidence interval 2.04 to 48.96).

AUTHORS' CONCLUSIONS

There is weak evidence that it may be advantageous, for dentists providing a complete denture service, to prescribe prosthetic posterior teeth with cusps to improve patient satisfaction compared to providing cuspless teeth. However, this conclusion may only be made tentatively until further well conducted trials comparing different occlusal schemes for complete dentures are undertaken.