Occlusion is the foundation for clinical success in fixed, removable, and implant prosthodontic treatment. Understanding those principles is critical when restoring a patient’s occlusion. Many philosophies, devices, and theories of occlusion have evolved based on anecdotal clinical observations and applied geometric perceptions. The literature has reported these classic and contemporary occlusal concepts. As evidence-based dentistry emerged, it championed scrutiny of previously held beliefs, resulting in the abandonment of many pragmatic, yet beneficial occlusal procedures. The impetus toward scientific discovery, whereby factual information might be universally applied in dental education and clinical practice, has renewed interest in occlusal studies.
Key points
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In dentistry, articulation is the static and dynamic contact relationship between the occlusal surfaces of the teeth during function.
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The exact maxillomandibular position at which maximum intercuspation should occur or be restored has been deliberated. Patients presenting with occlusal instability and tooth loss may require that a functional occlusion be reestablished. Understanding the accepted terminology and definitions in the Glossary of Prosthodontic Terms is essential before prescribing any particular occlusal scheme.
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The literature supports that bilateral mandibular manipulation, compared with gothic arch tracing or chin-point guidance is a clinical method to consistently record centric relation (CR).
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The 3 most likely temporomandibular disorders observed in clinical practice are occlusal-muscle disorders related to parafunction, internal joint derangements, and degenerative joint disease. It is important for the clinician to evaluate each patient for the range of motion during mandibular movement and observe signs and symptoms for a variety of the temporomandibular disorders.
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Selecting the occlusal scheme for dentate patients, or those requiring implant, fixed or removable prosthodontic care, should take into consideration the prevailing patient conditions and anticipated prosthetic needs to achieve occlusal stability.
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