A cross‐over randomised clinical trial of eccentric occlusion in complete dentures

Abstract

The objective of this study is to compare the effects of canine guidance (CG) and bilateral balanced occlusion (BBO) on denture satisfaction and kinesiographic parameters of complete denture wearers, by means of a cross-over trial. Fifty edentulous patients received new maxillary and mandibular complete dentures. After the intra-oral adjustments and adaptation period, 44 participants were enrolled in the trial and randomly received a sequence of occlusal schemes: BBO followed by CG, or CG followed by BBO. Outcomes were assessed after 30 days of each occlusal scheme. Participants answered a denture satisfaction questionnaire and a kinesiograph instrument recorded mandibular physiologic movements and pattern of maxillary denture movement during chewing. Wilcoxon test and paired sample t-test were used to compare satisfaction levels and kinesiographic data for each occlusal scheme, respectively (α=0.05). The results showed no differences between occlusal schemes on participant's satisfaction and in any of the kinesiographic parameters studied, except for the vertical intrusion of the maxillary complete denture during chewing, which was lower with CG. It can be concluded that the occlusal scheme did not influence on satisfaction and kinesiographic parameters evaluated, as long as volume and resilience of residual edentulous ridges of the participants were normal. Clinical Trial Registration Identifier: NC.T01420536.

Bilateral balanced occlusion compared to other occlusal schemes in complete dentures: A systematic review

“…Many authors have asserted that BBO confers better occlusion, as it promotes better masticatory efficiency and allows a greater distribution of contacts between the dental surfaces during each masticatory movement . Some studies in this systematic review observed no difference for masticatory performance compared to CG and ZD. However, other studies reported negative influence of BBO in terms of masticatory performance compared to LO and muscle activity compared to CG …”

“…In this regard, different evaluated methods were reported, namely maximum occlusal force (MOF), the sieving method, electromyography (EMG), kinesiography (K) and chewing rate (CR). Studies reported no significant difference in EMG or masticatory performance between of BBO and CG, and ZD . BBO showed negative effect compared to LO and CG .…”

“…Twelve studies evaluated quality of life and satisfaction . In this regard, the quality of life indices reported by the authors included the Visual Analog Scale (VAS), Oral Health‐Related Quality of Life (OHRQoL), the Oral Health Impact Profile (OHIP and OHIP‐EDENT) and the Satisfaction questionnaire.…”

Occlusion and Removable Prosthodontics

“…While canine guidance has not been recommended by prosthodontists as an occlusal scheme for complete dentures, studies have shown little difference in patient satisfaction between groups of patients having complete dentures with either canine guidance or balanced occlusion (Hey decke et al 2008, Paleari et al 2012, FariasNeto & Carreiro 2013. Canine guidance is commonly present in the natural dentition of young patients; however, throughout life attrition of the natural dentition generally leads to the establishment of a unilateral group function.…”

Patient satisfaction with occlusal scheme of conventional complete dentures

“…To date, different types of occlusal schemes have been investigated to find the occlusion of choice for CCDs . While the conventional prosthodontic wisdom prefers the balanced occlusion to non‐balanced schemes, some studies did not verify this finding . Studies on balanced occlusal schemes have reported variable results.…”