Comparison of Canine-Guided Occlusion with Other Occlusal Schemes in Removable Complete Dentures: A Systematic Review

Abstract

Choosing an adequate occlusion is challenging during the construction of artificial dentures, and critical for patient satisfaction. However, there is no conclusive evidence to support which occlusal design is more appropriate. The aim of this systematic review was to evaluate canine-guided occlusion in comparison to other occlusal schemes in removable complete denture wearers. The review was conducted according to the Preferred Reported Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. An extensive search was carried out on (PubMed (National Library of Medicine)), Scopus (Elsevier), Cochrane collaboration (Wiley), Science Direct (Elsevier) and Europe PMC (European Bioinformatics Institute). English and non-English studies were identified using keywords on canine-guided occlusion, denture occlusion, dental occlusion and artificial occlusal schemes. Out of 1759 articles searched, 18 were selected based on the inclusion criteria. The included studies were interpreted for the descriptive analysis for the calculation of occlusal schemes, occlusion assessment parameters, the outcome of the occlusal schemes and types of removable prosthesis used. The systematic analysis of occlusal schemes revealed that canine-guided occlusion is viable compared with other occlusal designs in terms of patient satisfaction, mastication, retention, esthetics, phonetics, oral-health-related quality of life and muscle activity. The type of occlusal scheme influences the complete denture patient’s’ masticatory efficiency, satisfaction, retention, phonetics and esthetics. Nevertheless, physical, physiological, mechanical and psychological factors play a vital role in the success of removable complete dentures. The canine-guided occlusal scheme is preferred because of its simplicity, less time consumption, good masticatory performance, ease of fabrication and modification into bilateral balanced occlusion if required. Further studies are required to reduce the controversies related to jaw relations, gnathology and occlusal schemes in complete dentures.

Clinical performance of and patient satisfaction with conventional complete dentures with different occlusal schemes: A systematic review of systematic reviews

“…32 One other study was identified from the nonpeer-reviewed literature and was included. 19 A total of 10 systematic reviews were included in this overview (Fig. 1).…”

“…All systematic reviews 6,7,11,[17][18][19][20][21][22][23] included randomized clinical trials, and 5 reviews also included prospective studies. 18,[20][21][22][23] In addition to clinical studies, 2 reviews included other systematic reviews, 11,20 1 included an in vitro study, 22 removable denture or implants.…”

“…18,[20][21][22][23] In addition to clinical studies, 2 reviews included other systematic reviews, 11,20 1 included an in vitro study, 22 removable denture or implants. 19,20 However, as the reviews met the inclusion criteria, and the results of interest for this overview were reported separately, to allow data extraction, none of these were excluded. None of the included systematic reviews presented statistical analysis or meta-analysis or evaluated the certainty of evidence with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool.…”

“…6 The other 9 reviews did not meet most of the requirements and were classified as of low 11,21 or critically low quality. 7,[17][18][19][20]22,23 From the 10 included systematic reviews, only 2 had a written review protocol. 6,21 Most of the reviews did not conduct a comprehensive search 7,11,17,18,20,22,23 and failed to explain the design of the included studies.…”

“…2,[14][15][16] In addition, systematic reviews have compiled study results and provided data to support evidence-based clinical procedures. 6,7,11,[17][18][19][20][21][22][23] An overview (systematic review of systematic reviews) can be conducted to summarize information from individual systematic reviews and assess their methodological quality. 24,25 Generally, overviews have evaluated the evidence from several systematic reviews to assess the effectiveness of multiple interventions to interpret or treat a particular clinical condition.…”