Occlusion and Removable Prosthodontics

What Occlusal Scheme Should Be Used with Removable Partial Dentures?

“…Due to this small number of expert opinion publications, a decision was made to perform a hand search of removable partial denture textbooks to see if any evidence‐based references were included in the texts as well as what expert opinions were presented in the books. Nine textbooks 27–35 contained varying amounts of information related to occlusal schemes for RPDs and they were included in this literature review but no evidence‐based references related to RPD occlusal schemes were found in the textbooks. Since this entire review is based on expert opinion, no attempt was made to critique the opinions expressed by these authors but rather to present their perspectives for evaluation by readers.…”

“…proposed two concepts for RPD occlusions, one being ‘conformative’ and the other being ‘re‐organized.’ The conformative concept ‘conforms’ to the patient's present occlusal scheme whereas the re‐organized concept is focused on producing a more idealized occlusion that sometimes includes altering the occlusal vertical dimension. Colman 15 stated that “the influence of the remaining natural teeth is usually such that the occlusal forms of the teeth on the partial denture must conform to an already established occlusal scheme.” Another proposed concept is that “the design of the prosthesis should conform with and be complementary to the existing occlusion.” 35 …”

“…Multiple authors indicate there should be simultaneous bilateral posterior tooth contact in maximum intercuspation with RPDs 16,20,33–35 with no deflective occlusal contacts 16 . This contact should be present between natural teeth, between natural teeth and replacement denture teeth, and between opposing denture teeth.…”

“…However, “only limited protrusive balance is possible” when patients have substantial vertical overlap of the anterior teeth 28 . In addition, Johnson and Stratton 29 indicated the presence of steep anterior canine disclusion “usually precludes any possibility of developing extensive working or balancing contacts in the artificial occlusion.” Jagger 35 proposed use of a balanced occlusion with bilateral extension base RPDs 35 . For maxillary bilateral extension base RPDs, Henderson 16 recommended developing simultaneous working and nonworking side contacts along with simultaneous contact of the remaining natural teeth during a working side mandibular movement.…”