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For more than a hundred years, it has been supposed that canine guidance should be avoided in conventional complete dentures, since it would result in denture instability. Thus, bilateral balanced articulation has been held by many authors as fundamental for treatment success. However, randomized clinical trials have shown that balanced articulation is not as important as previously thought. The issue about which occlusal concept is the most appropriate for individual needs is clinically and economically relevant for both the dentist and dental technician. Therefore, the purpose of this study is to provide an evidence-based update on complete denture occlusion.
Clinical Relevance: The issue about which occlusal concept is the most appropriate for individual needs is clinically and economically relevant.
Article
Using evidence-based dentistry, Carlsson1 presented a list of old and current dogmas in prosthodontics:
The author concluded that many procedures regarding prosthodontic interventions are based more on belief than scientific evidence.1
Current scientific evidence suggests that bilateral balanced articulation is not essential for successful treatment with conventional complete dentures. A recent systematic review revealed that canine-guided dentures do not seem to affect masticatory function and patient satisfaction.2 The issue about which occlusal concept is the most appropriate for individual needs is clinically and economically relevant. For the dentist and dental technician, the construction of a set of dentures with bilateral balanced articulation is more complex and time consuming than the construction of canine-guided dentures. Therefore, the purpose of this study was to provide an evidence-based update on complete denture occlusion.
For more than a hundred years, it has been supposed that oblique and lateral forces, like those present during canine guidance, should be avoided in conventional complete dentures, since this kind of force would result in denture instability (Figure 1). Thus, the bilateral balanced articulation has been held by many authors as fundamental for treatment success. This occlusal concept presents posterior contacts on both sides of the mandible (working side and balancing side) during eccentric movements (Figure 2). According to those who advocate the need for a balanced articulation, this occlusal concept improves retention and stability, and provides better masticatory function.3
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