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Ask UsDental Implants: Patterns of Occlusion
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What patterns of occlusion are you having success with? I have been using a lingualized contact pattern of occlusion.
Specifically, the maxillary palatal cusps on the premolars and molars contact the flat mandibular occlusal surfaces of the mandibular premolars and molars. The maxillary buccal cusps are out of occlusion. Since the mandibular premolars and molars are 0 degrees, it is relatively easy to eliminate destructive lateral guidance contacts. This pattern works very well when the dental implant patient has canine guidance. Any thoughts on additional patterns?
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7 Responses to “ Dental Implants: Patterns of Occlusion ”
CANINE GUIDANCE MIGHT PRESENT DESTRUCTIVE LATERAL GUIDANCE CONTACTS. IT CAN DO IT ON AN ATROPHIC RIDGE.
If Canine Guidance is present , than you can have nicer aesthetic cusps on the posteriors. Flat cusps cannot appear natural. If thee is no canine guidance on the natural teeth and we are restoring posterior occlusion then we must ” re-create” healthy cuspid guidance to protedt natural and implant teeth. The concept of using guidance and protected occlusion has been providing health and long term stability of posterior restorations. Lingual cusps in contact has been working but some patients complain that they can’t chew with their $10,000 teeth. It poses a bit of a problem when the contacts are too light. We need more discussion and documentation for implant occlusion. And we need to talk more about all of our experiences to formulate a consensus…Area of much anicdotal (sp?) skeptisms!!
Guys, quit re-inventing Prosthodontics! The first comment does not describe lingualized occlusion. It describes monoplane teeth. This is a topic already debated to death in the literature from the late 50s and 60s. Regardless if the occlusion is natural, or artivicial, Mutually protected occlusion has proven itself through the years to be esthetic, as well as functional. There are plenty of individuals with mal-occlusion and they function fine, however. If it is my choice, I’d rather give my patient the better estheics and functionality and teeth that look like teeth. Creating a flat occlusal surface on teeth without proper guidance just perpetuates bruxism. Dr. Dean is right: create what we know works well. Everything else is anecdotal.
I learn something everytime I read this site. Keep the open dialogue collegues!
Lingualized contact occlusion is relatively easy to grind in to adjust premature contacts. As a rule I leave the anatomic maxillary palatal cusps alone and grind the opposing flat mandibular occlusal table. One factor I appreciate is that as long as the maxillary palatal cusps lie along the line connecting the mandibular central fossae and marginal ridges, the occlusion works well.
Does anyone have any suggestions on what to do in case of angulated abutments. Vertical occlusal stresses in this case are not directed vertically along the implant. How can we correct this?
Is there any study done on building occlusion on angulated abutments?
Dear Colleagues:
I think occlusion patterns may be over the implant platform (axially, of course), I think the most contacts the better results -cause they neutralize one and others-, and crown must be almost like a normal tooth, what do you think?
Regards
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