linear occlusion/ oral surgery courses

MAXIMIZING MANDIBULARMAXIMIZING MANDIBULAR
PROSTHESIS STABILITY UTILIZINGPROSTHESIS STABILITY UTILIZING
LINEAROCCLUSION, OCCLUSALLINEAROCCLUSION, OCCLUSAL
PLANESELECTION, ANDCENTRICPLANESELECTION, ANDCENTRIC
RECORDING.RECORDING.
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.comwww.indiandentalacademy.com

OBTAINING CONSISTENT MANDIBULAROBTAINING CONSISTENT MANDIBULAR
DENTURE STABILITY HAS LONG BEEN ADENTURE STABILITY HAS LONG BEEN A
CHALLENGE FOR DENTAL PROFESSIONALS.CHALLENGE FOR DENTAL PROFESSIONALS.
THE DYNAMIC CONTACT OF TEETH HAS ANTHE DYNAMIC CONTACT OF TEETH HAS AN
EFFECT ON THE STABILITY OF DENTUREEFFECT ON THE STABILITY OF DENTURE
BASES, THE FORCES TRANSMITTED TOBASES, THE FORCES TRANSMITTED TO
DENTURE BEARING TISSUES, AND THEDENTURE BEARING TISSUES, AND THE
COMFORT AND FUNCTION EXPERIENCEDCOMFORT AND FUNCTION EXPERIENCED
BY PATIENTS.BY PATIENTS.

LITERATURE HAS SUPPORTED THE USELITERATURE HAS SUPPORTED THE USE
OFOF LINEARLINEAR ((LINEALLINEAL)) OCCLUSION TOOCCLUSION TO
ENHANCE THE STABILITY OFENHANCE THE STABILITY OF
COMPLETE DENTURE PROSTHESES.COMPLETE DENTURE PROSTHESES.
NONINTERCEPTIVENONINTERCEPTIVE OCCLUSIONOCCLUSION
((LINEARLINEAR OCCLUSIONOCCLUSION)) REQUIRES THATREQUIRES THAT
THERE SHOULD BE NO INTERFERENCETHERE SHOULD BE NO INTERFERENCE
OR INTERCEPTION WITH MANDIBULAROR INTERCEPTION WITH MANDIBULAR
MOVEMENT IN PROTRUSIVE ORMOVEMENT IN PROTRUSIVE OR
LATERAL EXCURSIONS.LATERAL EXCURSIONS.

IT HAS BEEN REPORTED THAT LINEARIT HAS BEEN REPORTED THAT LINEAR
OCCLUSION MINIMIZESOCCLUSION MINIMIZES HORIZONTALHORIZONTAL
FORCE VECTORS THAT ACT TOFORCE VECTORS THAT ACT TO
DISLODGEDISLODGE PROSTHESES. IT HAS BEENPROSTHESES. IT HAS BEEN
THE EXPERIENCE OF THE AUTHORSTHE EXPERIENCE OF THE AUTHORS
THAT THE USE OF LINEAR OCCLUSION,THAT THE USE OF LINEAR OCCLUSION,
IN CONJUNCTION WITH AIN CONJUNCTION WITH A STEEPERSTEEPER THANTHAN
CONVENTIONAL OCCLUSAL PLANE,CONVENTIONAL OCCLUSAL PLANE,
ASSISTS IN STABILIZINGASSISTS IN STABILIZING MANDIBULARMANDIBULAR
DENTUREDENTURE BASES.BASES.

THIS IS PARTICULARLY HELPFUL FORTHIS IS PARTICULARLY HELPFUL FOR
PATIENTS EXHIBITINGPATIENTS EXHIBITING ADVANCEDADVANCED
MANDIBULAR RESIDUAL RIDGEMANDIBULAR RESIDUAL RIDGE
RESORPTIONRESORPTION. THE ADDITIONAL USE OF. THE ADDITIONAL USE OF
INTRAORAL CENTRAL BEARING GOTHICINTRAORAL CENTRAL BEARING GOTHIC
ARCH-TRACING DEVICES AIDS INARCH-TRACING DEVICES AIDS IN
PRODUCING REPEATABLE CENTRICPRODUCING REPEATABLE CENTRIC
RELATION MEASUREMENTSRELATION MEASUREMENTS
CONTRIBUTING TOCONTRIBUTING TO MORE STABLEMORE STABLE
MANDIBULAR DENTURE BASESMANDIBULAR DENTURE BASES..

CONCEPT OF LINEAR OCCLUSIONCONCEPT OF LINEAR OCCLUSION

THE GLOSSARY OF PROSTHODONTIC TERMSTHE GLOSSARY OF PROSTHODONTIC TERMS
(JANUARY 1999, 7TH EDITION)(JANUARY 1999, 7TH EDITION) CREDITSCREDITS
WILLIAM H. GODDARDWILLIAM H. GODDARD,, WITH THE FOUNDINGWITH THE FOUNDING
OFOF LINEAR OCCLUSIONLINEAR OCCLUSION..
IN 1966IN 1966 J.P. FRUSHJ.P. FRUSH DESCRIBED OCCLUSIONDESCRIBED OCCLUSION
IN GEOMETRIC TERMS AS ONE-DIMENSIONALIN GEOMETRIC TERMS AS ONE-DIMENSIONAL
(LINEAR),(LINEAR), TWO DIMENSIONALTWO DIMENSIONAL (FLAT PLANE),(FLAT PLANE),
AND THREE-DIMENSIONALAND THREE-DIMENSIONAL (CUSPED).(CUSPED). THISTHIS
GEOMETRIC CLASSIFICATION OF OCCLUSIONGEOMETRIC CLASSIFICATION OF OCCLUSION
SPECIFICALLY CLASSIFIED THE DIMENSIONALSPECIFICALLY CLASSIFIED THE DIMENSIONAL
CONTACT BETWEEN OCCLUDING POSTERIORCONTACT BETWEEN OCCLUDING POSTERIOR
TEETH.TEETH.

LINEAR OCCLUSION WAS PROMOTED AS ANLINEAR OCCLUSION WAS PROMOTED AS AN
OCCLUSAL SCHEME THAT LED TOOCCLUSAL SCHEME THAT LED TO
INCREASED STABILITY OF DENTURE BASESINCREASED STABILITY OF DENTURE BASES
BY MINIMIZING THE LATERAL FORCESBY MINIMIZING THE LATERAL FORCES
APPLIED TO THOSE BASES.APPLIED TO THOSE BASES.
GRONASGRONAS ANDAND STOUTSTOUT EXPLAINED HOWEXPLAINED HOW
BOTH ANATOMIC AND NONANATOMICBOTH ANATOMIC AND NONANATOMIC
OCCLUSAL SCHEMES TRANSMIT SIGNIFICANTOCCLUSAL SCHEMES TRANSMIT SIGNIFICANT
LATERAL FORCES TO THE DENTURE BASES,LATERAL FORCES TO THE DENTURE BASES,
AND THEY SUGGESTED THAT LINEARAND THEY SUGGESTED THAT LINEAR
OCCLUSION HAD THE POTENTIAL FOROCCLUSION HAD THE POTENTIAL FOR
CREATING THE SMALLEST LATERALCREATING THE SMALLEST LATERAL FORCEFORCE
COMPONENT.COMPONENT.

MASSADMASSAD REFERS TO A SIMILARREFERS TO A SIMILAR
CONCEPT TO MINIMIZE THE LATERALCONCEPT TO MINIMIZE THE LATERAL
INTERFERENCES THAT CONTRIBUTEINTERFERENCES THAT CONTRIBUTE
TO DENTURE BASE INSTABILITYTO DENTURE BASE INSTABILITY..
LINEAR (NONINTERCEPTIVE)LINEAR (NONINTERCEPTIVE)
OCCLUSION CONSISTS OF THEOCCLUSION CONSISTS OF THE
FOLLOWING BASIC PARAMENTERS:FOLLOWING BASIC PARAMENTERS:
ZERO DEGREEZERO DEGREE ((FLAT PLANEFLAT PLANE)) TEETHTEETH
ARE OPPOSED BY BLADEDARE OPPOSED BY BLADED ((LINELINE
CONTACTCONTACT)) TEETH IN WHICH THE BLADETEETH IN WHICH THE BLADE
IS IN A PRECISELY STRAIGHT LINEIS IN A PRECISELY STRAIGHT LINE
OVER THE CREST OF THEOVER THE CREST OF THE RIDGE.RIDGE.

MANDIBULAR TEETH ARE SET TO AMANDIBULAR TEETH ARE SET TO A
FLAT (FLAT (MONOPLANEMONOPLANE) OCCLUSAL PLANE.) OCCLUSAL PLANE.

THERE IS NO ANTERIOR TOOTHTHERE IS NO ANTERIOR TOOTH
INTERFERENCE TO PROTRUSIVE ORINTERFERENCE TO PROTRUSIVE OR
LATERAL MOVEMENTS.LATERAL MOVEMENTS.

MANDIBULAR PROSTHESIS STABILITY MAYMANDIBULAR PROSTHESIS STABILITY MAY
BE ANALYZED BY COMPARINGBE ANALYZED BY COMPARING
THEDIRECTIONAL FORCES TRANSMITTEDTHEDIRECTIONAL FORCES TRANSMITTED
TO ASSOCIATED DENTURE BASES BYTO ASSOCIATED DENTURE BASES BY
ANATOMIC TEETH, ZERO-DEGREE TEETH,ANATOMIC TEETH, ZERO-DEGREE TEETH,
AND LINEAR TEETH. IN THE MAXIMUMAND LINEAR TEETH. IN THE MAXIMUM
INTERCUSPATION POSITION, SURFACEINTERCUSPATION POSITION, SURFACE
CONTACT BETWEEN POSTERIOR ANATOMICCONTACT BETWEEN POSTERIOR ANATOMIC
TEETH CONSISTS OF MULTIDIRECTIONAL,TEETH CONSISTS OF MULTIDIRECTIONAL,
BUT EQUALIZED, VECTORS.BUT EQUALIZED, VECTORS.

THE DIRECTIONAL FORCES CHANGE INTHE DIRECTIONAL FORCES CHANGE IN
ECCENTRIC POSITIONS, AND THERE ISECCENTRIC POSITIONS, AND THERE IS
A SIGNIFICANT LATERAL FORCEA SIGNIFICANT LATERAL FORCE
COMPONENT EXERTED ON THECOMPONENT EXERTED ON THE
DENTURE BASES.DENTURE BASES.

ZERO DEGREE TEETH MAY ESTABLISHZERO DEGREE TEETH MAY ESTABLISH
A MONOPLANE (A MONOPLANE (FLAT PLANEFLAT PLANE))
OCCLUSAL SCHEME, (OCCLUSAL SCHEME, ( LANGLANG ANDAND
JONESJONES ), IN WHICH THE TEETH ARE), IN WHICH THE TEETH ARE
ARRANGED IN A SINGLE PLANE. ZEROARRANGED IN A SINGLE PLANE. ZERO
DEGREE TEETH SET TO A CURVE, INDEGREE TEETH SET TO A CURVE, IN
AN ATTEMPT TO ACHIEVE BALANCE,AN ATTEMPT TO ACHIEVE BALANCE,
RESULT INRESULT IN ADDITIONAL PLANES.ADDITIONAL PLANES.

THESETHESE INCLINED PLANESINCLINED PLANES CAN CAUSECAN CAUSE
SKIDDINGSKIDDING OF THE DENTURE BASESOF THE DENTURE BASES
AND INDUCE EXCESSIVE FRICTION. AAND INDUCE EXCESSIVE FRICTION. A
MONOPLANE OCCLUSAL SCHEME WITHMONOPLANE OCCLUSAL SCHEME WITH
ZERO DEGREE TEETH REDUCES THEZERO DEGREE TEETH REDUCES THE
HORIZONTAL FORCE COMPONENTSHORIZONTAL FORCE COMPONENTS
BECAUSE THE DIRECTION OF FORCESBECAUSE THE DIRECTION OF FORCES
BETWEEN ZERO DEGREE TEETH INBETWEEN ZERO DEGREE TEETH IN
CENTRIC AND ECCENTRIC POSITIONSCENTRIC AND ECCENTRIC POSITIONS
IS ESSENTIALLY VERTICAL.IS ESSENTIALLY VERTICAL.

HOWEVER, IN ECCENTRIC POSITIONS THEREHOWEVER, IN ECCENTRIC POSITIONS THERE
IS AN INEQUITY IN THE OPPOSING SURFACEIS AN INEQUITY IN THE OPPOSING SURFACE
AREA CONTACT BETWEEN WORKING ANDAREA CONTACT BETWEEN WORKING AND
NONWORKING SIDES AND THERE IS A SHIFTNONWORKING SIDES AND THERE IS A SHIFT
IN THE LOCATION OF THE FORCED BETWEENIN THE LOCATION OF THE FORCED BETWEEN
THE OCCLUDING TEETH.THE OCCLUDING TEETH.

THE FRICTIONAL RESISTANCE BETWEENTHE FRICTIONAL RESISTANCE BETWEEN
THE WIDE OCCLUSAL TABLES OF ZEROTHE WIDE OCCLUSAL TABLES OF ZERO
DEGREE TEETH MAY CONTRIBUTEDEGREE TEETH MAY CONTRIBUTE
HORIZONTAL FORCES TO THE DENTUREHORIZONTAL FORCES TO THE DENTURE
BASES.BASES. THE DIRECTION OF FORCE TO THETHE DIRECTION OF FORCE TO THE
MANDIBLE CHANGES LOCATION DURINGMANDIBLE CHANGES LOCATION DURING
MOVEMENT FROM CENTRIC TO ECCENTRICMOVEMENT FROM CENTRIC TO ECCENTRIC
POSITIONS IN BOTH ANATOMIC AND FLATPOSITIONS IN BOTH ANATOMIC AND FLAT
PLANE OCCLUSIONS, THUS CONTRIBUTINGPLANE OCCLUSIONS, THUS CONTRIBUTING
TO INSTABILITY OF THE DENTURE BASE.TO INSTABILITY OF THE DENTURE BASE.

IN LINEAR OCCLUSION, THE REQUIREMENTIN LINEAR OCCLUSION, THE REQUIREMENT
OF GREATER STABILITY MAY DETERMINEOF GREATER STABILITY MAY DETERMINE
THE ARCH RECEIVING THE BLADED TEETH.THE ARCH RECEIVING THE BLADED TEETH.
THE MANDIBLE MOST OFTEN REQUIRESTHE MANDIBLE MOST OFTEN REQUIRES
GREATER STABILITY, THUS IN THIS CASEGREATER STABILITY, THUS IN THIS CASE
THE BLADED TEETH ARE PLACED ON THETHE BLADED TEETH ARE PLACED ON THE
MANDIBULAR ARCH.MANDIBULAR ARCH. THE OCCLUDINGTHE OCCLUDING
FORCES BETWEEN A ZERO DEGREE AND AFORCES BETWEEN A ZERO DEGREE AND A
BLADED TOOTH ARE VERTICAL IN CENTRICBLADED TOOTH ARE VERTICAL IN CENTRIC
AND ECCENTRIC POSITIONS.AND ECCENTRIC POSITIONS.

THE LOCATION OF FORCE TO THETHE LOCATION OF FORCE TO THE
MANDIBULAR EDENTULOUS RIDGEMANDIBULAR EDENTULOUS RIDGE
DOES NOT VARY REGARDLESS OF THEDOES NOT VARY REGARDLESS OF THE
OCCLUDING POSITION.OCCLUDING POSITION.

THERE ISTHERE IS MINIMAL SURFACE CONTACTMINIMAL SURFACE CONTACT
AREA BETWEEN THE FLAT PLANE ANDAREA BETWEEN THE FLAT PLANE AND
BLADE IN LINEAR OCCLUSION, THUSBLADE IN LINEAR OCCLUSION, THUS
DENTURE BASE MOVEMENT DUE TODENTURE BASE MOVEMENT DUE TO
FRICTIONAL RESISTANCE IS MINIMIZED.FRICTIONAL RESISTANCE IS MINIMIZED.
NONINTERCEPTIVE OCCLUSIONNONINTERCEPTIVE OCCLUSION
PROVIDES A CONSISTENT VERTICALPROVIDES A CONSISTENT VERTICAL
SEATING FORCE IN BOTH CENTRIC ANDSEATING FORCE IN BOTH CENTRIC AND
ECCENTRIC MOVEMENT; HENCE,ECCENTRIC MOVEMENT; HENCE,
TRANSVERSE FORCETRANSVERSE FORCE VECTORS AREVECTORS ARE
ESSENTIALLYESSENTIALLY ELIMINATED.ELIMINATED.www.indiandentalacademy.comwww.indiandentalacademy.com

THE ZERO DEGREE TEETH ARETHE ZERO DEGREE TEETH ARE
FLATTENED AGAINST FINE-GRITFLATTENED AGAINST FINE-GRIT
ABRASIVE PAPER OVER PLATE GLASS TOABRASIVE PAPER OVER PLATE GLASS TO
ENSURE AN IDEAL ONE-DIMENSIONALENSURE AN IDEAL ONE-DIMENSIONAL
OCCLUSAL PLANE BETWEEN LEFT ANDOCCLUSAL PLANE BETWEEN LEFT AND
RIGHT QUADRANTS.RIGHT QUADRANTS.
THE BLADE-LINE CONTACT WITH THETHE BLADE-LINE CONTACT WITH THE
ZERO DEGREE (FLAT PLANE)ZERO DEGREE (FLAT PLANE) REDUCESREDUCES
THE WIDTH COMPONENTTHE WIDTH COMPONENT OF THE FORCEOF THE FORCE
SEEN IN OTHER ZERO DEGREE DENTURESEEN IN OTHER ZERO DEGREE DENTURE
OCCLUSIONS ANDOCCLUSIONS AND INCREASES THEINCREASES THE
FORCE PER UNIT AREA OF CONTACT.FORCE PER UNIT AREA OF CONTACT.

NONINTERCEPTIVE OCCLUSION, ASNONINTERCEPTIVE OCCLUSION, AS
UTILIZED IN THIS TECHNIQUE, ISUTILIZED IN THIS TECHNIQUE, IS
DEVELOPED USINGDEVELOPED USING OPPOSINGOPPOSING
PORCELAIN SURFACES.PORCELAIN SURFACES.
PORCELAIN TEETH HAVE BEENPORCELAIN TEETH HAVE BEEN
REPORTED TOREPORTED TO MAINTAIN THE VERTICALMAINTAIN THE VERTICAL
DIMENSION OF OCCLUSIONDIMENSION OF OCCLUSION LONGERLONGER
THAN DO PLASTIC TEETH DUE TOTHAN DO PLASTIC TEETH DUE TO
THEIR ABILITY TO WITHSTAND WEARTHEIR ABILITY TO WITHSTAND WEAR

OCCLUSAL DISHARMONY IN A PORCELAIN-OCCLUSAL DISHARMONY IN A PORCELAIN-
PORCELAIN OCCLUSION MAY ALSO BEPORCELAIN OCCLUSION MAY ALSO BE
IDENTIFIED EARLIERIDENTIFIED EARLIER BY CAUSING A SORE SPOT,BY CAUSING A SORE SPOT,
AS THE PORCELAIN DOES NOT WEAR RAPIDLYAS THE PORCELAIN DOES NOT WEAR RAPIDLY
ENOUGH TO KEEP UP WITH THE ANATOMICENOUGH TO KEEP UP WITH THE ANATOMIC
CHANGES OF THE RESIDUAL RIDGES.CHANGES OF THE RESIDUAL RIDGES.
IN THE AUTHORS’ OPINION, THIS ENABLES AIN THE AUTHORS’ OPINION, THIS ENABLES A
PRACTITIONER TO ELIMINATE OCCLUSALPRACTITIONER TO ELIMINATE OCCLUSAL
DISCREPANCIES SOONER, RESULTING INDISCREPANCIES SOONER, RESULTING IN LESSLESS
POSTINERSTION DISCOMFORTPOSTINERSTION DISCOMFORT FOR THEFOR THE
PATIENT AND SIGNIFICANTLY FEWERPATIENT AND SIGNIFICANTLY FEWER
POSTINSERTION ADJUSTMENTS.POSTINSERTION ADJUSTMENTS.

PLANE OF OCCLUSIONPLANE OF OCCLUSION

THE PLANE OF OCCLUSION ISTHE PLANE OF OCCLUSION IS
STEEPERSTEEPER THAN IN DENTURE TOOTHTHAN IN DENTURE TOOTH
ARRANGEMENTS COMMONLYARRANGEMENTS COMMONLY
ADVOCATED IN THE LITERATUREADVOCATED IN THE LITERATURE TOTO
HELP SEATHELP SEAT THE MANDIBULAR DENTURETHE MANDIBULAR DENTURE
BASE INTO THE MEAN FOUNDATIONBASE INTO THE MEAN FOUNDATION
PLANE OF THE MANDIBLE(SECONDPLANE OF THE MANDIBLE(SECOND
PREMOLAR/FIRST MOLAR REGION) ANDPREMOLAR/FIRST MOLAR REGION) AND
TO FACILITATE THE DEVELOPMENT OFTO FACILITATE THE DEVELOPMENT OF
PROTRUSIVE BALANCING CONTACTSPROTRUSIVE BALANCING CONTACTS
FOR A FLAT OCCLUSAL PLANE (NOFOR A FLAT OCCLUSAL PLANE (NO
COMPENSATING CURVE).COMPENSATING CURVE).

THETHE POSTERIOR DETERMINANTPOSTERIOR DETERMINANT OF THEOF THE
PLANE OF OCCLUSION IS THE SUPERIORPLANE OF OCCLUSION IS THE SUPERIOR
EXTENT OF THEEXTENT OF THE RETROMOLAR PAD.RETROMOLAR PAD.

ESTHETICSESTHETICS ANDAND PHONETICSPHONETICS AREARE
USED TO DETERMINE THE MAXILLARYUSED TO DETERMINE THE MAXILLARY
ANTERIOR TOOTH POSITION, AND THEANTERIOR TOOTH POSITION, AND THE
MANDIBULAR INCISORS ARE SETMANDIBULAR INCISORS ARE SET
ALONG THIS HORIZONTAL PLANE WITHALONG THIS HORIZONTAL PLANE WITH
NO VERTICAL OVERLAP.NO VERTICAL OVERLAP.

MAXILLARY AND MANDIBULAR INCISORSMAXILLARY AND MANDIBULAR INCISORS
ARE SET WITH NO VERTICAL OVERLAP SOARE SET WITH NO VERTICAL OVERLAP SO
AS TOAS TO REDUCE ANTERIOR INTERFERENCEREDUCE ANTERIOR INTERFERENCE
(INTERCEPTION) IN LATERAL AND(INTERCEPTION) IN LATERAL AND
PROTRUSIVE MOVEMENTS.PROTRUSIVE MOVEMENTS.
VERTICAL OVERLAP IS PERMISSIBLEVERTICAL OVERLAP IS PERMISSIBLE IFIF AA
SUFFICIENT HORIZONTAL OVERJET WILLSUFFICIENT HORIZONTAL OVERJET WILL
PROTECT AGAINST PREMATURE ANTERIORPROTECT AGAINST PREMATURE ANTERIOR
TOOTH CONTACT.TOOTH CONTACT.

VERIFICATION OF ADEQUACY OF THEVERIFICATION OF ADEQUACY OF THE
OCCLUSAL PLANE IS MADE AT THE WAXOCCLUSAL PLANE IS MADE AT THE WAX
TRY-IN APPOINTMENT.TRY-IN APPOINTMENT.

CENTRIC RELATIONCENTRIC RELATION

FOR EXTREMELY RESORBED RIDGES,FOR EXTREMELY RESORBED RIDGES,
A CONSISTENT, REPEATABLE, ANDA CONSISTENT, REPEATABLE, AND
EASILY VERIFIED CENTRIC RELATIONEASILY VERIFIED CENTRIC RELATION
RECORDING MAY BE ACHIEVEDRECORDING MAY BE ACHIEVED
THROUGH USING ANTHROUGH USING AN INTRAORALINTRAORAL
GOTHIC ARCH-TRACING DEVICEGOTHIC ARCH-TRACING DEVICE
(GENEVA DENTAL, BEVERLY HILLS,(GENEVA DENTAL, BEVERLY HILLS,
CA).CA).

THE WORK OFTHE WORK OF KAPURKAPUR ANDAND YURKSTASYURKSTAS
CONFIRMED THE FINDINGS OFCONFIRMED THE FINDINGS OF
TRAPOZZANOTRAPOZZANO ANDAND KINGERYKINGERY THAT THETHAT THE
CENTRAL BEARING ASSEMBLY WILLCENTRAL BEARING ASSEMBLY WILL
PROVIDE EQUALIZATION OF OCCLUSALPROVIDE EQUALIZATION OF OCCLUSAL
PRESSURE AND INCREASE BASEPRESSURE AND INCREASE BASE
STABILITY WHEN MUCOSAL PRESSURESTABILITY WHEN MUCOSAL PRESSURE
AND INCREASE BASE STABILITY WHENAND INCREASE BASE STABILITY WHEN
MUCOSAL RESILIENCY IS MODEST.MUCOSAL RESILIENCY IS MODEST.

ALTHOUGHALTHOUGH THE WAX METHODTHE WAX METHOD OFOF
RECORDING CENTRIC RELATION ISRECORDING CENTRIC RELATION IS
ACCURATE,ACCURATE, IT REQUIRESIT REQUIRES
CONSIDERABLE EXPERIENCECONSIDERABLE EXPERIENCE TOTO
PRODUCE REPRODUCIBILITY. THEPRODUCE REPRODUCIBILITY. THE
GOTHIC TRACING METHOD IS A HIGHLYGOTHIC TRACING METHOD IS A HIGHLY
RELIABLE TECHNIQUE FOR EVEN THERELIABLE TECHNIQUE FOR EVEN THE
INEXPERIENCED OPERATOR.INEXPERIENCED OPERATOR.

CENTRIC RELATION RECORDS CAN BECENTRIC RELATION RECORDS CAN BE
READILY VERIFIED AT THE WAX TRY-INREADILY VERIFIED AT THE WAX TRY-IN
STAGE.STAGE.

CLINICAL TECHNIQUECLINICAL TECHNIQUE

IRREVERSIBLE HYDROCOLLOIDIRREVERSIBLE HYDROCOLLOID
(ACCU-GEL, IVOCLAR NORTH AMERICA,(ACCU-GEL, IVOCLAR NORTH AMERICA,
INC., AMHERST, NY) AND STOCKINC., AMHERST, NY) AND STOCK
EDENTULOUS TRAYS (ACCU-DENT,EDENTULOUS TRAYS (ACCU-DENT,
IVOCLAR NORTH AMERICA, INC) AREIVOCLAR NORTH AMERICA, INC) ARE
USED TO MAKE OVEREXTENDEDUSED TO MAKE OVEREXTENDED
MAXILLARY AND MANDIBULARMAXILLARY AND MANDIBULAR
IMPRESSIONS. MAXILLARY ANDIMPRESSIONS. MAXILLARY AND
MANDIBULAR IMPRESSIONS AREMANDIBULAR IMPRESSIONS ARE
POURED AND CASTS TRIMMED.POURED AND CASTS TRIMMED.

MUSCLE TONICITY AND FRENUMMUSCLE TONICITY AND FRENUM
EXTENSIONS ARE DETERMINEDEXTENSIONS ARE DETERMINED
INTRAORALLY AND NOTED FOR BOTH THEINTRAORALLY AND NOTED FOR BOTH THE
MAXILLARY AND MANDIBULAR DENTUREMAXILLARY AND MANDIBULAR DENTURE
ARCHES.ARCHES.
FOLLOWING LOCATION OF THE MYLOHYOIDFOLLOWING LOCATION OF THE MYLOHYOID
RIDGES, EXTERNAL OBLIQUE RIDGES, ANDRIDGES, EXTERNAL OBLIQUE RIDGES, AND
RETROMOLAR PADS INTRAORALLY, ARETROMOLAR PADS INTRAORALLY, A
MYOSTATIC OUTLINE FORM IS SCRIBED ONMYOSTATIC OUTLINE FORM IS SCRIBED ON
THE MANDIBULAR CAST.THE MANDIBULAR CAST.

ANTERIOR TOOTH POSITION,ANTERIOR TOOTH POSITION,
MAXILLARY INCISOR LENGTH,MAXILLARY INCISOR LENGTH,
AND LIP SUPPORT WEREAND LIP SUPPORT WERE
DETERMINED WITH THE WAX RIMDETERMINED WITH THE WAX RIM
AFTER WHICH THE ANTERIORAFTER WHICH THE ANTERIOR
SIX TEETH WERE SET.SIX TEETH WERE SET.

VERTICAL DIMENSION OF OCCLUSION ISVERTICAL DIMENSION OF OCCLUSION IS
DETERMINED BY EVALUATING THEDETERMINED BY EVALUATING THE
PATIENT’S INTEROCCLUSAL REST SPACE,PATIENT’S INTEROCCLUSAL REST SPACE,
PROFILE, TACTILE SENSE, AND COMFORT,PROFILE, TACTILE SENSE, AND COMFORT,
AND CENTRIC RELATION RECORDINGSAND CENTRIC RELATION RECORDINGS
WERE OBTAINED WITH THE INTRAORALWERE OBTAINED WITH THE INTRAORAL
GOTHIC ARCH TRACING.GOTHIC ARCH TRACING.

THE CASTS ARE MOUNTED ANDTHE CASTS ARE MOUNTED AND
OCCLUSAL PLANE DETERMINED USINGOCCLUSAL PLANE DETERMINED USING
THE HEIGHTS OF THE RETROMOLARTHE HEIGHTS OF THE RETROMOLAR
PADS AND POSITIONS OF THE INCISALPADS AND POSITIONS OF THE INCISAL
EDGE OF THE CENTRAL INCISORS.EDGE OF THE CENTRAL INCISORS.
A METAL TEMPLATE WAS SET ATA METAL TEMPLATE WAS SET AT
THE LEVEL OF THE INCISAL EDGE OFTHE LEVEL OF THE INCISAL EDGE OF
THE CENTRAL INCISORS AND MADETHE CENTRAL INCISORS AND MADE
LEVEL WITH THE HEIGHT OF THELEVEL WITH THE HEIGHT OF THE
HIGHEST RETROMOLAR PAD ANDHIGHEST RETROMOLAR PAD AND
SECURED TO THE MANDIBULAR CAST.SECURED TO THE MANDIBULAR CAST.
THE TEMPLATE THEN SERVES AS THETHE TEMPLATE THEN SERVES AS THE
FLAT SURFACE TO WHICH THEFLAT SURFACE TO WHICH THE
MAXILLARY ZERO DEGREE TEETH AREMAXILLARY ZERO DEGREE TEETH ARE
SET.SET. www.indiandentalacademy.comwww.indiandentalacademy.com

AFTER THE MAXILLARY TEETH AREAFTER THE MAXILLARY TEETH ARE
SET, THE MANDIBULAR ANTERIORSET, THE MANDIBULAR ANTERIOR
TEETH ARE ARRANGED ENSURING NOTEETH ARE ARRANGED ENSURING NO
ANTERIOR ARE LATERAL PROTRUSIVEANTERIOR ARE LATERAL PROTRUSIVE
CONTACTS.CONTACTS.

THE CORRESPONDING MANDIBULARTHE CORRESPONDING MANDIBULAR
POSTERIOR BLADED TEETH ARE SETPOSTERIOR BLADED TEETH ARE SET
IN A STRAIGHT LINE OVER THEIN A STRAIGHT LINE OVER THE
EDENTULOUS RIDGE.EDENTULOUS RIDGE.

CENTRIC RELATION, VERTICALCENTRIC RELATION, VERTICAL
DIMENSION OF OCCLUSION, ESTHETICDIMENSION OF OCCLUSION, ESTHETIC
AND PHONETIC RELATIONSHIPSAND PHONETIC RELATIONSHIPS
OCCLUSUAL PLANE ANGULATION, ANDOCCLUSUAL PLANE ANGULATION, AND
DENTURE BASE STABILITY AREDENTURE BASE STABILITY ARE
VERIFIED AT A WAX TRY-INVERIFIED AT A WAX TRY-IN
APPOINTMENT. AFTER RECEIVINGAPPOINTMENT. AFTER RECEIVING
PATIENT APPROVAL, THE DENTURESPATIENT APPROVAL, THE DENTURES
ARE PROCESSED AND DELIVERED.ARE PROCESSED AND DELIVERED.

EQUILIBRATION

ALTHOUGH COMPLETE DENTUREALTHOUGH COMPLETE DENTURE
OCCLUSION MAY BE EQUILIBRATED WITHOCCLUSION MAY BE EQUILIBRATED WITH
THE COBLE INTRA-ORAL BALANCER (COBLETHE COBLE INTRA-ORAL BALANCER (COBLE
DENTURE RESEARCH CO. INC GREENSBORO,DENTURE RESEARCH CO. INC GREENSBORO,
NC) OR UTILIZING A CLINICAL REMOUNT, INNC) OR UTILIZING A CLINICAL REMOUNT, IN
THE AUTHORS’ EXPERIENCE, A MORETHE AUTHORS’ EXPERIENCE, A MORE
SIMPLIFIED APPROACH DOES EXIST FORSIMPLIFIED APPROACH DOES EXIST FOR
LINEAR OCCLUSION.LINEAR OCCLUSION.
FOLLOWING POSTPROCESSINGFOLLOWING POSTPROCESSING
EQUILIBRATION ON THE ARTICULATOR,EQUILIBRATION ON THE ARTICULATOR,
OCCLUSION IS EVALUATED INTRAORALLY VIAOCCLUSION IS EVALUATED INTRAORALLY VIA
A THREE-STEP CLINICAL PROCESSA THREE-STEP CLINICAL PROCESS

WHILE SOME WHAT SUBJECTIVE, THEWHILE SOME WHAT SUBJECTIVE, THE FIRSTFIRST STEPSTEP
IS TO LISTEN FOR A CLEAR, DISTINCTIVEIS TO LISTEN FOR A CLEAR, DISTINCTIVE SINGLE-SINGLE-
CLICKCLICK UPON CLOSING, WHICH IS INDICATIVE OFUPON CLOSING, WHICH IS INDICATIVE OF
UNIFORM CENTRIC CONTACT. A DOUBLE-CLICKUNIFORM CENTRIC CONTACT. A DOUBLE-CLICK
INDICATES ONE SIDE IS OCCLUDINGINDICATES ONE SIDE IS OCCLUDING
PREMATURELY.PREMATURELY.
SECONDLYSECONDLY, A CLOSE, A CLOSE INTRAORAL OBSERVATIONINTRAORAL OBSERVATION OFOF
CENTRIC RELATION CLOSURE WILL FREQUENTLYCENTRIC RELATION CLOSURE WILL FREQUENTLY
ENABLE A PRACTITIONER TO DETERMINE WHICHENABLE A PRACTITIONER TO DETERMINE WHICH
SIDE IS OCCLUDING PREMATURELY.SIDE IS OCCLUDING PREMATURELY.
FINALLY,FINALLY, THE OFFENDING CONTACT IS VERIFIEDTHE OFFENDING CONTACT IS VERIFIED
WITHWITH THIN ARTICULATINGTHIN ARTICULATING FILM BEFOREFILM BEFORE
ADJUSTMENT.ADJUSTMENT.

DISCUSSIONDISCUSSION

MANDIBULAR DENTURE BASEMANDIBULAR DENTURE BASE
STABILITY HAS BEEN REPORTED TO BESTABILITY HAS BEEN REPORTED TO BE
INCREASED THROUGH LINEARINCREASED THROUGH LINEAR
OCCLUSION. IT IS THE AUTHORS’OCCLUSION. IT IS THE AUTHORS’
OPINION THAT THE MANDIBULAROPINION THAT THE MANDIBULAR
DENTURE BASE STABILITY ISDENTURE BASE STABILITY IS
IMPROVED VIAIMPROVED VIA LINEAR OCCLUSIONLINEAR OCCLUSION, A, A
STEEPERSTEEPER-THAN-CONVENTIONAL PLANE-THAN-CONVENTIONAL PLANE
OF OCCLUSION, AND AN ACCURATEOF OCCLUSION, AND AN ACCURATE
CENTRIC RELATIONCENTRIC RELATION RECORDING BY ARECORDING BY A
CENTRAL BEARING INTRAORAL GOTHICCENTRAL BEARING INTRAORAL GOTHIC
ARCH TRACING.ARCH TRACING.www.indiandentalacademy.comwww.indiandentalacademy.com

LINEAR OCCLUSION HAS BEENLINEAR OCCLUSION HAS BEEN
REPORTED TO SIGNIFICANTLY REDUCEREPORTED TO SIGNIFICANTLY REDUCE
TRANSVERSE FORCE VECTORS AND TOTRANSVERSE FORCE VECTORS AND TO
PROVIDE A AND ECCENTRIC MANDIBULARPROVIDE A AND ECCENTRIC MANDIBULAR
MOVEMENT, THUS IMPROVING STABILITY.MOVEMENT, THUS IMPROVING STABILITY.
ALTHOUGH LINEAR OCCLUSAL SCHEMESALTHOUGH LINEAR OCCLUSAL SCHEMES
CAN BE ACHIEVED USING ACRYLICCAN BE ACHIEVED USING ACRYLIC
OPPOSING ACRYLIC OR PORCELAINOPPOSING ACRYLIC OR PORCELAIN
OPPOSING ACRYLIC, THE USE OFOPPOSING ACRYLIC, THE USE OF
PORCELAIN-PORCELAIN OCCLUSION ISPORCELAIN-PORCELAIN OCCLUSION IS
MOST RESISTANT TO WEAR.MOST RESISTANT TO WEAR. PORCELAIN-PORCELAIN-
PORCELAINPORCELAIN OCCLUSION ISOCCLUSION IS DISTASTEFULDISTASTEFUL
TO SOME PRACTITIONERS.TO SOME PRACTITIONERS.www.indiandentalacademy.comwww.indiandentalacademy.com

FIRST,FIRST, THE INCREASEDTHE INCREASED CLICKING SOUNDCLICKING SOUND DURINGDURING
MASTICATION MAY BE DISTURBING TO THEMASTICATION MAY BE DISTURBING TO THE
PATIENT ANDPATIENT AND
SECONDSECOND, SOME BELIEVE IT IS MORE DIFFICULT TO, SOME BELIEVE IT IS MORE DIFFICULT TO
ADAPT TO PORCELAIN TEETHADAPT TO PORCELAIN TEETH. SOME BELIEVE. SOME BELIEVE
PLASTIC AS OPPOSED TO PORCELAIN, WILL MOREPLASTIC AS OPPOSED TO PORCELAIN, WILL MORE
EASILY ACCOMMODATE AN OCCLUSALEASILY ACCOMMODATE AN OCCLUSAL
DISHARMONY. IT SEEMS A LOGICAL DEDUCTIONDISHARMONY. IT SEEMS A LOGICAL DEDUCTION
THAT THIS COULD POTENTIALLY ELIMINATE SOMETHAT THIS COULD POTENTIALLY ELIMINATE SOME
POSTOPERATIVE DISCOMFORT. SOMEPOSTOPERATIVE DISCOMFORT. SOME
PRACTITIONERS PREFER THE HARDNESS OFPRACTITIONERS PREFER THE HARDNESS OF
COMPOSITE RESIN TEETH AS WELL AS THE EASECOMPOSITE RESIN TEETH AS WELL AS THE EASE
OF OCCLUSAL ADJUSTMENT.OF OCCLUSAL ADJUSTMENT.

PORCELAIN TEETH WILL ALWAYS WEARPORCELAIN TEETH WILL ALWAYS WEAR
LESS THAN ACRYLIC TEETH, AND ITLESS THAN ACRYLIC TEETH, AND IT
WOULD STAND TO REASON THAT THISWOULD STAND TO REASON THAT THIS
CAN HELPCAN HELP PRESERVE THE VERTICALPRESERVE THE VERTICAL
DIMENSIONDIMENSION OF OCCLUSION OVER TIME.OF OCCLUSION OVER TIME.
LINEAR OCCLUSION CAN OCCASIONALLYLINEAR OCCLUSION CAN OCCASIONALLY
CAUSE ANCAUSE AN ESTHETIC CONCERNESTHETIC CONCERN FOR THEFOR THE
PATIENTS WHEN FLAT PLANE TEETH AREPATIENTS WHEN FLAT PLANE TEETH ARE
SET ON THE MAXILLARY ARCH.SET ON THE MAXILLARY ARCH.

THIS PROBLEM CAN BE EASILYTHIS PROBLEM CAN BE EASILY
RECTIFIEDRECTIFIED BY USING EITHER ANBY USING EITHER AN
ANATOMIC FIRST PREMOLARANATOMIC FIRST PREMOLAR OROR
ESTHETICALLY RESHAPINGESTHETICALLY RESHAPING THETHE
BUCCAL ASPECT OF THE FLAT PLANEBUCCAL ASPECT OF THE FLAT PLANE
TOOTH.TOOTH.
ALTHOUGH THERE ARE MANYALTHOUGH THERE ARE MANY
ACCEPTABLE TECHNIQUES, THEACCEPTABLE TECHNIQUES, THE
INTROARAL GOTHIC ARCH TRACINGINTROARAL GOTHIC ARCH TRACING
HAS BEEN PROVEN TO BEHAS BEEN PROVEN TO BE
REPEATABLE AND CONSISTENT EVENREPEATABLE AND CONSISTENT EVEN
IN INEXPERIENCED HANDS.IN INEXPERIENCED HANDS.

IT ALSO INCREASES MAXILLARY ANDIT ALSO INCREASES MAXILLARY AND
MANDIBULAR BASE STABILITYMANDIBULAR BASE STABILITY BYBY
PROVIDING A CENTRAL BEARING AREAPROVIDING A CENTRAL BEARING AREA
DURING THE RECORDINGDURING THE RECORDING PROCESS.PROCESS.
THIS IS ESPECIALLY EVIDENT INTHIS IS ESPECIALLY EVIDENT IN
SEVERELY RESORBED MANDIBULARSEVERELY RESORBED MANDIBULAR
RIDGES.RIDGES.

CONCLUSIONCONCLUSION

THE PURPOSE OF THIS ARTICLETHE PURPOSE OF THIS ARTICLE
WAS TO PRESENT A LESS FAMILIARWAS TO PRESENT A LESS FAMILIAR
CONCEPT FOR PROVIDING IMPROVEDCONCEPT FOR PROVIDING IMPROVED
MANDIBULAR PROSTHESIS STABILITYMANDIBULAR PROSTHESIS STABILITY
WITH THE USE OF LINEAR OCCLUSIONWITH THE USE OF LINEAR OCCLUSION
AND STEEPER OCCLUSAL PLANEAND STEEPER OCCLUSAL PLANE
SELECTION . IN THIS CLINICALSELECTION . IN THIS CLINICAL
TECHNIQUE, A GOTHIC ARCH TRACINGTECHNIQUE, A GOTHIC ARCH TRACING
DEVICE WAS UTILIZED TO RECORDDEVICE WAS UTILIZED TO RECORD
CENTRIC RELATION.CENTRIC RELATION.

IN THE AUTHORS’ EXPERIENCE WITHIN THE AUTHORS’ EXPERIENCE WITH
LINEAR OCCLUSION AND THELINEAR OCCLUSION AND THE
TECHNIQUES PRESENTED HERE,TECHNIQUES PRESENTED HERE,
EXCEPTIONAL MANDIBULAREXCEPTIONAL MANDIBULAR
PROSTHESIS STABILITY AND PATIENTPROSTHESIS STABILITY AND PATIENT
SATISFACTION DUE TO LACK OFSATISFACTION DUE TO LACK OF
MOVEMENT OF THE DENTURE BASES,MOVEMENT OF THE DENTURE BASES,
LACK OF SORE SPOTS, AND FEWERLACK OF SORE SPOTS, AND FEWER
POSTOPERATIVE VISITS HAVE BEENPOSTOPERATIVE VISITS HAVE BEEN
THE RESULT.THE RESULT.

REFERENCESREFERENCES

WINKLER S:WINKLER S: ESSENTIALS OF COMPLETEESSENTIALS OF COMPLETE
DENTURE PROSTHODOTNICSDENTURE PROSTHODOTNICS, ED 2., ED 2.
PHILADELPHIA, PA, WB SAUNDERS, 1996.PHILADELPHIA, PA, WB SAUNDERS, 1996.
JONES PM:JONES PM: THE MONOPLANE OCCLUSIONTHE MONOPLANE OCCLUSION
FOR COMPLETE DENTURESFOR COMPLETE DENTURES. J AM DENT. J AM DENT
ASSOC 1972;85:94-100.ASSOC 1972;85:94-100.
ZARB GA, BOLENDER, CL, CARLSSON GE,ZARB GA, BOLENDER, CL, CARLSSON GE,
ET AL:ET AL: BOUCHER’S PROSTHODONTICBOUCHER’S PROSTHODONTIC
TREATMENT FOR EDENTULOUS PATIENTSTREATMENT FOR EDENTULOUS PATIENTS,,
ED 11. ST. LOUIS, MO, MOSBY 1997ED 11. ST. LOUIS, MO, MOSBY 1997

LEVIN B:LEVIN B: A REEVALUATION OF HANAU’SA REEVALUATION OF HANAU’S
LAWS OF ARTICULATION AND THELAWS OF ARTICULATION AND THE
HANAU QUINTHANAU QUINT. J PROSTHET DENT. J PROSTHET DENT
1978;39:254-2581978;39:254-258
BAUMAN R:BAUMAN R: MINIMIZINGMINIMIZING
POSTINSERTION PROBLEMS. APOSTINSERTION PROBLEMS. A
PROCEDURE FOR REMOVABLEPROCEDURE FOR REMOVABLE
PARTIAL DENTURE PLACEMENTPARTIAL DENTURE PLACEMENT. J. J
PROSTHET DENT 1979;42:381-385.PROSTHET DENT 1979;42:381-385.

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