Hanaus Quint Rudolph. L.

Hanau proposed
nine factors that govern the articulation of
artificial teeth. They are:
Horizontal condylar inclination
Compensating curve
Protrusive incisal guidance
Plane of orientation
Buccolingual inclination of tooth axis
Sagittal condylar pathway
Sagittal incisal guidance
Tooth alignment
Relative cusp height

 These nine factors are called the laws of

balanced articulation. Hanau later condensed
these nine factors and formulated five factors,
which are commonly known as Hanaus Quint:
Condylar guidance
Incisal guidance
Compensating curves
Relative cusp height
Plane of orientation of the occlusal plane .

 Trapozzanos concept of occlusion

He reviewed and simplified Hanaus Quint and proposed his
triad of occlusion. According to him, only three factors are
necessary to produce balanced occlusion. He dismissed the
need for determining the plane of occlusion to produce
balanced occlusion. He said that the plane of occlusion could
be shifted to favour weak ridges; hence its location is not
constant and is variable within the interarch distance.
He also dismissed the need for setting compensating curves,
because, he suggested that when we arrange cusped teeth
in principle these curves are produced automatically. He
considered that compensating curve as a passive factor,
which is a resultant of setting cusped teeth.
Though his triad was simpler than the Hanaus Quint, it
eliminated the important compensating curves and plane of
orientation.

 Bouchers concept
Boucher confronted Trapozzanos concept and
proposed the following three factors for
balanced occlusion.
Orientation of the occlusal plane, the incisal
guidance and the condylar guidance.
The angulation of the cusp is more important
than the height of the cusp.
The compensating curve enables one to
increase the height of the cusp without
changing the form of the teeth.

 He also stated that, the plane of occlusion should be

oriented exactly as it was when natural teeth were
present. According to him, the plane of occlusion cannot
be changed to favour weak ridges and that the teeth
should be located in their original position. He believed it
was necessary to fulfil the anatomical and physiological
needs.
Boucher also emphasized the need for the compensating
curve. He stated that, the value of the compensating
curve is that it permits alteration of cusp height without
changing the form of the manufactured teeth . . . if the
teeth themselves do not have any cusps, the equivalence
of a cusp can be produced by a compensating curve.

 Lotts concept
Lott clarified Hanaus laws of occlusion by relating
them to the posterior separation that is a resultant
of the guiding factors
The greater the angle of the condylar path, the
greater is the posterior separation during protrusion.
The greater the angle of the overbite, the greater is
the separation in the anterior and posterior regions
irrespective of the angle of the condylar path.
The greater the separation of the posterior teeth the
greater or higher must be the compensating curve.

 Levins concept :
Bernard Levin believed that it was not necessary to consider the
plane of occlusion because it was not very useful practically .Levin
also stated that the plane of occlusion can be slightly altered by 12mm in order to improve the stability of a denture.
He named the other four factors of occlusion as the quad.
Essentials of a quad are:
The condylar guidance is fixed and is recorded from the patient. The
balancing condylar guidance will include the Bennett movement of
the working condylar .this may or may not affect the lateral balance.
The incisal guidance is usually obtained from patients aesthetic and
phonetic requirements. However, it can be modified for special
requirements .e.g. the incisal guidance is decreased for flat ridges.
The compensating curve is the most important factor in obtaining
occlusal balance. Monoplane or low cusp teeth must employ the use
of compensating curve.
Cusp teeth have the inclines necessary for balanced occlusion but
nearly always are used with a compensating curve.

Factors influencing balanced occlusion :

[K x I] / [OP x C x OK]
Where K = Condyle guidance.
I = Incisal guidance.
C = Cusp height inclinations.
OP = Inclination of the occlusal plane.
OK = Curvature of the occlusal surfaces.

 Factors of protrusive balance :

Inclination of the condylar path.
Inclination of the incisal guidance chosen for
the patient.
Inclination of the plane of the occlusion set to
physiologic factors.
The compensating curve set to harmonize
with 1 and 2.
The control of cusp heights and tooth
inclination of the posterior teeth.

Factors of lateral balance :

The inclination of the condylar path on the balancing side.
The inclination of the incisal guidance and cuspid lift.
The inclination of the plane of occlusion on the balancing
side and working side.
The compensating curve on the balancing side and
working side.
The buccal cusp heights or inclinations on the working
side.
The lingual cusp heights or inclination on the working side.
The Bennett side shift on the working side.

 Factors that affect occlusal balance :

Condylar Guidance : Is the mandibular
guidance generated by the condyles traversing
the contours of the glenoid fossa. It is one of the
end controlling factors. It is independent of tooth
contact. The condylar path is determined on the
patient by a protrusive record and set on the
instrument. It acts as a posterior control factor.

 Incisal Guidance : Is the influence of the contacting surfaces

of the mandibular and maxillary anterior teeth on mandibular
movements. It can be set by dentist in accordance with
esthetics and phonetics. If the incisal guidance is steep it calls
for steep cusps, steep occlusal plane or a steep compensating
curve to effect an occlusal balance. This type of occlusion is
detrimental to the stability and equilibrium of the denture base.
For complete dentures the incisal guidance should be as flat as
esthetics and phonetics will permit. When the arrangement of
the anterior teeth necessitatesa vertical overlap, a
compensating horizontal overlap should be set to prevent
dominant incisal guidance, from upsetting the occlusal balance
on the posterior teeth. Incisal guidance should never exceed
the condylar guidance. It is the anterior controlling factor.
The above 2 factors determine the movements of the
articulator. In order to achieve balance, the other 3 balancing
factors are arranged to correspond to these articulator
movements.

 The inclination of the occlusal plane : Plane

of orientation is established in the anterior by
height of the lower cuspid and in the posterior by
the height of the retromolar pad. Its position can
be altered only slightly.

 The compensating curve is one of the most

important factors in establishing a balanced
occlusion. The compensating curves eliminate
Christensens phenomenon to achieve balance. It
is determined by the inclination of the posterior
teeth and their vertical relationship to the
occlusal plane so that the occlusal results in a
curve that is in harmony with the movemen of
the mandible.
The anteroposterior curvature of the occlusal
plane is desired to permit protrusive disclusion of
the posterior teeth by the combination of anterior
guidance and condylar guidance.

 Mediolateral curve : It results from the inward inclination of the

lower posterior teeth, making the lingual cusps lower than
buccal cusps on the mandibular arch and buccal cusps higher
than the lingual cusps on the maxillary arch. Aligning the teeth
according to the above, produces the greatest resistance to
masticatory forces.
The inward inclination of the lower occlusal table is designed for
direct access from the lingual with no blockage by lower lingual
cusps. The outward inclination of upper occlusal table provides
access from the buccal for the food to be tossed directly onto
the occlusal table by the buccinator muscle. When the curve of
Wilson is made too flat, ease of masticatory function may be
impaired, because of increased activity required to get the food
onto the occlusal table.
A steep condylar path requires a steep compensating curve for
occlusal balance. A less compensating curve would result in a
steeper incisal guidance which would cause loss of molar
balancing contacts.

 Cusp height and inclination : These are

important determinants, as they modify the
effect of the plane occlusion and the
compensating curve.
Intercondylar distance influences positions
and directions of ridge and groove placement.
The greater the intercondylar distance, the
more distal are the working and balancing
cusp paths on the mandibular teeth and the
more mesial they are on the maxillary teeth.

 Angle of Eminentia : If greater, longer are the cusps, and

deeper the fossae.
Greater the Bennett movement, more mesial must be
directional placement of ridges and grooves on the the
mandibular teeth and more distal on maxillary teeth,
shorter must be cusps relative to fossa depth and greater
must be the lingual concavity of anterior maxillary teeth.
Fischer angle also influences grooves and cusp ridges.
All the five factors of balance interact with each other.
The dentist can control only four of the 5 factors, since
the condylar path is fixed by the patient. Incisal guidance
and plane of occlusion can be altered only slightly. The
important working factors for the dentist to manipulate
are the compensating curve and the inclinations of cusps
on the occlusal surfaces of the teeth.

 Contacts in balanced articulation :

Working side : The mandibular buccal cusp ridges
make articulator contact with the maxillary cusp ridges
as the mandibular lingual cusp ridges are making
contact with the maxillary lingual cusp ridges.
Balancing side : The mandibular buccal cusps and
their occlusal facing ridge, contacts maxillary lingual
cusps and ridge.
Protrusion : Incisal edges of the mandibular anterior
teeth contact with the lingual surfaces of the maxillary
anterior teeth. The mesiobuccal and lingual cusp
ridges of the mandibular teeth contact the distobuccal
and lingual cusp ridges of the maxillary teeth.

 Balance in non anatomic teeth:

Can be accomplished in one of 2 ways. One can either
set the teeth in a compensating curve as is done in
anatomic forms, or one can set the teeth in a flat plane,
and utilize a balancing ramp just distal to the 2 nd molar.
This ramp adjusted so that the upper 2nd molar will
contact it eccentric movements and thus provide three
point contact.
Pleasure (1937) set premolars and 1st molars in an antiMonson curve, this avoids a tipping force and seats the
denture. In order to provide eccentric balance during
tooth contacts the 2nd molars are set in the conventional
Monson curve. This combination of Monson and antiMonson curve in posterior occlusion is often referred to
as the pleasure curve.

 Advantages of balanced occlusion :

As Winkler stated balancing occlusion in complete
dentures is like changing stumbling prose to poetry.
Bilateral simulataneous contact help to seat the
dentures in a stable position during mastication,
swallowing and maintain retention and stability of
the denture and the health of the oral tissues.
Due to cross-arch balance, as the bolus is chewed
on one side, the balancing cusps will come close or
will contact on the other. The dictum Enter bolus,
exit balance is therefore refuted.
Denture bases are stable even during bruxing
activity.

 Disadvantages of balanced occlusion :

It is difficult to achieve in mouths where an
increased vertical incisor overlap is present
Class 11 cases.
It may tend to encourage lateral and protrusive
grinding habits.
A semi adjustable or fully adjustable articulator is
required.

 LINGUALIZED OCCLUSION

It was originally given by Alfred Gysi (1927) and Payne

in 1941 familiarized it. Gysi described a mortar and
pestle action of this occlusal scheme. Pound and Murrel
(1973) also advocated this concept of occlusion.

It is an attempt to maintain the esthetic and food

penetration advantages of the anatomic form while
maintaining the mechanical freedom of the non-anatomic
room. This concept utilizes anatomic teeth for the
maxillary denture and modified non-anatomic or semianatomic teeth for the mandibular denture. So, maxillary
lingual cusp of posterior teeth contact with mandibular
teeth in all centric and eccentric movements.

 Indications: In patients with severe ridge resorption, which

need non-anatomic teeth and patient, desires
on increased esthetics and efficiency of
denture.
Class II jaw relation
Highly displaceable tissue
When complete denture opposing an RPD.

 Advantages: 1) Advantages of both anatomic and nonanatomic

teeth are made use of.
2) Cusp form- increases esthetics.
3) Good chewing ability.
4) Bilateral balance
5) Vertical forces are centralized on mandibular
teeth.

 Principles of lingualized occlusion: Maxillary teeth- anatomic teeth (30-33 0) with

prominent lingual cusps.
Mandibular teeth- non-anatomic with narrow
occlusal table. They may be modified by
selective grinding to create smooth central
fossa with concavity.
Maxillary lingual cusp should contact
mandibular teeth in CO. Maxillary buccal cusps
are trimmed to decrease interference.
Balancing and working contacts should occur
only on upper lingual cusp with in 2-3 mm
excursive movements.

 Lingualized occlusion with cutter bars: use metal

blade teeth for maxillary denture and flat
nonanatomic mandibualr porcelain teeth

Nonbalanced lingualized occlusion:

Indications: Severely resorbed ridges/ flabby ridges.
Poor oral dexterity
Who are not able to adjust to intricate occlusal
patterns.
Patients who receive transitional / immediate
dentures, and insist on unlocked occlusal scheme
that is easy to adjust at the time of insertion.
Patients who show poor accuracy of oral records
(jaw relation)
If patients who do not accept monoplane occlusion
for esthetic reasons.

 Features:
Maxillary posterior teeth should be
anatomic teeth with large, blunt lingual cusp.
Mandibular posterior teeth with 00 teeth and
large marginal ridge areas and very shallow
grooves and sluice ways.

Mandibular posterior teeth are arranged as

monoplane with all central fossa in same line
(a flat block posterior teeth can be used).
Maxillary teeth are arranged perpendicular to
occlusal plane, buccal cusps raised (1mm) and
lingual cusps set on central fossa.

 Clough etal (1983): - compared efficiency of

lingualized occlusion and monoplane occlusion in
complete dentures. Two sets of dentures, one with
lingualized occlusion and the other with
monoplane occlusion, were made for each of 30
edentulous patients. 67% of patients preferred
lingualized occlusion due to improved masticatory
abilities, comfort, and esthetics.

 Myersons Lingualized Integration (MLI):

Myerson proposed specialized tooth molds for arranging

teeth in lingualized occlusion. He proposed two different
molds for the maxillary posteriors namely control contact
(cc) mold and maximum contact (MC) mold. The
remaining teeth are common for both these molds.

He advocates the use of MC mold for patients who can

reproduce accurate centric position and the CC mold for
patients with variations in centric position.

These teeth provide maximal intercuspation, good

cuspal height to perform occlusal reshaping, and a natural
and pleasing appearance. The MC mold maxillary
posteriors have taller cusps with a more anatomical
appearance compared to the CC mold. The MC mold
also offers a more exacting occlusion.

 MONOPLANE OCCLUSION

It is a type of nonbalanced occlusion where posterior teeth

have masticatory surfaces that lack any cusp height.
Advantages: More adaptable to class II and III malocclusions.
Used more easily when variations in the width of upper and
lower jaws indicate a cross bite set-up.
00teeth provide sense of freedom in mandibular movement.
Eliminate horizontal forces
00teeth occlude in more than one position. CR is not that
critical.
It is simple, less time-consuming technique and efficient for
longer duration.
They accommodate better, to inevitable negative changes in
ridge height that occurs with aging.

 Requirements: 00 teeth
Articulator- A simple articulator that can maintain
VD, and incisal guide pin-do not need any complex
movements.
Features:
Anterior teeth have no overlap vertically &
horizontally,overlap depend on jaw relationship2,12,0 mm for class I, II, III respectively. Maxillary
posterior teeth are arranged first after occlusal plane
is determined (Posteriorly fall on upper and middle
1/3rd of retromolar pad and anteriorly on canine).
Lower posteriors are directed on crest of ridge. 2 nd
molar is place on molar slope area. lower 2 nd molar is
set 2mm above occlusal plane.

 Indications of the monoplane occlusion

1) Flat ridge(s)
2) Class II jaw relations
3) Class III jaw relations
4) Maxillofacial patients
5) Handicapped patients
6) Cross bite
7) Doubtful or Without any perfect centric relation
records
The primary objective was to prevent the destruction of
tissue and preserve the integrity of the residual ridge.

Many dentists believe that use of monoplane

occlusion , which is flat mesiodistally and
buccolingually and is oriented as close as possible
parallel to the upper and lower mean foundation
planes, will create more stable dentures

This term is used to denote a concept of occlusion

that eliminates and anteroposterior
or
mediolateral inclines of the teeth and directs the
forces of occlusion to the posterior teeth.
The plane of occlusion should not be dictated by
the horizontal condylar guidance and must be flat
and the form of the posterior teeth is devoid of cusp.
The horizontal and lateral condylar guidance may
be set at zero.

 MERITS
A freedom of occlusion from centric to
eccentric position.
The elimination of inclined plane forces
which create horizontal displacement of
the bases during function.
The lack of interference when the
dentures settle.

 DEMERITS
Nonanatomic teeth occlude in only two dimensions (length and width), but
mandible has an accurate three-dimentional movement due to its condylar
behavior.
The vertical component present in mastication and nonfunctional
movements is not provided for, so that this form loses shearing efficiency.
Bilateral and protrusive balance is not possible with a purely flat occlusion.
The flat teeth do not function efficiently unless the occlusion surface
provides cutting ridges and generous spillways (sluiceways).
They cannot be corrected by much occlusal grinding without impairing their
efficiency.
Teeth look dull and unnatural which may lead to psychological problems.
With this concept of occlusion, there is no attempt to eliminate deflective
occlusal contacts in lateral or protrusive excursions.
When the nonanatomical teeth are arranged to satisfy the monoplane
occlusal concept, the condylar inclinations on the articular are set at 0
degrees. When the positioning of the maxillary posterior teeth completed,
the occlusal surfaces of them should be flat against the mandibular wax
occlusal rim.

 BALANCING RAMPS IN PROSTHETIC OCCLUSION

Balanced occlusion may be generally associated with the
use of anatomic teeth. When non-anatomic teeth are used
in complete denture and an attempt is made to balance the
occlusion, a compromise may be done in relation to
aesthetics.
If aesthetics is considered more important, the posterior
teeth will not contact in protrusive positions of the
mandible and this lack of posterior teeth contact will cause
tipping of dentures.
This drawback can be overcome by the use of balancing
ramps regardless of the vertical and horizontal overlap of
anterior teeth. As the mandible moves in protrusive
relation to the maxilla, the distal marginal ridges of the
occlusal surfaces of most posterior maxillary teeth, usually
the second molars begin to ascend the balancing ramps.

 The maxillary molars against the ramps balance the

incisors, in protrusive position. The same balancing
ramps are made broad enough so that they will balance
the denture in lateral excursions of the mandible. Wax is
added to the surface, posterior to the most distal
mandibular molar in relation to the most posterior
maxillary molar.
Centric locks are released on the articulator. The upper
member is moved sequentially into edge-to-edge
position and centric relation. The wax is reheated and
the upper member is moved through lateral border
excursions. The balancing contacts are evaluated and
wax is added wherever necessary. The balancing ramps
are evaluated during clinical remount to ensure smooth
balancing contacts without interference.

Concept of prosthodontic occlusion with the use of non-anatomical posterior

tooth forms (A) Posterior teeth parallel to the occlusal plane (B) Balancing
ramp

 PHYSIOLOGICALLY GENERATED
OCCLUSION
Mehringer J E(1973) developed this
occlusion to harmonize complete denture
occlusion neuromuscular system and Rt and
Lt TMJ.

It is mainly indicated for patients having

adequate foundation with stable record
bases. And good neuromuscular control &
can give functional movements consistently.

 The main advantages are, it is comfortable to

patient as it is built physiologically, and
swallowing and masticatory movements are taken
into consideration along with CR and CO. but it is
time consuming and has no scientific evidence of
its efficiency in attaining the goal.

 Procedure:
The complete denture construction is proceeded till jaw
relations and then try-in and processing of only maxillary
denture is done. After it is polished a 200 conical disc is
attached to the palatal region of maxillary denture. The
lower denture base is attached with plexiglass followed by
fabrication of rim with plaster (1/3 talc and 2/3 plaster) and
attaching central bearing device exactly fitting into the
upper conical disc.
Patient is asked to make chewing and swallowing
movements, which created functionally generated paths.
Then apply separating medium to obtain maxillary stone
cast of generated paths.

Then lower teeth are arranged according to maxillary cast

of generated path. 2-point contact on working side is
eliminated and converted to one point contact, this
increases stability and transmit forces on lingual cusps only.

 Physiologically generated occlusion by Edward J Mehringer (1973 JPD)

1. This technique for physiologically generating occlusion in complete
dentures permits the use of varying occlusal schemes, including the
conjugated use of carnivorous and herbivorous types of posterior teeth. It
further permits the selection of any one of three posterior tooth
combinations, each with identical occlusal principles but with slightly
different wear potentials: (1) naturally glazed maxillary porcelain teeth
opposing plastic mandibular posterior teeth; (2) naturally glazed maxillary
porcelain teeth opposing plastic mandibular posterior teeth with a cast gold
occlusion; (3) naturally glazed maxillary porcelain teeth opposing plastic
mandibular posterior teeth with a cast chrome-cobalt occlusion.
2. It correlates the occlusion for normal masticatory movements to the
existing neuromuscular patterns and the temporomandibular joint functions.
3. The physiologically generated paths are especially suited for recording
the masticatory and swallowing occlusions, because both are incorporated
in the development of the generated paths.
4. The dentures can be inserted when fully equilibrated, with the original
glaze of the maxillary porcelain posterior teeth intact and the reciprocating
mandibular posterior teeth completely restored and polished

 LINEAR OCCLUSION OR LINEAL OCCLUSION

GPT-7 the occlusal arrangement of artificial teeth, as viewed
in the horizontal plane, where in the masticatory surfaces of
the mandibular posterior artificial teeth have a straight, long,
narrow occlusal form resembling that of a line, usually
articulating with opposing monoplane teeth FRUSH (1996)

Teeth are arranged on a flat plane, which extend from tip of

maxillary incisors top of the retromolar papilla. The 2-3 mm
interocclusal clearance is not needed (CR recorded at VDR
with 0.020 inch vertical clearance). The anterior vertical
overlap is absent lead to non-interception in eccentric
movements. The posterior teeth used are non-anatomic with
mandibular blade form of teeth. They exhibit bilateral fulcrum
of protrusive stability on protrusion blade of mandibular 2 nd
molar contacts maxillary 1st premolar bilaterally and prevent
anterior rotational contact.

 This type of occlusion uses straight line of points / knife edge contacts on
artificial teeth in one arch against flat non anatomic teeth in opposing arch
thereby decreasing unfavorable forces and simplifying occlusal adjustment.
The main advantages are it decreases lateral forces component , decrease
frictional resistance & no change in contact during eccentric movements so
direction of force is constant.
Different type of posterior teeth combinations can be used: Nonanatomic maxillary porcelain teeth opposing mandibular porcelain lineal
teeth.
Nonanatomic maxillary plastic teeth with mandibular lineal plastic teeth.
Nonanatomic maxillary plastic teeth with mandibular lineal porcelain teeth.
Anatomic maxillary porcelain teeth with mandibular non-anatomic plastic
teeth.
Lower posterior teeth are arranged with buccal cusp centered on crest of
ride, and lingual cusp 0.5mm below occlusal plane. Maxillary posterior teeth
have flat occlusal surface parallel to flat horizontal plane. There is no anterior
teeth overlap.