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The International Journal of Periodontics & Restorative Dentistry

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The establishment and examination ofthe occlusal relationships of dentureteeth are integral to the clinical and lab-oratory procedures of complete den-ture fabrication. The occlusal contactsof teeth in occlusion rims will changeafter polymerization of acrylic resinbases and following wearing in themouth.1

The relationships between artificialteeth on complete dentures consid-erably affects the uniform loading ofdenture foundations and their stabilityduring denture wearing. When den-tures are first given to patients, clini-cians often resort to a direct determi-nation of occlusion and grinding ofdenture teeth in the mouth. Directgrinding of occlusion is a difficult andimprecise method of correctingocclusal contacts. The seating of thedenture bases on the mucosa of den-ture foundations is insufficiently secureand not easily observed. Also, patientsmay have difficulties in performingexcursive occlusal contacts.

A remount procedure is carriedout for the purpose of establishing cor-rect occlusal contacts of denture teeth;this is done by placing the definitivedentures back on an articulator.

Checking the Occlusal Relationships ofComplete Dentures via a RemountProcedure

Tomislav Badel, DMD, PhD*Josip Panduric, DMD, PhD**Sonja Kraljevic, DMD, PhD***Niksa Dulcic, DMD, MSD****

Correct occlusal relationships are part of the successful prosthetic treatment ofedentulous patients. Occlusal checking should be performed via a remount proce-dure because denture base materials and fabrication procedures cannot providedimensionally accurate complete dentures. Occlusal errors caused by the adjust-ment of denture bases to the denture foundation after a certain period of wearingcan also be corrected by means of remounting. The following remount proceduresfor complete dentures are described: fabrication of transfer casts, transfer of amaxillary denture with a facebow, centric relation record, and mounting of den-tures with transfer casts in an articulator with a dental stone. Deflective occlusalcontacts of denture teeth in centric occlusion can be eliminated by selectivegrinding and by tooth-guided excursive movements. In complete denture treat-ment, priority is given to anterior/canine-guided occlusion. (Int J PeriodonticsRestorative Dent 2007;27:181–192.)

*Teaching and Research Assistant, Department of Prosthodontics, School of DentalMedicine, University of Zagreb, Croatia.

**Professor, Department of Prosthodontics, School of Dental Medicine, University ofZagreb, Croatia.

***Associate Professor, Department of Prosthodontics, School of Dental Medicine,University of Zagreb, Croatia.

****Research Assistant, Department of Prosthodontics, School of Dental Medicine,University of Zagreb, Croatia.

Correspondence to: Dr Tomislav Badel, Department of Prosthodontics, School of DentalMedicine, University of Zagreb, Gunduliceva 5, HR-10000 Zagreb, Croatia; fax: +385-1-48-02-159; e-mail: [email protected].

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Remounting is necessary for severalreasons:

• Acrylic resin is the basic constituentmaterial of complete dentures, andduring its polymerization for thedefinitive denture base it is liable todimensional changes. Regardlessof the method of investing theacrylic resin into the flask and thetype of polymerization used, theprocess results in contraction, whichcauses a certain displacement ofdenture teeth and a change in theocclusal contacts, which can affectthe relationship between the func-tional margin of the denture andthe denture foundation.2–4

• Dimensional changes caused bywater absorption from the oral envi-ronment into the acrylic resin basewill occur beginning on the first dayof denture wearing. Expansion occursin all three dimensions, and verticaldisplacement of single teeth in vitrois established later. The method ofpolymerization used and the thick-ness of the denture base have impor-tant effects on the dimensionalchanges of acrylic resin dentures.4–6

• The mucosa of the denture foun-dation, on which the denture basestill must find its position, reacts todenture wearing. Prosthetic factorsthat influence the wearing of com-plete dentures are the arrangementof denture teeth and occlusal rela-tionships. Changes in occlusal con-tacts may affect patient comfort andcan initiate pathologic changes onthe denture foundation. The posi-tion of denture bases on the den-ture foundation changes during theentire denture-wearing period.7,8

Subsequent patient care com-prises control of patient comfort, con-trol of occlusal relationships, and timelyreplacement with new dentures.Occlusion of complete dentures is animportant factor in correct distributionof masticatory loading on the denturefoundation, stability of the denturebases, and, to a certain extent, patientsatisfaction.9

The purpose of this article is topresent a remount procedure and amethod of occlusal correction for com-plete dentures. A remount procedureis performed by means of transfercasts. The first remounting is per-formed before the dentures are givento the patient, and the second andthird remountings are done after thedentures have been worn for a periodof time. The first procedure correctsocclusal errors caused by imperfectlaboratory fabrication, and the secondprocedure corrects dimensionalchanges of the acrylic resin caused bywater absorption from saliva. With thethird remounting, harmony of the den-ture teeth is achieved by the adjust-ment of denture bases on the denturefoundation.

Occlusal concepts for complete dentures

There are three different occlusal con-cepts for the natural dentition: bilat-erally balanced occlusion, unilaterallybalanced occlusion, and canine/ante-rior guided occlusion.10 With com-plete dentures, the occlusion mustsatisfy the patient’s needs for com-fort, function, and esthetics.1 Toothcontacts have an important influence

on the stability of denture bases, mas-ticatory efficiency, and the transfer ofmasticatory forces to the supportingareas. Specific tooth contacts duringmandibular movements or articula-tion are described as occlusal con-cepts. The previously mentionedocclusal concepts are related to thearrangement of denture teeth as aprosthetic factor of complete denturewearing. The most commonly appliedocclusal concepts for edentulouspatients are (1) balanced occlusion,(2) lingualized occlusion, and (3)monoplane occlusion.11,12

The concept of bilaterally bal-anced occlusion is a completely balanced occlusion, which was devel-oped for the purpose of stabilization ofcomplete dentures and established byGysi, who improved scientific knowl-edge about occlusion. Tooth contactsoccur on all surfaces, simultaneously,and in all directions and mandibularmovements. During functional move-ments, teeth are supported on the lat-erotrusive and mediotrusive side.During laterotrusive movement, allteeth are in contact on the workingside, and on the nonworking side, atleast one pair of antagonist teeth is incontact.13 The concept of reducedocclusion according to Gerber is char-acterized by bilateral balance withincertain areas of movement; by meansof the occlusal surface pattern, occlusalcontacts are shifted toward the middleof the residual ridge or orally, in thesense of lingualized occlusion.14

The lingualized occlusion createsreduced contacts on the palatal cuspsin the fissures of mandibular teeth.Therefore, the buccal cusps are out ofcontact, and during masticatory func-

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tion the pressure is transferred linguallyto the foundation of the mandibularcomplete denture. Pound describedthis concept as unilateral balancedocclusion, whereby during unilateralmovement, the sliding movement hasno support with the sliding movementon the balancing side (opposite to theworking side). During protrusive move-ment, balance is achieved by means ofcontact between the anterior teethand the rearmost molars. This kind ofocclusal relationship provided betterstability for complete dentures duringmastication.15

Monoplane occlusion includesocclusal contacts of the maxillary andmandibular teeth in maximum inter-cuspation, disclusion of posteriorteeth as a result of their arrangementin a single plane, and contacts of ante-rior teeth during mandibular move-ments. The concept of the arrange-ment of posterior teeth without cuspswas modified later. This concept isalso called nonbalanced occlusionbecause occlusal balance is notachieved with it.11,16,17

According to Stallard, bilateralocclusion is inadequate for both nat-ural teeth and complete dentureteeth.17 Therefore the most recent con-cept for the arrangement of dentureteeth in complete dentures is ante-rior/canine guidance, introduced bySchwab and Stuart and later modifiedby Gausch and Gutowski.18

Stuart and Stallard introduced theprinciple of anterior/canine guidanceinto clinical practice, along withD’Amico later; this became the maincharacteristic of the gnathologicschool.19,20 Canine-guided (protected)occlusion implies uniform contacts of

the mouth is protected, and the sec-ond molars are omitted to permit bet-ter stabilization of the dentures. Thisconcept is recommended in the fabri-cation of complete dentures accordingto Gutowski,25 in the modified methodaccording to Lauritzen,18 and accord-ing to the Innsbruck concept of fabri-cation of complete dentures.26

Remount procedure

Problems with the occlusal relation-ships of teeth on complete denturesare caused by various factors. Theseinclude unstable trial bases for theinterarch relationship record, incorrectuse of a facebow, transfer of casts onan articulator, inaccurately establishedvertical and horizontal dimensions,irregular arrangement of posteriorteeth, excessive use of pressure duringpressing of the acrylic resin into theflask, inadequately closed flask duringpolymerization, and overheating of thefinished dentures during final polish-ing. All these factors result from errorson the part of the clinician or the tech-nician in the course of fabrication ofcomplete dentures.1

Remounting begins with attach-ing the maxillary complete denture tothe transfer tray with a bite registrationmaterial (Fig 1). The transfer in relationto the cranial referential plane (axisorbital plane) is performed with ananatomic facebow, which gives satis-factory accuracy and is practical to use.The facebow is then placed on an artic-ulator (Fig 2). Rather than split dentalstone casts, it is better to use a controlsystem with a magnet (eg, the SAMAxiosplit system for the SAM 3 articu-

premolars and molars in maximal inter-cuspal position, while the intercaninearea is held outside contacts. Duringlaterotrusive movement, antagonisttooth contacts are present only oncanines, whereas every other toothcontact, including the nonworkingside, is considered as an interference.This concept has shown practical valuein the initial treatment of temporo-mandibular disorders by means of astabilization splint. The activity of thejaw-closing muscles is reduced, whichthen reduces eccentric clasping ofteeth and strain in the temporo-mandibular joint.21

Nowadays this occlusal conceptfor complete dentures is described bythe predominant performance ofmovements on canines or sequentialperformance on premolars (elementsof anterior guidance are twice as longon anterior teeth in relation to poste-rior teeth), and therefore this conceptis called anterior-posterior sequence ofguidance elements or sequential guid-ance with the prevalence of anteriorteeth/canines.22–24 According to thebasic principle, the guidance surfaceon a canine is steeper compared withthat on distal teeth, and therefore theirdisclusion is achieved. Anterior teethare arranged without occlusal contacts.Posterior teeth are arranged so thattheir occlusal surfaces in the medialplane show an anteroposterior curve(the curve of Spee). The arrangementand mutual contacts of posterior teethshow characteristics of lingualizedocclusion, which enables better trans-fer of masticatory pressure onto theedentulous alveolar ridge and betterstabilization of mandibular and maxil-lary complete dentures. The floor of

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lator, Präzisionstechnik). The denture isdried, and the undercuts of the den-ture base are filled with firm silicone(Fig 3). The transfer casts are made ofhard stone and are mounted on theupper stand of the articulator (Fig 4). Assoon as the stone is hardened, the sil-icone is removed from the dentures,and the adherence of the denture tothe cast is checked.

The next step is creating a hori-zontal maxillomandibular relationshiprecord with the mandible in centric rela-tion. Dawson27 defined centric relationas “the relationship of the mandible to

the maxilla when the properly alignedcondyle/disc assemblies are in the mostsuperior positions against the eminenceirrespective of toothposition or verticaldimension.” Centric relation is the opti-mal arrangement of joint, disc, andmasticatory muscles. The mandibularposition in which the condyles are incentric relation and denture teeth are inmaximal intercuspal position is usuallycalled centric occlusion.28

Centric relation is determinedonce again by a remount procedure,and the mandibular complete dentureis mounted in the articulator by means

of the centric relation record. Centricrelation of the mandible is recordedbimanually with a thermoplastic com-pound, which is placed on the driedmandibular complete denture over theexternal and internal surfaces of theposterior teeth. The making of a recordis enabled by finger rests for the oper-ator, made of a thermoplastic com-pound, which are placed in the area ofthe buccal flange of the denture. Inthis way, a steady seating of themandibular denture on the denturefoundation is achieved. The mandibu-lar denture, with a wax layer, is

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Fig 1 (left) Preparation for transfer of com-plete dentures in an articulator with a face-bow begins with attaching the maxillarycomplete denture to the transfer tray with abite registration material (Dimension Bite,ESPE).

Fig 2 (right) Transfer of the occlusal sur-face in relation to the axis orbital plane isachieved by placement of a facebow (SAM,Präzisionstechnik) in the transverse horizon-tal plane of the mandible and a point on theinferior border of the right and left bonyorbit (orbitale) and on the maxillary com-plete denture attached with screws, which isplaced on the edentulous jaw. The patientassists in the procedure so that he or sheholds the anterior part of the facebow withthe hands and fixes the denture on the den-ture foundation by biting into cotton pellets.

Fig 3 (left) The maxillary denture isremoved from the mouth together with thefacebow and is mounted on the upper por-tion of the articulator (SAM 3). The under-cuts of the denture base are filled with firmsilicone (Optosil P Plus, Heraeus Kulzer).

Fig 4 (right) Mounting of the maxillarycomplete denture in the SAM 3 articulatorwith a hard stone (Vel-Mix Stone, Kerr)accomplishes simultaneous fabrication of atransfer cast for remounting.


immersed in a water bath at 52°C for20 seconds and placed on the denturefoundation in the patient’s mouth. Thepatient is instructed to guide themandible into centric relation until con-tact is reached (Figs 5 and 6). Themandibular denture is then removedfrom the mouth and chilled in water.The impressions in wax are removedwith a scalpel, and the procedure isrepeated in the mouth by guidanceinto centric relation. The patient, in theupright position, touches the mandibu-lar denture gently and simultaneouslyto the maxillary dental arch without

The mandibular denture base andthe floor of the mouth are filled withfirm silicone for fabrication of transfercasts. The dentures are mounted inthe articulator by means of the record(Fig 8). The dentures are fixed on thecasts using an applicator for thermo-plastic gluing (ie, Pattex, Henkel). Thecentric record control is repeated byremoval of the impressions, and thecontrol in the articulator is performedby means of a system of split casts.

the operator’s assistance. The denturesare removed from the mouth, and theimpressions are chilled in water andtheir depth and uniformity checked.Only the canines and the cusps of pos-terior teeth are allowed to makeimpressions. The procedure isrepeated if uneven pressure causesimpressions of different depth. Themaxillary denture teeth must fit per-fectly into the respective impressionson the mandibular denture. The den-tures, attached to the final centricrecord, are carefully removed from thepatient’s mouth (Fig 7).

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Fig 5 (left) The centric record of the hori-zontal interarch relationship is performed bybimanual stabilization of the mandibularcomplete denture and unforced mandibularguidance into centric relation. The patientbites gently with the complete denturesinto an impression compound (ImpressionCompound, Kerr).

Fig 6 (right) The mandibular completedenture with finger rests and a record of theocclusal surfaces of posterior teeth made ofa thermoplastic compound. Impressions inthe record are chilled in water and reducedwith a scalpel. The procedure of making acentric record is repeated.

Fig 7 (left) Dentures attached to the cen-tric record are carefully removed from thepatient’s mouth.

Fig 8 (right) The maxillary denture ismounted on the upper transfer cast in thearticulator. The mandibular denture isattached to the maxillary denture by meansof the centric record. After the undercuts ofthe denture base are filled with firm sili-cone, the transfer cast is fabricated, and themandibular denture is mounted on thelower part of the articulator.


Occlusal errors

The final correction of possible occlusaldisharmony on dentures is carried outwith the procedure of selective grind-ing. Each occlusal error is correctedby grinding of specific tooth surfaces,which preserves the desired tooth formand type of occlusion.1

On denture teeth, occlusal errorscan include errors in centric occlusion,errors during protrusive movements,and errors on the working and non-working (balancing) side.

In centric occlusion, A and/or Cand B contacts should be establishedon posterior denture teeth in thefrontal plane for each pair of antago-nist teeth (Fig 9).29 There are threetypes of occlusal errors1:

• Any pair of antagonist teeth can betoo long and thus keep other teethout of contact. To correct this error,the fossae are deepened by grind-ing so that teeth can telescope intoeach other. The cusps are notreduced (Fig 10a).

• Mandibular and maxillary teeth maybe placed almost edge to edge. Tocorrect this error, the cusp inclinesare ground. The buccal inclines ofthe maxillary teeth and the lingualinclines of the mandibular teeth areground. The central fossae arewidened. The maxillary palatal cuspis narrowed by grinding on thepalatal side, and the mandibularbuccal cusp is narrowed by grindingon the buccal side. The cusps arenot reduced (Fig 10b).

• Maxillary teeth can be placed toofar buccally in relation to mandibu-lar teeth. To correct this error, the

maxillary palatal cusp is narrowedby widening the central fossa, andthe mandibular buccal cusp isground on the buccal side bywidening the central fossa. Thepalatal cusp is ground on the palatalside and the mandibular buccalcusp is ground buccally so that theteeth telescope into each other. Thecusps are not reduced (Fig 10c).

On the working side, occlusalerrors can be in the frontal and sagit-tal plane (Figs 11 and 12). By selectivegrinding of specific cusp inclines, thecorrect contacts are achieved accord-ing to the chosen occlusal concept.According to the concept of bilaterallybalanced and lingualized occlusion,uniform contacts are established onall posterior teeth, whereas the canineguidance concept requires contactsonly on the canines or the first premo-lars of the working side.

Errors in the frontal plane caninclude:

• The maxillary buccal cusp and themandibular lingual cusp are toolong. To correct this error, thelength of the cusps is reduced bygrinding to change the inclineextending from the central fossa tothe cusp tip. The central fossa isnot deepened, but the maxillarybuccal cusps and the mandibularlingual cusps are reduced (Fig 11a).

• The buccal cusps are in contact,but the lingual ones are not. Themaxillary buccal cusps should beground from the central fossa tothe cusp tip to reduce the cuspand change the lingual cusp inclineto become less steep (Fig 11b).

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• The lingual cusps are in contact,but the buccal cusps are not. Themandibular lingual cusps arereduced by grinding their buccalinclines. The maxillary palatal cuspis not reduced, and the centralfossa is not deepened (Fig 11c).

Errors in the sagittal plane caninclude the following:

• The maxillary buccal or lingualcusps are placed mesially to theirmaximal intercuspal position. Thiserror can occur along with any ofthe three errors already described.To correct this, the mesial inclines

is excessive contact on the nonworkingside.

Occlusal errors on the nonworkingside can be so severe that the teeth onthe working side are held out of con-tact. To correct this error, the paths areground over the mandibular buccalcusp to reduce the incline of the partof the cusp that is preventing toothcontact on the working side. Eachinterfering cusp is preserved as muchas possible. Grinding is not performedon the lingual cusps that can beincluded in this contact. According tothe lingualized and canine/anteriorguided occlusal concept, each bal-ancing contact should be removed.

of the maxillary buccal cusps areground distally as if they were nar-rowed, and the distal inclines ofthe mandibular cusps are groundmesially. In this way, the same cus-pal inclination is achieved (Fig 12a).

• The maxillary buccal and lingualcusps are placed distally to theirmaximal intercuspal position. Thiserror can also occur along with thebuccolingual errors. To correct this,grinding is performed on the max-illary cusps distally and on themandibular cusps mesially (Fig 12b).

If there is no occlusal contact onthe working side, the cause of this error

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Fig 9 (left) Fingers demonstrate the A, B,and C contacts between the cusps and fos-sae of the distal teeth in centric occlusion.

Fig 10 (right) Occlusal errors and theircorrection in centric occlusion: (a) the teethare too long, (b) the teeth are almost edgeto edge, and (c) the horizontal overlap ofthe teeth is too great.

Fig 11 (left) Occlusal errors and their cor-rection in the frontal plane on the workingside: (a) the buccal cusp of one tooth andthe lingual cusp of its antagonist tooth aretoo long, (b) the buccal cusps are too long,and (c) the lingual cusps are too long.

Fig 12 (right) Occlusal errors and theircorrection in the sagittal (mesiodistal) planeon the working side: the position of thecusps is (a) mesial or (b) distal to its maximalintercuspal position. M = mesial; D = distal.

a b c

a b c

a b

M

D

M

D

A B C

Buccal Lingual


Correction of occlusal contacts in the articulator

Correction of occlusal relationshipsbegins with placement of the dentureson the casts in the articulator. The rela-tionship between the fossae and cuspson the buccal and oral surfaces of pos-terior teeth from the cusp tip to thelargest circumference of the toothis recorded with a permanent marker(Fig 13).

Contacts in centric occlusion aremarked with thin articulating paper.Bilateral, simultaneous, and uniformcontacts of all distal teeth—and of thecanines if desired—should be achievedby grinding. A and/or C and B contactsare established for each tooth (see Fig9). A sufficient number of anteropos-terior and buccolingual stabilizingtooth contacts are needed. Everydeflective contact is trimmed with abur to preserve tooth morphology.Incisors must be kept out of occlusion

(Figs 14a and 14b). It is important thatthe incisal pin contacts the incisal tablesimultaneously with tooth contacts.

The next step is the elimination ofdeflective occlusal contacts duringstraight protrusive movement. Theedge occlusion of anterior teeth istransferred to the articulator by a pro-trusive interocclusal record, and thisposition is maintained by means of aprotrusive screw and contact betweenthe incisal pin and the anterior guid-ance holder. Only the incisors makesimultaneous and uniform contacts.The deflective contacts are groundwith a bur on the palatal side of the biteedge for esthetic reasons (Figs 15 and16). Then the maxillary portion of thearticulator is moved gradually, 1 mm ata time, toward centric occlusion toestablish contacts on the canines, andif contacts between incisors are notpossible, contacts should be estab-lished on the first premolars as well(protrusive group contacts).

Correction of right and left tooth-guided lateral movement can start ifthe articulator is programmed (with theSAM articulator by setting of Bennettangle with the red SAM extension at 10degrees on both sides). The processstarts with right lateral movement. Themaxillary portion of the articulator ismoved toward the left, whereby thecondylar ball on the working sidetouches the rear wall of the housing. Itis necessary to establish contacts oncanines by selective grinding.Deflective contacts are eliminated bygrinding of excursive contacts (of thepart beside the cusp), and contactsnearer to the fossae are preserved,because this is the area of centric stops(Fig 17). By arranging the denture teethaccording to anterior/ canine guidance,each contact on the nonworking sideduring laterotrusive movement is con-sidered an interference and should beeliminated. The same corrections arecarried out on the left side (Fig 18).

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Fig 13 The intercuspal relationshipbetween the fossae and the cusps of thecomplete denture teeth is indicated with apermanent marker.

Figs 14a and 14b Centric stops are achieved by selective grinding on the mandibularcomplete denture (a, left) and (b, right) the maxillary complete denture.


Purpose of a remount procedure

Physical, biologic, and prosthetic fac-tors determine the functional quality ofcomplete dentures.7,8 The denturebase, mucosa under the denture base,and saliva enable retention by adhe-sion, cohesion, and atmospheric pres-sure. Biologic factors are dependenton neuromuscular balance and thecontent and amount of saliva. Theresidual ridge can, to a certain extent,mechanically hold the denture baseon the denture foundation as well asmovable parts of the mucosa and mus-cles that have a favorable effect on thestabilization of complete dentures.Prosthetic factors include the arrange-ment and occlusal contacts of dentureteeth.7,30 Therefore the control andcorrection of occlusal contacts duringdenture fabrication, polymerization ofthe denture base, and subsequentpatient care are very important.

increases the vertical relation by 5 to 10mm. The functional record raises thebite by about 0.5 mm, and it is the mostcommon procedure. Aiming at unifor-mity and simultaneity of the bite in thearea of distal teeth, this procedure hasbeen proven clinically reliable.34,36

The most often applied occlusalconcept is balanced occlusion.11,14 Inthe occlusal treatment of edentulouspatients, preference is more oftengiven to the lingualized occlusal con-cept, which is achieved by a specifictooth form, and it is logical and lesscomplicated than balanced occlusion.It has been established that both bal-anced and lingualized occlusalschemes require less force to beexerted during mastication, andtherefore the denture-bearing tissuesare subjected to lower forces thanwith the monoplane (nonbalanced)occlusion.11,17,37–41

Gausch22 was one of the first toreport a positive experience in the

According to Suzuki et al,31 theocclusal forces, area, and number andposition of occlusal contact pointswere significantly larger in an adjustedgroup than in a nonadjusted group ofcomplete dentures.

Remounting of complete dentureson preliminary casts should beavoided. Preliminary casts are inade-quate because they are usually dam-aged, and the insertion of completedentures is difficult because of dimen-sional changes. Alternatively, denturebases can be attached to the articula-tor with a putty material, although fab-rication of stone transfer casts is a sim-ple and precise procedure.32–34 Checkrecord mounting blocks can be usedfor faster mounting of dentures in thearticulator.35

Determination of interarch rela-tionships is possible with the centricrelation record by means of a support-ing pin, but this narrows the lingualarea, prohibits muscle function, and

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Fig 15 (left) Insufficient contacts on themaxillary anterior teeth during protrusivemovement.

Fig 16 (right) Uniform protrusive contactson the maxillary anterior teeth are achievedby selective grinding.

Fig 17 (left) Deflective contact on theright second premolar (green) during rightlaterotrusive movement.

Fig 18 (right) Contact between thecanines is achieved during tooth-guided lat-eral movement without contacts of dentureteeth on the balancing (nonworking) side.


application of the canine/anteriorguided occlusion on complete den-tures. Later, other authors reportedsuccessful performance with this pros-thetic treatment.18,23–26

According to Gutowski33 andPeroz et al,42 the advantage of canine/anterior guided occlusion is its sim-plicity, because anteroposterior andbilaterally balanced occlusal schemesare difficult to achieve. Esthetics andstability of complete dentures duringeccentric movements are better andthe occurrence of parafunctions isreduced. Less muscle activity is foundin complete denture wearers with ante-rior/canine guided occlusion than inthose with balanced occlusion.43

Remounting should definitely beperformed after polymerization of den-ture bases and before complete dentures are given to the patient.1

However, the best timing of remount-ing after optimal incorporation of thedenture into the patient’s mouth isuncertain. According to Lauritzen,33

this should be done after 8 to 10 daysof the patient wearing the completedenture, and Dapprich and Oidtman18

recommend it be performed after 2weeks. Utz44 emphasized the differentextent of occlusal changes in completedentures and recommended remount-ing between the first and the thirdweek of wearing. Gutowski25 recom-mended remounting after 1 to 3 daysof wearing and again after 1 week.

The occlusal aspect of completedentures plays a role in achieving uni-form distribution of masticatory forcesand improved retention and stabiliza-tion of denture bases.7 The occlusionof complete dentures should satisfythe dynamic interrelationships of sta-

bilization and destabilization forces,including freedom in centric occlusion,centric relation, and the individualarrangement of denture teeth.Although many factors influencepatient satisfaction with complete den-tures—for example, denture quality,oral health, the patient-clinician rela-tionship, the patient’s opinion aboutdentures, the patient’s personality, andpsychosocial factors—it has beenreported that masticatory efficacy andsatisfaction are more important thanocclusion for patients with completedentures.9,45,46

Occlusion varies constantlydepending on muscle tonus, remod-eling of the supporting structures,tooth wear, and mental health.47 A fol-low-up of patients with complete den-tures48 established that, in half of them,occlusion was not stable, and in someof them, a new maximal intercuspalocclusion was determined clinically.The consequences of undesirablechanges in occlusal relations includeresorption of the edentulous jaw andabrasion of denture teeth. Remountingcan help reduce and prevent changesin occlusion and improve denture com-fort, as well as the efficacy of occlusalrehabilitation of edentulous patients.49

Remounting of complete denturesand control of occlusal contacts canalso be performed after denture relin-ing, although no considerable dimen-sional changes in complete dentureshave been observed.50

The success of prosthetic treat-ment in edentulous patients is deter-mined by acceptable function of com-plete dentures. Pressure points shouldbe eliminated in two or three visits,which can help heal any lesions on the

denture foundation. A remount pro-cedure, which can be repeated severaltimes, also helps. If the process of den-ture base adjustment on the denturefoundation is not completed, aremount procedure should be per-formed again after 2 to 6 weeks. It isadvisable to carry out a functional con-trol of dentures once a year. Recall isnecessary every 1 to 2 years of denturewearing, together with remounting,relining of denture bases, and replace-ment of the dentures with new onesafter 7 years of wearing.1,8,18,25,33

Conclusions

1. Remounting of finished completedentures is an integral part ofprosthetic treatment.

2. The first remounting should beperformed after polymerization ofthe denture bases, the secondafter 1 to 3 days, and the thirdafter 1 week of wearing.

3. Occlusal errors can be correctedby selective grinding of dentureteeth. The anterior/canine guidedocclusal concept is the preferredoption for tooth arrangement. Incentric occlusion, only the poste-rior teeth are in uniform and simul-taneous contact, whereas a slightdistance should be kept betweenthe anterior teeth. During lateralmovements, contacts on the bal-ancing side are considered asocclusal interferences. Thearrangement of teeth in suchocclusion is simpler, esthetics arebetter, and patients experiencefewer parafunctional movements.

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Acknowledgment

This article was made with the support of theMinistry of Science, Education and Sports of theRepublic of Croatia, project no. 0065010.

References

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FACULTY POSITION AVAILABLE:

PERIODONTIST

The Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, is

seeking applications for a full-time, term appointment of two years possibly

leading to a tenure-track faculty position at the rank of Assistant, Associate or

Full Professor, in the Division of Periodontics in the Department of Dental

Clinical Sciences. Qualified candidates may be considered for a tenure-track

position.

Responsibilities will include undergraduate teaching, collaborative research,

continuing education presentations and associated administrative duties.

Depending on the successful applicant’s credentials (s)he may be invited to

participate in planning a graduate program. The Division collaborates in

research with other Divisions, Departments, Faculties, Universities, and the

School of Biomedical Engineering.

Academic rank will be based on the successful candidate’s qualifications,

experience, and achievements. It is expected that the successful applicant will

have graduated from an accredited specialty program, or a non-accredited

specialty program and hold a Ph.D. The successful applicant will also have

demonstrated experience in research, undergraduate and graduate teaching, and

administration. Salary and rank will be commensurate with qualifications and

experience.

The successful applicant must be eligible for licensure in Nova Scotia. Private

practice privilege is integrated with the appointment.

All qualified candidates are encouraged to apply; however, Canadians and

permanent residents will be given priority. Dalhousie University is an

Employment Equity/Affirmative Action employer. The University encourages

applications from qualified Aboriginal people, persons with a disability,

racially visible persons, and women.

Dalhousie University is one of Canada’s leading teaching and research

universities, with four professional Faculties, a Faculty of Graduate Studies and

a diverse complement of graduate programs. Collaborative and interactive

research is encouraged, as is cooperation in teaching among the Faculties. We

inspire students, faculty, staff, and graduates to make significant contributions

to our region, Canada, and the world. Dalhousie is located in Halifax, Nova

Scotia; it is a vibrant capital city, and the business, academic, and medical

centre for Canada’s east coast.

Review of applications will begin in February 2007. Applicants should submit

a letter of application with Curriculum Vitae, and up to three reprints of

research publications to the chair of the Search Committee listed below. Three

letters of reference are to be sent under separate cover.

Dr. Tom Boran

Search Committee

Faculty of Dentistry

Dalhousie University

Halifax, Nova Scotia

B3H 3J5


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