Alternate occlusal schemes

Comparative jaw size and the loss of function of the anterior determinants dictates establishing alternate types of occlusion. The chewing envelope and protrusive disocclusion are generally established by functioning anterior teeth. Dramatic changes in tooth morphology are dictated when the anterior teeth do not function. Bilateral balanced occlusion establishes guidance and support. When the mandible is much larger than the maxillae, a well-designed reverse occlusion will properly distribute the forces through the long axis of the teeth and provide a stable occlusal base. Bilateral balance and reverse occlusions are the recommended physiologic occlusions to use when a mandible disparity exists. Accurate reproduction of the posterior determinants is necessary. The arbitrary removal of balancing contacts can introduce imbalance, pain, lack of guidance, and serious compromise of an otherwise sound occlusion.