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What occlusal scheme should be used for tooth-supported fixed partial dentures?
Charles Goodacre1, Gary Goldstein2
1Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA.
Summary
Current evidence does not support specific occlusal schemes for fixed partial dentures on natural teeth. Further research is needed to determine optimal eccentric and maximal intercuspal position (MIP) schemes for dental restorations.
Area of Science:
- Dental Prosthetics
- Occlusion Science
- Restorative Dentistry
Background:
- Fixed partial dentures (FPDs) on natural teeth require careful consideration of occlusal schemes.
- Existing scientific literature lacks robust evidence to guide the selection of specific occlusal schemes for FPDs.
Purpose of the Study:
- To evaluate the scientific evidence for occlusal schemes in eccentric mandibular movements and maximal intercuspal position (MIP) for FPDs on natural teeth.
Main Methods:
- A comprehensive literature search was conducted using PubMed with keywords related to natural teeth, dental occlusion, and FPDs.
- Searches included various study types (Case Reports, Clinical Trial, Randomized Controlled Trial, Systematic Review), but yielded no relevant citations for FPDs on natural teeth.
Main Results:
- Three natural dentition eccentric occlusal relationships (canine protected articulation, group function, balanced occlusion) lack clinical trial data for FPDs.
- No studies compare occlusal schemes for FPDs on natural teeth, and evidence for maximal intercuspal position (MIP) schemes (cusp-to-fossa, cusp-to-marginal ridge) is insufficient.
- Group function is more prevalent than canine protected articulation in natural dentitions, but superiority for FPDs is not established.
Conclusions:
- There is no clinical evidence favoring one eccentric occlusal relationship over another for FPDs on natural teeth.
- Current understanding of optimal occlusal schemes for FPDs in maximal intercuspal position (MIP) and eccentric movements is limited, necessitating further research.
- Restorations should harmonize with the patient's existing occlusal scheme when possible, avoiding nonworking side posterior contacts and directing forces along the long axis of teeth in MIP.
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