Study on the Effect of Different Occlusal Schemes on Temporomandibular Joint Health in Complete Denture Wearers

Temporomandibular joint (TMJ) disorders are commonly observed in edentulous patients, potentially exacerbated by improper occlusal schemes in complete dentures. Various occlusal concepts, including balanced occlusion, lingualized occlusion, and monoplane occlusion, are used in prosthodontics, each claiming advantages in preserving TMJ health.

A total of 60 completely edentulous patients aged between 50 and 75 years were selected and randomly divided into three groups (n = 20) based on the occlusal scheme: Group A - Balanced Occlusion, Group B - Lingualized Occlusion, and Group C - Monoplane Occlusion. All patients received new maxillary and mandibular complete dentures fabricated using conventional techniques. TMJ health was assessed at baseline, 3 months, and 6 months post-insertion using Helkimo's Clinical Dysfunction Index and patient-reported outcomes on pain and joint sounds.

At the 6-month follow-up, Group A showed minimal TMJ symptoms with a mean dysfunction index score of 0.8 ± 0.5, compared to 1.2 ± 0.6 in Group B and 2.1 ± 0.7 in Group C. Joint sounds and pain were reported in 10% of patients in Group A, 15% in Group B, and 35% in Group C. Statistical analysis revealed significant differences between the groups (P < 0.05), favoring balanced occlusion for TMJ stability.

Balanced occlusion in complete dentures appears to better maintain TMJ health compared to lingualized and monoplane schemes. It minimizes joint dysfunction symptoms and improves patient comfort over time.