ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Patient Satisfaction Ratings are Similar for Lingualized Balanced Occlusion and Cross-Tooth Cross-Arch Balanced Occlusion
Clinical Question Will complete dentures fabricated with a lingualized occlusal scheme provide greater patient satisfaction than dentures with a cross-tooth cross-arch balanced arrangement?
Clinical Bottom Line Patients are equally accepting of dentures with lingualized balanced and cross-tooth cross-arch balanced occlusions.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23342330Abduo/20133 RCTs and 1 clinical study related to this question includedSystematic review of randomized trials
Key resultsThe author concluded that both lingualized balanced occlusion and cross-tooth cross-arch balanced occlusion are equally acceptable to patients. There is limited evidence suggesting lingualized balanced occlusion might be more advantageous than cross-tooth cross-arch balanced occlusion for patients with severe residual ridge resorption (Matsumaru, 2010). The discrepancy between the objective and subjective assessments of denture performance illustrates the importance of psychological factors and of patient perception on the success of complete dentures. Since publication of this review, two additional RCTs have been published: Deniz DA. J Oral Rehabil 2013. Feb; 40(2): 91-8. PMID: 23189997. Concluded that lingualized occlusion provided greater denture patient satisfaction than anatomical (cross-tooth cross-arch) occlusion. Shirani M, et al. J Prosthodont 2014 Jun; 23(4): 259-66. PMID: 2418344. Concluded from a study of student fabricated dentures that patients had greater comfort with lingualized occlusion than fully balanced. It is unclear if the fully balanced dentures were corrected with a clinical remount as is customary with the technique, however.
#2) 23911601Zhao/20132 RCTs related to this question includedSystematic review of randomized trials
Key resultsZhao identified seven studies meeting inclusion criteria, with only two having a direct comparison between treatment approaches. This review used the same randomized controlled trials to arrive at their conclusions as the Abduo study in the same year. Zhao found no conclusive evidence supporting one occlusal design over another for successful complete dentures. The conventional requirement of a fully bilateral balanced occlusion for denture success was not supported by the available evidence.
Evidence Search Complete denture lingualized occlusion
Comments on
The Evidence
Validity: Overall, the validity of the findings is limited. The level of available evidence is moderate. In Abduo/2013, of the 12 included studies, only 4 made a direct comparison between treatment approaches. Also, only 4 were RCTs, 2 of which used the same patient group (Sutton, 2007). Perspective: There is limited high-quality evidence to address this theme because of a lack of randomized controlled studies. In addition, each of the few available randomized controlled studies has a relatively small sample size with potentially confounding anatomical differences and dropout rates. While the available evidence stops short of affirming the superiority of lingualized occlusion for dentures, it can be inferred that it is at least on a par with fully balanced articulation.
Applicability This information may benefit a practitioner in deciding to fabricate a conventional complete denture with lingualized balanced occlusion or cross-tooth cross-arch balanced occlusion.
Specialty/Discipline (General Dentistry) (Prosthodontics)
Keywords Lingualized occlusion, balanced occlusion, complete denture, fully balanced
ID# 2797
Date of submission: 12/01/2014spacer
E-mail Sugita@uthscsa.edu
Author Ryushiro Sugita, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Stephan J. Haney, DDS
Faculty mentor/Co-author e-mail haneys2@uthscsa.edu
Basic Science Rationale
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