Occlusal designs on masticatory ability and patient satisfaction with complete denture: A systematic review

Abstract Objectives To systematically review clinical outcomes of different occlusal designs of complete dentures. Methods Using a various key words, an electronic search of clinical trials published in English and Chinese literature was performed from four databases: Medline/PubMed, EMBASE, Cochrane Library, and CBM. Furthermore, a manual searching of the relevant journals and the bibliographies of reviews was performed. General satisfaction, masticatory ability, retention, and stability were major criteria for the evaluation of the outcomes. Studies met these criteria were selected for a full-text reading. The whole processes were performed by two reviewers independently. Results This systematic review started with 1030 articles, which were finally narrowed down to seven, according to the inclusion criteria. The following occlusal designs were included and analyzed: anatomic occlusion, balanced occlusion, canine guidance occlusion, lingualized occlusion, monoplane occlusion, and bilateral-balanced and canine-guided design. Three of the seven studies showed that lingualized occlusion had ratings of higher patients’ satisfaction than other occlusion designs. On the other hand, the canine-guided occlusion dentures demonstrated equal or better clinical performances than bilateral-balanced dentures. Because of the heterogeneity and bias of the studies, it was not possible to analyze the data statistically. Conclusions Lingualized occlusion and canine-guided occlusion can be successfully applied in the fabrication of complete dentures. Canine guided occlusion has also been shown to be satisfactory. More well-controlled randomized trials are needed regarding canine-guided occlusion and the relationship between alveolar ridge resorption, different occlusal schemes and patient satisfaction. The conventional prosthodontic wisdom that complete dentures require a balanced occlusal design is not supported by the included literature. Clinical significance A suitable occlusal scheme would be a critical factor for a successful complete denture. However, there is no conclusive evidence to support which occlusal design is more appropriate for fabricating a successful complete denture. In occlusal design of conventional complete denture, lingualized occlusion can provide better clinical outcomes than other occlusal designs; meanwhile, canine-guided occlusion also can be used in clinic practice.