Lingualized Occlusal Scheme
Lingualized occlusion is a type of bilaterally balanced occlusal schemes. The philosophy of a balanced occlusal scheme is to improve denture stability by maintaining contacts on both sides of the denture in excursions during function. Patients feel more confident and have less discomfort when dentures are more stable. There is indirect evidence that balanced occlusion may reduce ridge resorption and allow for increased functional forces in excursions. Lingualized occlusion differs from traditional fully balanced schemes by having only the lingual cusp of the maxillary tooth contacting the mandibular teeth to maintain this contact.
a) Centric position contacts are set maxillary lingual cusp to fossae of the mandibular posterior teeth. No anterior contacts should be present in the centric position.
b) Anatomic teeth are used in the maxilla opposing a flat-cusped, or shallow cusped mandibular tooth.
c) Overbite is incorporated into the anterior setup to improve esthetics, and eccentric contacts.
d) In eccentric movements there are contacts on both the working and balancing sides of the denture, whether excursions are protrusive or lateral in nature. Anterior teeth make grazing contact in excursions.
e) The condylar guidance, incisal guidance, angle of the occlusal plane, cusp angle of the denture teeth, and compensating curves placed during the posterior tooth setup all affect the ability to achieve these contacts.
Advantages: More natural appearance (anatomic teeth) of the maxillary teeth with forces centered over the mandibular teeth
Disadvantages: Technically more challenging than monoplane scheme, no definitive studies to prove improved stability;
Contraindications: Extreme cases of the following: difficulty in obtaining repeatable centric record (incoordination, jaw malrelations, severe ridge resorption (lateral forces displace the denture) may more easily be handled with a monoplane scheme.