• To identify and correct potential areas of denture base that will

cause soreness or discomfort to the patient

• To identify and correct any portion of the denture that interferes

with the retention and stability of dentures

• To identify and correct any part of the dentures that is aesthetically

unpleasing

• To refine the occlusion

• To deliver the dentures to the patient

Procedure before patient appointment

Once the dentist receives the dentures, he/she should evaluate the

dentures for the following:

• Polished surfaces should be smooth and well contoured.

• Denture borders are rounded and fully extended.

• All imperfections on the tissue surface have been removed.

• Maxillary and mandibular remount casts have been properly made.

• The maxillary remount cast has been accurately mounted on the

articulator.

Procedures followed during insertion of the

dentures

Evaluation of accuracy of tissue surface

• Dentures are placed separately in the patient’s mouth and evaluated

for comfort and stability.

• If tissue undercuts are present, pressure indicating paste is used for

detection.

• Any interference is removed by carbide acrylic bur at slow speed.

• The denture is removed and placed two or three times to ascertain

that the areas are adjusted.

• Procedure is repeated until adequate relief is obtained.

Evaluation of the border extensions

• Denture borders are carefully evaluated to check the extensions.

• Denture border should completely fill the vestibular areas within

the anatomical limits.

• The labial and buccal notches should allow adequate freedom to the

muscular frenum.

• Hamular notch areas of the maxillary denture should not be

overextended.

• Distal end of the maxillary denture and the posterior palatal seal

should be properly located.

• The borders of the maxillary denture under the zygomatic arches

should not be overextended.

• The lingual flange of the mandibular denture should allow freedom

for the mylohyoid muscle.

• Dentures should be stable during speech and swallowing.

• Border extensions are examined visually and by using pressuresensitive paste or mouth temperature waxes.

• The patient is instructed to make functional movements when

dentures are inserted in mouth.

• Any discrepancy at the denture border is detected and removed.

Evaluation of retention and stability

• Dentures are assessed for adequate retention and stability, once the

tissue adaptations and border extensions are evaluated.

• The dentures should be retentive and stable when they are not in

occlusion.

Evaluation of aesthetics and facial contours

• Dentures are critically evaluated for aesthetics and facial contours.

• They should provide proper facial support.

• Proper facial support and natural appearance are accomplished by

proper positioning of the teeth and by contouring the denture

flanges to correct height, thickness and shape of the surface.

• Any obvious alterations should be corrected before the final denture

polishing.

Centric relation interocclusal records

• The final step is to make and verify the centric interocclusal record.

• To correct the occlusal errors, clinical remount procedure is

necessary.

Occlusal disharmony can occur due to the following:

• An incorrect centric relation record at the time of wax try-in

• Errors in mounting the cast on the articulator

• Tissue fit of the processed denture that is different from the tissue fit

of the trial occlusal rims

• Changes which may have occurred in the soft tissues since the final

impressions

• Dimensional changes in the base material from processing

• Dimensional changes from polishing procedures

Clinical remount procedure

Clinical remount procedure is defined as ‘any method used to relate

restorations to an articulator for analysis and/or assist in development of a

plan for occlusal equilibration or reshaping’. (GPT 8th Ed)

Rationale for Clinical Remount Procedure

• Difficult to see occlusal discrepancies intraorally

• Resiliency and displaceability of the supporting tissues to varying

degrees tend to disguise premature occlusal contacts

• Visual inspection of dentist cannot be relied on to checking the

occlusal discrepancies

• The dentist cannot depend on the patient to diagnose occlusal

problems

This is the procedure to remount the patient dentures on the

articulator by means of interocclusal records made in the patient’s

mouth.

Advantages

• This procedure reduces chairside time.

• This permits the dentist to see the occlusion better.

• This provides a stable working foundation and the bases are not

resting on resilient tissues.

• Marks of articulating paper are more accurate in the absence of

saliva.

• Correction needs not be made in front of the patient.

Procedure

• Both the dentures are placed in the patient’s mouth and the

relationship of centric occlusion to centric relation is verified.

• When closing, the patient should stop at the point of first contact

between the opposing dentures, so that any possible occlusal

contact is observed.

• This procedure is repeated until the closure into centric position is

assured.

• Centric interocclusal record is made as close to the vertical dimension

of occlusion (VDO) as possible without denture contact.

• Small amount of fast setting impression plaster is mixed and laid

over the mandibular posterior teeth.

• A wax or modelling compound can also be used.

• The patient is then instructed to close into the centric relation

position which was practiced.

• Allow the interocclusal record to set.

• Place the interocclusal record and mandibular denture on the lower

mounting cast. The maxillary denture is positioned over the cast

attached to the articulator. Maxillary denture is secured over the

mandibular denture using the interocclusal record in between them.

• Make sure that there is no contact between the two dentures.

• Seal the opposing dentures to the interocclusal record by means of

sticky wax.

• The incisal pin is lengthened.

• The lower cast is mounted on the articulator using plaster.

• Once the plaster is set, the interocclusal record is removed and the

first contact between the dentures on the articulator and in the

mouth is same or altered.

• Any alteration points to discrepancy in the mounting and the

procedure needs to be repeated.

• Adjust the condylar guidances to the original settings or new eccentric

records are made.

• Ensure that the teeth are dry before using articulating paper.

• Articulating paper is used over the occlusal surfaces of the

mandibular posterior teeth.

• Tap the articulator in centric relation position.

• Any coloured marks with white centres that are transferred to the teeth

will indicate the areas of heaviest tooth contact.

• Selective grinding procedure is undertaken to refine the occlusion.

Selective grinding

Selective grinding is defined as ‘the intentional alteration of the occlusal

surfaces of teeth to change their form’. (GPT 8th Ed)

Objectives of Selective Grinding

• To correct occlusal discrepancy in centric and eccentric positions

• To develop contacts bilaterally when anatomic teeth are used and

balanced occlusion is desired

• To alter cuspal inclines to develop maximum intercuspation in

centric relations.

• To obtain balanced occlusion.

Procedures in selective grinding

Selective grinding of anatomic teeth

• The anatomic teeth are altered by selective grinding to obtain

balanced occlusion in centric relation position.

• Once both upper and lower dentures are mounted on the articulator

with the interocclusal record, a protrusive record is made in the

patient’s mouth.

• Both the horizontal and condylar settings are adjusted using the

protrusive record.

• Evaluate the areas of centric and eccentric contacts.

• Articulating paper of minimum thickness is used to mark the actual

contact of the teeth.

• High marks are observed on the mandibular and maxillary teeth.

• Grinding is accomplished using Chayes stones No. 16, 11 and 5.

Grinding is done only in the fossa and not on the cusps.

• While grinding, the incisal pin is relieved from the contact on the

incisal guidance table to allow for slight reduction of the vertical

dimension.

• Once the centric deflective occlusal contacts are removed, the incisal

pin is placed in contact with the incisal guidance table.

• Then again the articulating paper is placed between the teeth on

both sides and the articulator is moved laterally to one side, the

paper marks contact on both the sides for the same lateral

movements.

• Any interfering contact is grinded with appropriate stone.

• Grinding to correct occlusal errors in lateral movements is limited to

altering the lingual inclines of the upper buccal cusps and buccal inclines

of the lower lingual cusps on the working side and to alter the lingual

inclines of the lower buccal cusps on the balancing side.

• Selective grinding to remove occlusal errors for anatomic teeth is

described below.

Types of occlusal errors and their corrections.

Occlusal errors can occur in three positions:

1. Centric occlusion Table 10.1

2. Working side Table 10.2

3. Balancing side Table 10.3

TABLE 10-1

OCCLUSAL ERRORS IN CENTRIC OCCLUSION AND THEIR

CORRECTION

Types of Occlusal Error Correction

1. Any pair of opposing teeth, one too long

keeps the other tooth out of contact (Fig. 10-

1)

• To correct this error, the fossa of the teeth is deepened by

grinding and bringing both teeth in contact

• Cusp is not shortened

2. Upper and lower teeth are nearly end-toend (Fig. 10-2)

• Inclines of the cusp are grinded in such a way that upper

cusp inclines buccally and the lingual cusp inclines lingually

• Central fossae are broadened

• Cusps are not shortened

3. Upper teeth can be too far buccally in

relation to lower teeth (Fig. 10-3)

• To correct this error, the lingual cusp of the upper tooth is

made more narrow by broadening of the central fossa

• Buccal cusp of the lower tooth is moved buccally by

broadening of the central fossa

• Cusps are not shortened

FIGURE 10-1 Teeth too long prevent proper tooth contact.

FIGURE 10-2 Upper and lower teeth nearly end-to-end.

FIGURE 10-3 Upper teeth are too far buccally placed.

TABLE 10-2

OCCLUSAL ERRORS ON WORKING SIDE AND THEIR

CORRECTION

Types of Occlusal Error Correction

1. Both upper buccal cusp

and lower lingual cusp are

too long Fig. 10.4

• Upper buccal cusp and the lower lingual cusp are reduced by grinding, so

that the other teeth will touch in that position

• Central fossa is not deepened

2. Buccal cusp contacts but

lingual cusp does not

(buccal cusp is too long)

(Fig. 10-5)

• To correct this error, the buccal cusp is reduced and the lingual incline of the

cusp is changed so that it becomes less steep

3. Lingual cusp contacts but

buccal cusp does not

• To correct this error, the lower lingual cusp is shortened by grinding the

buccal inclines of lower lingual cusp so that it is not that steep

(lingual cusp is too long)

(Fig. 10-6)

4. Upper buccal or lingual

cusp is mesial to their

intercuspating positions

(Fig. 10-7)

• To correct this error, selective grinding is done, so that the mesial inclines of

the upper buccal cusp move distally when the cusps are narrowed and the

distal inclines of the lower lingual cusp are reduced to move them forward

5. Upper buccal or lingual

cusp is distal to their

intercuspating positions

(Fig. 10-8)

• To correct this error, selective grinding is done on the distal inclines of the

upper cusp and mesial inclines of the lower cusp

6. Teeth on the working side

do not contact at all (Fig.

10-9)

• May be caused due to excessive contact on the balancing side

FIGURE 10-4 Upper buccal and lower lingual cusps are too

long.

FIGURE 10-5 Buccal cusp is too long.

FIGURE 10-6 Lingual cusp is too long.

FIGURE 10-7 Upper buccal or lingual cusps are mesial to

their intercuspating position.

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FIGURE 10-9 No contact occurs on working side.

TABLE 10-3

OCCLUSAL ERRORS ON THE BALANCING SIDE AND THEIR

CORRECTION

Occlusal Errors on Balancing Side Correction

1. Heavy balancing side contacts leave

the working side teeth out of contact

(Fig. 10-10)

• To correct this error, the lingual inclines of the lower buccal cusp

are reduced as paths on the balancing side so that contact on the

working side is established

• As far as possible, each interfering cusp is preserved

• Grinding of the lower lingual cusp is avoided

2. No balancing contact on the

balancing side