Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (1): 133-138. doi: 10.19723/j.issn.1671-167X.2026.01.017

Previous Articles     Next Articles

A clinical study on the centralized occlusal scheme for implant-supported overdentures in edentulous patients

Chang DIAO1, Shimin WANG2, Man LI2, Shaoxia PAN1, Yang LIU1,*()   

  1. 1. Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
    2. Denture Processing Center, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2025-10-10 Online:2026-02-18 Published:2025-11-28
  • Contact: Yang LIU
  • Supported by:
    the National Natural Science Foundation of China(81600846); the Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-23B08); the Education Research Project of Peking University School and Hospital of Stomatology(2022-PT-02)

RICH HTML

   

PDF (PC)

Abstract:

Objective: To address the mismatch between the support center and the occlusal load center in implant-supported overdentures, this study proposed a novel centralized occlusal scheme. This design aimed to utilize the supportive capacity of the anterior mandibular implants and the maxillary canine pillars by establishing occlusal contacts in the canine region. A preliminary evaluation of the clinical feasibility of this new occlusal scheme was conducted. Methods: In this study, five completely edentulous patients received two implants in the mandible. Each participant was provided with two complete prosthetic sets: mandibular implant-supported overdentures and corresponding complete maxillary dentures featuring either a conventional bilateral balanced occlusion or the novel centralized occlusal scheme, delivered in a randomized crossover sequence. For the new scheme, the maxillary canines were reshaped referencing the premolars, while preserving their labial contour and occlusal balance, the lingual fossa was modified to establish centric occlusal contacts. A comprehensive evaluation was conducted using standardized methods: chewing efficiency was measured using the two-color chewing gum method, occlusal contact area was calculated digitally using virtual articulating paper method, and patient satisfaction was assessed using validated questionnaires, and stress distribution patterns were examined through detailed three-dimensional finite element analysis. Results: Compared with the conventional occlusal scheme, the centralized occlusal scheme achieved M (P25, P75) improvements of 21.22% (17.48%, 26.01%) in occlusal contact area and 21.87% (17.51%, 24.18%) in masticatory efficiency, with the latter reaching 55.13% (43.73%, 59.09%) of the level observed in complete natural dentitions. Patient subjective evaluations indicated that the centralized scheme was comparable to the conventional scheme in terms of overall satisfaction, speech, and aesthetics. Finite element analysis revealed that the centralized scheme expanded the denture support area to the maxillary canine region. Conclusion: The proposed novel centralized occlusal scheme can enhance occlusal contact area and chewing efficiency by utilizing the support capacity of the anterior mandibular implants and the maxillary canine pillars, while maintaining denture stability, balance, aesthetics, and patient satisfaction. This study provides a new approach and preliminary evidence for improving the occlusal design of implant-supported overdentures.

Key words: Implant overdenture, Occlusal scheme, Masticatory efficiency

CLC Number: 

  • R783.6

Figure 1

Occlusal contact analysis of the complete denture with the centralized occlusal scheme A, centric occlusion, color bar representing the interocclusal distance, with green indicating larger gaps and red indicating closer contact; B, centric occlusion; C, protrusive balanced occlusion; D, lateral balanced occlusion (left as working side); E, lateral balanced occlusion (left as balancing side); B-E color bar representing the interocclusal distance, with red indicating larger gaps and blue indicating closer contact."

Figure 2

Comparative analysis of occlusal contact area and masticatory efficiency between the centralized and conventional occlusal schemes A, distribution of occlusal contact points in the conventional occlusal scheme; B, distribution of occlusal contact points in the centralized occlusal scheme; occlusal contact points on the maxillary dentition are shown in blue; C, quantitative comparison of masticatory efficiency between the two occlusal schemes for 5 patients. *P < 0.05."

Figure 3

Comparative analysis of three dimensional finite element stress between the centralized and conventional occlusal schemes A, conventional occlusal scheme; B, centralized occlusal scheme."

1
王兴. 第四次全国口腔健康流行病学调查报告[M]. 北京: 人民卫生出版社, 2018: 40.
2
潘韶霞, 冯海兰. 无牙颌种植覆盖义齿的循证基础、设计方案及临床关键问题[J]. 中华口腔医学杂志, 2021, 56 (12): 1159- 1164.
3
Feine JS , Carlsson GE , Awad MA , et al. The McGill consensus statement on overdentures. Montreal, Quebec, Canada. May 24-25, 2002[J]. Int J Prosthodont, 2002, 15 (4): 413- 414.
4
Kern JS , Kern T , Wolfart S , et al. A systematic review and meta-analysis of removable and fixed implant-supported prostheses in edentulous jaws: Post-loading implant loss[J]. Clin Oral Implants Res, 2016, 27 (2): 174- 195.

doi: 10.1111/clr.12531
5
Kokich VO Jr , Kinzer GA . Managing congenitally missing lateral incisors. Part Ⅰ: Canine substitution[J]. J Esthet Restor Dent, 2005, 17 (1): 5- 10.

doi: 10.1111/j.1708-8240.2005.tb00076.x
6
Rocha COM , Longhini D , Pereira RP , et al. Masticatory efficiency in complete denture and single implant-retained mandibular overdenture wearers with different occlusion schemes: A randomized clinical trial[J]. J Prosthet Dent, 2023, 129 (6): 888- 894.

doi: 10.1016/j.prosdent.2021.06.028
7
Halazonetis DJ , Schimmel M , Antonarakis GS , et al. Novel software for quantitative evaluation and graphical representation of masticatory efficiency[J]. J Oral Rehabil, 2013, 40 (5): 329- 335.

doi: 10.1111/joor.12043
8
Schimmel M , Christou P , Miyazaki H , et al. A novel colourimetric technique to assess chewing function using two-coloured specimens: Validation and application[J]. J Dent, 2015, 43 (8): 955- 964.

doi: 10.1016/j.jdent.2015.06.003
9
Cheng YY , Cheung WL , Chow TW . Strain analysis of maxillary complete denture with three-dimensional finite element method[J]. J Prosthet Dent, 2010, 103 (5): 309- 318.

doi: 10.1016/S0022-3913(10)60064-9
10
Taczała J , Rak K , Sawicki J , et al. Numerical analysis of the bond strength between two methacrylic polymers by surface modification[J]. Materials, 2021, 14 (14): 3927.

doi: 10.3390/ma14143927
11
Ogata K , Satoh M . Centre and magnitude of vertical forces in complete denture wearers[J]. J Oral Rehabil, 1995, 22 (2): 113- 119.

doi: 10.1111/j.1365-2842.1995.tb00244.x
12
姜梦洋, 文静, 徐珊珊, 等. 下颌四枚种植体支持的两种附着体覆盖义齿的三维有限元分析[J]. 中华口腔医学杂志, 2019, 54 (1): 41- 45.
13
Borges MHR , Miranda LFB , Dini C , et al. Clinical performance of and patient satisfaction with conventional complete dentures with different occlusal schemes: A systematic review of systematic reviews[J]. J Prosthet Dent, 2023, 130 (3): 341- 350.

doi: 10.1016/j.prosdent.2021.10.018
14
Peck CC . Biomechanics of occlusion: Implications for oral rehabilitation[J]. J Oral Rehabil, 2016, 43 (3): 205- 214.

doi: 10.1111/joor.12345
15
Bhambhani R , Joshi S , Roy SS , et al. Choosing the denture occlusion: A systematic review[J]. J Indian Prosthodont Soc, 2020, 20 (3): 269- 277.

doi: 10.4103/jips.jips_409_19
16
Lemos CAA , Verri FR , Gomes JML , et al. Bilateral balanced occlusion compared to other occlusal schemes in complete dentures: A systematic review[J]. J Oral Rehabil, 2018, 45 (4): 344- 354.

doi: 10.1111/joor.12607
17
Abduo J . Occlusal schemes for complete dentures: A systematic review[J]. Int J Prosthodont, 2013, 26 (1): 26- 33.

doi: 10.11607/ijp.3168
18
徐军. 总义齿与可摘局部义齿的设计[M]. 北京: 人民卫生出版社, 2005: 16- 17.
19
Kuriakose R , Nair A , Bamigdad MS , et al. Impact of occlusal schemes on implant-supported overdentures[J]. J Pharm Bioallied Sci, 2024, 16 (Suppl 4): S3257- S3259.

doi: 10.4103/jpbs.jpbs_795_24
[1] Yongtao YANG, Yuwen TIAN, Shenyao SHAN, Wenbo LI, Xiangyi SHANG, Yizhen WANG, Shuwei GUO, Zixiang GAO, Aonan WEN, Yijiao ZHAO, Yong WANG. A multi-view stereo vision methodology for digital soft-tissue impressions in fixed implant rehabilitation of edentulous patients [J]. Journal of Peking University (Health Sciences), 2026, 58(1): 126-132.
[2] Miao ZHENG, Xinrong MA, Hao CHEN, Hengxin ZHAO, Yu ZHANG, Jianguo TAN, Heping LI, Xiao WANG. Effects of cold atmosphere plasma treatment on the biological behavior of human gingival fibroblasts [J]. Journal of Peking University (Health Sciences), 2026, 58(1): 60-67.
[3] Yi TANG, Xuezhu ZHAO, Xu YANG, Huimei JIA, Yunsong LIU. Impact of ultrasonic scaling on abutment screw torque in implant restorations [J]. Journal of Peking University (Health Sciences), 2026, 58(1): 84-88.
[4] Yulan WANG, Hao ZENG, Yufeng ZHANG. Current situation and exploration of clinical transformation of plasmatrix in oral implantology [J]. Journal of Peking University (Health Sciences), 2025, 57(5): 836-840.
[5] Fangru LIN, Zhihui TANG. Correlation analysis of peri-implant health after single-tooth dental implant [J]. Journal of Peking University (Health Sciences), 2025, 57(2): 347-353.
[6] Juan WANG, Lixin QIU, Huajie YU. Influence of emergence profile designs on the peri-implant tissue in the mandibular molar: A randomized controlled trial [J]. Journal of Peking University (Health Sciences), 2025, 57(1): 65-72.
[7] Hong LI, Feifei MA, Jinlong WENG, Yang DU, Binzhang WU, Feng SUN. Accuracy of dynamic navigation system for immediate dental implant placement [J]. Journal of Peking University (Health Sciences), 2025, 57(1): 85-90.
[8] Meng-en OU,Yun DING,Wei-feng TANG,Yong-sheng ZHOU. Three-dimensional finite element analysis of cement flow in abutment margin-crown platform switching [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 548-552.
[9] WANG Juan,YU Hua-jie,SUN Jing-de,QIU Li-xin. Application evaluation of prefabricated rigid connecting bar in implants immediate impression preparation of edentulous jaw [J]. Journal of Peking University (Health Sciences), 2022, 54(1): 187-192.
[10] Feng LIANG,Min-jie WU,Li-dong ZOU. Clinical observation of the curative effect after 5-year follow-up of single tooth implant-supported restorations in the posterior region [J]. Journal of Peking University (Health Sciences), 2021, 53(5): 970-976.
[11] XU Xiao-xiang,CAO Ye,ZHAO Yi-jiao,JIA Lu,XIE Qiu-fei. In vitro evaluation of the application of digital individual tooth tray in the impression making of mandibular full-arch crown abutments [J]. Journal of Peking University (Health Sciences), 2021, 53(1): 54-61.
[12] Yang LIU,Jin-ru HU,Yi-jiao ZHAO,Yong WANG,Yu-chun SUN,Shao-xia PAN,Hai-lan FENG. A novel tray for recording maxillomandibular relationship of edentulous patients based on dimensional surveying of complete dentures [J]. Journal of Peking University (Health Sciences), 2020, 52(2): 368-372.
[13] Yu-chun SUN,Yong WANG,Ke-hui DENG,Hu CHEN,Wei-wei LI,Yi-jiao ZHAO,Shao-xia PAN,Hong-qiang YE,Yong-sheng ZHOU. Independent innovation research of functionally suitable denture digital system [J]. Journal of Peking University (Health Sciences), 2020, 52(2): 390-394.
[14] Yue CAO,Jun-kai CHEN,Ke-hui DENG,Yong WANG,Yu-chun SUN,Yi-jiao ZHAO. Accuracy of three intraoral scans for primary impressions of edentulous jaws [J]. Journal of Peking University(Health Sciences), 2020, 52(1): 129-137.
[15] Chun-ping LIN,Song-he LU,Jun-xin ZHU,Hong-cheng HU,Zhao-guo YUE,Zhi-hui TANG. Influence of thread shapes of custom-made root-analogue implants on stress distribution of peri-implant bone: A three-dimensional finite element analysis [J]. Journal of Peking University(Health Sciences), 2019, 51(6): 1130-1137.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd