University J Dent Scie 2018; Vol.

4, Issue 3
University
Journal of
Dental Sciences

SELECTIVE GRINDING /OCCLUSAL

RESHAPING IN PROSTHODONTICS
Review
1
Article
Dr. Rosy Raheja, 2Dr Tanu Mahajan, 3Dr. Reshu Singh,4Dr. Neha Singh
1
Student , Prosthodontics, Rama Dental College, Hospital and Research Centre , Kanpur.
2
Head of the Dept. Prosthodontics, Rama Dental College, Hospital & Research Centre, Kanpur.
3
Reader, Dept. Prosthodontics, Rama Dental College, Hospital & Research Centre, Kanpur.
4
Reader, Dept. of Pedodontics and Preventive Dentistry, Bhabha College of Dental Sciences, Bhopal.

Abstract- Success of prosthodontic treatment in edentulous patients depends upon acceptable function Keywords:
and esthetics of complete dentures. Complete denture occlusion plays a role in providing uniform occlusal equilibrium,
distribution of masticatory forces, better retention and stabilization of denture bases. Complete denture selective grinding, TMD,
centric contacts,
occlusion should satisfy the dynamic interrelationships between forces which stabilize and destabilize the
BULL'S law
denture, including freedom in centric, and the individual arrangement of denture teeth. A good occlusal
philosophy combined with esthetics is paramount in the patient acceptance of a complete denture Conflict of interest: Nil
prosthesis. In this article brief review is made about selective grinding procedure in static, protrusive, No conflicts of interest : Nil
balancing and working contacts after initial balance achieved during the set up of the posterior teeth.

INTRODUCTION – Occlusal adjustment, through selective Definition- Selective grinding is defined as the, “any change
grinding of the tooth surfaces, is one modality of improving in the occlusion intended to alter the occlusal surfaces of the
the overall contact pattern of the teeth. It can be used as an teeth or restorations to change their form.”2 -- GPT -9.
adjunct to orthodontic, restorative or prosthetic and
endodontic (emergency) treatment. Occlusal adjustment Goals of selective grinding - This procedure should
may involve one or multiple, natural and or prosthetic teeth. accomplish the following requirements. It should
Extensive restorative and prosthetic procedures, resulting in
major occlusal changes, sometimes require prior selective 1. Develop a stable intercuspal position in CO, so that all
grinding, so that a stable functional mandibular position is possible posterior teeth centric cusp tips contact opposing flat
established, to which the new restorations, with optimal surfaces evenly and simultaneously with the occlusal forces
occlusal contacts, can be fabricated. In these cases, the end directed along the long axis of teeth.
result of occlusal adjustment must be determined in advance
by performing mock adjustments on mounted casts, as only 2. Develop a plane of occlusion with adequate inter-arch
minimal corrections are possible within the enamel layer of space for prostheses replacing missing teeth.
the teeth. If more extensive surface alterations are necessary,
the patient must be prepared for the possibility that crown 3. Provide laterotrusive contacts to disocclude the posterior
restorations might, eventually, be required.[1]. teeth when the mandible moves laterally.

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4. Provide anterior contacts to disocclude the posterior teeth, 2. When it is determined that a periodontally involved tooth
when the mandible is protruded. has increased mobility which is due to traumatic occlusion
rather than solely to attachment loss.
5. In the upright head position, provide for heavier contacts of
the posterior teeth than of the anterior teeth.[3] 3. In the management of symptomatic fractured teeth or of
prosthetically restored teeth which fracture repeatedly
Selective grinding Guidelines
With respect to the removal of vertical interferences, the rule 4. Occasionally, prior to procedures which will result in major
of thirds can be used to determine if selective grinding should occlusal changes, such as prosthetic reconstructions.
be attempted. Accordingly, if the occlusal interference
represents a cusp tip occluding against the opposing cusp 5. Following orthodontic treatment to correct minor
incline close to the opposing fossa, selective grinding is likely interferences that cannot be corrected solely by tooth
to eliminate the interference without exposing dentin. If, movement.
however, the cusp tip occludes against the opposing cusp
incline closest to the opposing cusp tip, selective grinding 6. As a form of limited supportive therapy, e.g. when a tooth in
would likely expose dentin, and restorative procedures would parafunction becomes hypermobile and hypersensitive,
be, eventually, required. keeping in mind that selective grinding does not replace
treatment aimed at decreasing parafunction (In these cases
With respect to the removal of horizontal, lateral or anterior- the occlusal contact should be reduced, but not eliminated
posterior interferences, it may be expected that slides of less altogether.
than 2mm can be eliminated by selective grinding.[4]
7. Following occlusal splint therapy, selective grinding is
CAUSES OF OCCLUSAL DISHARMONY: indicated, once occlusal appliance therapy has eliminated the
1) Incorrect registration of retruded contact position (RCP) TMD symptoms, and only if it is determined that the
2) Irregularities in setting the teeth. symptoms would disappear permanently, if the occlusal
3) Tooth movement when flasking and packing contacts and jaw position provided by the appliance were
4) Incomplete flask closure. permanently reproduced in the patient's occlusion.

Rationale for Occlusal Adjustments 8. Following the placement of implant-supported crowns, in

Occlusal adjustment, through selective grinding of the tooth order to decrease the incidence of biomechanical
surfaces, is one modality of improving the overall contact complications, such as crown-screw loosening or denture
pattern of the teeth. It can be used as an adjunct to orthodontic, tooth fracture.[5]
restorative or prosthetic and endodontic (emergency)
treatment. Occlusal adjustment may involve one or multiple, Contraindications to Occlusal Adjustment:
natural and or prosthetic teeth. 1. The absence of signs and symptoms of TMD
2. The presence of acute orofacial pain and /or dysfunction
Indications for Occlusal Adjustment: unrelated to occlusion
1. To eliminate isolated occlusal interferences, when a tooth
becomes symptomatic after the placement of a new, 3.When the occlusal adjustment would require grinding
hyperoccluding restoration or following orthodontic beyond the enamel (e.g. slides greater than 2mm).[6]
treatment (In rare cases, therapeutically-induced changes in
occlusion can be associated with the onset of TMD-like SELECTIVE GRINDING OF ANATOMIC TEETH:
symptoms. In these uncommon instances, adjustment of the
occlusion may be warranted, as it will decrease the pain and Articulating paper of minimum thickness is used for marking
mobility and it will improve function, but it should be the actual contacts of the teeth. The diagnostic adjustment was
undertaken with as little invasiveness as possible. first made on the casts and then on the patient using four
differently colored ribbons:

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University J Dent Scie 2018; Vol. 4, Issue 3

1. Red: centric stops posterior teeth and the cuspids in their working position on the
2. Black: protrusive interferences opposite side . The teeth are placed in these positions and not
3. Green: working side interferences shifted from the centric to the eccentric position with the teeth
4. Blue: balancing side interferences[7] in contact . This procedure often results in breaking or
chipping teeth . when the teeth in the balancing side is not in
In the first step, cusp form teeth are altered by selective correct relation , the error appears on either the balancing or
grinding to obtain balanced occlusion when the jaws are in working side . if the balancing contact is excessive , the
centric relation . occlusal balance in a lateral direction is working side teeth will not be in contact . if the working side
obtained by having all of the posterior teeth and the cuspids in contact is excessive , the excess prevents contact on the
contact on the working side and in posterior contact only on balancing side . if the teeth on the working side are too long ,
the balancing side . in the protrusive balance the anterior teeth there will be no contact on the balancing side . if a single tooth
should make incisal edge contact at the same time that the tips is high on the working side , there will be contact neither on
of the buccal and lingual cusps of the posterior teeth contact. the balancing side nor on the working side .

The techniques are as follows: 7. Record the premature contacts . repeat the procedure
1. Adjust the horizontal and lateral condylar inclinations of with the left side as the working side and record the premature
the articulator to the settings dictated by the protrusive contacts. Use articulating tape to mark the areas of premature
interocclusal maxillomandibular relationship record. contact for selective grinding . when using tape , exercise care
to prevent the tape from wrinkling or doubling , as this will
2. Release the horizontal condylar elements to allow result in an error in marking . place the tape on occlusal
freedom of the articulator movements in the eccentric surfaces and the incisal edges of all the mandibular teeth .
positions . when the teeth are brought together, this position assures that
the same force is exerted on all the teeth .
3. Raise the incisal guide pin from the guide table and
secure it above the height of the table . 8. Return the incisal guide pin to the table and use the
following grinding procedures to ensure balanced occlusion
4. Evaluate the areas of the tooth contact in the centric and in the centric and eccentric position .
eccentric positions prior to selection of the point or area to be
reduced or altered . a. If the cusp is high in centric or eccentric position , reduce
the cusp.
5. With the condylar elements against the centric relation
stops , close the articulator until the posterior teeth are in b. If the cusp is high in centric and not in the eccentric
contact . the anterior teeth should not be in contact . examine position , deepen the fossae or the marginal ridges . after all
the lingual cusps of the maxillary posterior teeth and the interceptive contacts have been removed in the centric and
buccal cusps of the mandibular posterior teeth . premature eccentric positions,
contact appears when the remainder of the teeth fail to make
maximum intercuspation. record the area or areas of (1) Do not reduce the maxillary lingual cusp or the
premature contact . The contacts may be in varying amounts mandibular buccal cusp and
and may involve more than one cusp or tooth . These varying (2) Do not deepen the fossa or marginal ridge of any tooth .
situations make necessary critical evaluation prior to grinding
procedures in the centric position ;however further evaluation 9. when one wishes to refine the teeth to retain contact when
in the eccentric positions is necessary before one starts any the articulator is being moved to and from centric and
grinding . eccentric position – balanced gliding occlusion - use the
following selective grinding procedures : on the working side
6. Secure the right condylar element in the centric position reduce the inner inclines of (a) the buccal cusps of the
and place the lingual cusps of the maxillary posterior teeth in maxillary teeth and (b) the lingual cusps of the mandibular
balancing relation with the buccal cusps of the mandibular teeth .

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University J Dent Scie 2018; Vol. 4, Issue 3

On the balancing side reduce the inner inclines of the This remounting may either be laboratory remount or patient
mandibular buccal cusps . to achieve balance in protrusive remount. Inspite of carrying out each step in denture
excursion reduce the distal inclines of the maxillary cusps and construction very carefully it is seen that in the end when the
the mesial inclines of the mandibular cusps dentures are remounting there is an occlusal prematurities or
. interferences may be needed. Although no single occlusal
10.after completing the selective grinding procedures to concept can be identified as adequate in all patients each
establish and maintain the desired occlusion (a) refine the philosophy has its own indications and limitations. Only
occlusal anatomy , using the mounted inverted cone points through a thorough understanding of these and their benefits
and (b) polish all the ground surfaces with wet powdered and drawbacks can we provide the best possible prosthetic
pumice on a wet rag wheel . rehabilitation to our patients.
Conflict of interest - NO
ELIMINATING OCCLUSAL ERRORS IN NON
ANATOMIC TEETH : REFERENCES:
An Interocclusal Centric Relation record is made in a bite 1. Zarb GA, McGinney GP. Completing the rehabilitation
registration material with the opposing teeth just out of of the patient.In: Zarb GA, Bolender CL, Carlsson GE
contact. Dentures are mounted on articulators and the (eds). Boucher's Prosthodontic Treatment for
following procedures are undertaken. Edentulous Patients. St Louis: Mosby, 1997:358–389.
2. The glossary of prosthodontics terms. J Prosthet Dent
1) After being detected by articulating paper between the May 2017; e63
teeth, gross premature contact in Centric Relation are 3. Okeson J.P., Management of Temporomandibular
removed by grinding. Same procedures are used to locate and Disorders and Occlusion. 7th edition Elsevier, Mosby
remove all occlusal interferences lateral and protrussive 2013.
movements. The grinding is done that appear to have been 4. Manfredini D., Favero L., et al., Natural course of
ripped or elongated in processing. In Centric Occlusion no temporomandibular disorders with low pain-related
grinding is done on the distobuccal portion of the lower impairment: a 2-to- 3 year follow-up study. Journal of
second molar. All balancing- side grinding is done on the Oral Rehabilitation 2013;40:436-442.
lingual position of the occlusal surfaces of the upper second 5. List T., Axelsson S., Management of TMD: evidence
molar. from systematic reviews and meta-analyses. Journal of
2) Abrasive paste is placed on the teeth on the articulator. Oral Rehabilitation 2010;37:430-451.
These teeth are milled when the upper member of the 6. Rollman A., Visscher C.M., Gorter R.C., Naeije M.,
articulator moves in and out of protrusive and right and left Improvement in patients with a TMD-pain report. A 6-
lateral excursions. When the teeth slide smoothly through all month follow-up study. Journal of Oral Rehabilitation
excursions, the dentures are removed from the articulators 2013;40:5-14.
and washed. Seldom is any correction necessary to attain a 7. Tetsuo saito et al : Quintessence international , vol 21 ,
bilaterally balanced occlusion. number 11/1990.
8. Heartwell C M and Rahn A R . Denture insertion . 4th
3) Spot grinding is done to correct any small discrepancies in edition . Bombay; Varghese publishers 1992; 402-404.
Centric Relation that remain after the grinding with abrasive
paste. The dentist adjust them after identifying the CORRESPONDIND AUTHOR:
discrepancies with articulating paper – using a light tapping Dr. Rosy Raheja
motion with the articulator and grinding the marks to ensure Student , Prosthodontics , Rama Dental College, hospital And
even occlusal contact in Centric Occlusion.8 Research Centre , Kanpur.
SUMMARY AND CONCLUSION : Email – rosy.raheja@yahoo.com .
Selective grinding in complete denture Prosthodontics is PHONE – 08604626064 .
an important laboratory procedure which is carried out by
remounting of the dentures after processing is completed.

University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 113