Do complete dentures have to have a balanced occlusion?


When constructing conventional complete dentures incorporating a bilateral balanced occlusion (BBO) is considered by many to be important for a successful outcome.  The aim of this review was to compare whether BBO or canine-guided (CG) dentures were important for successful denture treatment.

The Medline, ISI Web of Science, LILACS (Latin American and Caribbean Literature on the Health Science), and BBD (Brazilian Bibliography of Dentistry) databases were searched together with the reference lists of identified studies and current textbooks. Randomised controlled trials with patients of any age wearing conventional complete upper and lower dentures that compared BBO and CG dentures were included.  Two reviewers conducted study selection independently.

  •  Seven RCTs involving a total of 191 patients were included, 6 trials used a cross-over design, and a qualitative summary of the studies presented.
  • 4 studies reported no difference
  • 2 found better outcomes for CG approaches and one trial for BBO

The authors concluded

Current scientific evidence suggests that BBO is not imperative for successful treatment with conventional complete dentures in average patients when masticatory function and patient satisfaction are considered as treatment outcomes. More studies are necessary to identify if specific clinical conditions may benefit from a balanced occlusion.


The numbers of patients included in the studies is relatively small with the largest trial having 60 patients. However, the majority used a crossover design with no ‘wash-out period’ a point noted in the authors discussion.  The reviewers have not assessed the quality of the included studies and outcome measures vary between the studies.


Farias-Neto A, Carreiro AD. Complete Denture Occlusion: An Evidence-Based Approach. J Prosthodont. 2012 Sep 17. doi: 10.1111/j.1532-849X.2012.00927.x. [Epub ahead of print] PubMed PMID: 22984917.





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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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