Class II Lives Matter: Restoring Natural Occlusion for Long-Term Comfort

In the world of dentistry, achieving patient comfort and functional restoration is paramount. However, many challenges arise when attempting to correct occlusion, particularly in patients with natural Class II or Class III jaw relationships. This blog explores a real-world case study highlighting the importance of honoring a patient’s natural occlusion for successful outcomes in full-arch implant-supported restorations.

The Obstacle: Speech Challenges, Tongue Biting, and Pain

A patient with a full-arch implant-supported hybrid restoration presented with significant issues:

• • Speech challenges
  • Tongue biting
  • Pain that was intolerable long-term
  • Insufficient lip support

Upon evaluation, it was revealed that the patient’s restoration was designed to achieve an “ideal” Class I occlusion. However, their natural jaw relationship was Class III, which had been disregarded. The resulting lower arch was positioned too far lingual from the ridge, leading to tongue crowding and subsequent discomfort.

The Solution: Returning to Natural Class III Occlusion

To address the problem, a thorough evaluation was conducted:

1. Study Models and Jaw Relationship Assessment: Models of the patient’s existing restorations were analyzed to identify the misalignment.
2. Prototype Adjustment: The patient was placed in their natural Class III occlusion using a screw-retained temporary provisional prototype. This adjustment immediately alleviated their symptoms: 
   • Pain was resolved.
   • Tongue biting subsided.
   • Speech challenges disappeared.

The patient’s immediate relief confirmed the accuracy of the diagnosis.

The Outcome: Long-Term Success Through Natural Occlusion

After allowing the patient to rest for two weeks with the prototype, a new final restoration was created, respecting their natural Class III jaw relationship. The results were profound:

• The patient’s functionality and comfort improved significantly.
• The restoration’s durability and long-term success were enhanced.

Lessons from the Lab: Avoiding Common Pitfalls

From a laboratory perspective, many remakes in full-arch implant-supported restorations (commonly All-on-X cases) stem from attempts to force a natural Class II or Class III occlusion into an “ideal” Class I. Here’s why this approach often fails:

• Natural Growth Patterns: A patient’s natural jaw relationship dictates where the teeth emerge from and how they function.
• Forced Adjustments: Altering the natural occlusion can result in pain, improper function, and restoration failure.

Key Takeaway: Honor the Patient’s Natural Occlusion

The case underscores a critical principle: always restore patients to their natural occlusion. Disregarding this can lead to discomfort, functional challenges, and compromised restoration longevity. By respecting a patient’s natural jaw relationship, dentists and laboratories can ensure better outcomes, improved patient satisfaction, and fewer remakes.

In dentistry, one size does not fit all. Embracing individual differences in occlusion is the key to lasting success. To learn more about how Wiand Dental Lab can support you in restoring your natural occlusion, contact us today.