Rehabilitation of a Patient using a Twin-Stage Technique to achieve Balanced Occlusion in Implant-Supported Overdenture: A Clinical Report

Ideal occlusion on an osseointegrated implant has not been investigated with 6� of freedom biomechanically. The current accepted tenet is to avoid horizontal forces on fixtures and for edentulous cases, a balanced articulation must be created. Hobo and Takayama proposed a twin stage procedure to develop disocclusion and anterior guidance more precisely and scientifically. They concluded that effective cusp angle is the most reliable among all the factors effecting occlusion. They proposed a two stage procedure to develop effective cusp angle of 25� in order to achieve balanced occlusion in complete denture prosthesis. This clinical report describes a step-by-step procedure involved in developing balanced occlusion using twin stage technique in implant supported overdenture.