Buccal Tooth Position Instability — ORE Part 1 MCQ

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ModerateProsthodonticsBuccal Tooth Position InstabilityORE Part 1

A patient presents with a complete denture with bilateral balanced occlusion. The posterior teeth have been set too far buccally in relation to the residual ridge. What is the most likely consequence during mastication?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — The denture rocks laterally under occlusal loading

Explanation lettering: D = shown as A · E = shown as C · A = shown as D · C = shown as E

A is correct. Posterior teeth placed excessively buccal to the residual ridge apply masticatory loads with an unfavourable lateral lever arm, tending to tip and rock the denture during function. Bilateral balanced occlusion may reduce dislodgement in excursions, but it does not overcome poor bucco-lingual tooth position. B is incorrect because buccal tooth placement does not reliably increase retention; teeth should instead lie within the neutral zone so cheek and tongue forces are favourable. C concerns an excessive occlusal vertical dimension, not posterior tooth position. D is the opposite of the expected biomechanical effect. E is incorrect because balanced contacts alone cannot compensate for lateral loading outside the supporting area.

Reference: Jooste CH, Thomas CJ. Complete mandibular denture stability when posterior teeth are placed over a basal tissue incline. Journal of Oral Rehabilitation. 1992;19(5):441-448. https://pubmed.ncbi.nlm.nih.gov/1453256/