Angle's Classification-A Prosthodontic Consideration: Best Evidence Consensus Statement

Purpose: This Best Evidence Consensus Statement evaluated the existing Angle's classification clinical literature to determine if the Angle's classification as historically determined in maximum intercuspal position (MIP) with hand held casts is coincident with the centric occlusion (CO) determined Angle's classification. In addition, it explored the value of using Angle's classification for edentulous patients MATERIALS AND METHODS: The search strategy was related to the focus questions and limited to Meta-analyses, Systematic Reviews (SR), Randomized Controlled Trials (RCT) and Clinical Trials. Searches were completed using the term Angle's classification and Boolean Modifiers (AND) with the key terms: dental occlusion, dental occlusion centric, centric occlusion, centric relation, maximal intercuspation, MIP, intercuspal position, and edentulous patient, retrognathia, determination, and prognathia. Additional related articles were culled from the reference lists in the articles found in the PubMed searches.

Results: The search identified 494 articles related to the selected terminology. Titles were reviewed and selected if related to the focus questions for further review. Seven papers could be identified that addressed the specifics of the questions.

Conclusions: There is evidence that the Angle's classification for many patients will change when recorded in CO compared to the historical MIP determination/definition. A different Angle's classification recorded in CO is potentially a significant diagnostic finding for patients needing complete mouth rehabilitation. The current definitions of Angle's Classification are not useful in the management of edentulous patients.