Background: The selection of an appropriate occlusal scheme is considered a critical factor in the success of complete denture therapy, as it directly influences denture stability, retention, masticatory efficiency, and patient satisfaction. Among the various occlusal concepts available, balanced occlusion and lingualized occlusion are commonly employed in clinical practice. However, the comparative effectiveness of these two occlusal schemes remains inconclusive in the existing literature.Objective To systematically evaluate and compare balanced occlusion and lingualized occlusion in complete denture patients with respect to denture stability, retention, and oral health–related quality of life (OHRQoL). Materials and Methods: A systematic review was conducted following a comprehensive search of relevant electronic databases and manually selected references. Following established inclusion and exclusion criteria, clinical trials, randomized controlled trials, and comparative studies assessing balanced and lingualized occlusion in individuals with full dentures were included. Data regarding study characteristics, participant demographics, intervention protocols, and outcome measures including denture stability, retention, and OHRQoL were extracted and qualitatively analyzed. Appropriate risk-of-bias assessment instruments were used to evaluate the research included for their methodological quality. Results: The computerized database searching yielded 72 records, with 16 studies meeting the inclusion requirements after screening and full-text evaluation. Clinical results for patients with full dentures treated with Balanced Occlusion or Lingualized Occlusion were positive in the included trials. While some studies found that lingualized occlusion improved denture stability and masticatory efficiency, denture retention and oral health-related quality of life were similar between the two occlusal schemes, and there was no clear evidence that one was better. Conclusion: Both Balanced Occlusion and Lingualized Occlusion demonstrated comparable clinical and patient-centered outcomes in complete denture therapy. Although lingualized occlusion showed potential biomechanical advantages in denture stability, current evidence does not confirm the clear superiority of either occlusal scheme. Therefore, occlusal scheme selection should be individualized based on clinical findings, prosthodontic requirements, and patient-specific considerations.
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