The Curve of Wilson in Prosthodontic Rehabilitation: A Systematic Review of Evaluation and Reconstruction Methods

Despite its theoretical importance, the COW remains a subject of controversy in the clinical literature.Methods for its evaluation and reconstruction vary considerably, ranging from traditional approaches based on averages (e.g., Monson's 4-inch sphere) to modern digital techniques (CBCT, intraoral scanners) that allow for more individualized analysis.5,7,8 Studies 5,9,10 have shown significant variability in its parameters (radius, depth) depending on ethnicity, sex, and type of malocclusion, challenging the application of a single standard for all patients. IntroductIonProsthodontic rehabilitation aims to optimally restore masticatory functions impaired by various pathologies and anomalies of the masticatory system.Among the fundamental parameters of occlusion, compensatory curves-including the curve of Wilson (COW)-play a pivotal role.Initially described by George Henry Wilson (1855-1922), 1 the COW is defined as a frontal curve that is generally concave upward, resembling a segment of a circle with a variable radius, connecting the apices of the buccal and lingual cusps of two homologous teeth. 2 This transverse curve, together with the sagittal curve (curve of Spee) and the occlusal plane, serves as an essential reference in functional analysis and prosthodontic restoration.2 It results from the progressive axial inclination of the posterior teeth: the mandibular molars exhibit a lingual inclination, while the maxillary molars have a buccal inclination.3 Combined with the curve of Spee, the COW forms a complex three-dimensional occlusal surface, often conceptualized as the Monson sphere or the Ackermann helicoid.4 This anatomical organization responds to precise biomechanical and functional requirements.Statically, it allows occlusal forces to be directed axially, ensuring greater resistance of the dento-periodontal structures and a distribution of stresses towards the load-bearing pillars of the craniofacial skeleton.2 Dynamically, it facilitates lateral excursion movements of the mandible by preventing occlusal interferences on the nonworking side.2,5,6