-

Variations in organic occlusion

Francis S. Johnson, D.D.S.
Santa Barbara, Calif.

0 rganic occlusion had been presented as a basic

concept of occlusion.’ This type of occlusion includes
a cusp-fossa contact with tripoding of cusps in fossae
for stability, a tooth-to-tooth occlusion, coincidence
of centric occlusion and centric relation, and disclu-
sion or separation of the posterior teeth by the
anterior teeth during eccentric jaw movements.
The functioning element of organic occlusion is
the stamp cusp in a fossa. The fnaxillary lingual
cusps and mandibular buccal cusps are stamp cusps.
As the -jaw moves from centric occlusion these cusps Fig. 1. Mandibular stamp cusps are indicated with the
occlusal contact points being the apices of the triangles.
pass into grooves to prevent occlusal interferences.
The cusp tips themselves do not contact thr fossae.
The working grooves are transverse and the idling
grooves oblique.’ The maxillary buccal cusps and
the mandibular lingual cusps are shearing cusps.
The posterior stamp cusps protect the anterior
teeth in centric occlusion. The anterior teeth protect
the posterior teeth from eccentric or horizontal
stresses and from grinding during empty mouth
contacts.
The cusp tips of the teeth do not touch the
opposing teeth at anytime, either in centric or
eccentric occlusion. The contact surface of the cusp-
fossa unit is a small contact area at the apex of the
triangles (Figs. 1 to 4):’
Fig. 2. Maxillary fossae centric occlusion contact points
Variations in the mesial-distal position of the of the mandibular buccal stamp cusps. The only contact
cusps and fossae do occur. These variations require points are the apices of the triangles.
ad.justments in the occlusal pattern of the teeth and
must be understood to maintain an organic occlu-
sion. mandibular molars close into the maxillary mesial,
central, and distal fossae of the maxillary molars,
OCCLUSAL VARIATIONS respectively (Fig. 5). Conversely, the lingual stamp
Neutroclusion cusps of the maxillary premolars close into the distal
The usual mesial-distal stamp-cusp position (Class fossae of the mandibular premolars, and the lingual
I occlusion) is known as neutrochion. The buccal stamp cusps of the maxillary molars close into the
stamp cusps of the mandibular premolars close into central and distal fossae of the molars, respectively.
the mesial fossae of the maxillary premolars in The mesial fossae of the mandibular molars and the
centric occlusion. The buccal stamp cusps of the distal fossae of the maxillary premolars are vacant,
since there are no available stamp wsps (Figs. 5
Kcad before the Pacitic Coast Society of Prosthodontists, Newport and 6).
Beach, Calif. The direction the stamp cusps of the premolars

(K)22-3313:73’060625 + 05%00.50/O (0 1979 The C. V. Mosby Co. THE JOURNAL OF PROSTHETIC DENT ISTRY 62.5
Fig. 3. Maxillary lingual stamp cusps. The tripod contact
points of each cusp are only the three points of the
triangles. The cusp tips do not contact the opposing teeth
at any time.

Fig. 5. In neutroclusion the mandibular buccal stamp

cusps occlude with the indicated maxillary fossae in
centric occlusion and centric relation.

Fig. 4. Mandibular fossae contact points are indicated at

the apices of the triangles. There is no maxillary cusp that
occludes in the mesial fossae of mandibular molars.

and molars move during eccentric border move-

rnents are seen in Figs. 7 and 8. There is no cuspal
interference during these movements, since the cusps
work and idle in their respective grooves. The
working grooves are transverse (rotation around the
near condyle) and the idling grooves are oblique
(rotation around the far condyle). The grooves are
Fig. 6. In neurroclusion the maxillary lingual stamp
formed from developmental and supplemental cusps occlude with the indicated mandibular fossae in
occlusal grooves. centric occlusion and centric relation.
There are no posterior interferences of the teeth
during mandibular closure. If there were an interfer- lar premolar cusps are one half-tooth distal and the
ence it would deflect the mandible and would be mandibular molars are one cusp distal to normal.
called a deflective occlusal contact, a type of maloc- This tooth position is called distoclusion. This mesio-
clusion. distal position also causes the maxillary lingual
Each stamp cusp, as it leaves its opposing stamp premolar stamp cusps to be one half-tooth forward
fossa, moves eccentrically out of contact and into a or to close into the mesial fossa of the mandibular
groove. This prevents posterior tooth rubbing and premolars. The maxillary molar stamp cusps move
wear and eliminates lateral stresses on the posterior one cusp forward so that they function in the mesial
teeth. and central fossa of the mandibular molars, respec-
tively. This is also called a Class II occlusion (Figs. 9
Distoclusion and 10).
A variation to the normal mesial-distal stamp CUSF ‘I-his cusp position places the mandibular premo-
position exists in centric relation when the mandibu- lar stamp cusp posterior to the maxillary premolar

626 JUNE 1979 VOLUME 41 NUMBER 6

Fig. 7. Maxillary working (transverse), idling (oblique),
and protrusive grooves marked where mandibular buccal
cusps pass through during eccentric occlusal movements
in a neutrociusion tooth arrangement.

Fig. 9. In distoclusion the mandibular buccal stamp

cusps occlude with the indicated maxillary fossa in centric
occlusion and centric relation.

Fig. 8. Mandibular working (transverse), idling

(oblique), and protrusive grooves marked where maxillary
lingual cusps pass through during eccentric occlusal
movements in a neutroclusion tooth arrangement.

stamp cusp. As the mandible rotates around the

vertical rotation center during function, the advanc-
ing or idling condyle comes forward and medial. Fig. 10. In distoclusion the maxillary lingual stamp cusps
This causes the mandibular stamp cusp to travel occlude with the indicated mandibular fossae in centric
medially and forward and interfere with the maxil- occlusion and centric relation.
lary stamp cusp.* This idling interference of the
premolars and molars appears in the oblique or distal and buccal and the affected maxillary stamp
idling groove (Figs. 11 and 12). Because of the cusps slightly mesially and lingual. This allows
changed fossae in which the stamp cusps function, further travel of the respective cusps in their idling
the maxillary premolars, the mandibular premolars, grooves before coming to an opposing cusp tip
and the mandibular mesial fossae all have oblique position. As the advancing condyle travels further it
paths that lead to a cusp tip. This cusp tip, passing also descends and further separa.tes the idling teeth.
directly over or under the opposing cusp tip, could Also, supplemental grooves along the idling cusp
cause eccentric contact or interference. paths (oblique grooves) are placed to further
In restoring teeth in this mesiodistal position, the enhance eccentric clearance.
elimination of these eccentric interferences is done by
moving the affected mandibular stamp cusps slightly
Mesioclusion
The mesial placement of the rnandibular teeth by
*Personal communication: C. E. Stuart. Oct. 1977 one half-tooth in the premolars and one cusp in the

THE JOURNAL OF PROSTHETIC DENTISTRY 627

Fig. 11. Maxillary working (transverse), idling (oblique),
and protrusive grooves marked where mandibular buccal
cusps pass through during eccentric occlusal positions in
distoclusion. Premolar oblique grooves lead to cusp tips
and interference unless modified as suggested in the
text.
Fig. 13. ln mesioclusion the mandibular first premoiar
buccal stamp cusp occludes with the maxillary canine, and
the remairiing buccal stamp cusps occlude with the
indicated maxillary fossae in centric occlusion and centric
relation.

Fig. 12. Mandibular working (transverse), idling

(oblique), and protrusive grooves marked where maxillary
lingual cusps pass through during eccentric occlusal
positions in distoclusion. Premolar oblique and molar
mesial fossa oblique grooves lead to cusp tips and
interference unless modified as suggested in the text.
Fig. 14. In mesioclusion the maxillary lingual stamp
cusps occlude with the indicated mandibular fossae in
centric occlusion and centric relation.

molars is called mesioclusion. This also places the As noted in the preceding section on distoclusion,
maxillary lingual stamp cusps one half-tooth distally the conflict in eccentric interference occurs when a
in the premolar area and one cusp distally in the mandibular stamp cusp is placed distal to its oppos-
molar relationship. This is a Class III occlusal ing maxillary stamp cusp.
relationship where the anterior teeth are often close This potential cuspal interference is corrected by
to an end-to-end position. moving the involved maxillary lingual stamp cusps
The mandibular first premolar buccal stamp cusp slightly mesial and lingually. Conversely, the
will function against the maxillary canine. The involved mandibular buccal stamp cusps are moved
respective fossae that the other maxillary and mandi- slightly buccal and distally (Figs. 15 and 16). The
bular stamp cusps function in are visualized in Figs. amount these cusps are moved is established by
13 and 14. observing the idling side in eccentric position to

628 JUNE 1979 VOLUME 41 NUMBER 6

Fig. 15. During mesioclusion the mandibular. stamp
cusps function as indicated. Th* maxillary premolar
oblique grooves lead to the cusp tips and will interfere
unless corrected as suggested in the text.
Fig. 16. During mesioclusion the maxillary iingual cusps
function as indicated. The oblique groove oi the second
premolar and oblique grooves extending frown the mcbsi,ll
fossa of the molars lead directly to cusp tips md must be
corrected to eliminate interferences

verify an adequate clearance. Idling (oblique)

grooves are also established to allow free travel to the REFERENCES
border position for the cusps.
1. Stuart, C. E.: What is organic occlusion. Orai Rehabilitation
and Occlusion, University of California, Sept i”ii6.
SUMMARY 2. Stuart, C. E.: The geometries of the gnathit svsrem. Oral
The principles of organic occlusion were illus- Rehabilitation and Occlusion; tini\-er+ If California.
trated and described as neutroclusion. Variations of Sept. 1976.
3. Stuart. C. E.: Why dental restorations sixmlri II>:XC c uupq ,J
occlusion in a mesial and distal position were South Calif Dent Assoc 27:198, I95!$
described as distoclusion and mesioclusion. The
potential areas of conflict in these variations were
Refmnt requea to.
described, and the methods for correction were
DR. FRANCIS S. JOHNSON
shown so that the principles of organic occlusion 2780 STATE ST.. Sm. I1
would not be compromised even in these varia- SAW.\ BARBARA.C~LIF. 93105
tions.

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