Fundamentals of occlusion

Reference: Shillingburg Funamentals of Fixed Prosthodontics, third edition chapter two

Objective
Appreciate the importance of occlusion
The ability to diagnose and treat simple occlusal

disharmonies To produce restorations that will avoid the creation of iatrogenic disease

Centric Relation
The maxillomandibular relationship in which the condyles articulate with the

thinnest avascular portion of their respective disks with the complex in the anterior-superior position against the shapes of the articular eminencies. This position is independent of tooth contact. This position is clinically discernible when the mandible is directed superior and anteriorly. It is restricted to a purely rotary movement about the transverse horizontal axis (GPT-5)

Only hinge rotation movement of the condyle takes place in centric relation position

Inter-cuspal position (ICP)

Also called maximum intercuspation MIC The position of maximum intercuspation between

teeth The most cranial position of the mandible

Maximum Intercuspation

Mandibular Movement
Series of motions occurring around three axes: Horizontal axis Vertical axis Sagittal axis

Horizontal Axis
This Movement in the sagittal plane, happens when the

mandible in centric relation makes a purely rotational opening and closing border movement around the terminal hinge axis

Pure hinge rotation

translation

Vertical Axis
This movement occurs in the horizontal plane when the mandible moves into a lateral excursion.

Sagittal Axis
This movement occurs in the frontal plane during a lateral excursion around an anteroposterior axis

Protrusion

Laterotrusion and mediotrusion

Condyle in non working

Side moves forward and medially Condyle in working Side moves laterally And Slightly posteriorly
Non Working side Working side

Bennett angle
The angle formed in the horizontal plane, between the pathway of the non working condyle in a mandibular lateral translation, and the sagittal plane.

NWS

WS

NWS

WS

Bennett movement

Bennett angle

The determinants of mandibular movement

Two condyles

Contacting teeth

The determinants of mandibular movements

Two condyles: Condylar guidance, Bennett angle (the

dentist has no control over the posterior determinants.)

Contacting teeth: posterior and anterior teeth

Condylar guidance
The angle formed in the sagittal plane, between the condylar path during protrusion, and the horizontal plane

Contacting teeth
Posterior teeth:

Provide vertical stops for mandible closure Guide the mandible into the position of maximum intercuspation

Anterior teeth:

Guide the mandible into right and left lateral excursive movement. Guide the mandible in the protrusion movement. Why are the anterior teeth more suitable to carry the guidance in excursions??

Anterior guidance
During protrusive movement of the mandible , the incisal

edges of the mandibular anterior teeth move forward and downward along the lingual concavities of the maxillary anterior teeth

Anterior guidance
The track of the incisal edges from max.

intercuspation to edge-to-edge occlusion is called the protrusive incisal path

The angle formed between the

protrusive incisal path and the horizontal reference plane is called the protrusive incisal path inclination

 In a healthy occlusion, the anterior guidance is 5 to 10

degrees steeper than the condylar guidance

Anterior guidance
Affect occlusal surface morphology of the posterior teeth: Vertical overlap Horizontal overlap

 One of the objectives of restorative dentistry is to place

the teeth in harmony with TMJ. This will result in min. stress on the teeth and joint

Interferences

Occlusal interferences

Contacts that may produce mandibular deviation during closure to maximum intercuspation or may hinder smooth passage to and from the intercuspal position:
Centric Working Non-working Protrusive

1.

2.
3. 4.

1.Centric interference
Premature contact that occurs when the mandible closes with the condyles in their optimum position in the glenoid fossae

2.working interference
An occlusal contact between the maxillary and mandibular posterior teeth on the same side of the arches as the direction in which the mandible has

moved

3.nonworking interference
An occlusal contact between maxillary and mandibular

teeth on the side of arches opposite to the direction in which the mandible has moved

4.protrusive interference
Premature contact that occurs between the mesial aspects of mandibular posterior teeth and distal aspects of maxillary posterior teeth

Consequences of pathologic occlusion

Trauma to TMJ
Parafunctional jaw activities (bruxism and

clenching) Muscle fatigue or spasm Facets and wear of teeth Teeth mobility

Optimum occlusion
Minimum adaptation by the patient
Criteria for optimum occlusion

Organisation of the occlusion

Bilateral balanced occlusion Unilateral balanced occlusion Mutually protected occlusion

Bilateral balanced occlusion

Prosthetic concept : (not frequently used)

max. number of teeth contact in all excursive positions of the mandible useful in complete denture construction in which contact on the non working side is needed

Unilateral balanced occlusion

Commonly known as group function :
(Widely used)

working side : all teeth are in contact nonworking side : teeth are free of any contact

Unilaterally balanced occlusion

Contacts between

opposing posterior teeth on the working side only during lateral excursion (group function lateral guidance) Incisors and canines carry the protrusive guidance

Mutually protected occlusion

Also known as canine protected occlusion:

ease of fabrication, greater tolerance by patients

anterior teeth protecting the posterior teeth in mandibular excursions post. teeth protecting anterior teeth at the intercuspal position

Mutually protected occlusion

- Posterior teeth come in contact only in intercuspal position acting as vertical stops - Canines on the

working side carry the lateral guidance - Incisors and canines carry protrusive guidance

Thats it