INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

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OCCLUSION (PART II)

www.indiandentalacademy.com
CONTENTS
1. Concepts of occlusion
2. Optimum orthopaedically stable joint
position
3. Optimum functional tooth contacts
4....
5.Criteria for
occlusion

Optimum

functional

6.Occlusal contact patterns
a) Canine guided occlusion
b) Group function oc...
“What is the best functional
relationship or occlusion of the
teeth” ?

www.indiandentalacademy.com
Concepts of occlusion
Three occlusal concepts:
The Gnathological
The Freedom-in-centric
European conceptual model

www....
THE GNATHOLOGICAL
CONCEPT

•Mid 1920’s McCollum.
Gnathology: exact science of
mandibular movement and resultant
occlusal c...
Balanced
occlusion:(complete
dentures)
“During functional excursions there
is multiple simultaneous contacts
present both ...
ARNE G. LAURITZEN
Direction of occlusal stresses-long axis of
teeth.
 Centric relation=centric occlusion
(condyles in up...
www.indiandentalacademy.com
NILES GUICHET AND GNATHOLOGY
Optimal occlusion (1966)
Canine guided occlusion- biomechanics
Occlusion must be in harmony...
 There is horizontal movement of the
mandible
from
the
maximal
intercuspal position and teeth are
capable of standing tha...
VISION OF TRANSOGRAPHIC CONCEPT
Page’s
Four principles:
1. Opening axis
2. Cranial plane
3. Bennett movement
4. Envelope o...
2.Cranial planes:No translatory condyles,
so no practical support for horizontal
plane.
3.Bennett movement: such a movemen...
FREEDOM IN CENTRIC
Posselt was first
Functional occlusion- Ramfjord and Ash1970’s
Criteria are to attempt to eliminate t...
cusps occlude, will allow for a certain
degree of freedom in both centric and
eccentric movements without the guiding
infl...
www.indiandentalacademy.com
www.indiandentalacademy.com
OCCLUSAL CONCEPTS OF SCHUYLER
Correction of occlusal disharmonies in the
natural dentition and to the concepts of
freedom...
Anteroposterior difference – 0.5 to 1
mm
Variation in centric relation recording –
not a point – area in relation to
hor...
www.indiandentalacademy.com
BEYRON’S OCCLUSAL CONCEPTS
Based on functional convenience and
avoidance of discomfort
Most
physiological
inter-relation...
PANKEY MANN PHILOSOPHY
Monson’s sphere (occlusal line and
plane) + Meyer’s concepts of a
functionally generated path
Pan...
Stable and Static contacts - greatest
number of teeth
Long centric – Occlusal harmony with an
anterior slide between cen...
www.indiandentalacademy.com
DAWSON’S CONCEPT
Peter Dawson
 Manipulation of the jaw in centric
relation (Bimanual technique)
 Recording the border mo...
Anterior guidance:
 Anterior teeth are more capable of
supporting stress than posteriors:
(a)Position of anteriors
(b)Hig...
GERBER’S CONDYLAR
DISPLACEMENT THEORY
European concept
“ The normal or ideal occlusion was one
in which the teeth would be...
www.indiandentalacademy.com
RAMFJORD AND ASH CONCEPTS OF
OCCLUSION
 Equilibrium
between
the
different
components of masticatory system.
 Freedom for...
www.indiandentalacademy.com
Normal versus Ideal occlusion

www.indiandentalacademy.com
Optimum orthopaedically stable
joint position
Centric relation, is the position
of the mandible when the
condyles
are
in
a...
Centric relation

1:The maxllomandibular relationship in
which the condyles articulate with the
thinnest
avascular
portion...
It is restricted to a purely rotary
movement about the horizontal axis(GPT5).
2:The most retruded physiologic relation
of ...
3:The most retruded relation of he
mandible to the maxillae when the
condyles are in the most posterior
unstrained positio...
5:A maxilla to the mandible relationship in
which the condyles and the disks are
thought to be in the midmost,uppermost
po...
6:The relation of the mandible to the
maxillae when the condyles are in the
uppermost and the rearmost position in
the gle...
www.indiandentalacademy.com
Centric relation has been described in
three
different
ways:
anatomically,
conceptually, and geometrically.
Anatomical:
It...
Conceptual:
It is that position of the mandible relative
to the maxilla, with the articular disc in
place, when the muscle...
Dawson’s
concept

Gelb’s
concept

www.indiandentalacademy.com
Optimum functional tooth contacts
Closure in CR

Creates an unstable occlusion
Neuromuscular system
Feed back muscles
Mand...
Musculoskeletal stable position
HARMONY

Stable occlusal condition

www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
Conclusion:
Optimum occlusal conditions
during
mandibular
closure
would be provided by even and
simultaneous contact of al...
Criteria for optimum functional
occlusion
Even and simultaneous contact of
all
possible
teeth when the
mandibular condyles...
Occlusal contact patterns
Direction of force
Amount of force

www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
Criteria for optimum functional
occlusion
First - Even and simultaneous
contact of all possible teeth +
centric relation
S...
Nutcracker theory

www.indiandentalacademy.com
Canine guided occlusion

www.indiandentalacademy.com
Group function occlusion

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Buccal to buccal cusp contacts are
desirable
No non-working side contacts

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Protrusive contacts

www.indiandentalacademy.com
Postural considerations and
functional tooth contacts
Depends on head position
In the alert feeding position, as well as...
Summary
1. When the mouth closes, the condyles are
in their most superoanterior
(Musculoskeletal stable) position, resting...
2. All tooth contacts provide axial loading
of occlusal forces.
3. When the mandible moves into a
laterotrusive
position,
...
4. When the mandible moves into a
protrusive position, there are adequate
tooth-guided contacts on the anterior
teeth to d...
REFERENCES
 Occlusion series in BDJ, 2001;191:6-7


Okeson
JP.
Management
of
Temporomandibular
Disorders and
Occlusion, ...
Santos JD. Occlusion Principles and
Concepts, ed. 2nd, 1999; Ishiyaku
EuroAmerica, Inc. U.S.A.
 Shillingburg HT. Fundame...
www.indiandentalacademy.com
Thank you
For more details please visit
www.indiandentalacademy.com

www.indiandentalacademy.com
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Occlusion part ii /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Occlusion part ii /certified fixed orthodontic courses by Indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. OCCLUSION (PART II) www.indiandentalacademy.com
  3. 3. CONTENTS 1. Concepts of occlusion 2. Optimum orthopaedically stable joint position 3. Optimum functional tooth contacts 4. Normal versus ideal occlusion www.indiandentalacademy.com
  4. 4. 5.Criteria for occlusion Optimum functional 6.Occlusal contact patterns a) Canine guided occlusion b) Group function occlusion 7. Summary 8. References www.indiandentalacademy.com
  5. 5. “What is the best functional relationship or occlusion of the teeth” ? www.indiandentalacademy.com
  6. 6. Concepts of occlusion Three occlusal concepts: The Gnathological The Freedom-in-centric European conceptual model www.indiandentalacademy.com
  7. 7. THE GNATHOLOGICAL CONCEPT •Mid 1920’s McCollum. Gnathology: exact science of mandibular movement and resultant occlusal contacts. Instruments: • Kinematic face bow, Gnathoscope and Gnathograph www.indiandentalacademy.com
  8. 8. Balanced occlusion:(complete dentures) “During functional excursions there is multiple simultaneous contacts present both on the working side and on the balancing side” Stallard and Stuart: organic or organised occlusion. -neglected that mastication is more vertical than lateral. www.indiandentalacademy.com
  9. 9. ARNE G. LAURITZEN Direction of occlusal stresses-long axis of teeth.  Centric relation=centric occlusion (condyles in uppermost and rearmost position) Simultaneous occlusal loads fall on as great number of teeth. Lateral excursion may be free. Canine guided occlusion. Group contact between upper and lower www.indiandentalacademy.com anterior teeth during protrusive movement.
  10. 10. www.indiandentalacademy.com
  11. 11. NILES GUICHET AND GNATHOLOGY Optimal occlusion (1966) Canine guided occlusion- biomechanics Occlusion must be in harmony with the mandibular movements of each patient. Ganathograph and Pantograph. Denar articulator. www.indiandentalacademy.com
  12. 12.  There is horizontal movement of the mandible from the maximal intercuspal position and teeth are capable of standing that horizontal stress in function .  (D’ Amicos)-canines - eight times stress than on the 2nd premolars. www.indiandentalacademy.com
  13. 13. VISION OF TRANSOGRAPHIC CONCEPT Page’s Four principles: 1. Opening axis 2. Cranial plane 3. Bennett movement 4. Envelope of motion 1. Opening axis:12º to 15º of rotation. Transverse hinge axis –reproducible. www.indiandentalacademy.com
  14. 14. 2.Cranial planes:No translatory condyles, so no practical support for horizontal plane. 3.Bennett movement: such a movement is because of mouth opening to 2 noncolinear axes, Page did not concede to the existence of the Bennett side shift. 4. In the discussions conceding the envelope of motion, when one takes the motions to a narrow functional terminal orbit, raised a great number of questions www.indiandentalacademy.com in the oral rehabilitation.
  15. 15. FREEDOM IN CENTRIC Posselt was first Functional occlusion- Ramfjord and Ash1970’s Criteria are to attempt to eliminate the need for neuromuscular adaptation. According to this concept, Maximum intercuspation and centric relation are coincident but flat areas on the depth of the fossae, on which opposing www.indiandentalacademy.com
  16. 16. cusps occlude, will allow for a certain degree of freedom in both centric and eccentric movements without the guiding influences of occlusal inclines. Vertical dimension of occlusion in maximum intercuspation and centric relation might be the same when all the interferences for closing in centric relation are eliminated. www.indiandentalacademy.com
  17. 17. www.indiandentalacademy.com
  18. 18. www.indiandentalacademy.com
  19. 19. OCCLUSAL CONCEPTS OF SCHUYLER Correction of occlusal disharmonies in the natural dentition and to the concepts of freedom in centric and incisal guidance. According to Schuyler, Freedom in centric is a maxillomandibular position where maximum intercuspation and centric relation coincide to a certain degree of freedom for eccentric excursions www.indiandentalacademy.com without the influence of occlusal inclines.
  20. 20. Anteroposterior difference – 0.5 to 1 mm Variation in centric relation recording – not a point – area in relation to horizontal plane. Anterior guidance – Purpose: permit a condylar motion without restrictions along with the prevention of posterior contacts, during lateral excursions www.indiandentalacademy.com
  21. 21. www.indiandentalacademy.com
  22. 22. BEYRON’S OCCLUSAL CONCEPTS Based on functional convenience and avoidance of discomfort Most physiological inter-relationship between morphology and function might be the most natural one. Neuromuscular mechanismprotects teeth – excessive loads – protective reflex- important role in mandibular www.indiandentalacademy.com movement patterns.
  23. 23. PANKEY MANN PHILOSOPHY Monson’s sphere (occlusal line and plane) + Meyer’s concepts of a functionally generated path Pankey Mann rehabilitation Philosophy – oral Objectives:- optimal health, masticatory efficiency, comfort and esthetics Recently, Pankey Mann Schuyler concept www.indiandentalacademy.com (based on group function)
  24. 24. Stable and Static contacts - greatest number of teeth Long centric – Occlusal harmony with an anterior slide between centric relation and maximum intercuspation (1mm) and a small amount of lateral freedom for accommodation of the Bennett movement on the horizontal plane. Group function during lateral excursion (working side) Balancing side - No contacts www.indiandentalacademy.com Protrusion – Immediate disocclusion
  25. 25. www.indiandentalacademy.com
  26. 26. DAWSON’S CONCEPT Peter Dawson  Manipulation of the jaw in centric relation (Bimanual technique)  Recording the border movements (Modification of functionally generated path technique) www.indiandentalacademy.com
  27. 27. Anterior guidance:  Anterior teeth are more capable of supporting stress than posteriors: (a)Position of anteriors (b)Higher density of bone (c)Longer roots, better crown : root ratio.  Theory of “Nutcracker” www.indiandentalacademy.com
  28. 28. GERBER’S CONDYLAR DISPLACEMENT THEORY European concept “ The normal or ideal occlusion was one in which the teeth would be in maximum intercuspation, with the condyles centered in the articular surfaces in the median and uppermost position. Any deviation related to this mandibular centralization constitutes a condylar www.indiandentalacademy.com displacement.”
  29. 29. www.indiandentalacademy.com
  30. 30. RAMFJORD AND ASH CONCEPTS OF OCCLUSION  Equilibrium between the different components of masticatory system.  Freedom for condyle movement  The occlusal concept applied should promote occlusal stability, does not exceed the needs and finances of most persons, is controlled by general clinician and does not need a specialized www.indiandentalacademy.com laboratory technician.
  31. 31. www.indiandentalacademy.com
  32. 32. Normal versus Ideal occlusion www.indiandentalacademy.com
  33. 33. Optimum orthopaedically stable joint position Centric relation, is the position of the mandible when the condyles are in an orthopaedically stable position. www.indiandentalacademy.com
  34. 34. Centric relation 1:The maxllomandibular 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 eminences.This position is independent of tooth contact. This position is clinically discernible when the mandible is directed superiorly and anteriorly. www.indiandentalacademy.com
  35. 35. It is restricted to a purely rotary movement about the horizontal axis(GPT5). 2:The most retruded physiologic relation of the mandible to the maxillae to and from which the individual can make lateral movements.It is a condition that can exist at various degrees of jaw separation.It occurs around the terminal hinge axis(GPT-3). www.indiandentalacademy.com
  36. 36. 3:The most retruded relation of he mandible to the maxillae when the condyles are in the most posterior unstrained position in the glenoid fossae from which lateral movement can be made , at any given degree of jaw separation(GPT-1). 4:The most posterior relation of the lower to the upper jaw from which lateral movement can be made at a given vertical www.indiandentalacademy.com dimension(Boucher).
  37. 37. 5:A maxilla to the mandible relationship in which the condyles and the disks are thought to be in the midmost,uppermost position.The position has been difficult to define anatomically but is determined clinically by assessing when the jaw can hinge on a fixed terminal axis (upto 25mm).It is clinically determined relationship of the mandible to the maxilla when the condyle–disk assemblies are positioned in their most superior position in the mandibular fossae and against the www.indiandentalacademy.com distal slope of the articular eminence(ash).
  38. 38. 6:The relation of the mandible to the maxillae when the condyles are in the uppermost and the rearmost position in the glenoid fossae.This position may not be able to be recorded in the presence of dysfunction of the masticatory system. 7: A clinically determined position of the mandible placing both the condyles into their anterior uppermost position.This can be determined in patients without pain or www.indiandentalacademy.com derangement in the TMJ (Ramfjord)
  39. 39. www.indiandentalacademy.com
  40. 40. Centric relation has been described in three different ways: anatomically, conceptually, and geometrically. Anatomical: It is the position of the mandible to the maxilla, with the intra-articular disc in place when the head of the condyle is against the most superior part of the distal facing incline of the glenoid fossa.This can be paraphrased uppermost www.indiandentalacademy.com and foremost.
  41. 41. Conceptual: It is that position of the mandible relative to the maxilla, with the articular disc in place, when the muscles that support the mandible are in their most relaxed and least strained position. Geometrical: It is the position of the mandible relative to the maxilla,with the intra- articular disc in place, when the head of the condyle is www.indiandentalacademy.com in terminal hinge axis.
  42. 42. Dawson’s concept Gelb’s concept www.indiandentalacademy.com
  43. 43. Optimum functional tooth contacts Closure in CR Creates an unstable occlusion Neuromuscular system Feed back muscles Mandibular position More www.indiandentalacademy.com stable occlusion
  44. 44. Musculoskeletal stable position HARMONY Stable occlusal condition www.indiandentalacademy.com
  45. 45. www.indiandentalacademy.com
  46. 46. www.indiandentalacademy.com
  47. 47. Conclusion: Optimum occlusal conditions during mandibular closure would be provided by even and simultaneous contact of all posterior teeth. www.indiandentalacademy.com
  48. 48. Criteria for optimum functional occlusion Even and simultaneous contact of all possible teeth when the mandibular condyles are in their most superoanterior position, resting against the posterior slopes of the articular eminences, with the discs properly interposed. www.indiandentalacademy.com
  49. 49. Occlusal contact patterns Direction of force Amount of force www.indiandentalacademy.com
  50. 50. www.indiandentalacademy.com
  51. 51. www.indiandentalacademy.com
  52. 52. Criteria for optimum functional occlusion First - Even and simultaneous contact of all possible teeth + centric relation Second – each tooth should contact in such a manner that the forces of closure are directed through the long axis of the teeth. www.indiandentalacademy.com
  53. 53. Nutcracker theory www.indiandentalacademy.com
  54. 54. Canine guided occlusion www.indiandentalacademy.com
  55. 55. Group function occlusion www.indiandentalacademy.com
  56. 56. Buccal to buccal cusp contacts are desirable No non-working side contacts www.indiandentalacademy.com
  57. 57. Protrusive contacts www.indiandentalacademy.com
  58. 58. Postural considerations and functional tooth contacts Depends on head position In the alert feeding position, as well as in the normal upright position, the posterior teeth should contact more heavily than the anterior teeth (mutually protected occlusion). www.indiandentalacademy.com
  59. 59. Summary 1. When the mouth closes, the condyles are in their most superoanterior (Musculoskeletal stable) position, resting on the posterior slopes of the articular eminences with the discs properly interposed. In this position there is even and simultaneous contact of all posterior teeth. The anterior teeth also contact but more lightly than the posterior teeth. www.indiandentalacademy.com
  60. 60. 2. All tooth contacts provide axial loading of occlusal forces. 3. When the mandible moves into a laterotrusive position, there are adequate tooth-guided contacts on the laterotrusive (working) side to disocclude the mediotrusive (nonworking) side immediately. The most desirable guidance is provided by the canines (canine guidance). www.indiandentalacademy.com
  61. 61. 4. When the mandible moves into a protrusive position, there are adequate tooth-guided contacts on the anterior teeth to disocclude all posterior teeth immediately. 5. In the alert feeding position, posterior tooth contacts are heavier than anterior tooth contacts. www.indiandentalacademy.com
  62. 62. REFERENCES  Occlusion series in BDJ, 2001;191:6-7  Okeson JP. Management of Temporomandibular Disorders and Occlusion, ed. 4th, 1998; Mosby  Ash MM and Ramfjord S. Occlusion, ed. 4th, 1966; WB Saunders Company, Michigan www.indiandentalacademy.com
  63. 63. Santos JD. Occlusion Principles and Concepts, ed. 2nd, 1999; Ishiyaku EuroAmerica, Inc. U.S.A.  Shillingburg HT. Fundamentals of Fixed Prosthodontics, ed.3rd, 1997;Quintessence www.indiandentalacademy.com
  64. 64. www.indiandentalacademy.com
  65. 65. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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