Attritional occlusion

ATTRITIONAL
OCCLUSION
www.indiandentalacademy.com

Definitions
AttritionAttrition::
It’s a process in which tooth tissue isIt’s a process in which tooth tissue is
removed as a result of opposing tooth surfacesremoved as a result of opposing tooth surfaces
contacting during function or para function.contacting during function or para function.
Such direct contact occurs at proximal areas,Such direct contact occurs at proximal areas,
on supporting cusps and on guiding surfaceson supporting cusps and on guiding surfaces
during empty grinding movements.during empty grinding movements.

Attritional Occlusion:
It is an occlusion which is
continually changing through out the life and
are caused mainly by the tooth migration and
changing anatomy of teeth, due to the
physiological process of attrition.

Different stages of occlusal attrition seen in Australian
Aboriginal Dentition are shown in the figures.

Introduction
The objective of orthodontic treatment is to correctThe objective of orthodontic treatment is to correct
malocclusion of the teeth and those deformities of themalocclusion of the teeth and those deformities of the
jaw and face associated with it.jaw and face associated with it.
Modern era of dentistry always accepted “textbookModern era of dentistry always accepted “textbook
normal” occlusion as anatomically and functionallynormal” occlusion as anatomically and functionally
correct occlusion.correct occlusion.
Presence of deformities and orthodontic treatmentPresence of deformities and orthodontic treatment
needs are determined with the “textbook normal”needs are determined with the “textbook normal”
occlusion in mind.occlusion in mind.
The concept of “Attritional Occlusion” was introducedThe concept of “Attritional Occlusion” was introduced
by the Australian Dr P.R.Begg after intense studies ofby the Australian Dr P.R.Begg after intense studies of
dentitions in Australian Aboriginal skulls.dentitions in Australian Aboriginal skulls.

Broca’s Classification of Attrition
First stage-enamel worn without cusp
obliteration or exposure of dentine.
Second stage-cusps worn down and dentine
exposed.
Third stage-appreciable amount of the
crown of the tooth is worn away.
Fourth stage-extreme stage where most of the
crown has disappeared and the wear has
extended to the neck of the tooth.

As a boy he saw the skulls of Australian Aboriginals,
and noticed that their teeth were worn flat. This
motivated him to study these skulls later and came up
with the concept of “Attritional Occlusion”.
Attritional Occlusion was mainly observed in stone age
man and Begg used Australian Aboriginals as a model
for stone age man.
The teeth of these skulls had extensive occlusal and
inter proximal wear. The most astonishing fact was that
crowding and malocclusion was almost absent in these
skulls.
Dr Begg was the first to appreciate the fact that the
teeth are ever on the move.
Begg’s Hypothesis

All these time he was following the “Non Extraction
Technique” advocated by Dr Angle.
But he was not satisfied with the post treatment results he
obtained.
In 1954, Begg reasoned that the relatively low incidence
of malocclusion in stone age man is due to the reduction by
more than half an inch in the total length of each of these
dental arches.
This was caused by tooth attrition so that the smaller
crowns (in mesio distal diameter) could be more easily
accommodated into the jaws.
So he advised extractions and proximal stripping in
patients with excess tooth substance so as to attain a
correct occlusion. www.indiandentalacademy.com

Thus he stated that the “Textbook normal” Occlusion
was itself a malocclusion and the stone age man’s
“Attritional Occlusion” as the anatomically and
functionally correct occlusion of the human race.
He advocated that this should be the basic concept on
which to build the foundations for the development of
the various branches of dental treatment, mainly in
Orthodontics.

Adult Australian aboriginal dentition - described
by Begg as anatomically correct attritional
occlusion, including the edge-to-edge bite of the
incisor teeth.

Two Factors in Correct Occlusion
Changing Anatomy of TeethChanging Anatomy of Teeth
Attrition plays an important part in the evolution ofAttrition plays an important part in the evolution of
the anatomy of the teeth, their growth processes,the anatomy of the teeth, their growth processes,
function and characteristics, which confer freedomfunction and characteristics, which confer freedom
from diseases of the teeth and their supporting tissues.from diseases of the teeth and their supporting tissues.
This tooth wear chiefly takes place occlusally, incisallyThis tooth wear chiefly takes place occlusally, incisally
and proximally.and proximally.
According to the concept, continual loss of toothAccording to the concept, continual loss of tooth
substance by attrition is a normal functional processsubstance by attrition is a normal functional process
and absence of this causes malocclusion.and absence of this causes malocclusion.
However it has affected man’s esthetic sense so that heHowever it has affected man’s esthetic sense so that he
now prefers the appearance of unworn teeth.now prefers the appearance of unworn teeth.

Attrition causes continual changes in the
shapes and sizes of the teeth

Tooth Migration
Teeth continually move throughout life in two
directions simultaneously.
1. Horizontal (mesial migration).
2. Vertical (continual eruption).
This is caused mainly by the attrition.
Figure shows mesial
migration and vertical
eruption;move the teeth
occlusomesially in the
jaws.

Anatomically Correct Occlusion
Anatomically correct occlusion can develop only whenAnatomically correct occlusion can develop only when
there is sufficient attrition of the teeth for them tothere is sufficient attrition of the teeth for them to
assume correct occlusial relationship.assume correct occlusial relationship.
Stone age man’s teeth have occlusal and proximalStone age man’s teeth have occlusal and proximal
attrition.attrition.
Often this is so marked that the dentine is exposed butOften this is so marked that the dentine is exposed but
are not subjected to dental caries.are not subjected to dental caries.
In civilized man, the occlusion is anatomically incorrectIn civilized man, the occlusion is anatomically incorrect
because his food is too soft and concentrated to causebecause his food is too soft and concentrated to cause
tooth attrition.tooth attrition.
The incisal, occlusal, proximal and axial relations ofThe incisal, occlusal, proximal and axial relations of
civilized man’s teeth remain almost static throughoutcivilized man’s teeth remain almost static throughout
life.life.

Again civilized man’s jaws are prevented by
unworn teeth from assuming correct relations to
each other in all directions, especially the vertical.
In fact civilized man’s upper and lower jaws are
forced farther apart as his teeth continually erupt
without being continually reduced in vertical length
by occlusal and incisal attrition.

Process of Attritional Occlusion in
Stone Age Man
Australian Aborigines- the original inhabitants of theAustralian Aborigines- the original inhabitants of the
continent- were one of the best known but least undercontinent- were one of the best known but least under
stood people in the world.stood people in the world.
They have occupied Australia for atleast fortyThey have occupied Australia for atleast forty
thousand years.thousand years.
Although aborigines are Homo sapiens, biologicalAlthough aborigines are Homo sapiens, biological
isolation has meant that they are not racially closelyisolation has meant that they are not racially closely
related to any other people.related to any other people.
Since the nineteenth century, they have been singledSince the nineteenth century, they have been singled
out as the most primitive culture and the livingout as the most primitive culture and the living
representatives of the ancestors of mankind.representatives of the ancestors of mankind.

They were mainly hunter gatherers.
Their food contained much more indigestible bulk and
roughage than civilized man’s food.
He had to eat a larger quantity of food than we do in
order to sustain himself.
Therefore extensive and rapid occlusal and proximal
attrition developed throughout the life of their
deciduous and permanent dentitionwww.indiandentalacademy.com

Attritional Occlusion in Deciduous Dentition
Deciduous incisors erupt in overbite relation
(primitive man & civilized man)
Incisal and occlusal wear---hard,coarse and gritty food.
Initially – oblique, later- horizontal relation of incisors
Lower incisors tip labially while upper incisors get
more upright until an edge to edge relationship is
obtained—seen in both deciduous,& permanent
dentition of stone age man.

Because of this edge to edge relationship and
the continual attrition, the lower dentition is
moving forward.
This forward movement of the occlusal relation
of stone age man’s lower deciduous dental arch,
related to the upper, causes distal surfaces of the
lower second deciduous molar to assume positions
farther mesially than the distal surfaces of upper
deciduous second molar.

In civilized man
Persistence of the anterior overbite
Lower incisors locked in a functionally
and anatomically incorrect position
Lower incisors restrained from proclining
Crowding of teeth

Mixed Dentition- Eruption of Permanent Teeth
Occlusal Attrition causes the occluso-cervical heights ofOcclusal Attrition causes the occluso-cervical heights of
all stone age man’s deciduous teeth to be reduced.all stone age man’s deciduous teeth to be reduced.
Therefore stone age man’s upper and lower firstTherefore stone age man’s upper and lower first
permanent molars have less distance to erupt beforepermanent molars have less distance to erupt before
occluding with each other.occluding with each other.
Because of extensive proximal attrition of theBecause of extensive proximal attrition of the
deciduous teeth, the over all mesio – distal lengths ofdeciduous teeth, the over all mesio – distal lengths of
the upper and lower deciduous dental arches arethe upper and lower deciduous dental arches are
considerably reduced.considerably reduced.

Due to this, the second deciduous molars migrate so farDue to this, the second deciduous molars migrate so far
mesially that stone age man’s first permanent molars erupt inmesially that stone age man’s first permanent molars erupt in
a much farther mesial position.a much farther mesial position.

In contrary, the distance between the upper and
lower jaws of civilized man is much more compared to
that of stone age man.
As a result the upper and lower first permanent
molars have greater distance to erupt before occluding
with each other.
Also persistent anterior overbite causes initial end to
end molar occlusion in civilized man.

In Angle’s classification of malocclusion diagnosis is
claimed to be aided by observing the occlusal relation
of the first permanent molars.
Whereas according to the attritional occlusional
concept the unqualified use of the first permanent
molars as diagnostic landmarks in angle’s
Classification is misleading.
Since in civilized man there is absence of proximal
and occlusal attrition in deciduous dentition, it
prevents the continual mesial migration of the first
permanent molars that must necessarily occur for the
development of anatomically and physiologically
correct occlusion.

Shallow Glenoid Fossa and Flat Head of
Mandibular Condyle
During the period of development of stone age man’sDuring the period of development of stone age man’s
deciduous dentition, the glenoid fossa is shallow and thedeciduous dentition, the glenoid fossa is shallow and the
head of the condyle is relatively flat.head of the condyle is relatively flat.
Therefore, lateral mandibular movements duringTherefore, lateral mandibular movements during
mastication are extensive and wide.mastication are extensive and wide.
Civilized man’s condylar head is smaller and moreCivilized man’s condylar head is smaller and more
rounded and it fits up farther into the glenoid fossa sorounded and it fits up farther into the glenoid fossa so
that the range of mandibular masticatory excursions isthat the range of mandibular masticatory excursions is
more restricted.more restricted.

The absence of attrition
of deciduous teeth in
civilized man creates
conditions that prevent
development of proper
occlusion of permanent
teeth resulting in
crowding,overlapping and
bimaxillary protrusion.
In developing attritional dentition, each tooth of the
second set after it erupts comes into occlusion and
immediately begins to wear both occlusally and
proximally. So when the next teeth erupts, the
previous one is already worn considerably.

Attritional Occlusion in Permanent
Teeth
With the establishment of the edge toWith the establishment of the edge to
edge permanent incisor bite due toedge permanent incisor bite due to
attrition, the stone age man’s “Curve ofattrition, the stone age man’s “Curve of
Spee” is not so curved as in “textbookSpee” is not so curved as in “textbook
normal” occlusion.normal” occlusion.
It is usually almost a flat plane mesio-It is usually almost a flat plane mesio-
distally.distally.

MODERN MAN-The anterior overjet and the acute
angle formed by the incisors.
STONE AGE MAN-Observe the reduced overjet and the
more upright inclination of the incisor teeth.

In the absence of attrition, there is not enough space
for the canine to erupt as in civilized man.
Attrition brings about enough reduction in mesio-distalAttrition brings about enough reduction in mesio-distal
dimensions of teeth to allow adequate space for the eruptingdimensions of teeth to allow adequate space for the erupting
permanent canine.permanent canine.

During this stage of development of stone age
man’s dentition, all the erupted teeth undergo the
process of attrition.
This early attritional reduction in the overall
lengths of the dental arches prevents the
development of crowding, overlapping, rotation and
bimaxillary protrusion of the six upper and lower
permanent anterior teeth, as well as irregularities
and crowding of the premolars, all of which would
inevitably occur in the absence of attrition.
Again, this attritional reduction in the lengths of
the dental arches leaves more space at the distal ends
of the dental arches for the eruption of the third
permanent molars.

Eruption of Third Permanent Molars
As all teeth erupt several years before their root formationAs all teeth erupt several years before their root formation
is completed, stone age man’s third permanent molarsis completed, stone age man’s third permanent molars
obey this rule by erupting in their correct positions in theobey this rule by erupting in their correct positions in the
jaws much farther mesially than they are able to erupt injaws much farther mesially than they are able to erupt in
civilized man.civilized man.
Where as the civilized man’s unerupted third permanentWhere as the civilized man’s unerupted third permanent
molars are held too far distally in the jaws causingmolars are held too far distally in the jaws causing
impactions. Also they are the only teeth that have theirimpactions. Also they are the only teeth that have their
root formation completed before eruption.root formation completed before eruption.
By calculations, it was estimated that there was 14.7mmBy calculations, it was estimated that there was 14.7mm
attritional dental arch reduction in the mandible of stoneattritional dental arch reduction in the mandible of stone
age man for providing enough space for third molarage man for providing enough space for third molar
eruption.eruption.

Super imposition of attritional over non -attritional
occlusion is shown in the above figure to illustrate the
amount of space left by attrition and mesial migration
for earlier eruption of third permanent molars.

•The recent secular trend in increasing impactions does
not seem to be a genetic change in humans. Instead, it is
merely a response to a soft food diet.
•Without interproximal wear of the teeth, there simply is
not enough room for third molar.
•Other factors at work with modern soft diets is dental
arch width: narrower dental arches that result from
disuse also contribute to shorter dental arches with less
space available distal to second molars.

Advanced Attrition In Stone Age Man.
In some Aboriginal skulls, occlusal attrition of the firstIn some Aboriginal skulls, occlusal attrition of the first
permanent molars has extended so far that the crownspermanent molars has extended so far that the crowns
of these teeth have worn away completely and attritionof these teeth have worn away completely and attrition
has extended down the roots, beyond the level ofhas extended down the roots, beyond the level of
bifurcation of these roots.bifurcation of these roots.
It is not strictly correct to state that the process ofIt is not strictly correct to state that the process of
continual tooth eruption evolved to compensate for thecontinual tooth eruption evolved to compensate for the
tooth attrition specifically.tooth attrition specifically.
It is only a particularization of the much moreIt is only a particularization of the much more
primitive and general process of continual outwardprimitive and general process of continual outward
growth of all surface epithelial structures.growth of all surface epithelial structures.

Vertical And Mesial Eruption
 The maintenance of proximal tooth contact, asThe maintenance of proximal tooth contact, as
proximal attrition proceeded was madeproximal attrition proceeded was made
possible by mesial migration of the teeth.possible by mesial migration of the teeth.
 The occlusion is also maintained by theThe occlusion is also maintained by the
continual vertical eruption of teeth.continual vertical eruption of teeth.
 In short the both vertical and horizontalIn short the both vertical and horizontal
eruption of the teeth simultaneously results ineruption of the teeth simultaneously results in
the gross movement of the teeth obliquely.the gross movement of the teeth obliquely.

Effects of Attrition on The
Evolution of Human Teeth
The evolutionary development, both of theThe evolutionary development, both of the
individual teeth and of anatomically correctindividual teeth and of anatomically correct
attritional occlusion is dependent on continualattritional occlusion is dependent on continual
tooth attrition.tooth attrition.
Following are some of the important effectsFollowing are some of the important effects

Deposition of Secondary Dentin
The process of deposition of secondary dentin by theThe process of deposition of secondary dentin by the
tooth pulp evolved to prevent the exposure of the pulptooth pulp evolved to prevent the exposure of the pulp
by attrition.by attrition.
This process did not evolve to wall of dental caries fromThis process did not evolve to wall of dental caries from
exposing the tooth pulp, because dental caries wasexposing the tooth pulp, because dental caries was
almost non existent in stone age man.almost non existent in stone age man.
Secondary dentin is continually laid down in civilizedSecondary dentin is continually laid down in civilized
man’s teeth, even when there is no attrition or dentalman’s teeth, even when there is no attrition or dental
caries, so that, in old age the pulp chamber is oftencaries, so that, in old age the pulp chamber is often
almost obliterated.almost obliterated.

Continual Vertical Tooth Eruption
B. Gottlieb have been the first to drawB. Gottlieb have been the first to draw
attention to this process in man.attention to this process in man.
P. R. Begg in 1938 showed that the process ofP. R. Begg in 1938 showed that the process of
continual eruption and mesial migrationcontinual eruption and mesial migration
evolved to compensate for tooth attrition.evolved to compensate for tooth attrition.

Continual Mesial Migration of The Teeth
This process is evolved to preserve theThis process is evolved to preserve the
continuity of the dental arches by proximalcontinuity of the dental arches by proximal
contact of the teeth as they continually worecontact of the teeth as they continually wore
away on their proximal surfaces.away on their proximal surfaces.
Mesial migration prevents the development ofMesial migration prevents the development of
tooth spacing, which detracts from thetooth spacing, which detracts from the
masticatory efficiency of the dental apparatus.masticatory efficiency of the dental apparatus.

Large Mesio-Distal Diameters of Unworn
Deciduous Molars
If the mesio-distal diameters of stone age man’sIf the mesio-distal diameters of stone age man’s
unworn deciduous molars were not greaterunworn deciduous molars were not greater
than the corresponding diameters of thethan the corresponding diameters of the
premolars which succeed them, attrition,premolars which succeed them, attrition,
coupled with mesial migration, would havecoupled with mesial migration, would have
made the diameters of the deciduous molars somade the diameters of the deciduous molars so
small that there would not have been sufficientsmall that there would not have been sufficient
mesio-distal space for the eruption of themesio-distal space for the eruption of the
premolars.premolars.

Shapes and Forms of The Crowns of The
Teeth
In order to prevent the rapid attrition from exposingIn order to prevent the rapid attrition from exposing
the occlusal and proximal aspects of stone age man’sthe occlusal and proximal aspects of stone age man’s
tooth pulps, the teeth evolved into shapes and formstooth pulps, the teeth evolved into shapes and forms
they have at the present time.they have at the present time.
Thus, the greatest thickness of the enamel and dentinThus, the greatest thickness of the enamel and dentin
covering the pulp is on the occlusal, incisal, mesial andcovering the pulp is on the occlusal, incisal, mesial and
distal surfaces.distal surfaces.
Whereas the lingual, buccal and labial surfaces of theWhereas the lingual, buccal and labial surfaces of the
teeth which are not subjected to attrition are thereforeteeth which are not subjected to attrition are therefore
relatively thin.relatively thin.

Small Mesio-Distal Diameters of Tooth
Necks and Roots
Due to the proximal attrition and mesial migration ofDue to the proximal attrition and mesial migration of
the tooth crowns, proximal contact is alwaysthe tooth crowns, proximal contact is always
maintained.maintained.
If the tooth roots were as wide as the original unwornIf the tooth roots were as wide as the original unworn
tooth crowns and if it did not taper off in the directiontooth crowns and if it did not taper off in the direction
of the apex, the unerupted portion of the roots ofof the apex, the unerupted portion of the roots of
neighbouring teeth would soon be in proximal contactneighbouring teeth would soon be in proximal contact
along their whole length causing interdental septa ofalong their whole length causing interdental septa of
alveolar bone and periodontal membrane to resorb andalveolar bone and periodontal membrane to resorb and
disappear.disappear.
The teeth roots thus without support interdentallyThe teeth roots thus without support interdentally
would be useless for mastication.would be useless for mastication.www.indiandentalacademy.com

Tooth Enamel and Alveolar Bone
Tooth enamel is the unalterable rigid substance in theTooth enamel is the unalterable rigid substance in the
body.body.
On the other hand alveolar bone is the most plastic ofOn the other hand alveolar bone is the most plastic of
all of the bones in the body.all of the bones in the body.
The juxta position anatomically of these opposites, oneThe juxta position anatomically of these opposites, one
rigid and the other plastic, was essential for therigid and the other plastic, was essential for the
evolutionary development of the highly specializedevolutionary development of the highly specialized
dental apparatus.dental apparatus.
The inertness of the enamel is compensated by theThe inertness of the enamel is compensated by the
plastic and mutable alveolar bone and periodontalplastic and mutable alveolar bone and periodontal
membrane.membrane.

Pupal Pain
Pulpal pain did not evolve to warn of dental caries butPulpal pain did not evolve to warn of dental caries but
to signal that the attrition was approaching the pulpto signal that the attrition was approaching the pulp
faster than the secondary dentine which was being laidfaster than the secondary dentine which was being laid
down.down.
This allowed the transfer of chewing to other teeth inThis allowed the transfer of chewing to other teeth in
another part of the mouth until secondary dentineanother part of the mouth until secondary dentine
deposition could overtake the too advanced attrition,deposition could overtake the too advanced attrition,
thus protecting the pulp from exposure and death.thus protecting the pulp from exposure and death.

Tubercle of Carabelli
It’s a tooth cusp that is often but not always present onIt’s a tooth cusp that is often but not always present on
the lingual surfaces of upper molars.the lingual surfaces of upper molars.
Because of its failure to occlude in civilized man, thisBecause of its failure to occlude in civilized man, this
was regarded as a vestigial remnant.was regarded as a vestigial remnant.
As attrition progressed in stone age man,this tubercleAs attrition progressed in stone age man,this tubercle
occluded with lower antagonizing tooth.occluded with lower antagonizing tooth.
The value of this tubercle was that after sufficientThe value of this tubercle was that after sufficient
occlusal attrition occurred, it increased the availableocclusal attrition occurred, it increased the available
masticatory surface areas of this teeth.masticatory surface areas of this teeth.

Also as shown in the figures, The Curve of Wilson
reverses direction with attrition and tubercle of
Carabelli increases overall occlusal surface area.
The arrow denotes the attritional change in the
angle of bucco-lingual plane of occlusion of first
permanent molars.

Variations of Lengths of Unworn
Tooth Crowns.
Its seen that the occluso-cervical lengths of theIts seen that the occluso-cervical lengths of the
unworn first permanent molars are greaterunworn first permanent molars are greater
than that of the second permanent molars.than that of the second permanent molars.
The first permanent molar is already inThe first permanent molar is already in
occlusion several years before the secondocclusion several years before the second
permanent molar, thus subjected to morepermanent molar, thus subjected to more
attrition.attrition.
So the greater occluso-cervical dimension isSo the greater occluso-cervical dimension is
needed to compensate for this attrition.needed to compensate for this attrition.

Attritional Occlusion and The Future of
Dentistry
Many forms of malocclusion of teeth found in civilizedMany forms of malocclusion of teeth found in civilized
man are entirely due to absence of tooth wear.man are entirely due to absence of tooth wear.
It is evident from the attritional occlusional study thatIt is evident from the attritional occlusional study that
in the orthodontic treatment of many individuals,in the orthodontic treatment of many individuals,
reduction of tooth substance must also be carried out.reduction of tooth substance must also be carried out.
The development of stone age man’s attritionalThe development of stone age man’s attritional
occlusion is a normal physiologic process in whichocclusion is a normal physiologic process in which
there is an overall continual but ever changingthere is an overall continual but ever changing
integration and harmonization of tooth size with jawintegration and harmonization of tooth size with jaw
size, tooth migration, repositioning of teeth and eversize, tooth migration, repositioning of teeth and ever
changing relationships of teeth and jaws.changing relationships of teeth and jaws.
The sum total provides a successfully functional dentalThe sum total provides a successfully functional dental
apparatus.apparatus.

In all this we see how nature has provided for the
balance between tooth size and jaw size by
maintaining the correct tooth and inter arch
relationships.
On the contrary, these basic factors for the correct
occlusion are not present in civilized man.
Therefore the harmonious sequence of events does
not occur in civilized man. Failure of continual dental
arch reduction therefore causes mis placed teeth, ill
formed dental arches and malocclusion.
In stone age man’s attritional dentition, centric
occlusion does not exist.

Centric occlusion is regarded in civilized man’s textbook
normal occlusion as the very hallmark of anatomically
correct occlusion and absence of proper centric occlusion is
regarded as abnormal.
However as there are no high cusps but just flat worn
surfaces of teeth occluding in attritional occlusion, there is
nothing to guide the teeth into centric occlusal relation.
Each time stone age man swallows, his teeth seems to
occlude differently, some times to one side of the central
line and sometimes to the other side.
Some individuals favour mastication on certain teeth
using other teeth less frequently.
When teeth become worn so much as to cause pulpal
pain, mastication is transferred to less worn teeth.www.indiandentalacademy.com

Dental students should, from the start of their
education, be taught the truth concerning occlusion.
The harmful practice of artificially restoring teeth to
their original mesio-distal widths and of making
approximating teeth meet in point contact when placing
fillings as restorations after dental caries is the result of
acceptance of the concept of textbook normal occlusion.
Since it is stated now that attritional occlusion is the
correct form of occlusion for man the above practices
requires serious reconsideration.www.indiandentalacademy.com

It would be a more rational procedure and in
conformity with the concept of attritional occlusion
to make each successive set of full upper and lower
artificial dentures so that there is no more building
up of vertical height than is required to compensate
for the amount of alveolar resorption continually
taking place in edentulous mouths.
Stone age man’s jaws remained at a constant
distance apart in adulthood.
Therefore, it is logical to keep the edentulous jaws
a constant distance apart by means of alterations to
artificial dentures instead of continually increasing
the intra alveolar distance.

The current practice of grinding the buccal cusps of
upper molars and the lingual cusps of lower molars when
equilibrating the teeth needs reconsideration in view of the
fact that it is the lingual cusps of upper molars and the
buccal cusps of the lower molars that become worn to the
greatest extent in stone age man’s attritional occlusion.

Attritional occlusion

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Attritional occlusion