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Evolution Occlusion and Occlusal Instruments: Academics

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ACADEMICS AND EDUCATION

Evolution of Occlusion and Occlusal


Instruments
Curtis M. Becker, DDS, MSD* and Dauid A. Kaiser, DDS, MSDT

All occlusal concepts are based, in part, on theory, and all theories may have borrowed from the
past. This article reviews the evolution of occlusal concepts to understand how differing theories
interrelate, where they agree, and where each concept contributed to the ongoing understanding
and evolution of occlusion principles. Also, the flexible and practical concept of biologic occlusion is
presented. The philosophy of biologic occlusion is one that functions in health. The goals of biologic
occlusion are also presented.
J Prosthod 2:33-43.Copyright 0 1993by the American College of Prosthodontists.

INDEX WORDS: occlusion, articulator, gnathology, transographics, cranial orthopedics, centric


relation, biological occlusion

HEN STUDYING modern concepts of occlu- concept of bilatcral balanccd occlusion3 and devcl-
sion, one should consider how curreni princi- oped an articulator that applied his 4-inch triangular
ples evolved (Fig 1). Because modern schools of theory.4 In 1866 Balkwill discovered that during
occlusion may vary, acccptance or rejection of princi- lateral jaw movement, the translating condyle moved
ples tends to be based on: (1) past training (dental medially." In 1890 the German anatomist Von Spee
school), (2) personality of the authority presenting observed that the occlusal plane of the teeth followed
the theory, (3) the latest fad, (4)ease in technique, a curve in the sagittal plane. Von Spec attempted to
and (5) scientific evidence. All occlusal concepts are describe the relationship between the condylar path
based in part on theory, and all of these theories and this compensating curve, or "curve of Spee," by
borrow in part from the past. This article reviews the stating that the steeper the condylar path (in protru-
evolution of occlusal concepts: not with thc idca of sive), the more pronounced would be the compensat-
criticism of each theory, but with attempt to evaluate ing We know today that this relationship is
these theories, their interrclationships, where they not necessarily true; however, from the concepts of
agree, and where each concept contribuied to our these three mcn came thc age of occlusal theory and
ongoing understanding of occlusion. occlusal articulators. Literally hundreds of articula-
tors came and went in the early 1900~.',~
Early Concepts
The first mechanical articulator was invented by J.B. Age of Occlusal Theories and
Gariot in 1805.',*It was a plain line instrument and it Occlusal Articulators
is still in use today (Fig 2). In 1858 Bonwill dcscribed
his triangular thcory whereby he postulated that the In 1899 Snow devised a method for transfcrring
distance from the incisal edges of the lower incisors articulated casts to the articulator with a face bow.'
to each condyle is 4 inches, and the distance between In 1901 Christensen observed the opening of the
the condyles is 4 inches (Fig 3). Honwill proposed a posterior teeth in mandibular protrusion (Christen-
sen phenomenon) .9Jo Christensen thcn devclopcd a
technique for registering the degree of posterior
*ilrsoriate Ciiniral Prufissor, Department of Fixed A-octhodorrtics,
School ofDentisty, lIniversi@~Coloradu,Dmzer, GO. separation and an articulator with adjustable condyle
TAssociatePr&w and Intm.m Chairman, Dejmrlment of Prnsthodon- controls. This was still a lwo-dimensional instru-
tics, Unznluerrigqf Texas Health Science Center at Sari Antonio, TX. ment, but an cvolutionary improvement over the
Address repnril teguestJ tu Dauid A. Kaiser. DDS, MSD, Dioirion of Gariot instrument. In 1908 Bennctt described the
Pmthodontir Dmtisty, Unioenity o j Texas Health Scimce Center ot Son
immediate side shift (Bennett tnovernent)." The
Antonio Dental School, 7703 Floyd Curl Dr, San ilntonio, TX 78284-
7890. origin for the introduction of the incisal pin to
Cofyright 01993 by the A w n c a n College oJFrodhodontirts articulators is uncleare; howcvcr, the first published
I0.59-981XJ 931O201-00O78.iOOj 0 article where an incisal pin is dcmonstrated was

Journol ofProsthodontics. Vol2,N o I (March), I993:pp 33-43 33


34 Occlusion and Occlilsal Instrument.r R d e r and Kaiser

Evolution of Occlusion
Gariot 1805
Snow 1806

Gysi 1910
Balkwill 1866

Stansberry 1929 THEORETICAL / GEOMETRICAL


(No Science)
Monson 1919
Hall 1914 \

c M Y I I'IWIWIYJUIY

Avery bros. 1930


Meyer 1933
Pleasure 1937

GNATHOLOGY
McCollum

P. M. S. SYSTEM Lauritren
Stallard
Sluart
Lucia
Thomas
Granger
3
Guichet
TR ANSOGRAPHICS
Dawson I ~

J
Page 1951

1PERIODONTAL PROSTHESIS I
x 1
Amsterdam
Prichard CRANIAL ORTHOPEDICS
Yuodelis
Lindhe Harold Gelb

Eversaul
BIOLOGIC OCCLUSION
t
Figure 1. Diagrammatic reprrsrntation o f the evolution of occlusion.

written in 1910 by Gysi.12 Gysi's instrument was one


of the first to allow for the Balkwill-Bennett move-
ments.
Before 1916 Monson formulated a three-dimen-
sional occlusal philosophy by conibirling the concepts
of Bonwill's 4-inch triangle and bilateral balanced
occlusion, Von Spee's compensating curve, and the
observances of Balkwill and Christensen on condylar
m o \ ~ e m e n t . ' ~This
- ' ~ occlusal model was named the
Sjhrical Thory (Fig 4) and was one of the first
attempts a t presenting a working theory of three-
dimensional occlusal concepts. Monson then dcvcl-
oped an articulator that attempted to allow the
dentist to apply the concepts of the spherical theory
in prosthetic dentistry; however, Monson's instru-
Figure 2. Plain line articulator similar to that invented ment did not provide for the condylar movements as
byJ.B. Gariot in 1805. described by Balkwill and Bennett. The occlusal
March 1993, Volume 2, iVuniber 1 35

Figure 5. One of Gysis adjustable articulators, which


uscd an incisal pin.

Figure 3. Bonnills 4-inch triangular theory of 1858.


also developed a series of articulators with surprising
concepts, techniques, and the articulator advocated sophistication and a d j ~ s t a b i l i t f J ~ , ~ ~5).
(Fig
by Monson was extremely popular throughout the Geometry of the articulator movements became
1920s and Lhough Monsons articulator is no longer paramount for .justification of theorics replacing
in use, vestiges of the spherical theory are still in use scientific investigaiion and observation. In 1918 Hall
today. presented his conical theory,18J9whcre it was be-
During and after the time Monson was unveiling lieved that the condyles were not the guides to
his spherical theory of occlusion,there was a period mandibular movement. Instead, the occluding planes
of time where technical advances were being per- of the teeth were the guides for mandibular move-
fcctcd in the recording of jaw rclations and in the ment. Bilateral balance was one of the goals of this
sophistication ofarticulators.The work of Gysi exern- theory Geometry was used as justification and an
plified this desire for technical improvement. In 1910 articulator was developed to fit the theoretical con-
G p i improved on Balkwills arrow point tracer to cepts (Fig 6).
allow visual registration of centric relational6Gysi In 1921, ihe engineer Hanau introduced an occlu-

Figure 4. Monsons Spheri-


cal theory was one of the first I
three-dimensional occlusal
concepts.
36 Orclanon and Orclural Imtrumentc. 0 Becker and Kuwr

anced occlusion with eccentric mandibular move-


ments and was the first to advocate that articulator
movements should be the equivalent of mandibular
movement.
In 1929 Stansberry modified Gysis arrow point
tracer by adding a central bearing point that allowed
convenience in making the centric relation record
and eccentric jaw position records. These records
were then used to transfer casts of the patient to the
articulator, the Stansberry Tripod (Fig 8).22
In the 1930s Meyer was advocating the use of the
functionally generated path or chew in technique
for recording bilateral balancing contacts in eccentric
r n o v e n i e n t ~ . At
~ ~ -about
~ ~ this same time, articles
began to appear that questioned the Monson theory.
The Avery brothers, in 1930, introduced the anti-
Monson Theov, which advocated a reverse occlusal
curve of Wilson-lateral compensating cunre (Fig
9).27 The Avery brothers theorized that this reverse
curve would stabilize the lower complete denture.
The theorywas based in part on the observation that
Figure 6. The Hall articulator was developed to imple-
the occlusion of dentures and natural dentitions tend
ment the Conical Theory of Occlusion and was based on
geometrical relationships. to wear in a reverse curve fashion, ie, maxillary
lingual cusps and mandibular buccal cusps showing
the most wear. The anti-Monson theory does not
sal instrument (Fig 7) that was based on the scientific
allow for bilateral balance in eccentric jaw move-
writings of Snokv and Gysi.J Hanau rejected the
ments and was one of the first occlusal theories to
spherical theory and proposed the rocking chair
abandon this concept. Pleasure, in 1937, introduced
denture occlusion in 1923.20This rocking chair theory
his Pleasure curve (Fig which advocates the
involved heavy contact to the first molar areas to
anti-Monson reverse cune except for the second
compensate for the resiliency and like effect, which
molars. The second molars are tipped up to allow for
referred to the resiliency of soft tissue and temporo-
bilateral balance of three points (incisal and both
mandibular joint. Hanau advocated bilateral bal-

Figure 7. A Hanau articulator. Figure 8. The Stansberry Tripod articulator.


Murch 199.7, V o h m 2
~,Number I 37

The maxillary posterior occlusion was thcn fabri-


cated to the mandibular occlusal form by using the
maxillary anterior teeth as guidesz3for the chew in
registration as advocated by M e ~ e r . A~ suspension
A n t i - Monson instrument (Fig 11) was used for articulating the
( A w r y brs.)
casts, which had no functional movement capability.
It was argued that articulator movement was unnec-
Figure 9. Diasgram of the anti-Monson concept as pro- essary because functional limits were recorded uith
posed by the Avery brothers in 1930. the chcw-in registration.
A few years later Schuylerjoined with Pankey and
second molars) in eccentric movements. The Plea- Mann to evolve what is now known as the P.iz/I.S.
sure curve retained the alleged benefits of the anti- (Panky, Mann, Schuyluj This occlusal system
Monson curve while allowing for bilateral balance in retained the Monson spherical theory and the func-
eccentric movements. tionally generated path technique; however, under
The occlusal concepts proposed during this period Schuylers i n f l ~ e n c e ~ (-1)
~ ~the
: balancing side con-
of dental history from 1800 to approximately 1930, tacts were eliminated; (2) the importance of incisal
which one could call the age of occlusal theories, can guidance was elevated; (3) the concept of long
be summarized as being basically formulated for centric or functional centric occlusion was pro-
complete denture patients in which bilateral bal- posed in which centric occlusion is thought of as an
anced occlusion in eccentric movements was consid- area ofcontact rather than a point contact; and (4)
ered essential. The efforts by these dental pioneers to the Hanau occlusal instrument with arbitrary face
develop occlusal instruments were driven primarily bow and Broadrick occlusal plane analyzer was adopt-
by the need to implement the proposed occlusal ed.3G
theory.
Gnathology
Modern Occlusal Concepts At approximately the same time that Pankey and
Pankey, Mann, Schuyler System Mann were forrnulating their concepts of occlusion,
another group of researchers headed by McCollum
In the late 1920s, groups of researchers began to
formulate systematic approaches to restoring the
natural dentition. Pankey and Mann are examples of
this evolutionary process of formulating concepts for
natural dentitions while also devising a systematic
approach to reconstructive dentistry. The Punkq-
Mann system was originally an amalgamation of the
Monson theory and the Meyer functionally gener-
ated path technique, where they attempted to gain
bilateral balance in eccentric movements (a holdover
from complete denture occlusal theories). The tech-
nique involved restoring the mandibular posterior
occlusion to a 4-inch sphere as described by Monson.

Pleasur e
Curve
Figure 11. A suspension instrument was originally used
Figure 10. Diagram of the Pleasure curve as proposed by thc Pankey-Mann-Schuyler system of occlusion. Note
byh1.A. Pleasure in 1937. this instrument is basically a plain line instrument.
38 Occlusion and Occlusal Instruments Beckerand Kairpr

was studying mandibular m o v e m ~ n t .The ~ ~ -main


~~
thrust of their study was the rotational centers of the
condyles in three dimensions: vertical plane; sagittal
plane; and horizontal plane, One assumption was
that the horizontal rotational center passes through
both condyles (collinear hinge axis). These research-
ers believed that if the rotational centers in the
condyles could be located, and if the border move-
ments of these rotational centers were recorded and
reproduccd on a sophisticated three-hmensional
articulator, then all functional motions for the pa-
ticnt could also be reproduced by that instrument.
Once the basic concepts were formulated, research
eKorts were centered on methods to locate and
record these rotational centers and their border
movements. Many ingenious inventions were tried
and discarded until finally the instrument we know as
the pantograph evolved. With the pantograph one
could, for the first time, record the three-dimen- Figure 12. The Stuart articulator.
sional border movements of the condylar rotational
centers. Great efforts were then directed to develop acceptable occlusal scheme when all the posterior
highly sophisticated three-dimensional adjustable ar- teeth had been prepared. Stuart improved the design
ticulators that would accept and reproduce the mea- of the gnathologic instrument (Fig 12). Guichet
surements recorded by the pantograph. The con- greatly simplified the pantographic recorder and
cepts taught by McCollum and his associates developed hi.; gnathologic instrument, the Denar
eventually became known as Gnathology. (Fig 13). Cuichet brought pathology into the aver-
Cnathologic theory at this early time included: (1) age dental office through extensive continuing educa-
establishing via a hinge axis location thc rotational tional courses for the practitioner and organized
centers of the condyles; (2) recording the three- study club^?^^^^ Guichet also advocated overcompen-
dimensional envelope of motion of the condyles via sation of the gnathologic instrument settings to give
the pantographic tracing; (3) maximum intercuspa-
tion of the teeth when the condyles are in their hinge
position; and (4) bilateral balance with eccentric jaw
movements. Because these gnathologic rcsearchers
felt that the condyles were the determinants of
occlusal schemes, they discovered that the side shift
of the condyle would greatly affect cuspal position,
especially if bilateral balance was deemed beneficial.
Two of the early gnathologic researchers, Stallard
and Stuart, felt that the basic theory of mandibular
movement was fundamentally correct, but the appli-
cation of this knowledge was misdirected. They
proposed eliminating the balancing contacts in eccen-
tric jaw movements by having the canines on the
working side disclude the posterior teeth; they named
it the Cuspid Protection Theoy.'O This also became
known as the Mutual& Protected System.41
Anumber ofother technical developments evolved
during the 1940s and 1950s that helped the popular-
ity and accessibility of the gnathologic concepts.
and Thomas43developed systematic waxing
techniques that allowed for the development of an Figure 13. The Denar articulator.
March 1993, Volume 2, iVumfkrI 39

increased disclusion rather than laboriously making unanswered questions it raised, such as: ( 1 ) are
the instrument follow the lines of the p a ~ i t o g r a p h . ~ ~ condylar axes collinear or asymmetrical?, (2) is imme-
diate side shift normal function or the result of
pathology?, and (3) should occlusal instruments be
Tmnsographics
expected to reproduce jaw movement? The diminish-
During the 1950s, the engineer Page contended that ing popularity of Transo<graphicsis apparently due
each mandibular condyle has its OWTI axis of rotation more to its awkward instrument, lack of technical
and that these axes are not c o I l i n ~ a r $as ~ ~was
~~ progress, and the passing of its chief spokesman
postulated by gnathologic theory. Page then devel- rather than hard scientific rebuttal from academic
oped an occlusal theory, which was called Transograph- research.
ki, and an occlusal instrument, the Transograph (Fig
14). This was dcsigned to allow for independent
three-dimensional condylar movement.9 Transo-
Cranial Ch-thupedics
graphic theory questioned the need to record the
total envelope of motion (pantographing) and in- The most visible proponent of the concept of cranial
stead advocated using wax rcgistrations to rccord a orthopedics (also called oral orthopedics) is Gelb.5-53
much smaller functional area within the envelope of The basic concept centers around the belief that the
motion, which Page termed the functional envelope. movement of the mandible is not influenced by the
Page felt that the occlusal form of posterior teethwas shape ofthe condyles, but the condyles may assume a
determined by the asymmetrical condylar axis, the certain shape because the mandible has assumed
functional envelope, and thc angle of thc mandible. certain movements. Cranial orthopedics is interested
Transographics lost favor as a widely accepted occlu- in establishing postural relationships of the jaws.
sal theory after Page died, but his theories did bring Occlusion is secondary to obtaining optimal postiiral
renewed interest in research to prove or disprove the relations of the mandible to the maxilla. The proper
existence of collinear condylar axes. Preston, in relationship of the head on the spine is essential for
reviewing this subject, states the following: proper total body posture and balance. Thus, an
Past experiments have been use@, but none haae proven or improper jaw relationship will mean impaired pos-
dirpoaen the presence qf collineur a7 noncollinear condylar ture and balan~e.5~
arcs. On& the arc of the ri,,id clutch and its arsonated Geometry is the primary basis for achieving pos-
mechanirm is h a t e d . Such an a[$arent arc m q re5ultjum tural balance, and like Halll8,lgin the 1920s, geome-
the resolution ojcompund condylar rnouements.j0 try is used to justify the theoretical and therapeutic
treatment recommendations. Extensive planes of
The value of the Transographic theory lies in the
orientation are drawn on unniounted casts of the
maxilla and the mandible. Four classes of malocelu-
sion are possible based on these planes of orienta-
tion? Class A correct occlusion; Class B: structural
malocclusion; Class C: functional malocclusion;Class
D: structuro-ftmctional malocclusion.
The recommended therapy (usually splint ther-
apy, orthodontic movement, and/or reconstructive
dentistry) is based on what is necessary to realign
these planes of orientation into more favorable rela-
tionships.
The primary appeal to cranial orthopedics lies in
the realization that the temporomandibular joint
has an adaptable remodeling capacity that has been
overlooked by- the static relationship concepts tradi-
tionally espoused by the other modern schools of
occlusion. The apparent universal lack of enthusiasm
by the dental community for the teachings of cranial
orthopedists can be traced to its reliance on unscien-
Figure 14. The Transograph articulator. tific geometrical justification.
40 Occlusion and Occlwal Instruments Becker and Kairer

Mandibular Centricity (Centric Relation) position, and terminal hinge position added con-
fusion. Even the different disciplines within dentistry
With the exception of cranial orthopedics, nearly all
could not agree on the definition of centric relation.
concepts of occlusion have embraced the practice of
Goldman and Cohen defined centric relation as the
mandibular centricity, which early writers loosely
most posterior relation of the mandible to the max-
referred to as centric relation (CR) but rarely de-
illa from which lateral movements can be made.61
fined this jaw position. Hanau, in 1929, defined
Glickman stated ccntric relation is the most re-
centric relation as the position of the mandible in
truded position to which the mandible can be carried
which the condylar heads are resting upon the
by the patients musculat~ire.~~ Graber refused to bc
menisci in the sockets of the glenoid fossae, regard-
drawin into the controversy, stating only that the
less of the opening of the jaws, and he also states
position must be the unstrained, neutral position of
that the relation is either strained or unstrained.
Hanau preferred the unstrained centric relation the mandible.. .63 Schluger, Yuodelis, and Page
associated with an accepted opening for the refer- stated that centric relation is the position assumed
ence j a w r e l a t i ~ n ?Niswonger,
~ in 1934, described CR by the mandible relative to the maxilla when the
as a position where the patient can clinch the back condyles are in their rearmost, midmost position in
teeth.j5 Schuyler, in 1935, defined the centro- the glenoid fossae.li4This definition is very close to
maxillomandibular position or centric position as the gnathologic RUM definition as proposed by
when the upper lingual cusps are resting in the McCollum and Stuart, where the condyles are in
central fossae of the opposing lower bicuspids and their rearmost, uppermost, and midmost position
molars.. . .5G Thompson, in 1946, lamented the lack in their respective f o ~ s a eIn
. ~an
~ effort to standardize
of knowledge upon which clinical procedures were this and other commonly used terms, the Academy
based by stating . . . some believe that, in centric of Prosthodontics (formerly the Academy of Denture
relation, the condyles are in the most retruded Prosthetics) has published the Glossay $Prosthodontic
position in their fossae, while others maintain they Terms.This glossary is updated periodically and has
are five editions since the first in 1956. Every time there
The earl,: writers rarely if ever advocated manual is an update, the definition of centric relation changes.
manipulation of the mandible to achieve their centric Avant, in 1971, decried the seven definitions of
jaw registration. Needles, in 1923, used an intraoral centric relation appearing in the 2nd edition of
arrow point tracer in which the patient retruded the 196flb6 Schluger, Yuodelis, and Page confessed that
mandible to its fullest extent.58 Schuyler, in 1932, the word centric may bc the most controversial
advised using wax interocclusal records and the term in dentistry, not only from a semantic point of
patient may be requested to place the tip of the view but also due to differences in concept, and they
tongue Far back on the palate and to hold it there admit that these serious differences in concept may
while closing. It is quite impossiblc for one to pro- never be resolved.@The newest edition (1987) of
trude the mandible when this position of the tongue the Glossa91 ?f Prosthodontics Term defines centric
is retained.59 Meyer, using the functionally gener- relation as A maxillomandibular relationship in
ated path Lechnique, did not attempt to manipulate which the condyles articulate with the thinnest avas-
the mandible other than to instruct the patient cular portion oftheir respective disks with the com-
occasionally in getting started by exerting a little plex in the anterior-superior position against the
pressure on the chin.*q Mandibular nianipulation slopes of the articular eminesces. The authors of
grew in acceptance with the increased interest in this 5th edition of the Glo.~say$Prosthodontic T m
gnathologic philosophy, and writers began to warn of state This term (CR) is in transition to obsoles-
strain to the condyles. Robinson, in 1951, stated that ~ e n c e . ~Wishful
thinking, or admission that the
the rnandible can be retruded beyond what we more we attempt to define this important concept of
should consider centric into a strained retruded clinical dentistry, the more confusing it becomes?
position.jo The current definition of CR is considerably different
As the debate of how to define the centric jaw from the definitions used by Hanau, Niswonger,
position escalated, new terms began to appear in Schuyler, and the other early giants of dentistry.
the literature. Terms like posterior border closure; These clinical dentists recorded centric relation differ-
relaxed closure, bracing position, hinge ently than is commonly done today, but the concept
position, ligamentous position, retruded contact of mandibular centricity remains constant even
March I993>Volume 2, Number I 41

though the definition and the tcchniques have evolved ing contacts in natural dentitions have the potential
and probably will continue to evolve. of being very destructive. The criteria requires that
disclusion occurs as thc mandible moves laterally.
Because the mandible can flex68.6qand the articulator
Biological Occlusion does not (except for the Transograph), the amount
There is ample reason to believe that many success- of disclusion needed can vary and must be tested in
ful long-term clinical treatments have bcen accom- the mouth for each individual patient.
plished using each of the modern schools of occlu-
sion. Because dentitions can be maintained
Cusp-to-FossaOcclusal Scheme
successfullywith several apparently conflicting occlu-
sal conccpts, there is a growing realization that While cusp tips can function effectively against mar-
occlusal concepts are not as cut and dried as we ginal ridges, a cusp-fossa relationship is potentially
once thought. The flexible concept of occlusion is more stable than any other relationship.
termed biological occlusion, and its philosophical
goal is to achieve an occlusion that functions and
maintains health. This occlusion may include malp- A Minimum of One Contactper Tooth
posed teeth, evidence of wear, missing teeth, and It is preferred that every vertical dimension cusp
centric occlusion may not always equal centric rela- (buccal of the lower and lingual of the upper) be in
tion. The dominant factor is that this occlusion has full contact with the opposing fossa. However, there
shown its ability to survive, thus implying an age are times when this is not practical, thus as a bare
factor, ie, a teenager with temporomandibular joint minimum one should have at least one cusp-to-fossa
symptoms does not fit this occlusal concept, while an contact for each posterior tooth. If this is not achieved,
asymptomatic 80-year-old with balancing side con- the noncontacting tooth has the potential of erupting
tacts does. One who fits this concept needs no and shifting into a malposition, producing a balanc-
occlusal therapy. However, when occlusal therapy is ing interference. The potential for a contacting tooth
indicated (ie, mutilated dentition, occlusal trauma- to shift into malposition is diminished if the vertical
tism, temporomandibular joint dysfunction), then dimension cusps are engaging opposing fossas.
basic guidelines for occlusal design are needed. These
goals are compatible with almost all of the occlusal
concepts commonly used today for natural dentitions Cuspid Rise or Group Function
including P.M.S., Gnathology, and Transographics.
In order to assure that there are no balancing
contacts, the working side must disclude the poste-
Goals of Biological Occlusion rior teeth on the balancing side during lateral ecccn-
tric jaw movements. It is equally acceptable to
No Intet$mnces Between Centric Occlusion achieve this disclusion with a cuspid rise or group
and Centric Relation [unction where the cuspid and/or bicuspids engage
Very few patients naturally function in centric rela- in lateral motion to disclude the balancing side
tion occlusion; however, centric relation is a very occlusion. Also acceptable is a combination of cuspid
valuable position in restorative dentistry. To demand rise and group function.
that the condyles be in their hinge position when the
teeth are in the maximum intercuspal position and
to stay that way for long periods of time is unreason-
No Posterior Contacts With Protrusive Jaw
able. It is not unreasonable to assure that there are
Movements
no cuspal interferences between centric relation As the mandible slides forward from the maximum
(CR) and centric occlusion (CO), CR and CO as intercuspal position, the anterior teeth should en-
defined by the Glossay ofProsthodontic Terms, 1987.3 gage and progressively disclude the posterior teeth.

No Balancing Contacts No Cross-Tooth Balancing Contacts


Years of observation, trial and error, and scientific A cross-tooth contact occurs when the lower lingual
investigation have brought realization that nonwork- cusps contact the upper lingual cusps on the working
side. Because the lower lingual cusps are nonfunction- 5. Balkwill FH: The best form and arrangement of artificial
ing, their reduction to eliminatp contact in lateral teeth for mastication. BrJ Dent Sci 18669278
6. Vun Spec F: Die vcrschiebungsbahn des unterkiefers a m
excursion is simple and prevents interference with
schatlel. Arch P Ariat U Physiol 1890
group function. The potential for fracturr of these 7. Gillis RR: Articulator development and the importance of
lower lingual cusps is also reduced. obsening the condyle paths in full denture prosthesis. J Am
Dent Assoc 1926;13:3
8. Hall KE: . h i analysis of the development of the articulator.,J
Eliminate All Possible Fremitus Am Dent Assoc 1930;17:3
9. Christensen C: A rational articulator. Ashs Q Circ 1901;18:
Fremitus is the movement of teeth in function; this 409
undesirable phenomena is also called functional mo- 10. Christensen C: Problems of the bite. Dent Cosmos 1905;47:
1184
k~ility.~Freniitus usually occurs with pcriodontally
1 I . Bcnnctt NG: A contribution to the vtudy of t h e movcmcnt of
compromised support. Fremitus often cannot be thc mandible. R Soc Med Sect Odont Proc 1908;1:79
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