PREPARED BY

DR. MOHAMED ASHOUR Biomechanics of

ASSISTANT PROFESSOR OF
REMOVABLE PROSTHODONTICS
Natural
OCCLUSION AND TMJ COURSE Occlusion
Objectives  Organization of
occlusion in natural
dentation.
 Concepts of occlusion
in natural dentation.
 Determinantsof
occlusal morphology.
Each requirement for successful occlusal therapy
(circles) is dependent upon the others.

A, Three primary requirements for successful occlusal therapy.

B, Masticatory muscle function is affected by the other structures.
 Concepts of occlusion in centric
relation( in natural dentation)

01 02 03
Point Slide in Freedom
centric. centric of centric.
 Point Centric
Maximum intercuspation (Centric
occlusion) coincides with centric
relation.

About 90% of all individuals with natural

dentition maximum intercuspation and
centric relation do not coincide.
 Slide in centric
 Definition:
two or three dimensional sliding movement
that the mandible makes as it moves from
retruded contact position to intercuspal
position.
 Causes:
1. wear,
2. Caries.
3. loss
of teeth.
4. Poor dentistry.
 The centric occlusion occlusal contacts are
stable, and the centric relation occlusal
contacts are not stable, thus resulting in a
Freedom of centric (long centric), (broad
centric)

Relatively flat area is created

between centric relation and
centric occlusion positions on the
occlusal surfaces of the teeth.
ORGANIZATION OF OCCLUSION IN
NATURAL DENTATION
 1. Canine
guidance(Canine
When the mandible is moved in rise)
a right or
left laterotrusive excursion, the maxillary
and mandibular canines are appropriate
teeth to contact and dissipate the
horizontal forces while disoccluding or
disarticulating the posterior teeth.
The canines are best suited to accept the horizontal forces that
occur during eccentric movements. They have the longest and
largest roots and therefore the best crown/root ratio. They are also
surrounded by dense compact bone, which tolerates the forces
better than does the medullary bone found around posterior teeth.
(26% of the general population have bilateral canine guidance)
Canine guidance
Canine guidance
 2-Group function
(Unilateral balanced occlusion)

 Many patients’ canines, however, are not in the

proper position to accept the horizontal forces;
other teeth must come into contact during
eccentric movements
 All teeth on the working side to be in contact
during a lateral excursion.
 (The most desirable group function consists of the
canine, premolars, and sometimes the
mesiobuccal cusp of the first molar)
On the other hand, teeth on the nonworking side
41% of the general population 20 to
30 years of age have group
function guidance; this percentage
increases to 68% in those from 50 to
60 years of age. It is likely due to
canine wear.
Group function
guidance
Group function
guidance
Mutually protected
occlusion
Posterior teeth should contact slightly more
heavily than anterior teeth when the teeth are
occluded in the intercuspal position. This
condition is described as mutually protected
occlusion.
i.e. mutually protected occlusion: it means
anterior teeth protecting the posterior teeth in
all mandibular excursions and the posterior
teeth protecting the anterior teeth at the
intercuspal position,
Protrusive movement with anterior guidance
 3-Bilateral Balanced (5% of
population)

 All teeth contact each other during centric and all eccentric
movement. There is cross mouth and cross tooth contacts. It is
not a healthy occlusion.
 Does not normally occur.
 Complete dentures are made with this type of occlusion for
the purpose of stability.
Formula for a perfected occlusion: dots in back, lines in front.
 OPTIMAL FUNCTIONAL OCCLUSION

1. When the mouth closes, the condyles are in

their most superoanterior position
(musculoskeletally stable), resting against
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 come into contact
but more lightly than the posterior teeth.
2. All tooth contacts provide axial loading of
occlusal forces.
 OPTIMAL FUNCTIONAL OCCLUSION (cont.)
3. When the mandible moves into laterotrusive
positions, 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).
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 upright head position and alert feeding
position, posterior tooth contacts are heavier
than anterior tooth contacts.
 Centric Relation (Dawson et.al.)
 Centric relation is the relationship of the
mandible to the maxilla when the properly
aligned condyle-disk assemblies are in the
most superior position against the eminentiae
irrespective of vertical dimension or tooth
position.
 At the most superior position, the condyle-disk
assemblies are braced medially, thus centric
relation is also the midmost position.
 A properly aligned condyle-disk assembly in
centric relation can resist maximum loading
by the elevator muscles with no sign of
Determinants of Occlusal
Morphology
Determinants of Occlusal Morphology
 Posterior controlling factors

(condylar guidance)

 Anterior controlling factors

(anterior guidance)
Posterior controlling factors
PCF

(Condylar guidance)
The movement of the two TMJs (right and left)
along the mandibular eminence.
 The condylar guidance is considered to be a
fixed factor, since it is unalterable in the healthy
patient.
 It can be altered under certain conditions
(trauma, pathosis, or surgical procedure).
Condylar guidance angle
Anterior controlling factors
ACF (anterior guidance)
 ACF is the relationship between the upper and lower
anterior teeth.
 As the mandible protrudes or moves laterally, the
incisal edges of the mandibular teeth occlude with the
lingual surfaces of the maxillary anterior teeth. The
steepness of these lingual surfaces determines the
amount of vertical movement of the mandible
 The anterior guidance is considered to be a variable
rather than a fixed factor.
 It can be altered by dental procedures such as
restorations, orthodontia, and extractions. It can also
be altered by pathologic conditions such as caries,
habits, and tooth wear.
Horizontal reference plane (HRP) of the mandible at both the posterior (PCF)
and the anterior (ACF) controlling factor. The mandible moves horizontally 4
units from a position marked by the dotted line. There is no vertical
movement. The solid line represents the position of the mandible after the
movement has taken place.
Movement of the mandible 4 units horizontally and 4 units vertically at both
the posterior (PCF) and the anterior (ACF) controlling factors. Note that
when the mandible moves 4 units down it moves 4 units forward at the same
time. The net result is that it is at a 45-degree angle from the horizontal
reference planes (HRP). Since both the PCFs and the ACFs are causing the
mandible to move at the same rate, every point on the mandible is at a 45-
degree angle from the horizontal reference plane at the end of a
mandibular excursion.
 A, The posterior and anterior controlling factors are the same,
causing the mandible to move away from the reference plane at a
45-degree angle.
B, For premolar A to be disoccluded from premolar B during a
protrusive movement, the cuspal inclines must be less than 45
degrees.
 A, Posterior and anterior controlling factors are identical and cause the
mandible to move away from the reference plane at a 60-degree angle.
B, For premolar A to be disoccluded from premolar B during a protrusive
movement, the cuspal inclines must be less than 60 degrees. Thus steeper
posterior and anterior controlling factors allow for steeper posterior cusps.
 Vertical Determinants of Occlusal
Morphology
1. The
anterior controlling factor of mandibular
movement (i.e., anterior guidance)
2. The
posterior controlling factor of mandibular
movement (i.e., condylar guidance)
3. Plane of occlusion.
4. Curve of Spee.
5. Lateral translation movement
Horizontal Determinants of Occlusal
Morphology (Ridge-and-Groove
Direction)
 Distance from rotating condyle.
 Intercondylar distance.
 Distance from midsagittal plane.
 References
 Peter E. Dawson: Functional Occlusion: From TMJ to Smile Design,
Mosby; 1 edition, 2007.
 Okeson, Jeffrey P.: Management of temporomandibular
disorders and occlusion, Mosby; 7 ed, 2013.
THE END