Dr.

Khaled AboulAzm ,2011

DESCRIPTION OF NORMAL OCCLUSION IN ADULTS

The purpose of the present lecture is to describe normal occlusion in adult subjects. In the present lecture, the following topics will be discussed. A. Prevalence of normal occlusion in Egypt. B. Static occlusion "Larry Andrews' six keys to normal occlusion". C. Functional occlusion " Ronald Roth' concepts". Physiologically speaking, the word "normal" designates a range rather than a single point. Literally, the word "occlusion" means closing up (oc=up, and clusion = closing). The description of normal occlusion at different ages was previously lectured (i.e., normal growth and development of the dental arches and occlusion).

A. Prevalence of Normal Occlusion in Egypt Published research has shown that the prevalence of normal occlusion among adult Egyptian is 34.3%. It is significantly more common in females (36.7%) than males (31.6%). The prevalence of normal occlusion among Egyptians is lower than that of the Indians. However, it is higher than that of the Americans, Swedish,

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B. Static Occlusion : Dr.Khaled AboulAzm ,2011 Larry Andrews' Six keys to normal occlusion
Lawrence F. Andrews studied dental casts of 120 nonorthodontic subjects having normal occlusion. Following his study, he described six dynamically-interrelated characteristics of normal occlusion designed bynature without any orthodontic intervention. He called these characteristics the "six keys". These keys are: molar relationship, crown angulation, crown inclination, rotations, tight contacts, and occlusal plane. a. The distal surface of the distal marginal ridge of the maxillary permanent first molar made contact and occluded with the mesial surface of the mesial marginal ridge of the mandibular permanent second molar. b. The mesiobuccal cusp of the maxillary permanent fist molar fell within the buccal groove located between the mesial and middle cusps of the mandibular permanent first molar- as indicated by Angle . c. The mesiolingual cusp of the maxillary permanent first molar was seated in the central fossa of the mandibular permanent first molar. (The molars and premolars enjoyed a cusp-embrasure relationship buccally, and a cusp-fossa relationship lingually. The tips of the maxillary canines The maxillary first permanent molar displayed a solid three- point contact with opposing teeth.

Key 1. Molar Relationship

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Dr.Khaled AboulAzm ,2011

were slightly mesial to the mandibular canine-premolar embrasure- which is consistent with the canine-rise concept).

viewed from a facial perspective) and a perpendicular line erected from the occlusal plane . It is positive when the gingival portion of the long axis of the crown is distal to the incisal portion , and vice versa. In normal occlusion, the crown angulation was positive for all the teeth.

Key II. Crown Angulation (Mesiodistal Tip)

Key III. Crown Inclination (Faciolingual Torque)

Fig. 3. Crown angluation (mesiodistal tip). P: perpendicular to the occlusal plane. A: crown angulation. M: mesial. D: distal. OP: occlusal plane. By definition, the crown angulation is the mesiodistal tip of the long axis of the crown. It is the angle formed between the long axis of the crown (as Fig. 4. Crown inclination (faciolingual torque). By definition, the crown inclination is the faciolingual torque of the long axis of the crown. It is the angle formed between the facial long axis of the

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Dr.Khaled AboulAzm ,2011

crown (as viewed from a proximal perspective) and a perpendicular line erected from the occlusal plane . It is positive when the gingival portion of the long aixs of the crown is lingual to the incisal portion, and vice versa In normal occlusion, the crown inclination was negative for all theteeth except the maxillary central and lateral incisors. Further, the lingual crown inclination was similar for the maxillary canines through the maxillary second premolars, and was slightly more pronounced in the maxillary molars. Furthermore, the lingual crown inclination progressively increased from the mandibular canines through the mandibular second molars.

Key IV. Rotations

Fig. 5. Rotation In normal occlusion, the dentition should be free from undesirable rotation . If a molar is rotated, it would occupy more space than normal within the dental arch . The reverse is true for the anterior teeth.

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Dr.Khaled AboulAzm ,2011

Key VI. Occlusal Plane

results in a more confined area for the maxillary teeth, creating spillage of the maxillary teeth mesially and distally . On the other hand, a reverse curve of Spee results in excessive room for the maxillary teeth . In other words, if the curve of Spee is not relatively flat teeth in one arch will tend to be crowded while those in the other will be spaced .

Fig. 6. Occlusal plane and curve of spec. By definition, the occlusal plane is the imaginary plane on which the teeth meet in occlusion. (It is indeed a curved compound surface which is commonly approximated by a planestraight lines on lateral views-based on specific reference points within the dental arches). In normal occlusion, the occlusal plane should be flat or nearly flat (Fig. 6). A deep curve of Spee

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Dr.Khaled AboulAzm ,2011

C. Functional Occlusion Ronald Roth's Concepts

Ronald Roth applied gnathological concepts to orthodontics. He has shown that functional occlusion can be orthodontically achieved even after therapeutic extractions. Roth described the mutually-protective occlusal scheme in which maximum dental interdigitation occurs when the mandible is in its rearmost, midmost, and uppermost position. The occlusal stops are equally distributed among the posterior teeth on their centric cusps. The anterior teeth are not in positive contact but may elicit a mark with an articulating paper. However, when the posterior teeth are in occlusion, a thin mylar strip will not be held by the anterior teeth. Fig.7. Mutually protective occlusal scheme

INCISAL GUIDANCE Protrusive movement

In protrusive movements,
the maxillary anterior teeth articulate
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Dr.Khaled AboulAzm ,2011

equally and evenly with the mandibular anterior teeth and the first premolars (or the second premolars in first premolars extract ion cases) to gently disclude the posterior teeth.

In lateral movements

. , the maxillary anterior teeth articulate with the same mandibular teeth to on any movement out of centric. The canines serve as the main guiding inclines. The rate of caninerise is very gentle and harmonious with the lateral excursions

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