HEN STUDYING modern concepts of occlusion, one should consider how curreni principles evolved (Fig 1). Because modern schools of
occlusion may vary, acccptance or rejection of principles tends to be based on: (1) past training (dental
school), (2) personality of the authority presenting
the theory, (3) the latest fad, (4)ease in technique,
and (5) scientific evidence. All occlusal concepts are
based in part on theory, and all of these theories
borrow in part from the past. This article reviews the
evolution of occlusal concepts: not with thc idca of
criticism of each theory, but with attempt to evaluate
these theories, their interrclationships, where they
agree, and where each concept contribuied to our
ongoing understanding of occlusion.
concept of bilatcral balanccd occlusion3 and devcloped an articulator that applied his 4-inch triangular
theory.4 In 1866 Balkwill discovered that during
lateral jaw movement, the translating condyle moved
medially." In 1890 the German anatomist Von Spee
observed that the occlusal plane of the teeth followed
a curve in the sagittal plane. Von Spec attempted to
describe the relationship between the condylar path
and this compensating curve, or "curve of Spee," by
stating that the steeper the condylar path (in protrusive), the more pronounced would be the compensatWe know today that this relationship is
ing
not necessarily true; however, from the concepts of
these three mcn came thc age of occlusal theory and
occlusal articulators. Literally hundreds of articulators came and went in the early 1900~.',~
Early Concepts
The first mechanical articulator was invented by J.B.
Gariot in 1805.',*It was a plain line instrument and it
is still in use today (Fig 2). In 1858 Bonwill dcscribed
his triangular thcory whereby he postulated that the
distance from the incisal edges of the lower incisors
to each condyle is 4 inches, and the distance between
the condyles is 4 inches (Fig 3). Honwill proposed a
*ilrsoriate Ciiniral Prufissor, Department of Fixed A-octhodorrtics,
School ofDentisty, lIniversi@~Coloradu,Dmzer, GO.
TAssociatePr&w and Intm.m Chairman, Dejmrlment of Prnsthodontics, Unznluerrigqf Texas Health Science Center at Sari Antonio, TX.
Address repnril teguestJ tu Dauid A. Kaiser. DDS, MSD, Dioirion of
Pmthodontir Dmtisty, Unioenity o j Texas Health Scimce Center ot Son
Antonio Dental School, 7703 Floyd Curl Dr, San ilntonio, TX 78284-
7890.
Cofyright 01993 by the A w n c a n College oJFrodhodontirts
I0.59-981XJ 931O201-00O78.iOOj 0
33
34
R d e r and Kaiser
Evolution of Occlusion
Gariot 1805
Snow 1806
Gysi 1910
Balkwill 1866
THEORETICAL / GEOMETRICAL
Stansberry 1929
(No Science)
Monson 1919
Hall 1914
M Y I I'IWIWIYJUIY
Meyer 1933
GNATHOLOGY
P. M. S. SYSTEM
McCollum
Granger
Stallard
Sluart
Lucia
Thomas
Guichet
Lauritren
TR ANSOGRAPHICS
Dawson
Page 1951
1PERIODONTAL PROSTHESIS I
x
Amsterdam
Prichard
Yuodelis
Lindhe
CRANIAL ORTHOPEDICS
Harold Gelb
Eversaul
BIOLOGIC OCCLUSION
35
36
Figure 6. The Hall articulator was developed to implement the Conical Theory of Occlusion and was based on
geometrical relationships.
sal instrument (Fig 7) that was based on the scientific
writings of Snokv and Gysi.J Hanau rejected the
spherical theory and proposed the rocking chair
denture occlusion in 1923.20This rocking chair theory
involved heavy contact to the first molar areas to
compensate for the resiliency and like effect, which
referred to the resiliency of soft tissue and temporomandibular joint. Hanau advocated bilateral bal-
anced occlusion with eccentric mandibular movements 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 antiMonson 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
the occlusion of dentures and natural dentitions tend
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
allow for bilateral balance in eccentric jaw movements and was one of the first occlusal theories to
abandon this concept. Pleasure, in 1937, introduced
his Pleasure curve (Fig
which advocates the
anti-Monson reverse cune except for the second
molars. The second molars are tipped up to allow for
bilateral balance of three points (incisal and both
Murch 199.7, V o h m 2
~,Number I
A n t i - Monson
( A w r y brs.)
Figure 9. Diasgram of the anti-Monson concept as proposed by the Avery brothers in 1930.
second molars) in eccentric movements. The Pleasure curve retained the alleged benefits of the antiMonson curve while allowing for bilateral balance in
eccentric movements.
The occlusal concepts proposed during this period
of dental history from 1800 to approximately 1930,
which one could call the age of occlusal theories, can
be summarized as being basically formulated for
complete denture patients in which bilateral balanced occlusion in eccentric movements was considered essential. The efforts by these dental pioneers to
develop occlusal instruments were driven primarily
by the need to implement the proposed occlusal
theory.
37
The maxillary posterior occlusion was thcn fabricated 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
instrument (Fig 11) was used for articulating the
casts, which had no functional movement capability.
It was argued that articulator movement was unnecessary because functional limits were recorded uith
the chcw-in registration.
A few years later Schuylerjoined with Pankey and
Mann to evolve what is now known as the P.iz/I.S.
(Panky, Mann, Schuyluj
This occlusal system
retained the Monson spherical theory and the functionally generated path technique; however, under
Schuylers i n f l ~ e n c e ~ (-1)
~ ~the
: balancing side contacts were eliminated; (2) the importance of incisal
guidance was elevated; (3) the concept of long
centric or functional centric occlusion was proposed in which centric occlusion is thought of as an
area ofcontact rather than a point contact; and (4)
the Hanau occlusal instrument with arbitrary face
bow and Broadrick occlusal plane analyzer was adopted.3G
Gnathology
Pleasur e
Curve
38
Beckerand Kairpr
39
40
position, and terminal hinge position added confusion. Even the different disciplines within dentistry
could not agree on the definition of centric relation.
Goldman and Cohen defined centric relation as the
most posterior relation of the mandible to the maxilla from which lateral movements can be made.61
Glickman stated ccntric relation is the most retruded position to which the mandible can be carried
by the patients musculat~ire.~~
Graber refused to bc
drawin into the controversy, stating only that the
position must be the unstrained, neutral position of
the mandible.. .63 Schluger, Yuodelis, and Page
stated that centric relation is the position assumed
by the mandible relative to the maxilla when the
condyles are in their rearmost, midmost position in
the glenoid fossae.li4This definition is very close to
the gnathologic RUM definition as proposed by
McCollum and Stuart, where the condyles are in
their rearmost, uppermost, and midmost position
in their respective f o ~ s a eIn
. ~an
~ effort to standardize
this and other commonly used terms, the Academy
of Prosthodontics (formerly the Academy of Denture
Prosthetics) has published the Glossay $Prosthodontic
Terms.This glossary is updated periodically and has
five editions since the first in 1956. Every time there
is an update, the definition of centric relation changes.
Avant, in 1971, decried the seven definitions of
centric relation appearing in the 2nd edition of
196flb6 Schluger, Yuodelis, and Page confessed that
the word centric may bc the most controversial
term in dentistry, not only from a semantic point of
view but also due to differences in concept, and they
admit that these serious differences in concept may
never be resolved.@The newest edition (1987) of
the Glossa91 ?f Prosthodontics Term defines centric
relation as A maxillomandibular relationship in
which the condyles articulate with the thinnest avascular portion oftheir respective disks with the complex in the anterior-superior position against the
slopes of the articular eminesces. The authors of
this 5th edition of the Glo.~say$Prosthodontic T m
state This term (CR) is in transition to obsoles~ e n c e . ~Wishful
Biological Occlusion
There is ample reason to believe that many successful long-term clinical treatments have bcen accomplished using each of the modern schools of occlusion. Because dentitions can be maintained
successfullywith several apparently conflicting occlusal conccpts, there is a growing realization that
occlusal concepts are not as cut and dried as we
once thought. The flexible concept of occlusion is
termed biological occlusion, and its philosophical
goal is to achieve an occlusion that functions and
maintains health. This occlusion may include malpposed teeth, evidence of wear, missing teeth, and
centric occlusion may not always equal centric relation. The dominant factor is that this occlusion has
shown its ability to survive, thus implying an age
factor, ie, a teenager with temporomandibular joint
symptoms does not fit this occlusal concept, while an
asymptomatic 80-year-old with balancing side contacts does. One who fits this concept needs no
occlusal therapy. However, when occlusal therapy is
indicated (ie, mutilated dentition, occlusal traumatism, temporomandibular joint dysfunction), then
basic guidelines for occlusal design are needed. These
goals are compatible with almost all of the occlusal
concepts commonly used today for natural dentitions
including P.M.S., Gnathology, and Transographics.
41
Cusp-to-FossaOcclusal Scheme
While cusp tips can function effectively against marginal ridges, a cusp-fossa relationship is potentially
more stable than any other relationship.
No Balancing Contacts
side. Because the lower lingual cusps are nonfunctioning, their reduction to eliminatp contact in lateral
excursion is simple and prevents interference with
group function. The potential for fracturr of these
lower lingual cusps is also reduced.
Summary
The historical origins of some concepts of occlusion
have been discussed. The cornerstones for several
prominent occlusal concepts that have been developed for natural dentitions and are currently being
applied to restorative dentistry have been presented.
It is presumptuous to state natures intent for an
ideal occlusion and therefore it is recommended to
avoid occlusal therapy for individuals who appear to
be functioning in health, even if their occlusal scheme
does not fit a concept of optimum occlusion. When
occlusal therapy is unavoidable, it is suggested to
treat within the guidelines of what has been called
biological occlusion.
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