Med Biol Eng Comput (2006) 44: 445450

DOI 10.1007/s11517-006-0046-0

TECHNICAL NOTE

Tomoaki Maruyama Yasuo Nakamura

Toyohiko Hayashi Kazumasa Kato

Computer-aided determination of occlusal contact points

for dental 3-D CAD

Received: 28 July 2005 / Accepted: 16 March 2006 / Published online: 12 April 2006
! International Federation for Medical and Biological Engineering 2006

Abstract Present dental CAD systems enable us to de-

sign functional occlusal tooth surfaces which harmonize
with the patients stomatognathic function. In order to
avoid occlusal interferences during tooth excursions,
currently available systems usually use the patients
functional occlusal impressions for the design of occlusal
contact points. Previous interfere-free design, however,
has been done on a trial-and-error basis by using visual
inspection. To improve this time-consuming procedure,
this paper proposes a computer-aided system for
assisting in the determination of the occlusal contact
points by visualizing the appropriate regions of the
opposing surface. The system can designate such regions
from data of the opposing occlusal surfaces and their
relative movements can be simulated by using a virtual
articulator. Experiments for designing the crown of a
lower first molar demonstrated that all contact points
selected within the designated regions completely satis-
fied the required contact or separation during tooth
excursions, confirming the eectiveness of our com-
puter-aided procedure.
Keywords CAD/CAM Computer simulation
Three-dimensional morphology Dental crown
Occlusal surface
T. Maruyama (&) T. Hayashi
Graduate School of Science and Technology, Niigata University,
2-8050, Ikarashi, Niigata 950-2181, Japan
E-mail: f04n002h@mail.cc.niigata-u.ac.jp
Y. Nakamura T. Hayashi
Department of Biocybernetics, Faculty of Engineering,
Niigata University, 2-8050, Ikarashi, Niigata 950-2181, Japan
K. Kato
Institute of Oral Science, Matsumoto Dental University,
1780, Hirooka, Shiojiri, Nagano 399-0781, Japan
1 Introduction
Dental prostheses such as crowns and bridges have been
used to reconstruct patients dentitions for hundreds of
years. At present, they are manufactured primarily by
using a traditional casting technique. Since their design
and manufacture require skilled techniques, their pro-
duction quality cannot easily be maintained within
acceptable limits. Consequently, attempts have been
made to apply advanced CAD/CAM technology to this
field. After a long and enthusiastic period of basic re-
search since the 1970s, Rekow [68] proposed a practical
dental CAD system, DentiCAD, for the automatic de-
sign of crowns, followed by the SOPHA system [1] and
the clinically available CEREC system [3, 4]. Currently,
several dental CAD systems are commercially available,
and are applied in the clinic [10].
These systems are known to be useful even for
designing functional occlusal surfaces [5], which is of
specific importance in the design of dental prostheses,
considering their function in the intercuspal position,
and in tooth sensation and chewing. Occlusal surfaces
consist of cusps and fissures, which have to be designed
anatomically in dental prostheses. It is critical that cusp
points are in contact with the opposing tooth in the
intercuspal position for functional occlusion, due to
their tooth-support function during biting. CAD-based
design of the contact points, however, has been done on
a trial-and-error basis in order to avoid occlusal inter-
ference during tooth excursions. Thus, present dental
CAD systems usually have a certain function capable of
checking occlusal interferences using the patients func-
tional impressions, which are recorded during tooth
excursions. However, it should be noted that we can
compute whether the designed contact points interfere
with the opposing cusps or not, if data of the opposing
surface geometry and tooth excursions are both given in
three dimensions. Then, if tooth excursions can be sim-
ulated using a virtual dental articulator in a dental CAD
system, we can compute regions of the opposing surface
446

in which the contact points can be located without cu-

spal interference during excursions. Visualization of
such regions in the CAD system helps us to easily
determine the contact points of the prosthesis. In order
to realize such a system, we propose a virtual semi-
adjustable articulator which can be implemented in
dental CAD, and a practical method for the computa-
tion and visualization of opposing surface regions suit-
able for contact points to be located.

2 Methods

2.1 Virtual articulator

In order to obtain a natural and functional occlusal

surface of the crown using dental CAD, we have to
simulate not only the intercuspation, but also tooth
articulation during gliding movements. During tooth
excursions, opposing occlusal surfaces separate or make
contact with each other. Their separation is referred to
as the disclusion in dentistry, while the contact can
be classified into two groups as follows: (1) natural
contact; and (2) interferential contact from a clinical
viewpoint. When designing a patients crown, dentists
have to provide its occlusal surface with appropriate
contacts both in intercuspation and during tooth
excursions.
Presently available dental CAD systems have yet to
include the function of a dental articulator, a mechanical
instrument capable of providing the patients dental cast
Fig. 1 Virtual articulator. a Computer model of articulator, b
with various tooth-gliding movements, and thus the computer model of articulator (sagittal view), c incisal table
clinical applicability of these systems has been limited. (enlarged view)
To eliminate these limitations, we facilitated the design
of the occlusal surface by simulating a dental articulator
and visualizing the proximity of opposing occlusal sur- counterpart using intercuspation data, such as an
faces. There are three categories of dental articulator: occlusal record.
fully adjustable, semi-adjustable, and non-adjustable.
For computer simulation, we employed a Whip-MixR-
type semi-adjustable articulator, because it can simulate 2.2 Computer-aided adjustment of occlusal contact
several gliding movements while remaining relatively points
simple to operate, as illustrated in Fig. 1.
Our virtual articulator consists of a maxillary frame In order to assist in designing the occlusal contacts of a
and a mandibular frame (Fig. 1), as in conventional crown using dental CAD, we propose a totally new
dental articulators. The mandibular frame has an incisal technique using the virtual articulator, which can visu-
table guiding the tip of the maxillary incisal pole (IP), alize whether each point of the opposing occlusal surface
and condylar points (CL, CR) simulating the center of is appropriate or not as a contact point. The visualiza-
the condylar ball capable of moving along the maxillary tion process is summarized as follows: (1) the operator
condylar housing. Adjustable components of the artic- sets an eccentric jaw position, in which the articulation is
ulator are as follows: (1) sagittal inclination of the evaluated; (2) the positional relationship between the
condylar housing denoted as Cs", and (2) sagittal and upper and lower teeth is computed in the designated jaw
lateral inclinations of the incisal table, denoted as Is" and position; (3) the suitability as a contact point is evalu-
Il", respectively. The patients maxillary cast can be ated at every point on the opposing surface; and (4)
mounted on the articulator in a standard manner, using suitable regions obtained on the opposing surface are
the average position and orientation of the occlusal visualized on the computer display.
plane with respect to our articulator. If detailed infor- Firstly, it is important to determine how to evaluate
mation from a face-bow transfer is available, the cast the displacement between the opposing occlusal surfaces,
can be mounted more precisely. Subsequently, the man- in order to assess the suitability of a contact point. We
dibular cast can be mounted relative to the maxillary will assume that a point on the crown surface, denoted as

A, contacts with the opposing surface in the intercuspal
position, and the contact point of the opposing surface is
denoted as B. The normal vector of the opposing surface
at B is denoted as n. The displacement vector of A from
the intercuspal position to the eccentric position is de-
noted as m. Vector m can be split into two rectangular
components, denoted as mn and mo which are defined as
an orthogonal projection of m on n and the residual
component, respectively, i.e., m=mn+mo. Vector mn can
be interpreted as the separation vector of the opposing
surfaces at the contact point. Then, the displacement can
be quantified by using the inner product of m and n,
denoted as D (m, n) (Fig. 2), which can be computed at
every point of the opposing surface. A contact point of
the crown can be created in the three dierent regions of
the opposing surface where D>0, D=0, and D<0. In
case of D>0, the contact point is separated from the
opposing surface during the designated excursion, while
in case of D=0 or D<0, the point remains in contact
with or interferes with the opposing surface during the
excursion, respectively.
The trial system can visualize the opposing surface in
the form of a wire-frame representation, which consists
of triangular patches, while displacement D is evaluated
in relation to every patch during the excursion. The
design procedure is summarized as follows: (1) to des-
ignate less than or equal to three gliding movements
which have to be considered seriously in the design of
crown; (2) to input motion parameters, such as Cs, Is, Il,
and motion distance, regarding the designated move-
ments; (3) to input displacement D, which is determined
by a dentist, for each gliding movement; (4) to compute
the areas satisfying all required conditions, where we can
select occlusal contact points; (5) to visualize the areas
on the opposing surface for assisting subsequent contact
point determination; and (6) to determine the contact
points of the crown aided by the visualization.
2.3 Experimental procedure
The experiment was carried out using the virtual
articulator. Our computer-aided adjustment system
Fig. 2 Quantification of disclusion during tooth excursion. A: the
contact point of the crown surface; B: the contact point of the
opposing surface; m: the displacement vector of A from the
intercuspal position to the eccentric position; n: the normal vector
of the opposing surface at B; and D: the displacement between the
opposing occlusal surfaces
447
mentioned in the previous section was implemented in
C-language on a personal computer (Microsoft Win-
dows XP, Celeron 2.4 GHz), and was applied to the
design of a crown for the lower right first molar. As
empirical data, we employed intercuspated upper and
lower dental arch models including the lower second
premolar, the lower first molar (abutment), the lower
second premolar and the upper first molar. As a library
model, which was an initial contour set to the abutment,
we used a model of the lower first molar, which was
developed by digitizing a plaster tooth model four times
larger than life size. The experiment was carried out
according to the following procedure: (1) initialization
(scale transformation of the library model, adjustment
of the position and orientation relative to the abutment,
and adjustment of the margin line); (2) design of prox-
imal and distal surfaces; (3) rough design of occlusal
surface; and (4) adjustment of occlusal contact points as
outlined in the previous section.
We provisionally decided to create nine dierent
occlusal contact points (P1P9) on the occlusal surface
of the crown in order to satisfy several required condi-
tions under the theory of tripodism, as illustrated in
Fig. 3. The contact points were classified into three
dierent groups (G1, G2, and G3), according to the fol-
lowing conditions:
G1 (points P1, P2, P3, and P4): the contact points were
separated from the opposing surface during all gliding
movements; G2 (point P5): the contact point stayed in
contact with the opposing surface during left lateral
movements, but was separated during other gliding
Fig. 3 Predetermined occlusal contact points on the occlusal
surface of the crown. M mesial side, D distal side, B buccal side,
L lingual side. a Distal lingual cusp, b distal buccal cusp, c mesial
lingual cusp, d mesial buccal cusp
448

movements; and G3 (points P6, P7, P8, and P9): the

contact points stayed in contact with the opposing sur-
face during right lateral movements, but were separated
during other gliding movements.
In order to verify that points P1P9 satisfied the re-
quired conditions, we computed the minimum distance,
denoted as Dmin, between every contact point and its
opposing surface during tooth excursions. We assumed
that if 0.2 mm Dmin mm during a certain tooth
excursion, the contact point is separated from the
opposing surface, while if 0 mm Dmin<0.2 mm with-
out interference, the point remains in contact.
Finally, we collected data for adjusting the virtual
articulator. In protrusive movements, the sagittal incli-
nation Cs of the condylar housing, the sagittal inclina-
tion Is of the incisal table, and the lateral inclination Il of
the incisal table were set at 38", 46", and 0", respectively.
In lateral movements, on the other hand, Cs, Is, and Il
were set at 46", 66", and 0", respectively. The distance
from the intercuspal position to an eccentric position
for every gliding movement was set at 1 mm at the tip of
the IP.

3 Results

Figure 4 shows a visual representation of the occlusal

surfaces of the crown and the opposing teeth in inter-
cuspation. In Fig. 4ac, the colored areas on the
opposing tooth depict the regions where the contact
points of G1, G2, and G3 have to touch in intercuspation.
According to these guidelines, we determined the posi-
tion of all contact points on the occlusal surface of the
crown.
The results are shown in Figs. 5 and 6. Figure 5
illustrates the obtained occlusal surface and its near
contact regions in intercuspation and other eccentric
jaw positions. Near contact regions are defined as the
areas where the distance between the upper and lower
surfaces are less than or equal to 0.2 mm. In intercus-
pation (Fig. 5a), the contact regions were successfully
created on the occlusal surface of the crown within the
predetermined areas, illustrated in Fig. 3. In the pro-
trusive position (Fig. 5b), no contact regions were ob-
served. In the right lateral position (Fig. 5c), contact
regions were observed solely in the area of G2. In the left
lateral position (Fig. 5d), on the other hand, a single
contact region was observed in the area of G3. In addi-
tion, no cuspal interference occurred in any eccentric jaw
positions.
Figure 6 shows the Dmin values during tooth excur-
sions at every contact point Pi (i=1, 2,...,9). In protru-
sive movements (Fig. 6a), the Dmin of every point
increased in proportion to the distance moved from the
tip of the IP. In right lateral movements (Fig. 6b), the
Dmin of points in G1 and G2 increased in the same
manner as in Fig. 6a, while the Dmin of points in G3
remained within 0.2 mm throughout the movement. In
left lateral movements (Fig. 6c), the Dmin of points in G1
Fig. 4 Tooth area suitable for occlusal contact points. a G1, b G2, c
G3
and G3 increased in the same manner as in Fig. 6a, while
the Dmin of points in G2 remained within 0.2 mm
throughout the movement.
4 Discussion
We suggest that our system for assisting in the deter-
mination of occlusal contact points for dental CAD has
important clinical applications. Our empirical results
have verified that (1) in protrusive movements, points in
every group Gi (i=1, 2, 3) were separated from the
opposing surface by a distance of more than or equal to
0.2 mm; (2) in right lateral movements, points in groups
G1 and G2 exhibited the same separation, while every
point in G3 remained in close contact (Dmin within
0.2 mm); and (3) in left lateral movements, points in G1
and G3 were separated from the opposing surface by a
distance of more than or equal to 0.2 mm, while the
point in G2 remained in close contact. In addition, no
cuspal interference was observed during any gliding
movements. Thus, the obtained occlusal surface of the
crown satisfied all required conditions, strongly sug-
gesting that our quantitative evaluation and visualiza-
tion of the occlusal relationship is eective for CAD-
based design of occlusal surfaces.
 449

a 2.0
G1
1.5 G2

Distance [mm]
G3

1.0

0.5

0.0
0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Movement of Incisal Point [mm]

b 2.0

1.5

Distance [mm]
1.0

0.5

0.0
0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Movement of Incisal Point [mm]

c 2.0

Fig. 5 Near contact regions on the occlusal surface of the crown. a 1.5
Distance [mm]

Intercuspal occlusal position, b protrusive position (1 mm), c

lateral position (right, 1 mm), d lateral position (left, 1 mm)
1.0

The occlusal surface has several important functions:

(1) the determination of the intercuspal position; (2)
tooth support in the occlusal position; and (3) com-
pression of food during chewing. These functions are
achieved in accordance with the entire stomatognathic
system consisting of the periodontium, the neuromus-
cular system, and the temporomandibular joint. Hence,
an occlusal surface unsuitable to such functions could be
destructive not only to the crown, but also to other
components of the stomatognathic system, and could
possibly cause occlusal trauma and temporomandibular
joint disorders. Therefore, several kinematic theories
concerning the design of functional occlusal surfaces
have been proposed, such as Gysis [2] facet and axis
theories and Slaviceks [9] sequential occlusion. The
clinical implementation of these theories, however, has
been limited, and practical theories applicable to ana-
tomical and functional crown design have yet to be
proposed. Looking at recent development of dental 3-D
CAD from this aspect, peripheral conditions for
achieving optimum design of functional occlusal sur-
faces seem getting prepared.
Among several procedures contributing to optimal
design of occlusal surfaces, the determination of contact
points is of particular importance. When making a
dental crown, the operator has to determine what
0.5
0.0
0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
Movement of Incisal Point [mm]
Fig. 6 Distance between the occlusal contact point and the
opposing surface during tooth excursions (Dmin). a Protrusive
movement, b right lateral movement, c left lateral movement. G1:
Dmin of contact points P1P4 (mean SD, n=4); G2: Dmin of
contact point P5; G3: Dmin of contact points P6P9 (mean SD,
n=4). Error bars represent the SD of the mean
portion of the cusps contact the opposing occlusal sur-
face, and then create the contact points on a wax pattern
of the crown. Such contact point determination is very
critical in respect of tooth support during biting, bite-
force application to the crown and chewing ecacy.
Thus, occlusal contacts need to be optimized for each
crown. Conventionally, this procedure has been
achieved manually by trial-and-error using a wax pat-
tern made on the patients casts mounted on a dental
articulator, thus depending significantly upon the oper-
ators skill. Even when the sophisticated dental CAD
systems currently available are used, such detailed de-
sign is still carried out in the conventional manner.
450
To improve contact point determination in dental
CAD, an advanced computer-aided system capable of
producing an optimal occlusal surface design for each
patient is required. Such a system should possess at least
three functions as follows: (1) computation of tooth
articulation during gliding movements; (2) quantitative
evaluation of the positional relationship between the
upper and lower dental arches during gliding move-
ments; and (3) visualization of the evaluation results for
the operator. Our trial system also includes the following
new functions: (1) a virtual articulator; (2) a mathe-
matical criterion evaluating the amount of separation or
interference between the opposing occlusal surfaces
during tooth excursions; and (3) a visualization of the
areas which satisfy all required conditions, and are thus
possible sites for occlusal contact points. The ecacy of
our trial system for contact point determination was
validated through experiments. Thus, our system could
be useful in the semi-automatic design of natural and
functional occlusal surfaces of crowns. To confirm the
systems clinical applicability, additional experiments
covering a diverse range of occlusal surfaces and tooth
excursions will need to be undertaken in subsequent
studies.
References
1. Duret F, Preston J, Chapouland E, Duret B (1991) CAD/CAM
in the dental oce. Quintessence 10(3):449467
2. Gysi A (1929) Handbuch der Zahnheilkunde IV. Urban &
Schwarzenberg, Berlin
3. Mormann WH, Bindl A (2000) The Cerec 3-a quantum leap for
computer-aided restorations: initial clinical results. Quintes-
sence Int 31(10):699712
4. Mormann WH, Brandestni M, Lutz F, Barbakow F (1989)
Chairside computer-aided direct ceramic inlays. Quintessence
Int 20(5):329339
5. Reich S, Troeltzsch M, Denekas T, Wichmann M (2004)
Generation of functional Cerec 3D occlusal surfaces: a com-
parison of two production methods relevant in practice. Int J
Comput Dent 7(3):229238
6. Rekow ED (1987) Computer-aided design and manufacturing
in dentistry: a review of the state of the art. J Prosthet Dent
58:512516
7. Rekow ED (1991) Dental CADCAM systems: what is the
state of the art. J Prosthet Dent 122:4348
8. Rekow ED, Thompson VP, Yang HS (1991) Margin fit of
CADCAM produced crowns. J Dent Res 70:715720
9. Slavicek R (1984) Die funktionellen Determinanten des Ka-
uorganes. Habilitationsschrift, Munchen
10. Tinschert J, Natt G, Hassenpflug S, Spiekermann H (2004)
Status of current CAD/CAM technology in dental medicine.
Int J Comput Dent 7(1):2545
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