Original Article

Functional Occlusal Patterns and Their Relationship to Static Occlusion

Kazem S. Al-Nimri
a
; Anwar B. Bataineh
b
; Sawsan Abo-Farha
c
ABSTRACTObjectives:
To test the hypothesis that there is no relationship between static occlusion anddynamic
occlusion.
Materials and Methods:
The relationship between static and dynamic occlusion was investigatedin a sample of 94 dental
students (39 males and 55 females) with an age range of 21–30 years.Static occlusion was
determined by intraoral examination. Dynamic occlusion was determined inregulated lateral
(0.5 mm and 3 mm lateral to the intercuspal position) and protrusive movementsof the mandible by
intraoral examination with the aid of shimstock.
Results:
At the 0.5 mm lateral excursion, 24.5% had bilateral group function and 12.7%
h a d bilateral canine guidance. At the 3 mm positions, the guidance pattern changed to a
predominantlyc a n i n e g u i d a n c e . F i f t y p e r c e n t o f s u b j e c t s h a d b i l a t e r a l c a n i n e
g u i d a n c e , a n d o n l y 8 . 8 % h a d bilateral group function. In terms of the anterior guidance pattern, a
predominant anterior contactwith posterior disocclusion (77.5%) was noted. Examination of the
relationship between static anddynamic occlusions revealed that at the 0.5 mm position, the
pattern of dynamic occlusion wasdifferent in relation to various static occlusion features
but without reaching a significant level.While at the 3 mm position, the pattern of dynamic
occlusion was significantly affected by incisorrelationship. The distribution of protrusive
excursion patterns was significantly influenced byincisor, canine, and molar relationships.
Conclusions:
The hypothesis is rejected. An association exists between dynamic occlusion anddifferent
aspects of static occlusion. (
Angle Orthod
2010;80:65–71.)
KEY WORDS:
Static occlusion; Functional occlusion; Lateral excursion; Anterior excursion
INTRODUCTION
Dental treatment has the capacity to fundamentallyc h a n g e s t a t i c a n d d y n a m i c o c c l u s a l
r e l a t i o n s h i p s , while aiming for achieving as near ‘‘ideal’’ occlusiona s p o s s i b l e .
Accepted criteria for the ‘‘ideal’’ statico c c l u s i o n w e r e e s t a b l i s h e d b a s e d
o n t h e w o r k o f Angle,
1
who is credited with making the professionmost aware of occlusion by
presenting standardsw h e r e b y a m a l o c c l u s i o n c o u l d b e c o m p a r e d
w i t h normal occlusion, and the work of Andrews,
2
whop r e s e n t e d s i x k e y s t h a t g a v e a w e l l - d e l i n e a t e d p r e s c r i p t i o n
f o r a n i d e a l i n t e r c u s p a t i o n o f t e e t h . Conversely, the features that
c o n s t i t u t e ‘ ‘ i d e a l ’ ’ d y - namic occlusion continue to be subject to great debateand have not, to date,
been conclusively established.T h e r e a r e t h r e e m a i n c o n c e p t s r e g a r d i n g
t o o t h c o n t a c t d u r i n g t h e l a t e r a l e x c u r s i o n o f m a n d i b u l a r movement: (1) balanced
occlusion, which was devel-oped from the work of Bonwill,
3
(2) canine guidance,described by D’Amico,
4
a n d ( 3 ) g r o u p f u n c t i o n , a s discussed by Beyron.
5
The relationship between static and dynamic occlu-s i o n i s o n e o f t h e a s p e c t s o f t h e s t u d y o f
f u n c t i o n a l occlusion that has received little attention. Few studiesh a v e e x p l o r e d t h e p o s s i b i l i t y
o f a n a s s o c i a t i o n b u t conflicting results have been reported. Scaife and Holt
6
found canine protected occlusion to be associated withClass II then Class I, and least associated
with ClassIII, malocclusion. The above mentioned findings wereconfirmed by Al-Hiyasat and
Abu-Alhaija
7
in a study of447 school children, aged 14–17 years. Other studies
a
Associate Professor, Department of Orthodontics, School ofDentistry, Jordan University of Science
and Technology, Irbid-Jordan.
b
Professor, Department of Oral and Maxillo-Facial Surgery,School of Dentistry, Jordan
University of Science and Technol-ogy, Irbid-Jordan.
c
Postgraduate student, Department of Orthodontics, Schoolof Dentistry, Jordan University of Science and
Technology, Irbid-Jordan.C o r r e s p o n d i n g a u t h o r : D r K a z e m S . A l - N i m r i ,
A s s o c i a t e Professor in Orthodontics, School of Dentistry, Jordan Universityof Science and Technology,
P.O. Box 3030, Irbid-Jordan(e-mail: kazemnimri@hotmail.com)Accepted: April 2009. Submitted:
February 2009.
G
2010 by The EH Angle Education and Research Foundation,Inc.
DOI:
1 0 . 2 1 3 9 / 0 2 1 2 0 9 -
9 8 . 1 6 5
Angle Orthodontist, Vol 80, No 1, 2010

found that most Class I Angle occlusion cases wereassociated with balanced occlusion.
8–10
On the otherh a n d , T i p t o n a n d R i n c h u s e
11
f o u n d n o s i g n i f i c a n t association between static and dynamic occlusion.A number of limitations
can be noted in the abovem e n t i o n e d s t u d i e s : N o r e f e r e n c e w a s m a d e t o t h e location
of the canine in terms of its relationship to thel i n e o f t h e a r c h n o r t o t h e d e g r e e o f
a t t r i t i o n o f t h e canine, which is of particular importance in examiningthe assumption that
attrition could lead from one typeo f c o n t a c t d u r i n g l a t e r a l m o v e m e n t t o
another.
12
Moreover, the position at which the occlusal contactpattern was recorded (cusp to cusp) is
not represen-tative of the functional range of the lateral excursion ofmandibular movement.A n o t h e r
f a c t f o r c o n s i d e r a t i o n i s t h a t c h a n g e s occurring during occlusal development could
influencet h e o c c l u s a l c o n t a c t p a t t e r n ; H e i k i n h e i m o e t a l
13
reported an increase in occlusal interferences betweenthe ages of 12 and 15 years in 167 Finns; other
studiesfound a decreasing prevalence with increasing age.
14,15
Although the results of these studies are contradictory,t h e y s u g g e s t t h a t c h a n g e s o c c u r
d u r i n g o c c l u s a l development that must not be overlooked in samples e l e c t i o n ;
s a m p l e s t h a t a r e b e y o n d t h e a d o l e s c e n t years would be more representative of a population
asit avoids the effects of age and occlusal developmenton the results of research.Based on
the above mentioned facts, we thought itwarranted to further investigate whether a
relationshipexists between static occlusion and dynamic occlu-sion, and, if such a
relationship exists, which type ofd y n a m i c o c c l u s i o n i s a s s o c i a t e d w i t h w h i c h t y p e
o f static occlusion.
MATERIALS AND METHODS
The population for this study consisted of 94 dentalstudents at Jordan University of
Science and Tech-nology (39 males and 55 females). The age of subjectsr a n g e d f r o m 2 1 – 3 0
years, with a mean age of 23.1(
6
1.44) years. Subjects who met the following criteriawere selected:
N
White
N
No previous or current orthodontic treatment.
N
The presence of fully permanent dentition except forthe third molars
N
No previous occlusal adjustments
N
No large restorations involving the incisal edge or acusp tip
N
No crowns or bridges
N
No apparent pathologic periodontal problems
N
Upper and lower canines in the line of the arch
N
No tooth showing attrition into the dentineThe static occlusion of each subject was
assessedby intraoral examination on a dental chair under directv i s i o n . T h e f o l l o w i n g s t a t i c
o c c l u s a l f e a t u r e s w e r e recorded:
N
Incisor relationship classified according to the BritishStandard Institute
16
N
Canine relationship classified according to Houstonet al
16
N
M o l a r r e l a t i o n s h i p c l a s s i f i e d a c c o r d i n g t o A n g l e ’ s criteria
1
Dynamic occlusion was determined with the aid ofshimstock (Almore shimstock, 8 mm wide, 8
m
m thick,Hanel, Langenau, Germany) to confirm tooth contact.The examination was carried out with subjects seated
inan upright position in a dental chair with the Frankfortplane parallel to the floor. All recordings were
made byt h e s a m e o p e r a t o r i n t h e s a m e p e r i o d o f t h e d a y (morning hours) to avoid
possible diurnal variation.
17
F o r t h e l a t e r a l e x c u r s i o n , o c c l u s a l c o n t a c t s w e r e recorded on the working and the
nonworking side at ½m m a n d a t 3 m m l a t e r a l t o t h e h a b i t u a l
c e n t r i c occlusion. To regulate each lateral position, marksw e r e m a d e o n
t h e m a x i l l a r y c e n t r a l i n c i s o r w i t h a water-resistant pencil to mark the intercuspal
positiona t 0 . 5 m m a n d 3 m m p o s i t i o n s f o r b o t h r i g h t a n d l e f t sides. Subjects were asked
to perform the movementswith the aid of a handheld mirror. The shimstock wasp l a c e d o n
t h e o c c l u s a l s u r f a c e s o f t e e t h f r o m t h e canine backward; the subject was then asked to
closehis/her mandible into maximum intercuspation. Glidingmovement was performed to the right
or the left whilethe examiner maintained a constant pulling force onthe shimstock; on
reaching the 0.5 mm position, theteeth holding the shimstock were recorded as workings i d e
c o n t a c t s . T h e s u b j e c t w a s a s k e d t o r e p e a t t h e movement with the shimstock placed
on the opposites i d e t o r e c o r d n o n w o r k i n g s i d e c o n t a c t . T h e s a m e procedure was carried
out to record occlusal contact at3 mm lateral to the habitual centric occlusion.O c c l u s a l
c o n t a c t s a t t h e p r o t r u s i v e e x c u r s i o n o f mandibular movement were recorded at the
edge-to-e d g e p o s i t i o n . T h e s h i m s t o c k w a s p l a c e d o n t h e o c c l u s a l s u r f a c e s
o f t h e a n t e r i o r t e e t h ; t h e s u b j e c t was asked to close into maximum intercuspation
andthen slide to the edge-to-edge protrusive position whilethe examiner maintained a constant
pulling pressure.O n c e t h e t e e t h w e r e a t t h e e d g e - t o - e d g e p o s i t i o n , teeth holding the
shimstock were considered to be incontact and were recorded. The shimstock was
thenplaced on the occlusal surfaces of post teeth, and thesubject was asked to repeat the
same movement tocheck for the presence of posterior teeth contac