Term occlusion is derived from the Latin word,

occlusio; defined as the relationship between

all the components of the masticatory system
in normal function, dysfunction and
parafunction.

An ideal occlusion is the perfect interdigitation
of the upper and lower teeth, which is a result
of developmental process consisting of the
three main events, jaw growth, tooth
formation and eruption
Evolution
To develop a functional occlusion it became
necessary for the teeth and bones to develop
synchronously. Over a period of time there was loss
or fusion of cranial and facial bones, the number of
bones have reduced and the dental formula has also
undergone changes.
Periods of Occlusal Development
Occlusal development can be divided into the following
development periods:
o Neo-natal period.
o Primary dentition period.
o Mixed dentition period.
o Permanent dentition period.
Neonatal Period
(lasts upto 6 months after birth)
Gum Pads
Alveolar processes at the time of birth- gum pads.
Pink in colour, firm and are covered by a dense layer of fibrous
periosteum.
Gum Pads
The gum pad soon gets segmented by
a groove called transverse groove, &
each segment is a developing tooth site.

The pads get divided into labio-
buccal & lingual portion, by a dental
groove.

The groove between the canine and
the 1
st
molar region is called the lateral
sulcus, useful for judging the inter
arch relationship at a very early stage.
Gum Pads contd
The lower gum pad is U
shaped and rectangular,
characterized by:
o Gingival groove: lingual
extension of the gum
pads.
o Dental groove.
o Lateral sulcus.
Relationship of Gum Pads
o Anterior open bite is seen at rest with
contact only at the molar region.

o Complete overjet.

o Class II pattern with maxillary gum
pad being more prominent.


A precise bite or jaw
relationship is not yet seen.
Therefore, neonatal jaw
relationship cannot be used as
a diagnostic criterion for
reliable prediction of
subsequent occlusion in the
primary dentition.
Status of Dentition at Birth
Precociously Erupted Primary
Teeth
Natal tooth
Neonatal teeth
Pre-erupted teeth or Early Infansive teeth are teeth that
erupt during the 2
nd
or 3
rd
month.

Natal/neonatal teeth
Complications
Interfere with feeding
Risk of aspiration
Traumatic injury to the babys tongue
and/or to the maternal breast
Riga-Fede disease- oral condition
found, rarely in newborns manifests
as an ulceration on the ventral surface
of the tongue or on the inner surface
of the lower lip. Caused by trauma to
the soft tissue from erupted baby
teeth.
Riga-Fede disease
(From around the 6
th
month to 6 years)
Sequence of Eruption
At around 5 6 Years
There are 48 teeth/parts of teeth present in the jaw. It is at this
time that there are more teeth in the jaws than at any other time.
Features Of Primary
Dentition
Spacing- 2 types of dentition are seen:
A) Spaced dentition - usually seen in the
deciduous dentition to accommodate the
larger permanent teeth in the jaws.

More prominent in the anterior region,
and are called physiological spacing or
developmental spacing.
Absence of spaces in the primary
dentition is an indication that crowding of
teeth may occur when the larger
permanent teeth erupt.
Features Of Primary
Dentition contd
Most subhuman primates
have it through out life and use
it for interdigitation of the
opposing canines. This space is
used for early mesial shift.
primate spaces, simian spaces or
anthropoid spaces.
Features Of Primary
Dentition contd
Almost vertical
inclination of anteriors.
Molar Relationship
The molar relationship in the primary dentition can be classified
into 3 types:
oStraight/flush terminal plane.
oMesial step.
oDistal step.
Flush Terminal Plane
If the distal surface of
maxillary and mandibular
deciduous second molars are in
the same vertical plane; then it
is called a flush terminal plane

Normal molar relationship in
the primary dentition, because
the mesiodistal width of the
mandibular molar is greater
than the mesiodistal width of
the maxillary molar.
Mesial Step
Distal surface of mandibular
deciduous second molar is
mesial to the distal surface of
maxillary deciduous second
molar.
Distal Step
Distal surface of mandibular
second deciduous molar is
more distal to the distal surface
of the maxillary second
deciduous molar
Canine relationship
Relationship of maxillary &
mandibular deciduous caninnes
is one of the most stable in
primary dentition

Classified as:
Class 1
Class 2

Class 1
Class 2
Mixed Dentition Period
(Around 6 years- 12 years)
The mixed dentition period can be divided into three
phases:
o First transitional period.
o Inter-transitional period.
o Second transitional period.
First Transitional Period
Eruption of 1
st
Permanent Molar
The location & relation of the 1
st
permanent molar depends much
upon the distal surface of the upper & lower 2
nd
deciduous molar.
Transition to Class I Molar
Relation
Early Shift
Early shift occurs during the early mixed dentition period.
Since this occurs early in the mixed dentition, it is called early shift.
Late Shift
This occurs in the late mixed
dentition period and is thus
called late shift.
Leeway Space of Nance

Described by Nance in 1947


Maxilla: 0.9 mm/segment = 1.8 mm.
Mandible: 1.7 mm/segment = 3.4mm.
Distal Step
When the deciduous second
molars are in a distal step, the
permanent first molar will
erupt into a class II relation.
This molar configuration is not
self correcting and will cause a
class II malocclusion despite
Leeway space and differential
growth.
Mesial Step
Primary second molars in
mesial step relationship lead to
a class I molar relation in
mixed dentition. This may
remain or progress to a half or
full cusp class III with
continued mandibular growth.
Influence of terminal plane on
the position of 1
st
permanent
molar


Distal Step 23.3%
incidence, abnormal,
Class II- 38.6%

Straight terminal plane
49.2% incidence, Class
I or II

Mesial Step - <2mm
26.7%, class I 58.9%
>2mm 0.8%. Class III-
2.5%
Exchange of Incisors
Transition of Incisors
The incisal liability is over come by the
following factors:
Interdental physiological spacing in the primary incisor region.
(4 mm in maxillary arch & 3 mm in mandibular arch)
Transition of Incisors contd
Increase in inter-canine arch width:
Significant amount of growth occurs with the eruption of
incisors and canines.
Transition of Incisors contd
Increase in anterior length of the dental arches:
Permanent incisors erupt labial to the primary incisors to obtain
an added space of around 2-3 mm.
Transition of Incisors contd
Change in inclination of
permanent incisors:
Primary teeth are upright but
permanent teeth incline to the
labial surface, thus decreasing
the inter-incisal angle from
about 151 degrees in the
deciduous dentition to 124
degrees in the permanent
dentition. This increases the
arch parameter.
Inter-Transitional Period
Inter-Transitional Period contd
Root formation of emerged
incisors, and molars
continues, along with
concomitant increase in
alveolar process height.
Inter-Transitional Period contd
Resorption of roots of
deciduous canines and
molars.
Second Transitional Period
Self correcting anomalies

Sequence of Eruption
The canines in the upper arch erupt only after the premolars
have replaced the deciduous molars, whereas the canine erupt
before the premolars in the lower arch.
Second Transitional Period contd
The Permanent Dentition
This period is marked by the
eruption of the four permanent
second molars.
The Permanent Dentition contd
The permanent incisors
develop lingual to the
deciduous incisors and move
labially as they erupt.
The Permanent Dentition contd
The premolars develop below
the diverging roots of the
deciduous molars.
The Permanent Dentition contd
At approximately 13
years of age all
permanent teeth
except third molars
are fully erupted.
Features of Permanent
Dentition
Coinciding midline. Class I molar relationship.
Features of Permanent
Dentition contd
Vertical overbite of about
one third the clinical
crown height of the
mandibular central
incisors. Overjet and over
bite decreases throughout
the second decade of life
due to greater forward
growth of the mandible.

Andrews keys to normal
occlusion
Key I Molar relationship
MB cusp of the max 1
st
molar falls
into the mesiobuccal groove of the
mand 1st molar and that the distal
surface of the DB cusp of the upper
first permanent molar should make
contact and occlude with mesial
surface of the MB cusp of the lower
second molar.

Andrews keys to normal
occlusion
Key II Crown angulation (Tip)

The angulation of the facial axis of
every clinical crown should be
positive

The gingival portion of the long axis
of the all crowns must be distal than
the incisal portion.
Andrews keys to normal
occlusion
Key III Crown inclination

In upper incisors, the gingival
portion of the crowns labial surface
is lingual to the incisal portion.

In all other crowns, including lower
incisors, the gingival portion of the
labial or buccal surface is labial or
buccal to the incisal or occlusal
portion.


Andrews keys to normal
occlusion
Key IV Rotations

The fourth key to normal
occlusion is that the teeth should
be free of undesirable rotations.

Andrews keys to normal
occlusion
Key V Tight contacts

contact points should be tight
(no spaces).

In absence of abnormalities
such as genuine tooth size
discrepancies, contact point
should be tight.

Andrews keys to normal
occlusion
Key VI Occlusal plane or curve
of spee
The curve of Spee should have no
more than a slight arch.

Intercuspation of teeth is best
when the plane of occlusion is
relatively flat.



Andrews keys to normal
occlusion
Key VII Correct tooth size or the boltons ratio

Bennett and McLaughlin in 1993 gave seventh key
to normal occlusion. i.e. the upper and lower tooth
size should be correct.