Journal of Oral Rehabilitation 2000 27; 911–917
The relation of canine guidance with laterotrusive
movements at the incisal point and the working side
condyle
Y. YANG*, M. YATABE†, M. AI† & K. SONEDA†
Medical University, China and †The First Department of Prosthodontics, Faculty of Dentistry, Tokyo Medical and Dental University, Japan
SUMMARY The effect of different types of canine
guidance on the patterns of laterotrusive tracing at
the incisal point and the relationship between the
laterotrusive inclinations and the working side
condylar movements were investigated in 42 young
subjects. The subjects were divided into M and D
groups according to their mesial and distal canine
guidance, and were also divided into protrusive
laterotrusion (PL) and retrusive laterotrusion (RL)
groups according to their laterotrusive tracing pat-
terns. No differences of laterotrusive inclinations
and working side condylar movements were found
between the M and D groups. The laterotrusive
Introduction
Canine guidance is considered to play an important
role in masticatory function. Based on his clinical ob-
servations, Farrar (1968) suggested that some occlusal
contacts on the working side could cause a posterior
shift of the ipsilateral condyle. He provided an example
of the contact of distal incline of the maxillary canine
and mesial incline of the buccal cusp of the mandibular
first premolar. Farrar regarded these findings as a pos-
sible cause of temporomandibular joint (TMJ) disease.
Nakano & Bando (1989), in accordance with the fact
that the mandibular canine cusp is guided by either
mesial or distal parts of the maxillary canine lingual
surface during ipsilateral excursion, divided canine
guidance into a M (mesial) group and a D (distal)
group. They stated that the D group could guide the
working side condyle into a more posterior movement
than could the M group. Coffey et al. (1989) were also
© 2000 Blackwell Science Ltd
*Department of Prosthodontics, College of Stomatology, Beijing
tracing pattern had no corresponding association
with the type of canine guidance. In relation to the
movements of the working side condyles, signifi-
cant differences were found between the PL and RL
groups. The condyles moved laterally and posteri-
orly in the RL group, but moved lateral and inferior
in the PL one. The distance of condylar movement
in the X direction was correlated with the horizon-
tal and sagittal inclinations of laterotrusion. The
results indicate that the movements of the working
side condyle were affected functionally by the lat-
erotrusion, but not by either the mesial or the distal
type of canine guidance.
of a similar opinion that the mandibular mesial cusp
ridge in contact with the distal cusp ridge of maxillary
teeth could induce a retrusive laterotrusion and a more
posterior movement of the lateral pole of the working
side condyle. However, most previous research is based
on experimental observations in a few subjects using
either an occlusal splint or a lingual plate to artificially
create protrusive and retrusive (or so-called M and D
group) canine guidance (Coffey et al., 1989; Sato,
1998), the results not being conclusive. The effect of
canine guidance on the direction of mandibular latero-
trusion of the natural dentition in a large group of
subjects does not appear in the literature.
In this study, the movements of mandibular latero-
trusion at the incisal point and of the working side
condyle were measured in a group of healthy young
subjects. The mesial and the distal aligned canine guid-
ance were also examined. The purpose of the study
911
912 Y . Y A N G et al.
was to investigate the effect of different types of canine
guidance on the pattern of laterotrusive tracing at the
incisal point and the relationship between the latero-
trusive inclination and the range of working side
condylar movements.
Materials and methods
Subjects
Forty-two subjects, 24 males and 18 females, with
complete dentitions except the third molars and with-
out obvious occlusal abnormalities, such as cross bite
and excessive overbite, were selected from the senior
dental students of the Tokyo Medical and Dental Uni-
versity. The subjects were fully informed of the nature
of the experiments. All were aged between 23 and
34 years, with a mean of 25·5 years. All had canine
guidance on either side. Twenty subjects were ex-
cluded because of clicking of the temporomandibular
joint (TMJ), following detection by palpation at maxi-
mum opening and closing movements and confirma-
tion by checking the incisal point tracing of the same
movements.
Clinical examination
The left and right canine guidances of each subject
were examined separately, by placing a strip of articu-
Fig. 1. View of jaw movement recording system with 6 d.f. The
face bow with three LEDs is attached to the lower incisal teeth
and the head frame with three LEDs is fixed to the subject’s
head. Two CCD cameras are set in front of the subject.
© 2000 Blackwell Science Ltd, Journal of Oral Rehabilitation 27; 911–917
lating paper between the opposing canines and the
posterior teeth, during an active ipsilateral excursion
from the intercuspal position (ICP) to the cusp-to-cusp
position of the canines. According to the articulating
contact marks that remained on the teeth, the canine
guidance was divided into two groups: M and D. M
group indicated that either the mesial cusp ridge or the
mesial part of the lingual surface of the upper canine
was in contact with either the distal cusp ridge or the
cusp of the lower canine during lateral excursion. D
group indicted that either the distal cusp ridge or the
distal part of the lingual surface of the upper canine
was in contact with either the mesial cusp ridge, the
cusp of the lower canine or the mesial ridge of the
buccal cusp of the lower first premolar during lateral
excursion.
Laboratory measurement
We used the Gnatho-Hexagraphy,* a new measuring
system developed in Japan (Fig. 1). It allows the simul-
taneous recording and analysing of the function of
stomatognathic components associated with mandibu-
lar movements, and can measure the movements of
any selected point in the mandible in three dimensions
with 6 d.f. By using the handy LED pointer, the opera-
tor can select and register several recognition points on
the mandible as recording points. The operator can also
register some points on either the maxilla or the head
to form several reference planes. This makes the results
measured at different times or from different individu-
als more comparable. The measurement error of this
system is less than 0·15 mm.
A series of mandibular movement tracings at the
incisal point and the points of left and right lateral pole
of the condyle on skin were recorded. The incisal point
was defined as the point between the mesial incisal
angles of the two lower central incisors. The lateral
pole of the condyle was determined by palpation. Four
series of maximum opening and closing movements
and 10 series of continuous left and right lateral excur-
sions were recorded. Subjects were instructed to ac-
tively perform these movements. Each movement
started and ended in the ICP. The Frankfort plane was
used as the horizontal reference plane.
* Ono Sokki Co., Tokyo, Japan.
 CANINE GUIDANCE AND LATEROTRUSIVE MANDIBULAR MOVEMENT 913

Fig. 2. The incisal point tracing of

mandibular laterotrusion (left) in
frontal, horizontal and sagittal planes.
Left: the pattern of protrusive
laterotrusion (PL); right: the pattern
of retrusive laterotrusion (RL).

Analysis planes) were calculated when the incisal point moved

The coordinate system of the Gnatho – Hexagraphy is
aligned in such a way that the X axis represents the
anterior and posterior direction, the Y axis represents
the left and right direction and the Z axis represents
the superior and inferior direction (Fig. 2). The X – Y
plane was made parallel to the Frankfort plane in this
study. In order to compare the transversal movements
of the left and right condyles, the direction of the Y
axis in the right condyle was reversed. Therefore, the Y
axis in two condyles was directed to the outside.
Five series of uniform and smooth tracings of left
and right laterotrusion were selected from a series of
10 recorded measurements. The laterotrusive inclina-
tions (project angles in frontal, horizontal and sagittal
3 mm laterally from the ICP (Fig. 2). The condylar
movements were calculated at the points 15 mm me-
dial to the lateral pole point on skin at the same time.
The left and right mandibular laterotrusion measure-
ments of one subject were used as two separate sam-
ples. Sixty-four samples in 42 subjects were divided
into M and D groups, according to their type of canine
guidance. They were also divided into the protrusive
laterotrusion (PL) group and the retrusive laterotrusion
(RL) group, according to the patterns of laterotrusive
tracing (Fig. 2). We then compared the differences of
laterotrusive movements at the incisal and the condy-
lar points between the M and D groups and between
the PL and RL groups, the corresponding association

© 2000 Blackwell Science Ltd, Journal of Oral Rehabilitation 27; 911 – 917
914 Y . Y A N G et al.

Table 1. The inclinations of

mandibular laterotrusive Average M D PL RL
tracing at the incisal point (°)
(mean 9s.d.) uF 53·779 7·05 53·559 6·12 54·5799·95 n.s. 55·6597·08 48·599 3·55 *
uH 83·569 11·63 83·189 11·17 84·919 13·51 n.s. 78·10 97·47 98·669 6·51 —
uS 79·21917·45 79·219 15·79 79·20923·12 n.s. 71·81 913·69 99·6897·30 —

* PB0·01.
n.s. = Not significant.

between the types of canine guidance and the latero-
trusive patterns, and the correlation of the movements
between the incisal and the condylar points.
Statistics
The t-test was used to compare the differences between
the different groups. The chi-square test was used to
analyse the corresponding association. The correlation
between the movements at the incisal point and at the
working side condylar point was analysed using Pear-
son’s correlation coefficient. Levels of P B 0·05 were
considered to be statistically significant.
Results
The mean values and the standard deviations of the
laterotrusive inclinations of all samples and in the four
groups are shown in Table 1. There was no significant
difference between the M and D groups. The types of
canine guidance had no corresponding association with
the patterns of laterotrusion (P = 0·380) (Table 2). The
frontal inclination (uF ) of the PL group was signifi-
cantly larger than that of the RL group (P B0·01)
(Table 1). A negative correlation existed between the
uF and the horizontal inclination (uH ) (r= − 0·593),
and between the uF and the sagittal inclination (uS )
(r= − 0·727) (Fig. 3).
Table 3 and Fig. 4 show the movements of the
working side condyles. There was no significant differ-
ence between the M and D groups (P\ 0·05). How-
ever, significant differences were found between the PL
and RL groups in the X and Z directions (P B0·01). The
condyles moved to lateral and posterior in the RL
group, but moved to lateral and inferior in the PL
group. Table 4 shows the correlation coefficient be-
tween the laterotrusive inclinations and the distances
of condylar movements. In all samples, the condylar
movement in the X direction (XCON) had a negative
correlation with both the uH (r= − 0·406, P B0·01)
and the uS (r= − 0·346, PB 0·01), while those in the Z
direction (ZCON) had a positive correlation with the uH
(r= 0·325, P B0·01). In the PL group, XCON had a
negative correlation with the uH (r= − 0·416, P B
0·01), whereas ZCON had a positive correlation with the
uF (r= 0·448, PB 0·01). In the RL group, however,
ZCON had a negative correlation with the uF (r = −
0·519, PB 0·05). Figure 5 shows the negative correla-
tion between the uH of laterotrusion and the distance of
XCON.
Discussion
The Camper (occlusal) plane has been used as the
horizontal reference plane for measuring the move-
ments of mandibular lateral excursion in most of the
previous research (Ai & Ishiwara, 1968; Coffey et al.,
1989; Sato, 1998). It inclines about 15° anteriorly to
the Frankfort plane. Using the Camper plane reference,
the laterotrusive inclination was less than 90° in most
of the subjects examined. In this study, the Frankfort
plane was then chosen as the horizontal plane. The
recording and analysis of all movements was related to
it. All 64 samples were divided into 47 PL groups and
17 RL groups, which were measured at a point 3-mm
laterally from the ICP at the incisal point. This measur-
ing point was within teeth (canines) contact during
lateral excursion. The distance on the transverse (Y)
axis from the ICP to the cusp-to-cusp (or edge-to-edge)
Table 2. The association between the types of canine guidance
and the patterns of mandibular laterotrusion
M D Total
PL 38 9 47
RL 12 5 17
Total 50 14 64
P =0·380; x 2 =0·77.

© 2000 Blackwell Science Ltd, Journal of Oral Rehabilitation 27; 911–917

 CANINE GUIDANCE AND LATEROTRUSIVE MANDIBULAR MOVEMENT 915

Fig. 3. Correlation of the frontal

inclination of mandibular laterotrusion
with the horizontal and sagittal
inclinations (°).

Fig. 4. Movements of the working

side condyles while the incisal point
moved 3 mm laterally from the ICP
(mm). Separately displayed in M and
D groups above and in PL and RL
groups below.

Table 3. The mean

Average M D PL RL values and s.d.s of
the distance of
XCON −0·0290·32 −0·0190·32 −0·1090·32 n.s. 0·0490·32 −0·209 0·25 * working side
YCON 0·3690·44 0·3690·45 0·39 9 0·43 n.s. 0·379 0·42 0·369 0·52 n.s. condylar movements
ZCON −0·2290·38 −0·2590·37 −0·129 0·38 n.s. −0·3190·39 0·0190·20 * (mm) (mean 9 s.d.)

* PB0·01.
n.s.= Not significant.

© 2000 Blackwell Science Ltd, Journal of Oral Rehabilitation 27; 911 – 917
916 Y . Y A N G et al.

Table 4. The coefficient (r)

of correlation between the Average (n =64) PL (n =47) RL (n=17)
inclinations of mandibular
laterotrusive tracing at the X Y Z X Y Z X Y Z
incisal point (u) and the
distances of working side uF 0·015 0·014 0·139 −0·232 −0·055 0·448* 0·355 0·312 −0·519**
condylar movements uH −0·406* 0·069 0·325* −0·416* 0·087 0·050 0·47 0·241 0·061
uS −0·346* 0·069 0·220 −0·267 0·078 −0·077 0·542** 0·280 −0·031

position of canines in laterotrusion was 3·96 mm. The
maximum distance (on the Y axis) from the ICP to the
lateral border was, on average, 8·48 mm.
Since it was first reported by Farrar (1968), the belief
has been that a distal aligned canine guidance could
result in a RL and a posterior movement of the work-
ing side condyle. However, there is little evidence to
prove it. Only a few experiments have been carried
out, with very few samples and through experimental
guidance (Coffey et al., 1989; Sato, 1998). The results
of this study indicate that the pattern of laterotrusion is
not determined by the location of canine guidance
surface, regardless of whether it is distal or mesial. The
D group canine guidance did not always induce a RL. It
is too simplistic to suggest that the distal or mesial
aligned canine guidance could induce either retrusive
or protrusive lateral excursion. Canine guidance is not
the only determination. It is just a slide of a cusp
(lower canine) on the articulating surface (upper ca-
nine) or a slide between two articulating surfaces.
Without the coordination of masticatory muscles and
the limitation of TMJ ligaments, the lower canine
could move along the articulating surface in any direc-
tion. Therefore, the tension of muscles and the TMJ
play a very important role in the determination of the
laterotrusive direction.
A negative correlation was found between both the
frontal and the horizontal inclinations of laterotrusion.
This is in accordance with the results of Ai & Ishiwara
(1968) and Sato (1998). That is, the deeper the canine
guidance, the greater the possibility for RL.
Several kinds of condylar reference points have been
used to study condylar movements. They can be di-
vided into two groups. One is based on kinematically
determined points, such as the hinge axis point (Hobo
& Mochizuki, 1983; Mauderli, Lundeen & Loughner,
1988; Piehslinger et al., 1991) and the kinematic axis
(or kinematic centre) (Kohno, 1972; Yatabe et al.,
1995). Another is based on anatomically determined
points, such as the arbitrary condylar point (Kang et al.,
1993) and the palpation point (Merlini & Palla, 1988;
Siegler et al., 1991). The kinematic point could well
represent the kinematic characteristics of the condyle.
However, its location varies individually. It would be
better to use an anatomic point to measure the relative
movement of the condyle. Merlini & Palla (1988), in
their study of the rotation and translation of condyles
during opening and closing movements, palpated the
lateral pole of the condyle and shifted its coordinates
15 mm medially to obtain a point within the condyle.
The same condylar point was used in this study to
investigate the movements of the working side
condyle. Tsukiyama et al. (1993) calculated the dis-
tance from the central plane of the condyle to the skin
as being 22·88 mm. The condylar point near to the
lateral pole of the condyle could well represent the
movements of the working side condyle without am-
plification as compared with the point on skin.
Fig. 5. Relationship of the horizontal inclination (uH ) of the
mandibular laterotrusive tracing at the incisal point and the
anterior – posterior movement of the working side condyle
(XCON). White points represent the M group; black points repre-
sent the D group. The dotted line separates them all into the PL
(uH B90°) and the RL groups (uH \90°).

© 2000 Blackwell Science Ltd, Journal of Oral Rehabilitation 27; 911–917

 CANINE GUIDANCE AND LATEROTRUSIVE MANDIBULAR MOVEMENT
The condyles in RL had a more limited movement to
the posterior and superior as compared with the
condyles in PL. There was not a strong correlation in
laterotrusion between the movements at the incisal
point and in the working side condyle. The horizontal
and sagittal inclinations of laterotrusion had a negative
correlation with the anterior – posterior movements of
the working side condyle. The bigger the horizontal
and sagittal inclinations, the more posterior the
condyle moved. However, the frontal inclination had
no correlation with the anterior – posterior movement
of the condyle, even though it had correlations with
the horizontal and sagittal inclinations.
The extent of the influence on the TMJ that can
result from the more posterior movement of the
condyle is still not clear. Farrar (1968) believed that
this movement would cause an increased pressure
within the TMJ, which would be associated with pain
and capsulitis. Coffey et al. (1989) postulated that the
posterior band of the articular disk may become com-
pressed or loosened from its attachment because of the
posterior deflection of the working condyle, and this
may be critical during parafunctional activities. While it
remains difficult to confirm a relationship between
occlusal movements and TMJ disease, further investi-
gations into the effects of RL on the joint should be
pursued.
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Correspondence: Dr Masaru Yatabe, The First Department of
Prosthodontics, Faculty of Dentistry, Tokyo Medical and Dental
University, 5-45 Yushima 1-chome, Bunkyo-ku, Tokyo 113,
Japan. E-mail: masapro1@dent.tmd.ac.jp