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The relationship between static and dynamic occlusion in 14-17-year-old

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Journal of Oral Rehabilitation 2004 31; 628–633
The relationship between static and dynamic occlusion in
14–17-year-old school children
A. S. AL-HIYASAT* & E. S. J. ABU-ALHAIJA†
Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
SUMMARY This study investigated the relationship
between static and dynamic occlusion in school
children. A total of 447 subjects, within an age range
of 14–17 years with no history of orthodontic treat-
ment or trauma to the teeth were included in this
study. Static occlusion was determined for both
incisal and molar relationship. Dynamic occlusion
was determined in lateral and protrusive move-
ments of the mandible. The majority of the subjects
had class I static occlusion for both incisor and molar
relationship (45 and 54%, respectively). Canine-
guided occlusion was the dominant type of dynamic
Introduction
The ideal static occlusion has been identified, based on
the work of Angle in 1907 (1) and later by Andrews in
1972 (2). This classification of occlusion was mainly
based on a description of arch form, tooth position and
tooth contacts in the intercuspal position (3, 4). This
type of occlusion is given a considerable emphasis by
the orthodontist; however, less emphasis is given to the
importance of dynamic or functional occlusion (3).
Two different types of dynamic occlusion have been
reported, canine-protected (canine-guided) occlusion
(5–8) and group function (9, 10). Canine guidance
occurs when there is contact only between the working
side canines during lateral excursions of the mandible,
and group function occurs when there is simultaneous
contact of the canine and posterior teeth on the
working side during lateral excursions. The two types
of occlusion have a common theme: the absence of
contact on the non-working side during lateral excur-
sion, and the absence of posterior occlusal contact
ª 2004 Blackwell Publishing Ltd
Departments of *Restorative Dentistry and †Preventive
occlusion (57%) and most of the subjects had no
posterior contact in protrusive movement (78%).
There was an association between canine guidance
with class II static occlusion. Statistically, a signifi-
cant relationship was found between the dynamic
and static occlusion of the incisor (P < 0Æ001) but not
with the molar (P > 0Æ05).
KEYWORDS: static occlusion, dynamic occlusion, lat-
eral excursion, protrusion
Accepted for publication 12 March 2003
during mandibular protrusion (3). It appears that there
is a contradiction in the literature, as some studies have
reported a predominance of canine-guided occlusion
(11, 12), whilst others have found a predominance of
group function (10, 13, 14). Furthermore, others have
stated that pure canine guidance or pure group function
rarely exists and balancing contact seems to be the
general rule in the population of contemporary civil-
ization (15). Indeed, the conflict between these studies
could be related to sample selection, and differences
between subjects investigated such as age, eating habits
and other patient-related factors (16).
The relationship between static and dynamic occlu-
sion has previously been investigated. Scaife and Holt
(12) reported that canine guidance was associated with
class II Angle classification and others have found that
the majority of normal/class I Angle static occlusion
was associated with balance occlusion (17, 18). How-
ever, other reports have found no significant relation-
ship between static and dynamic occlusion types (19).
The sample selection and number of subjects as well
628
 STATIC AND DYNAMIC OCCLUSION IN SCHOOL CHILDREN
as the methods used to examine the occlusion could be
the reason for the differences in the results of these
studies. Therefore, there is a need for further studies to
evaluate the static and dynamic occlusion in a large
number of randomly chosen subjects who had no
previous treatment that could affect the occlusal rela-
tionship. Thus, the aim of this study was to investigate
the relationship between static and dynamic occlusion
in 14–17-year-old school children.
Materials and methods
Sample
This investigation was carried out on 447 Jordanian
school pupils, aged 14–17 years. There were 146 males
and 301 females. The inclusion criteria were: the
presence of the 28 natural permanent teeth (excluding
the third molars); no prior orthodontic treatment; no
history of trauma or fractured teeth; no large restora-
tions that included the incisal edge or one or more
cusps.
Examination of occlusion
The static and dynamic occlusion of the subjects were
assessed by a chairside examination with the subjects
seated in a chair in an upright position. Occlusal
relationship was determined by visual examination
and tooth contact at the lateral excursion of the
mandible was recorded at cusp tip-to-cusp tip position
as in previous studies (19). Shimstock was used to
confirm contact between the teeth. No distinction was
made between the ideal occlusion and the class I
malocclusion. However, the incisor and molar relation-
ships were assessed and investigated separately.
Static occlusion
Incisor occlusion. Incisor relationship was classified
according to the British Standard Institution (BSI)
definition (20) as follows:
Class I The lower incisor edges occlude with or lie
immediately below the cingulum plateau of the
upper central incisors
Class II The lower incisor edges lie posterior to the
(div. 1) cingulum plateau of the upper incisors. Upper
incisors are proclined and the overjet is increased
ª 2004 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 31; 628–633
629
Class II The lower incisor edges lie posterior to the
(div. 2) cingulum plateau of the upper incisors. Upper
incisors are retroclined and overjet is usually
minimal but may be increased
Class III The lower incisor edges lie anterior to the cingulum
plateau of the upper incisors. The overjet is reduced
or reversed
Molar occlusion. Molar occlusion was defined as follows
(1):
Class I The mesio-buccal cusp of the lower first molar
occludes between the mesio-buccal cusp of the
upper first molar and the buccal cusp of the
second premolar
Class II The mesio-buccal cusp of the lower first molar
occludes between the two buccal cusps of the
upper first molar
Class III The mesio-buccal cusp of the lower first molar
occludes anteriorly to the buccal cusp of the
upper second premolar
Half- and quarter-unit class II or class III were
recorded as class II or class III, respectively.
Dynamic occlusion
The dynamic occlusion for both lateral and protrusive
movements of the mandible was directly and visually
determined with the aid of an 8-lm shimstock (Roeko,
Langenau, Germany) to confirm the contact between
the teeth. The examination was carried out as follows:
Lateral occlusion. Subjects were asked to bite in their
habitual intercuspal position and then slide the man-
dible into right or left lateral excursion up to cusp tip to
cusp tip contact. The contacts between the teeth in the
working and non-working side were recorded and the
occlusal contact was classified according to the follow-
ing criteria (18, 19):
1. Canine-guided occlusion: canines in contact on the
working side and no occlusal contact in the non-working
side for both right and left lateral excursions.
2. Group function occlusion: two or more teeth other than
the canines in contact on the working side and no
contacts on the non-working side for both left and right
lateral excursions.
3. Mixed canine guidance/group function occlusion: canine
guidance on one working side and group function on
630 A. S. AL-HIYASAT & E. S. J. ABU-ALHAIJA

the other working side and no contacts on the non- Table 1. Distribution of subjects to the types of static occlusion
working sides. for incisor and molar relationship

4. Non-working side contact: unilateral or bilateral tooth

Occlusal No. of
contact on the non-working side.
relationship Static occlusion types subjects (%)

Protrusive occlusion. Subjects were asked to bite in the Incisor relationship Class I 202 (45)
Class II (div. 1) 89 (20)
intercuspal position, and to perform a protrusive
Class II (div. 2) 76 (17)
movement of the mandible up to edge-to-edge contact Class III 80 (18)
of the anterior teeth. The contact between the anterior
Molar relationship Class I 239 (54)
teeth and the posterior teeth, if there were any, were
Class II 129 (29)
recorded and the occlusion was classified as follows: Class III 13 (3)
1. Anterior contact with posterior disocclusion in Asymmetric R/L 66 (15)
protrusion.
2. Anterior contact with unilateral or bilateral posterior the subjects had class I for both incisor and molar
contact in protrusion. relationships.
3. No anterior contact with unilateral or bilateral
posterior contact in protrusion.
Before examination of the occlusion, the examiner Dynamic occlusion
explained and demonstrated all the movements of the Table 2 shows the distribution of subjects in relation to
mandible (lateral excursions and protrusion) so that dynamic occlusion (lateral and protrusion). In lateral
each subject understood what he/she had to do. The excursion, the majority of the subjects had canine-
second author (E.S.J.A. – Orthodontist) carried out all guided occlusion. In protrusive excursion, most of the
the examinations of the static occlusion and the first subjects had contact on the anterior teeth with the
author (A.S.A. – Restorative Dentist) carried out all the posterior teeth excluded.
examinations of the dynamic occlusion.

Relationship between static and dynamic occlusion

Reliability
Intra-examiner reliability was tested by having the
same examiner re-examine thirty randomly chosen
pupils at an interval of 1 week. There was complete
agreement (Kappa ¼ 1) in the repeated examination
for the static occlusion. For the dynamic occlusion
Kappa values were 0Æ83 and 0Æ86 for the lateral and
protrusive excursions, respectively.
1 Static incisor occlusion versus dynamic occlusion
Static incisor occlusion versus lateral dynamic occlu-
sion. Canine guidance was more dominant in class II
(div. 1 and 2) followed by class I while the prevalence
of non-working side contact dominated in class III. Chi-
square test showed significant differences in the distri-
bution of the dynamic occlusal relationship in lateral

Table 2. Distribution of subjects to the types of dynamic occlu-

Statistical analysis sion for lateral and protrusive excursions of the mandible

Data were transferred from coded sheets to a personal

Mandibular Type of No. of
computer and analysed using SPSS program. excursions dynamic occlusion subjects (%)
Chi-square test was used to compare the proportion of
Lateral Canine guidance 253 (57)
different occlusal characteristics.
excursion Group function 57 (13)
Mixed (canine guidance 76 (17)
Results and group function)
Non-working-side contact 61 (14)
Protrusive Anterior teeth contact with 350 (78)
Static occlusion excursion disocclusion of posterior teeth
Anterior and posterior teeth contact 80 (18)
The distribution of subjects according to incisor and
No anterior teeth contact 17 (4)
molar relationships is shown in Table 1. The majority of

ª 2004 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 31; 628–633

 STATIC AND DYNAMIC OCCLUSION IN SCHOOL CHILDREN 631

Table 3. Distribution (%) of dynamic occlusion types (lateral and protrusion) in relation to the static occlusion types of the incisor
relationship

Static occlusion Dynamic occlusion types

types
Lateral excursion* Protrusion**

Anterior teeth No anterior teeth

Canine Group contact with Anterior and contact with
Incisor guidance function Mixed Non-working- posterior posterior posterior teeth
relationship (CG) (GF) CG + GF side contact Total disocclusion teeth contact contact Total

Class I 114 (56) 25 (12) 45 (22) 18 (9) 202 (100) 176 (87) 22 (11) 4 (2) 202 (100)
Class II (div. 1) 60 (67) 10 (11) 7 (8) 12 (14) 89 (100) 63 (71) 17 (19) 9 (10) 89 (100)
Class II (div. 2) 62 (82) 6 (8) 6 (8) 2 (3) 76 (100) 75 (99) 1 (1) 0 (0) 76 (100)
Class III 17 (21) 16 (20) 18 (23) 29 (36) 80 (100) 36 (45) 40 (50) 4 (5) 80 (100)
Total 253 (57) 57 (13) 76 (17) 61 (14) 447 (100) 350 (78) 80 (18) 17 (4) 447 (100)

*v2 ¼ 85Æ6; df ¼ 9; P < 0Æ001.

**v2 ¼ 95Æ6; df ¼ 6; P < 0Æ001.

excursion among the different static occlusal incisor
relationship (P < 0Æ001) (Table 3).
Static incisor occlusion versus protrusive dynamic occlu-
sion. Most of the subjects in class I and II (div. 1 and 2)
incisors had anterior contact with complete posterior
teeth disocclusion in protrusive movements of the
mandible. While for those subjects with class III incisors,
50% had anterior teeth contact associated with contact in
posterior teeth. Chi-square test showed significant dif-
ferences in the distribution of the dynamic occlusal
relationship in protrusion among the different static
occlusal incisors relationship (P < 0Æ001) (Table 3).
2 Static molar occlusion versus dynamic occlusion
Static molar occlusion versus lateral dynamic occlu-
sion. Although canine guidance was dominant in all
types of static molar relationship and its prevalence was
more associated with class II molars, the chi-square test
showed no significant differences in the distribution of
the dynamic occlusal relationship in lateral excursion
among the different static occlusal molar relationship
(P > 0Æ05) (Table 4).
Static molar occlusion versus protrusive dynamic occlu-
sion. The majority of the subjects in all types of static
occlusion molar relationship had anterior teeth contacts
with complete posterior teeth disocclusion in protrusive
movements of the mandible. Chi-square test showed no

Table 4. Distribution (%) of dynamic occlusion types (lateral and protrusion) in relation to the static occlusion types of the molar
relationship

Static occlusion Dynamic occlusion types

types
Lateral excursion* Protrusion**

Anterior teeth Anterior and No anterior

Canine Group contact with posterior teeth contact
Molar guidance function Mixed Non-working- posterior teeth with posterior
relationship (CG) (GF) CG + GF side contact Total disocclusion contact teeth contact Total

Class I 121 (51) 34 (14) 49 (21) 35 (15) 239 (100) 186 (78) 46 (19) 7 (3) 239 (100)
Class II 87 (67) 14 (11) 13 (10) 15 (12) 129 (100) 103 (80) 21 (16) 5 (4) 129 (100)
Class III 5 (39) 2 (15) 4 (31) 2 (15) 13 (100) 8 (62) 4 (31) 1 (8) 13 (100)
Asymmetric R/L 40 (61) 7 (11) 10 (15) 9 (14) 66 (100) 53 (80) 9 (14) 4 (6) 66 (100)
Total 253 (57) 57 (13) 76 (17) 61 (14) 447 (100) 350 (78) 80 (18) 17 (4) 447 (100)

*v2 ¼ 13Æ7; df ¼ 9; P ¼ 0Æ13.

**v2 ¼ 4Æ7; df ¼ 6; P ¼ 0Æ58.

ª 2004 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 31; 628–633

632 A. S. AL-HIYASAT & E. S. J. ABU-ALHAIJA
significant differences in the distribution of the dynamic
occlusal relationship in protrusion among the different
static occlusal molar relationship (P > 0Æ05) (Table 4).
Discussion
Subjects under investigation
The 14–17-year age group was chosen for this study,
because at this age all the permanent teeth (excluding the
third molars) are erupted and if older subjects had been
chosen the occlusal relationship might have been affec-
ted by tooth wear (14, 18, 21–23). The fact that the
number of male subjects was much lower than female
subjects was due to the willingness of the latter to take
part in this study. Nevertheless, there were no significant
differences in the data between male and female subjects,
therefore the data was pooled and analysed together.
Examination of occlusion
Tooth contact was confirmed using shimstock as it is
thought to be more accurate than the other methods
that have been used previously such as impression
materials, occlusal indicator wax, articulating paper and
dental floss (4, 16, 19).
Static occlusion
The prevalence of class II in the current study, namely
29% for molar and 37% for incisor (20% div. 1 and
17% div. 2), was much higher than that found by
Tipton and Rinchuse (19) (15Æ8%). The prevalence of
class III was only 3% for molar and 18% for incisor in
the current study compared with 6Æ9% in the study by
Tipton and Rinchuse (19). The differences found may
be because the number of subjects in our study was
much greater than that of Tipton and Rinchuse (19)
and as they classified occlusion by Angle’s classification,
which is based on molar relationship only. Further-
more, the prevalence of the type of occlusion may vary
from one racial group to another.
Dynamic occlusion
From the 447 subjects in this study, 253 (57%) had
canine guidance and 76 (17%) had mixed occlusion of
which one side was canine guided. Our findings are in
agreement with previous reports which also showed a
ª 2004 Blackwell Publishing Ltd, Journal of Oral Rehabilitation 31; 628–633
high prevalence of canine guidance (unilateral or bilat-
eral) in their subjects (12, 24). However, other studies
have reported the dominance of group function (10, 13).
The difference in findings between the two latter studies
and our study could be due to the difference in the age
groups as our subjects were much younger. It is a well-
documented fact that tooth wear is correlated with age or
more strictly speaking with the length of time that teeth
have been exposed to occlusal function (25–30).
We found that only 61 subjects (14%) had non-
working-side contact in contrast to previous reports
which reported that the majority of subjects had non-
working-side contact (16, 17, 19, 22, 31). The younger
age of the subjects in our study could be the reason for
this difference in the results. Furthermore, it was
observed that most of our subjects with non-working-
side contact (61 subjects) had either a group function
(38 subjects) or mixed occlusion (17 subjects), with
only six subjects of canine guidance occlusion. This
supports the hypothesis that canine guidance is far less
likely to be associated with occlusal interferences on the
non-working side than group function due to the
steeply inclined palatal surface of the canine (4).
The majority of our subjects (78%) had no posterior
contact between the teeth in protrusive movement of the
mandible. The prevalence of subjects who had posterior
contact combined with anterior contact was found to be
18%. The 17 subjects (4%) who had only posterior
contact and no anterior contact at all were those subjects
with anterior open bite, and thus anterior tooth-to-tooth
contact was impossible. The low prevalence of posterior
teeth contact in protrusion in this study is in agreement
with results reported by Madone and Ingervall (32) and
Ingervall et al. (14). On the other hand, Sadowsky and
BeGole (31) and Sadowsky and Polson (33) found a
different prevalence of posterior tooth contact in protru-
sion in a similar population of orthodontic patients, 50%
of the subjects were reported to have posterior tooth
contact in the first study compared with 20% in the
second study. This variations in the results was suggested
by the authors to be caused by the difference in the
technique used by different examiners.
Relationship between static and dynamic occlusion
For the relationship between static and dynamic
occlusion the results showed that canine guidance
was associated with class II (for both molar and incisor
relationship) followed by class I and was least associated
 STATIC AND DYNAMIC OCCLUSION IN SCHOOL CHILDREN
with class III. These results compared favourably with
the study by Scaife and Holt (12).
The prevalence of posterior contact in protrusion was
dominantly associated with class III occlusion incisor
and molar relationship (50 and 31%, respectively)
perhaps because of the reduced or reversed overbite
and overjet of the anterior teeth, while the least was
associated with class II molar and class II div. 2 incisor
(16 and 1%, respectively).
Finally, the results of this study have demonstrated
that there is a relation between the types of static
occlusion and certain types of dynamic occlusion.
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Correspondence: Dr Ahmad S. Al-Hiyasat, Department of Restorative
Dentistry, Faculty of Dentistry, Jordan University of Science &
Technology, P.O. Box 3030, Irbid, 22110, Jordan.
E-mail: hiyasat@just.edu.jo
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