An evaluation of the curve of Spee in the maxilla and mandible of human

permanent healthy dentitions

Hui Xu, DDS,a Toshihiko Suzuki, DDS,b Motoo Muronoi, DDS, PhD,c and Kiyoshi Ooya, DDS, PhDd
School of Stomatology, Jilin University, Changchun, China; Tohoku University Graduate School of
Dentistry, Sendai, Japan
Statement of problem. The characteristics of the curve of Spee in the mandibular arch have been extensively
investigated. However, few studies have examined the characteristics of the curve of Spee in the maxillary arch.
Purpose. The purpose of this study was to examine the differences in the curve of Spee between the maxillary
and mandibular arches. The effects of gender on the curve of Spee were also investigated.
Material and methods. Fifty Japanese adults (25 men and 25 women) with permanent healthy dentitions
participated. Standardized digital pictures of the right side of maxillary and mandibular dental casts were made
with a digital camera. The cusp tips of the molars, premolars, and canines of the maxilla and mandible were
identified. The radius and the depth of the curve of Spee were measured on the dental casts by means of
computer software (Occlcircle). The Mann-Whitney test and the Wilcoxon signed rank test were used to test the
statistical significance (a=.05).
Results. The curve of Spee showed a mean radius of approximately 106.4 mm in the maxillary arch and 83.4
mm in the mandibular arch. Radii of the curves of Spee in the maxillary arch were significantly larger than those
in the mandibular arch (P ,.0001) and had a depth of approximately 1.6 mm in the maxillary arch and 1.9 mm
in the mandibular arch. The depth of the curve of Spee in the mandibular arch was significantly deeper than that
in the maxillary arch (P=.0326).
Conclusions. The curve of Spee was not influenced by the gender of the subjects investigated. The shape of
the curve of Spee in the maxillary arch was significantly flatter than that in the mandibular arch. (J Prosthet
Dent 2004;92:536-9.)

CLINICAL IMPLICATIONS
Analysis of the curve of Spee may assist dentists in developing occlusion in the sagittal plane. The
maxillary and mandibular curves of Spee may be used as a reference for prosthetic and
orthodontic reconstruction. There is no significant difference in curves of Spee between Japanese
men and women.

I f an imaginary line is drawn through the buccal cusp

tips of the posterior teeth from the sagittal view, a curved
line following the plane of occlusion that is convex for
the maxillary arch and concave for the mandibular arch
is established. This curve was first described by Spee in
1890 and is therefore referred to as the curve of Spee.
It was derived by studying skulls with abraded teeth to
define a line of occlusion that lies on a cylinder tangential
to the anterior border of the condyle, the occlusal
surface of the second molar, and the incisal edges of
a
Lecturer, Department of Orthodontics, School of Stomatology, Jilin
University.
b
Assistant Professor, Division of Oral and Craniofacial Anatomy,
Tohoku University Graduate School of Dentistry.
c
Dentist, Division of Oral Pathology, Tohoku University Graduate
School of Dentistry.
d
Professor, Division of Oral Pathology, Tohoku University Graduate
School of Dentistry.
the mandibular incisors.1 The center of this cylinder is
located in the midorbital plane so that it has a radius
of 6.5 to 7.0 cm.1 The curve of Spee is defined as the an-
atomic curve established by occlusal alignment of the
teeth, as projected onto the median plane, beginning
with the cusp tip of the mandibular canine and following
the buccal cusp tips of the premolar and molar teeth.2
The functional significance of the curve of Spee
remains poorly understood.3-6 The morphologic ar-
rangement of the teeth in the sagittal plane has been
related to the slope of the articular eminence, incisal
vertical overlap, molar cusp height, and the amount of
posterior contact. Matched interactions between these
features and the curve of Spee ensure balanced occlusal
function.7 Recent studies have suggested that the curve
of Spee has a biomechanical function during food pro-
cessing by increasing the crush-shear ratio between the
posterior teeth and the efficiency of occlusal forces dur-
ing mastication.8,9

536 THE JOURNAL OF PROSTHETIC DENTISTRY VOLUME 92 NUMBER 6

XU ET AL
It is unclear whether the curve of Spee is a description
of the occlusal surface of each arch separately or in max-
imal intercuspation. The characteristics of the curve of
Spee in the mandibular arch have been investi-
gated.1,10-12 However, few studies have examined the
characteristics of the curve of Spee in the maxillary arch.
The purpose of this study was to examine the
differences in the curve of Spee between the maxillary
and mandibular arches. The effect of gender on the
curve of Spee was also investigated.
MATERIAL AND METHODS
This study was reviewed and approved by the Tohoku
University Graduate School of Dentistry in Sendai,
Japan. Twenty-five men and 25 women, between the
ages of 19 to 24 (mean, 21 years) were enrolled from
a group of 900 healthy Japanese dental students on
the basis of a detailed questionnaire, verified through
clinical examinations. All subjects had to meet the fol-
lowing criteria as recommended by Ferrario et al11,13:
complete permanent dentition, including the second
molars (at least 28 teeth) with bilateral Angle Class I
first permanent molar and canine relations, horizontal
overlap and vertical overlap ranging from 2 to 4 mm,
no temporomandibular or craniocervical disorders,
absence of extensive restorations, cast restorations, or
cuspal coverage, no previous or current orthodontic
treatment, absence of anterior or lateral reverse articula-
tion, absence of a pathologic periodontal condition, and
clinically normal arch shapes with minimal dental
crowding. Dental casts were made in Type III stone
(Orthodontic Stone; Whip Mix, Louisville, Ky) from
alginate impressions (Alginoplast; Bayer, South Bend,
Ind).
Standardized digital images of the right-hand side of
maxillary and mandibular dental casts were made with
a digital camera (Nikon D100, 180-mm f/2.8 Ai-S
Nikkor with a PK-13 extension tube; Nikon, Tokyo,
Japan) fixed on a tripod (EI Carmagne 640; Velbon,
Tokyo, Japan). The camera-to-tooth distance was 150
cm for all pictures to eliminate image distortion, and
casts were photographed beside a ruler, which ensured
control of magnification. The cast was oriented so that
the lens of the camera was parallel to the buccal surfaces
of the posterior teeth. The line between the distal cusps
of the second molar and the cusp of the canine was
oriented parallel to the horizontal axis of the camera
display.
Each digital image of the dental casts was transferred
to a personal computer for analysis. The cusp tips of the
molars, premolars, and canines of the maxilla and man-
dible were marked using the cursor. The radius (R) and
the depth (D) of the curve of Spee were measured on the
dental casts by means of computer software (Occlcircle
Version 1.1; Rise, Sendai, Japan). All dental landmarks
DECEMBER 2004
THE JOURNAL OF PROSTHETIC DENTISTRY
Fig. 1. Measurement of curve of Spee. Cusp tips used for
measurement of curve of Spee indicated with black dots; most
anterior and posterior dots intersected by orientation axis.
Deepest distance from orientation axis to tooth represents
depth of curve of Spee.
were confirmed and measurements performed by the
same author. A reference plane was drawn from the buc-
cal cusp of the canine to the distal-buccal cusp tip of the
second molar. Perpendicular lines were drawn from this
line to the cusp tips of the premolars, the first molar, and
the mesial-buccal cusp of the second molar. The deepest
of these distances represented the depth of the curve of
Spee and was used in this study (Fig. 1).
Mean and standard deviations were calculated for
each measured parameter. The Mann-Whitney test was
used to evaluate the difference in the curve of Spee be-
tween men and women, and the Wilcoxon signed rank
test was used to test the difference between maxillary
and mandibular arches. For all analyses, the level of
statistical significance was defined as a=.05.
To test the reliability of measurement, 30 sets of dig-
ital pictures (the right-hand views of the maxillary and
mandibular arches of 15 men and 15 women) were
remeasured by a second examiner. The method error
for all these measurements was calculated by using
Dahlberg’s formula14:
vffiffiffiffiffiffiffiffiffiffiffi
un
u
u + di2
ti¼1
error ¼
2n
where d1, ., dn are differences between the 2
measurements and n is the number of recordings.
Statistical differences between replicate measurements
were tested with paired Student t tests, with an a level
of .05. No statistical differences were found in the mea-
surements (P=.24). Moreover, repeated measurements
performed on the same arches resulted in nonsignificant
differences between the 2 measurements.
RESULTS
The mean radius of the curve of Spee was approxi-
mately 106.4 mm (men, 106.1 mm; women, 106.6
mm) in the maxillary arch and 83.4 mm (men,
537
THE JOURNAL OF PROSTHETIC DENTISTRY
Table I. Radius and depth of curve of Spee
Total (N = 50) Men (n = 25) Women (n = 25)
Mean SD Mean SD Mean
Radius (mm)
Maxilla 106.4 7.6 106.1 8.7 106.6
Mandible 83.4 5.2 82.0 6.3 85.1
Depth (mm)
Maxilla 1.6 0.4 1.6 0.4 1.5
Mandible 1.9 0.5 1.9 0.6 1.8
82.0 mm; women, 85.1 mm) in the mandibular arch.
Radii of the curves of Spee in the maxillary arch were
significantly larger than those in the mandibular arch
(P,.0001). There were no statistically significant dif-
ferences between men and women in the maxilla radius
(P =.4908) and mandible radius (P =.2289) (Table I).
The regression equation derived from these data in men
was y = 0.4139x 1 37, in women was y = 0.224x 1
59.15, and in total was y = 0.3106x 1 49.06, where y is
the curve of Spee in the mandibular arch, and x the curve
of Spee in the maxillary arch. R2 = .4245 in men,
R2 = .2268 in women, and R2 = .3009 in total, indicating
the significant correlation between the curves of Spee in
maxilla and mandible (Fig. 2).
The depth of the curve of Spee was approximately 1.6
mm (men, 1.6 mm; women, 1.5 mm) in the maxillary
arch and 1.9 mm (men, 1.9 mm; women, 1.8 mm) in
the mandibular arch. The depth of the curve of Spee in
the mandibular arch was significantly deeper than that
in the maxillary arch (P ,.05). There was no gender dif-
ference in the depth of the curve of Spee between men
and women (P ..1) (Table I). The deepest cusp tip
was the distobuccal cusp of the first molar in the maxil-
lary arch and the mesiobuccal cusp of the first molar in
the mandibular arch.
DISCUSSION
It has been postulated for almost a century that the
occlusal plane is curved because of the sagittal inclina-
tion of teeth.1 From the lateral view, this morphological
arrangement, called the curve of Spee, is convex for the
maxillary arch and concave for the mandibular arch.11
Measurement of the curve of Spee remains controver-
sial.1,11,13 Clinically, the curve of Spee is determined by
the distal marginal ridges of the most posterior teeth in
the arch and the incisal edges of the central incisors.10
Inclusion of the incisors in the interpolation generates
a larger and flatter curve and increases variability.12
The lengths and positions of the radii exhibit such large
deviations that the mean cannot be used as a stan-
dard.10,12 In the present study, the curve was described
as a line of best fit from the tip of the canine that touched
the tips of the buccal cusps of the posterior teeth.
538
XU ET AL
SD
6.7
3.3
0.4
0.2
Fig. 2. Scatter diagram indicating significant correlation
between curve of Spee in maxilla and mandible.
The curve of Spee permits total posterior disclusion
on mandibular protrusion, given proper anterior tooth
guidance. The curve of Spee may be pathologically al-
tered in situations resulting from rotation, tipping, or
extrusion of teeth. Restoration of the dentition to such
an altered occlusal plane can introduce posterior protru-
sive interference.3,4 Such interference has been shown to
cause abnormal activity in mandibular elevator muscles,
especially the masseter and temporalis muscles.5
Furthermore, it has been suggested that excursive inter-
ference may result in wear, fracture of restorations, and
temporomandibular joint dysfunction.5
In orthodontics, and whenever extensive prosthetic
reconstruction is planned, the dental cusps may show
a flat curve of Spee. This lessens the risk of relapse and
simplifies the problem of canine guidance for disclusion
of posterior teeth, but it reflects neither the
characteristics nor the functional significance of the
curve of Spee.7 Such simplification of a natural arrange-
ment may alter complex neuromuscular systems and,
subsequently, affect dentoalveolar relations. The depth
of the curve of Spee may be a critical point for treatment
protocols. In this study, the concavity of the curve of
Spee differed between the maxillary and mandibular
arches. The shape of the curve of Spee in the maxillary
arch was significantly flatter than that in the mandibular
arch. In the subjects investigated, the shape of the curve
of Spee was not influenced by gender. The lack of sexual
dimorphism is in agreement with previous findings.11,12
Analysis of the curve of Spee may assist dentists in de-
termining development of the occlusion in the sagittal
plane. The maxillary and mandibular curves of Spee
could be used as 1 reference for prosthetic and ortho-
dontic reconstruction. Management of the sagittal orga-
nization of the teeth is a critical determinant of the
stability of complete dentures6 and may play a role in
failure of implant-supported restorations. Standardized
digital images were made in the sagittal plane, which al-
though simple to use, represents a flat, 2-dimensional
VOLUME 92 NUMBER 6
XU ET AL THE JOURNAL OF PROSTHETIC DENTISTRY

plane. The sample size was relatively small and limited to 8. Osborn JW. Relationship between the mandibular condyle and the occlu-
sal plane during hominid evolution: some of its effects on jaw mechanics.
Japanese; there may be genetic factors that would make Am J Phys Anthropol 1987;73:193-207.
this population different from other populations. The 9. Osborn JW. Orientation of the masseter muscle and the curve of Spee in
use of an identical radius of the curve of Spee for all relation to crushing forces on the molar teeth of primates. Am J Phys
Anthropol 1993;92:99-106.
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248-53.
11. Ferrario VF, Sforza C, Miani A, Colombo A, Tartaglia G. Mathematical
CONCLUSION definition of the curve of Spee in permanent healthy dentitions in man.
Arch Oral Biol 1992;37:691-4.
The curve of Spee was not influenced by the gender of 12. Ferrario VF, Sforza C, Miani A. Statistical evaluation of Monson’s sphere in
the subjects investigated (P ..1). The curve of Spee was healthy permanent dentitions in man. Arch Oral Biol 1997;42:365-9.
13. Ferrario VF, Sforza C, Miani A, Colombo A, Tartaglia G. Mathematical
significantly flatter in the maxillary arch than mandibular definition of the shape of dental arches in human permanent healthy
arch (P,.0001). dentitions. Eur J Orthodont 1994;16:287-94.
14. Cooke MS, Wei SH. Cephalometric errors: a comparison between repeat
measurements and retaken radiographs. Aust Dent J 1991;36:38-43.
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