[Downloaded free from http://www.indjos.com on Monday, September 24, 2018, IP: 187.187.207.

244]

Review Article
Canine protected occlusion
Neeta Pasricha, Venus Sidana, Satpreet Bhasin, Monika Makkar
Department of Prosthodontics, National Dental College & Hospital, Dera Bassi, India

ABSTRACT

Over the years several concepts of occlusion have been developed and have gained varying
degrees of popularity. No single type of functional occlusion has been found to predominate
in nature. To suggest that one occlusal scheme is superior to other is not scientifically
defensible. However, current emphasis in fixed and restorative dentistry has been on the
concept of canine-protected occlusion as canines act as the first line of control to keep
mandible functioning more vertically. Canine-protected occlusion reduces the chances of
temporomandibular dysfunction, since it decreases lateral tooth contact and the possibility
of interfering contacts. This article reviews canine-protected occlusion, its biomechanics,
similarities and differences with group function, and components of anterior guidance.

Key word: Occlusion, canine protected occlusion, group function

Introduction adverse occlusal torsional forces to and

Address for Correspondence:
Dr. Neeta Pasricha,
Department of Prosthodontics,
National Dental College,
Dera Bassi, Punjab.
E-mail: pasrichaneeta@yahoo.com
Date of Submission: 20-04-2012
Date of Acceptance: 03-07-2012
Access this article online
Website:
www.indjos.com
DOI:
10.4103/0976-6944.101670
Quick Response Code:
Dentists at one time or other have been
exposed to the gnathological concept of
occlusion. The study of occlusion involves
not only the static relationship of teeth but
also their functional interrelationships and
all components of the masticatory system.
Every restoration, whether a simple amalgam
filling or complex crown and bridgework,
that involves the occlusal surface will affect
the occlusion.[1] Therefore restorations
should be planned so that they do not cause
effects that exceed the adaptive tolerance.
Based primarily on laterotrusive movements
from centric occlusion several functional
occlusal types are recognized or advocated --
balanced occlusion, group function, canine-
protected occlusion, mixed canine-protected
occlusion and group function, flat plane,
and multivareied occlusion. The evidence
in favor of one occlusal scheme over other
is scarce. Pragmatically, however, it is worth
considering that canine-protected occlusion
is far less likely to be associated with occlusal
interference on the nonworking side due to
the steep inclined palatal surface of canine.
The basic premise of canine-protected
function is that on laterotrusive movements
of mandible only the canine contacts and
therefore protects remaining dentition from
from centric relation and centric occlusion[2]
or as defined in GPT-8 the canine-protected
occlusion is a form of mutually protected
occlusion in which vertical and horizontal
overlap of canines disengages posterior
teeth in excursive movement of mandible.
This concept of occlusion is also known
as canine guidance, canine disclusion or
canine rise from the gnathology school of
occlusion. The theory of canine-protected
occlusion is attributed to Nagao, Shaw,
and D’Amico and is based on the fact that
canines are the most appropriate teeth to
guide mandibular excursion. There are a
number of reasons.[3]
The canines have a good crown root ratio
capable of tolerating high occlusal forces.
Canines provide high proprioception.
The shape of the palatal surface of canine
is concave and is suitable for guiding lateral
movements.
Posterior teeth are better suited to accept
vertical versus lateral forces. Lateral forces
placed on posterior teeth can result in a
fracture or excessive wear. Lateral forces
should be directed toward the anterior teeth
especially canines due to the root length

Indian Journal of Oral Sciences  Vol. 3  Issue 1  Jan-Apr 2012 13

[Downloaded free from http://www.indjos.com on Monday, September 24, 2018, IP: 187.187.207.244]
Pasricha, et al.: Canine protected occlusion
and position of these teeth being at a distance from the
temporomandibular joint. Canine-protected occlusion
reduces the chances of temporomandibular dysfunction,
since it reduces the lateral tooth contact and possibility of
interfering contacts. Consequently the chance of muscular
dysfunction is reduced.
Review of Literature
Over a century ago Bonwill and Gysi recommended
balanced occlusion for denture construction. In 1930,
McLean contended that this concept could also be applied
to the natural dentitions. However Macmillan took a
different view at the same time and suggested unilateral
balanced occlusion for both natural and prosthetically
restored dentition. Destructive forces associated with
nonworking side contacts were first observed by Schuyler
who concluded that they were traumatic to the natural
dentition. Further work by other investigators resulted in
balanced occlusion being replaced with unilateral balanced
occlusion also known as group function. Canine-protected
occlusion has its origin in the work of D’Amico, Stuart,
Stallard, and Lucia.[2] The requisite for canine-protected
occlusion is that only canines contact on the working side
during eccentric lateral mandibular movement, whereas on
the nonworking side, there are no balancing contacts. After
this work these two working side schemes took precedence.
Various epidemiological studies have been attempted
to discover which type of occlusal scheme is found in
untreated natural dentition. Beyron’s[4] work was the earliest
and showed quite conclusively that Australian aborigines
had predominance of group function. Weinberg[5] in 1964
found that 81% of sample had group function and 5% had
canine-protected occlusion. Scaife and Holt[6] examined
1200 individuals from North America less than 25 years
of age and found that majority had unilateral or bilateral
canine-protected occlusion. They also correlated that
canine-protected occlusion was associated with Angle
class II occlusion and then with class I and least with class
III. Panek et al,[7] in a study on 834 subjects found that the
frequency of canine-protected occlusion decreased with
age. It was concluded from the study that canine-protected
occlusion seems to be most suitable pattern for orthodontic
and prosthetic rehabilitation planned in younger patients.
D’Amico[8] stated that canine protection favors the vertical
chewing pattern and prevents the wear of teeth. Jemt,
Lundquist, and Hedegard[9] found that lateral displacement
and total displacement of mandible was greater with group
function than with canine-protected occlusion.
Lee[10] pointed out that from the biological point of view,
based on proprioceptive cuspid guidance, group function
14
is not ideal. Group function results in too flat and broad
occlusal surfaces to function efficiently.
Williamson and Lundquist[11] in 1983 studied that posterior
disclusion reduced the activity of temporal and masseter
muscles. Ash and Ramjford[12] believed that a steep canine
rise on Michigan splint can reduce the EMG activity of
masseter and temporalis. Murray[13] described a technique for the
provision of canine riser restoration, which deliberately altered
the cuspal inclines in canine teeth to provide canine guided
occlusion. According to him these restorations may help to
control excessive loading, limit the tooth wear, and assist
in management of TMJ disorders. Jiang, Su, and Cheng[14]
evaluated the clinical treatment effect on bruxism using
group functional splint and canine protect occlusal splint.
The successful rate of treatment of bruxism was 83.33% in
canine-protected occlusion and 79.1% with functional splint.
According to Henke and Friedrich[15] the canine-protected
occlusion decreased lateral stresses on posterior teeth and is
preferred over group function for restoring and altering the
anterior guidance. Goldstein[16] found the relationship of
canine-protected occlusion to periodontal index. The teeth
of mouth having canine-protected occlusion had significantly
lower mean periodontal indices.
Biomechanics in canine-protected occlusion
In canine-protected occlusion maximum intercuspation
coincides with optimal condylar position of mandible. Here
functional loading is directed axially by limiting the contact
of supporting cusps of posterior teeth to their opposing
fossa at or near their intercuspal position. The anterior teeth
either contact lightly or are very slightly out of contact (by
approximately 25 m), relieving them of laterally directed
forces. During lateral excursion all the teeth lose contact
except for the upper and lower canine on the working
side. Mastication mainly occurs with pounding motion and
chewing strokes are mainly sagittal from frontal aspect.
Functional efficiency is increased by well-formed marginal
ridges, triangular ridges, grooves and fossa so that occluding
cusps can readily penetrate fibrous food. In other words the
canines are situated and inclined in such a way that, while they
allow full contact of all teeth in centric occlusion, they force
the jaw to open as the upper and lower canine slide over each
other. This disengages all the cusp of teeth as person begins
to grind side to side, this phenomenon is called as cuspid
rise in deference to fact that most articulators are hinged in
such a way that upper teeth move instead of lower. This
artificial way of mounting the models make upper canine rise
instead of lower drop, which is what happens in real mouth.
According to this concept of occlusion, anterior teeth
bear the load when posterior teeth are disoccluded in any
excursive movement of mandible. The reason for redirecting
the occlusal forces are that anterior teeth are located far
away from TMJ and thereby have better leverage to offset
Indian Journal of Oral Sciences  Vol. 3  Issue 1  Jan-Apr 2012
[Downloaded free from http://www.indjos.com on Monday, September 24, 2018, IP: 187.187.207.244]
Pasricha, et al.: Canine protected occlusion
the closing muscles of mastication.[10] Keen proprioception
and strategic location protect anterior teeth from overstress
when occlusion is to function properly.
A better understanding of the role of the central
nervous system and learning process as well as muscle
physiology and proprioception shows that occlusion is
more than mechanics. It has been postulated that there is
a biofeedback mechanism which comes into action when
canines contact during lateral excursion. D’Amico stated
that the canines protect the periodontium and supporting
structures from lateral excursion. Upon functional
contact by canines, the periodontal proprioceptive
impulses are transmitted to the mesencephalic root of
trigeminal nerve, which alter the motor impulses to the
musculature.[8] The resultant involuntary reaction relaxes
the muscles and reduces the stresses to the periodontal
ligament. Kawamura[17] demonstrated that those teeth
most sensitive to pressure were incisors, canines,
premolars, followed by molar. Kruger and Michel[18]
discovered that canines had higher concentration of
neurons than any other teeth.
In order for the stomatognathic system to function,
teeth must work independently of each other. The
canines, due to their size, structure, root length, strategic
location from fulcrum, stress-breaking capabilities were
the most likely candidates for this function; they prevent
the lateral enmeshment of working side posterior teeth.
It has been observed that when this canine protection
is taken away, muscles stay active leading to clenching,
grinding of teeth, abfraction, and gum recession. Canine
guidance is considered the most physiologic of all occlusal
relationships because it protects the teeth from wear and
tends to prevent bruxing in most persons who are likely to
brux occasionally. In the absence of chronic bruxing habit
these relationships persist throughout life.
Similarities and differences between group
function and canine-protected occlusion
McAdam[19] summarized some similarities and differences
between canine-protected occlusion and group function.
Similarities
Both must provide multiple posterior contact with
intercuspal position (centric occlusion) located either
coincident with centric relation or within 1 mm of
protrusion in a straight sagittal direction.
There must be the absence of posterior contact during
mediotrusion.
There should be no posterior contact during anterior
incision whenever anatomic arrangement permits.
Indian Journal of Oral Sciences  Vol. 3  Issue 1  Jan-Apr 2012
There should be anterior group functional guidance
during the protrusive movement accompanied by a
posterior disclusion where the anatomic arrangement
permits.
Differences
The manner in which teeth function in laterotrusion.
In canine guidance the horizontal forces are minimized
by limiting the contact of the supporting cusps to their
opposing fossae at or near their intercuspal position. All
other lateral contacts are prevented by steeper inclines
of the canines; this results in chewing stroke being more
sagittal in frontal view.
In group function the first contact is not between
supporting cusp and opposing fossa but instead at a
lateral location followed by slide to centric occlusion,
this will result in some horizontal forces but these can be
minimized by
• Striking simultaneously as many as working contacts as
possible
• Reducing the angle of incline
• Reducing the friction by removing irregularities and
roughness
• Slightly round off the facio-occlusal line angle.
Components of Anterior Guidance
The anterior dentition is of paramount importance when
reconstructing the stomatognathic system. The primary
and permanent anterior teeth erupt into contact first, and
establish the anterior stop for the mandible. This allows the
posterior teeth to erupt into position at the proper vertical
dimension and centric relation. The canines are often
considered the primary protectors of the gnathological
system because they direct a vertical (rather than a
horizontal) masticatory pattern. Without this protection,
damaging horizontal forces can severely wear the posterior
occlusion
Harmonizing the lingual contours of the maxillary anterior
teeth with the facial contours of the mandibular incisors
and the neuromuscular system is the single most important
factor in the health and stability of the occlusal system.
According to Wynne[20] in a proper canine-guided occlusion,
there are two centric stops on each of the central incisors
and one stop on each lateral incisor and canine. During
straight protrusive occlusion, two paths are evident on
each central incisor on the lingual marginal ridge region.
Occasionally there may be anterior protrusive marks on the
canines. The paths on the central incisors extend until the
15
[Downloaded free from http://www.indjos.com on Monday, September 24, 2018, IP: 187.187.207.244]
Pasricha, et al.: Canine protected occlusion
incisal edges of the two maxillary central incisors and four
incisal edges of mandibular incisors are engaged. At this
point, these teeth should be able to slide smoothly [Figure 1].
After this point, the canines glide smoothly over the polished
and rounded lingual aspect of each tooth until the support
is transferred to the incisal edges of the maxillary incisors.
This transition should be a smooth, gliding path.
In the centric relation position, the relationship between the
maxillary incisors and mandibular incisors becomes clear
[Figure 2]. The facio-incisal leading edge of the mandibular
incisors engages the lingual aspect of the maxillary
incisors and canines. To maintain this relationship in a
reconstruction, it is necessary to hollow out approximately
0.5 mm of space on the gingival aspect of the centric
holding marks. This provides the freedom to close the
mandible either into centric relation or slightly anterior
without varying the vertical dimension of the anterior teeth.
The end-to-end position is indeed a rest position. Here,
the pitch of the maxillary and mandibular teeth is
complementary, allowing the maxillary central incisors and
four mandibular incisors to function in the same plane
[Figure 3].
Figure 1: Incisal view of the maxillary and mandibular teeth showing
proper occlusal pattern of function in a canine-guided occlusion
Figure 3: View of the end-to-end position
16
To create a smooth path in straight protrusive and when
moving into the crossover position, the lingual incisal line
angle of the mandibular incisors should be polished or
rounded in order to create a smooth transition from the
incisal edge onto the lingual aspect of the teeth [Figure 4].
In addition, there should be no rough edges on the lingual
incisal aspect of either mandibular canine; these areas should
also be rounded. These considerations will help create a
smooth, friction-free transition in all functional directions.
Establishing ideal distribution of stress on the anterior
teeth in lateral excursion (anterior guidance) can be
accomplished by either group function [Figure 5] or canine
guidance [Figure 6]. If group function exists, there is no
need to create canine guidance. In this case, changing to
canine guidance would increase the force on the canines,
which may destabilize the system. If canine guidance exists
and there is no tooth mobility or alveolar bone loss, then
rebuilding canine guidance is appropriate.
The next consideration in development of the occlusion is
lateral movement into what is called the crossover position,
which is defined as the portion of the occlusal path after
the canines have contributed their support and the incisors
then assume the support [Figures 7-11]. The functional
path is a smooth, lateral movement until the tips of the
canines are in contact.
Figure 2: View of centric relation
Figure 4: View of the smooth path in straight protrusion
Indian Journal of Oral Sciences  Vol. 3  Issue 1  Jan-Apr 2012
[Downloaded free from http://www.indjos.com on Monday, September 24, 2018, IP: 187.187.207.244]

Pasricha, et al.: Canine protected occlusion

Figure 5: View of group function (right, left protrusion) Figure 6: View of Canine guided occlusion( right, left protrusion)

Figure 7: View of centric relation Figure 8: View of the right working contact

Figure 9: View of right crossover contacts Figure 10: View of the left working contact

Figure 11: View of left crossover contacts
Conclusion
Both canine-protected and group function articulation
are commonly found in nature. The question of canine
guidance or group function depends upon individual case,
preexisting relationship, crown root ratio, degree of mobility
and fremitus of concerned teeth. In patients with anterior
open bite, extreme Angle class II division 1 or class III
malocclusion and crossbite, mandible cannot be guided
by anterior teeth and canine guidance cannot be achieved.
In order for canine-protected occlusion to function, the
anterior teeth must be healthy. The patient’s existing occlusal

Indian Journal of Oral Sciences  Vol. 3  Issue 1  Jan-Apr 2012 17

[Downloaded free from http://www.indjos.com on Monday, September 24, 2018, IP: 187.187.207.244]

Pasricha, et al.: Canine protected occlusion

scheme should not be altered unless such alterations
are required to correct a nonphysiological dentition. If
the restoration must reestablish lateral guidance canine-
protected occlusion is preferred when remaining canines
are present and not periodontally compromised. Canine
guidance reduces horizontal forces on posterior teeth and
promotes a more vertical chewing cycle.[11]
References
1. McCullock AJ. Making occlusion work: 1. Terminology, occlusal
assessment and recording. Dent Update 2003;30:150-7.
2. Rinchuse DJ, Kandasamy S, Sciote J. A contemporary and evidence- based
view of canine protected occlusion. Am J Orthod Dentofacial Orthop
2007;132:90-100.
3. Clark JR, Evans RD. Functional occlusion: I. A review. J Orthod
2001;28:76-81.
4. Beyron H. Occlusal relation and mastication in Australian aborigines.
Acta odonta Scand 1964;22:597-67.
5. Wienberg LA. The prevalence of tooth contact in eccentric movements
of the jaws. J Am Dent Assoc 1961;62:402-6.
6. Scaife RR, Holt JE. Natural occurrence of cuspid guidance. J Prosthet
Dent 1969;22:225-9.
7. Panek H, Matthews-Brzozowska T, Nowakowska D, Panek B, Bielicki G,
Makacewicz S. Dynamic occlusions in natural permanent dentition.
Quintessence Int 2008;39:337-42.
8. D’Amico A. Functional occlusion of the natural teeth of man. J Prosthet
Dent 1961;11:899-915.
9. Jemt T, Lundquist S, Hedegard B. Group function or Canine protection.
J Prosthet Dent 1982;48:719-24.
10. Lee RL. Anterior guidance. In: Lundeen, HC, editors. Advances in oc-
clusion. Boston: John Wright, P.S.G Inc; 1982. p. 71-6..
11. Williamson EH, Lundquist DO. Anterior guidance: Its effect on electro-
myograhic activity of temporal and masseter muscles. J Prosthet Dent
1983;49:816-23.
12. Ash MM, Ramjford S. Occlusion. 4th ed. Philadelphia: Saunders; 1996.
13. Murray MC, Brunton PA, Osborne-Smith K, Wilson NH. Canine risers:
Indications and techniques for their use. Eur J Prosthodont Restor Dent
2001;9:137-40.
14. Su SW, Jiang YH, Cheng Z. Evaluation of the treatment effect of bruxism
using two occlusal splints. Shanghai Kou Qianq Yi Xue 2010;19:253-4.
15. Henke DA, Freidrich TA. Occlusal rehabilitation of a patient with
Dentinogenesis imperfecta- a clinical report. J Prosthet Dent
1999;81:503-6.
16. Goldstein GR. The relationship of canine protected occlusion to a
periodontal index. J Prosthet Dent 1979;41:277-83.
17. Kawamura Y. Neurophysiologic background of occlusion. Periodontics
1967;5:175-83.
18. Kruger L, Michel F. A single neural analysis of buccal cavity representa-
tion in the sensory trigeminal complex of the cat. Arch Oral Biol 1962;7:
491-503.
19. McAdam DB. Tooth loading and cuspal guidance in canine and group
function occlusions. J Prosthet Dent 1976;35:283-90.
20. Wynne WP. Consideration for establishing and maintaining proper
occlusion in the aesthetic zone. Dent Today 2004;23:112-4,116-9.
How to cite this article: Pasricha N, Sidana V, Bhasin S, Makkar M.
Canine protected occlusion. Indian J Oral Sci 2012;3:13-8.
Source of Support: Nil, Conflict of Interest: None declared

Author Help: Online submission of the manuscripts

Articles can be submitted online from http://www.journalonweb.com. For online submission, the articles should be prepared in two files (first
page file and article file). Images should be submitted separately.
1) First Page File:
Prepare the title page, covering letter, acknowledgement etc. using a word processor program. All information related to your identity should
be included here. Use text/rtf/doc/pdf files. Do not zip the files.
2) Article File:
The main text of the article, beginning with the Abstract to References (including tables) should be in this file. Do not include any information
(such as acknowledgement, your names in page headers etc.) in this file. Use text/rtf/doc/pdf files. Do not zip the files. Limit the file size
to 1024 kb. Do not incorporate images in the file. If file size is large, graphs can be submitted separately as images, without their being
incorporated in the article file. This will reduce the size of the file.
3) Images:
Submit good quality color images. Each image should be less than 4096 kb (4 MB) in size. The size of the image can be reduced by decreasing
the actual height and width of the images (keep up to about 6 inches and up to about 1800 x 1200 pixels). JPEG is the most suitable file
format. The image quality should be good enough to judge the scientific value of the image. For the purpose of printing, always retain a good
quality, high resolution image. This high resolution image should be sent to the editorial office at the time of sending a revised article.
4) Legends:
Legends for the figures/images should be included at the end of the article file.

18 Indian Journal of Oral Sciences  Vol. 3  Issue 1  Jan-Apr 2012