Ranjgaran A,MOhsen

DMD-2D

During the 1970’s, andrews six keys to normal occlusion came forward

after studying models of 120 patients with ideal occlusion.
Andrews considered the presence of these features essential to achieve an
optimal occlusion. Andrews six keys to normal  occlusion are considered
under the following headings:

1. Molar inter-arch relationship

2. Mesio-distal crown angulation
3. Labio-lingual crown inclination
4. Absence of rotation
5. Tight contacts
6. Curve of spee

Molar inter-arch relationship

The mesio-buccal cusp of the upper first  molar should occlude in  the
groove between the mesial and medial buccal cup of the lower first molar.
The mesio-lingual cusp of the upper first molar should occlude in the
central fossa of lower first molar. The crown of the upper first molar must
be angulated so that the distal marginal ridge occludes with the mesial
marginal ridge of lower second molar. This is first key out of andrews six
keys.

Mesio-distal crown angulation

The second key makes use of a line that passes along the long axis of the
crown through the most prominent part in the center of the labial or buccal
surface. this line is called the long axis of the clinical crown. This is second
key out of andrews six keys.
For the occlusion to be considered normal, the gingival part of the long axis
of the crown must be distal to the occlusal part of the line. Different teeth
exhibit different crown angulation.

Labio-Iingual crown inclination

The crown inclination is determined from a mesial or distal view. If the
gingival area of the crown is more lingually placed than the occlusal area, it
is referred to as positive crown inclination. In case the gingival area of the
crown is more labially or buccally placed than the occlusal area it is
referred to as negative crown inclination.
The maxillary incisors exhibit a positive crown inclination while the
mandibular incisors show a very mild negative crown inclination. The
maxillary and mandibular posteriors have a negative crown inclination. This
is third key out of andrews six keys.

Absence of rotation
Normal occlusion  is charecterized by absence of rotation. Rotated
posterior teeth occupy more space in the dental arch while rotated incisors
occupy less space in the arch. This is fourth key out of andrews six keys.

Tight contacts
To consider an occlusion as normal, there should be tight contact between
adjacent teeth.

Curve of Spee
A normal occlusal plane according to Andrews should be flat, with the
curve of Spee not exceeding 1.5mm.