Movements and 

Mechanics of Mandible
Occlusion Concepts and Laws 8
of Articulation

Yasemin K. Ozkan

8.1 Movements and Mechanics
of Mandible Occlusion Concepts
and Laws of Articulation
8.1.1 The Mechanics of Jaw Movements
As clinicians we must understand mandibular movements in
relation to the maxillae and be able to record and transfer
mandibular movements to an articulator during complete
denture fabrication because complete dentures must be fabri-
cated extraorally on an articulator. Also we must understand
that factors regulate and control mandibular movement (such
as the teeth, the muscles, the temporomandibular joints
(TMJ), and their supporting structures).
The movements of humans are defined in three dimen-
sions using a series of planes and axes. Three basic planes
pass through the human body:
The axis is a straight line around which an object rotates.
Thus, a rotation is a form of movement, which takes places
around an axis. In the chewing system, rotation occurs
around an axis passing between the condyles or through a
fixed point on which the mouth opens and closes. Rotational
movements can take place on any of the three planes (hori-
zontal, vertical, and sagittal). On any given plane, the rota-
tion will take place around a single point, which is referred to
as the axis.
Vertical
Saggital

1. The Sagittal Plane: Sagittal plane extends vertically sepa-

rating the body into two as the left and right parts. Horizontal
2. The Frontal (Vertical) Plane: Frontal plane extends verti-
cally, separating the body into two as the anterior and pos-
terior parts.
3. The Transversal (Horizontal) Plane: A plane that extends
horizontally, separating the body into two parts as the
superior and inferior parts (Figs. 8.1, 8.2, and 8.3a).

The mandible can move across several planes. On these

planes, the mandible can move upward and downward (fron-
tal plane), sideways (horizontal plane), and forward and
backward (sagittal plane). Fig. 8.1  Vertical, sagittal, and horizontal planes on the condyles

Y. K. Ozkan (*)
Faculty of Dentistry, Department of Prosthodontics,
Marmara University, Istanbul, Turkey
e-mail: yozkan@marmara.edu.tr

© Springer International Publishing AG, part of Springer Nature 2018 293

Y. K. Özkan (ed.), Complete Denture Prosthodontics, https://doi.org/10.1007/978-3-319-69032-2_8
294 Y. K. Ozkan

Vertical axis

Saggital
plane
Frontal plane

Frontal
horizontal Sagital
axis horizontal axis

Fig. 8.2  Horizontal, sagittal, and frontal planes in the body

a b Z
Frontal
Vertical axis

Saggital
Horizontal Saggital axis
Horizontal axis

Fig. 8.3 (a, b) Axis and movement paths of mandibular movements

8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 295

There are three axes of rotation: horizontal, frontal (verti- the axis passing between the condyles during the opening
cal), and sagittal (Fig. 8.3b): and closing of the mouth. Contact between the teeth can also
take place without any positional change in the condyles.
1. Horizontal Axis Rotation around the temporomandibular joint occurs within
The mandible performs an opening motion around the the lower joint space. The movement between the upper sur-
horizontal axis (like the movement around a hinge). face of the condyle and the lower surface of the temporo-
2. Vertical Axis mandibular joint disc is a rotational movement (Fig. 8.5a, b).
The movement of the mandible around the vertical axis
occurs during lateral movements. Frontal (Vertical) Axis
3. Sagittal Axis Frontal axis movement occurs when a condyle moves from
When one of the sides of the mandible moves downward its terminal hinge position toward the anterior, while the
during lateral jaw movements, the mandible will perform other condyle remains at its terminal hinge axis (Fig. 8.6a).
a rotational movement around the sagittal axis (Fig. 8.3b). The inclination of the articular eminence determines the
frontal axis inclination of the condyle performing the orbital
8.1.1.1 Movement and Function Planes movement. This type of isolated movement does not occur
There is a tendency to describe a movement based on the naturally.
plane on which it takes place (Table 8.1). For example, walk-
ing is a sagittal plane movement. Such definitions allow the Sagittal Axis
direction of movement to be described. Regarding joints, Sagittal axis movement involves the inferior movement of a
movements may occur not only on the sagittal plane but also condyle, while the joint is at a terminal hinge axis (Fig. 8.6b).
across several planes. For example, when walking, the hip The ligaments and muscles prevent the joint from moving
performs flexion/extension across the sagittal plane, adduc- downward. Such movement does not occur naturally; how-
tion/abduction across the frontal plane, and internal/external ever, it is observed together with the downward and forward
rotation across the transversal plane. The same concept is movement of the condyle.
valid for all subarticulations. These three components of
simultaneous movement are perceived as a single movement. Horizontal Axis
The dominant planes, movements, and axes associated with The opening and closing of the jaw involves mandibular
general movements are shown in Fig. 8.4a–c and Table 8.1. movement around the horizontal axis (Fig. 8.6c). This open-
ing and closing movement of the mandible around the hori-
zontal axis is also called the hinge movement, while the axis
8.1.2 Types of Mandibular Movement is also called the hinge axis. This rotation is on average 12°,
ranging between 10 and 13°, or between 18 and 25 mm inci-
8.1.2.1 Rotation Movement sal opening (Fig. 8.7a–d). The hinge axis model allows higher
Rotation is the movement around an axis. The rotation is the vertical dimensions to be used on the articulator and the pan-
revolving movement of a body around its own axis tograph to be directed according to the horizontal plane.
(Table 8.2). In the chewing system, rotation occurs around
Transversal Hinge Axis
The transversal hinge axis is an imagined line around which
Table 8.1  Movements occurring around planes and axis the mandible can rotate through the sagittal plane. This line
Plane Movement Axis Example passes horizontally through the rotation centers of the right
Sagittal Flexion/extension Frontal Walking and left condyles, at the positions where they are the most
Crouching retracted in the glenoid fossa and the least tense that at the
Pressure over
head
distal location (Fig.  8.7c, d). To determine the transversal
Frontal Abduction Sagittal Raising arm hinge axis of the mandible, the relationship between the
laterally upper model and the rotation axis of the articulator must be
Lateral flexion Leaning laterally the same as the relationship between the maxilla and the
Inversion/eversion skull base. Otherwise, the border movement of the articula-
Transversal Internal rotation/external Vertical Throwing tor will not be the same as the movement of the mouth, which
rotation
Horizontal flexion/ Baseball rotation
will result in different closing arcs for the articulator and the
extension patient’s mouth and consequently in occlusal incompatibility
Supination/pronation Golf rotation in the patient’s mouth (Fig. 8.8).
296 Y. K. Ozkan

a b

Fig. 8.4 (a–c) Dominant planes, movements, and axis in body movements. (a) Movements around frontal axis in the sagittal plane, (b) move-
ments around sagittal axis in the frontal plane, and (c) movements around vertical axis in the horizontal plane
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 297

The vertical axis of the rotation could be better observed perform a purely rotational movement (Figs. 8.10 and 8.11a).
when the combined rotation is evaluated. During rotation, This movement is also known as the terminal hinge move-
the condyle performing the orbital movement slides down- ment. The axis on which this movement takes places is also
ward from the inclination of the condylar eminence. On the called the hinge axis. The hinge axis is an imaginary line that
other hand, the medial pole of the side performing the rota- passes through the axis on which the mandible performs an
tion will slide downward over a shorter distance. When the approximately 25  mm vertical hinge movement or a rota-
condyles move, the condyle of the working side cannot per- tional movement (Fig.  8.12a). The hinge movement is the
form a purely vertical rotation without also performing a only purely rotational movement performed by the mandi-
sagittal rotation (Fig. 8.9). ble. In movements other than the hinge movement, there will
The rotational movement of the mandible on the horizon- also be translational movement on the rotational axis. The
tal, sagittal, and vertical axes is evaluated in detail below. hinge movement could be repeated, and the patient can eas-
ily find the stable occlusal contacts. Although rotational
Rotational Movement Around the Horizontal Axis movements are easy to perform, they are not commonly used
The movement of mandible around the horizontal axis during the normal function.
involves the opening and closing movements (Fig. 8.7c). At
the uppermost position in the articular fossa, the condyles Rotation Around the Anteroposterior or Sagittal Axis
The anteroposterior/sagittal axis is an imaginary line passing
through the midsagittal plane. The mandible performs a
Table 8.2  The planes where the rotational movements of the mandible slight rotation around this axis. During this movement, one
are observed
of the condyles moves both downward and medially, while
Rotational movements of the mandible the condyle on the other side moves both upward and later-
Plane Movement axis Notes ally (i.e., lateral movement). During the lateral movement of
Sagittal Horizontal, The only rotational movement
plane terminal, and which can be examined 20–25 mm
the mandible, the downward movement of one side will
transversal hinge clinically takes place in the inferior cause the mandible to rotate around the sagittal axis
axis (all are the joint compartment (Fig. 8.12b).
same) Rotation in the sagittal direction occurs through the dislo-
Horizontal Vertical (frontal During lateral excursion the cation and inferior movement of the condyle on one of the
plane axis) condyle of the balancing side
moves medially and forward sides, while the other condyle remains in a terminal hinge
around the frontal axis in the position. As the ligaments and muscles of the temporoman-
horizontal plane dibular joint do not permit the downward dislocation of the
Frontal Sagittal axis Occurs during lateral excursion condyle, this movement generally does not occur as a pure
plane The condyle of the balancing side
movement and may therefore occur together with the other
moves inferiorly around the sagittal
axis in the frontal plane movements of the joint.

a b
ROTATIONAL MOVEMENT

Fig. 8.5 (a, b) Rotational movement occurring between the upper surface of the condyle and the lower surface of the temporomandibular
joint disc
298 Y. K. Ozkan

a b c

Fig. 8.6 (a) Frontal (vertical) rotation axis. (b) Sagittal rotation axis. (c) Horizontal rotation axis

-y
x

x
y

a b

x x y -y

y -y x x

z z

z z

c d

Fig. 8.7 (a–d) Hinge axis. x, sagittal hinge axis; y, horizontal hinge axis; z, vertical hinge axis
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
Hinge axis of patient
and articulator
closure arch
Fig. 8.8  The relationship between the upper model and the rotation
axis of the articulator must be the same as the relationship between the
maxilla and the skull base
Fig. 8.9  The condyle of the working side cannot perform a purely ver-
tical rotation without a sagittal rotation
Rotation Around the Vertical Axis
If the patient orients or moves his/her mandible toward the
right side, the vertical axis of the rotation will pass through
the right condyle. During lateral movement, the mandible
performs mandibular movements around the vertical axis
(Fig. 8.12c). Rotation in the vertical direction occurs through
the dislocation from the terminal hinge position and the ante-
rior movement of the condyle on one of the sides, while the
other condyle remains in a terminal hinge position. Depending
on the angle of the articular eminence in which the condyle is
moving in the anterior direction; there may be a shift in the
vertical rotation axis of the condyle on the opposite side. This
type of rotation does not occur naturally.
8.1.2.2 Translation Movement
Translation movement occurs when the mandible moves for-
ward. The teeth, condyle, and ramus move in the same direc-
tion and to the same extent. It occurs in the upper cavity of
the joint (Figs. 8.11b and 8.13). The translation movement
occurs along the articular eminence across the sagittal plane
or along the lateral inclination of the mandibular fossa across
the coronal plane (Table 8.3).
299
1. The Opening and Closing Movement of the Mandible
The Opening Axis
The transversal horizontal axis is the imagined line
joining the two condyles around which the mandible
rotates across the sagittal plane. The first few millime-
ters of this movement are defined as hinge
movements.
2. Forward Movement of the Mandible
Protrusion of the Mandible
The condyles will move downward and forward together
with the articular disc from the glenoid fossa and the
articular eminence (Fig. 8.14). The path followed by the
condyles during the protrusive movement is called the
sagittal condylar path (Fig. 8.15).
Sagittal Condylar Angle
The sagittal condylar path forms an angle with the
horizontal plane. This angle varies between 30 and 40°
(Fig. 8.16).
When the mandible moves forward toward the edge-­
to-­edge position, a form can be seen between the distal
arcs and the wax rims on the distal side. This gap is known
as the Christensen phenomenon.
300 Y. K. Ozkan

Articular
fossa Articular Articular
disc eminence
TME

Intra-articular
disc

Lateral
pterigoid

a b

Figs. 8.10 and 8.11 (a) Centric relation position in the temporomandibular joint. (b) The movement of the temporomandibular joint

a b c

Fig. 8.12 (a) The hinge axis is an imaginary line on which the man- mandible to rotate around the sagittal axis on the other side. (c) During
dible performs a rotational movement. (b) During the lateral movement lateral movements, the mandible performs mandibular movements
of the mandible, the downward movement of one side will cause the around the vertical axis
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 301

TRANSLATION MOVEMENT RETRUSION

LATERAL LATERAL
MOVEMENT MOVEMENT

PROTRUSION

Fig. 8.14  The reflections of the mandibular movements over the teeth

Fig. 8.13  Mandibular translation movement

Table 8.3  Translation movements of the mandible

Translational movements of the mandible
Direction of the
Movement movement Notes
Opening/ Downward First 20–25 mm pure
closure rotation
Forward Translation occurs in
>25 mm
Forward Downward Both condyles move
movement downward on the posterior
inclinations of articular
eminence
Forward The inclination of the
articular eminence is
variable; it is measured as
the condylar angle
Lateral Rotation in the working Downward, forward, and
movement side condyle medial movement in the
The lateral translation balancing side condyle
of the mandibular forms
the Bennett movement
Fig. 8.15  Mandibular protrusion

3. Backward Movement of the Mandible 4. The Sideways Movement of the Mandible

Mandibular retrusion results in the rearmost positioning
of the mandible, which is a tense position. This position
can be achieved as follows:
(a) The active and conscious contraction of the retractor
muscles (the posterior fibers of the temporal muscle)
(b) The passive application of pressure to the symphysis region
by the dentist while the patient is in a fully resting position
The lateral dislocation or bodily movement of the mandible
during its lateral movements is known as the Bennett move-
ment (Fig. 8.17). Protrusive movements are used for grasp-
ing and cutting food. Lateral movements are used to cut
fibrous and other types of larger foods into smaller pieces.
The combinations of these different types of movements
are effective in tearing and cutting food into smaller pieces.
302 Y. K. Ozkan

Fig. 8.16  The sagittal condylar path and angle

Fig. 8.18  Incisal path and angle

1. Centric Relation
The CR is the mandible position in which the condyles are
situated in the uppermost and foremost positions within the
articular fossa on the posterior inclinations of the articular
eminences when an articular disc is present between them
(Fig. 8.19). When the mandible is in centric position, the
condyles can make the rotation around horizontal axis until
a 20–25 mm gap is present between central incisors. If the
opening of the mandible exceeds 20–25 mm, the transla-
tion will occur on the mandible. This pure rotational move-
ment is referred to as a hinge movement, while its axis is
referred to as a hinge axis (Fig. 8.20a, b).
2. Maximum Intercuspal Position (MIP) or Maximum
w Intercuspation (MIC)
b The MIP or MIC refers to the position in which the maxil-
lary and mandibular teeth have the maximum surface
Fig. 8.17  Working and balancing sides during the lateral movements contact with one another. On the sagittal plane, the man-
of the mandible
dible is elevated as superior as possible. This position is
Incisal Path determined by the teeth and does not provide information
The incisal path refers to the path in which the incisal edges about the temporomandibular joint. In many people, the
of the lower incisors follow the palatal surfaces of the upper maximum intercuspal position does not coincide with the
incisors up to the edge-to-edge position (Fig. 8.18). centric relation. In maximum intercuspation, the condyle-­
disc junction is situated toward anterior and inferior or
medial and lateral positions (or a combination of these)
8.1.3 Reference Positions
relative to their position in the centric relation. Generally,
the condyle-disc junction is placed in the anterior and
Reference positions are usually described as:
inferior. Clinically, if the patient’s need for restoration is
minimal (e.g., in cases of amalgam, composite restora-
1. Centric relation
tion, single crown, and short bridges), this is the position
2. Maximum intercuspal position
in which the restoration should be performed.
3. Postural position—resting position
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 303

3. Postural Position (PP)
This is the habitual position of the mandible while the
patient is in an upright and resting position, as well as a
non-tense and neutral position in the glenoid fossa. In
this position, there is a balance between the forces act-
ing on the mandible. In PP, the muscles are not in a fully
relaxed position. There is a certain level of electromyo-
graphic activity. This position is determined by muscles
and gravity. It is not informative about either the con-
dyles or the teeth. Compared with their CR position, the
condyles are generally positioned toward anterior and
inferior. This position could be continued and represents
a comfortable position for the patient. In this position,
the teeth are not in contact with one another, with a
wedge-like shape between the teeth. This wedge-shaped
space between the teeth is called the interocclusal space
and is generally 2–3  mm between the incisors, 2  mm
between the premolars, and 1 mm between the molars.
There is a 1:3 ratio from the anterior to the posterior
(Fig. 8.21).
Clinically, this position is used to determine the occlusal
vertical dimension in patients who are edentulous or with
severe wear. The occlusal vertical dimension refers to the
distance between two points when the occluding mem-
bers are in contact. In the resting position, the vertical
dimension is 2–3  mm greater than the occlusal vertical
dimension.

8.1.4 Border Movements of the Mandible

The movements of the mandible are limited by ligaments,

the articular surfaces of the temporomandibular joint, and the
morphology and arrangement of the teeth. Nevertheless, the
outer limits of movements can be repeated and are referred to
as border movements. Functional movements occur within
the limits of border movements. They occur during the func-
tional activity of the mandible. They begin and end with
maximum intercuspation. Border movements of the mandi-
ble can be classified as:

1 . Border and functional movements on the sagittal plane

2. Border and functional movements in the horizontal plane
Fig. 8.19  The position of the condyle and the disc in centric relation 3. Border and functional movements in the frontal plane

a b

Fig. 8.20 (a) Hinge movement. (b) Rotation and translation movement

304 Y. K. Ozkan

Table 8.4  Border and functional movements in the sagittal plane

PHYSIOLOGICAL REST Border and functional movements in the sagittal plane
POSITION
Movement Action Notes
Posterior Rotation Translation is the function of
opening Downward and the temporomandibular
border forward translation ligament
movement
Anterior From maximum When the capsular and the
opening opening to maximum temporomandibular
border protrusion ligaments prevent forward
movement movement, it is maximum
2-3 mm opening
Maximum protrusion is
determined by the
stylomandibular ligament.
Condyles are in the most
anterior position
Superior 1. Centric relation 1. Superior anterior sliding
contact (CR) → maximum to MIP
border intercuspal position
Fig. 8.21  Physiological resting position movement (MIP)
2. MIP → edge to 2. Directed by the lingual
edge surfaces of the maxillary
3. Sliding with the anterior teeth
8.1.4.1 Border and Functional Movements incisal edge
on the Sagittal Plane 4. Sliding down on
the mandibular
The components of movement are shown in Table 8.4. They lingual surface
are classified as: 5. → Maximum 3. Horizontal sliding along
protrusion (PP). the width
• Posterior opening border movements PP → MIP 4. Directed by the lingual
• Anterior opening border movements (2–3 mm) surfaces of the mandibular
• Superior contact border movements anterior teeth
• Functional movements 5. Directed by the posterior
teeth
Functional From MIP to the Falls downward and forward
Posterior Opening Border Movement movements desired opening Return way is more straight
During the opening of the mouth, the condyles move for- position and then and slightly in posterior
ward and downward from the articular eminence. The maxi- again to MIP
mum opening is achieved when the capsular elements
prevent further movement (Fig. 8.22a, b). p­ osition, which is determined by the lingual surfaces of the
Anterior Opening Border Movement maxillary anterior teeth. The path has an inferior inclination.
The anterior opening border movement encompasses the This path moves horizontally on the edge-to-edge position as
movement from the maximum opening to the maximum pro- the incisal edge width amount. The forward movement of the
trusion. Maximum protrusion is partially determined by the mandible while the anterior teeth are in contact with one
stylomandibular ligament. The condyles are in their fore- another will result in an upward movement guided by the
most position (Fig. 8.22c). lingual surfaces of the mandibular anterior teeth. Until the
Superior Contact Border Movement mandible reaches maximum protrusion, the continuing for-
The first contact occurs between the mesial inclination of ward movement of the mandible will be guided by the poste-
the maxillary teeth and the distal inclination of the mandibu- rior teeth (Fig. 8.23a–h).
lar teeth. The mandible will then move toward the superior Functional Movements
and anterior until maximum intercuspation is achieved. In Chewing begins at maximum intercuspation and contin-
addition, this sliding motion can also have a lateral compo- ues with downward and forward movement until the desired
nent. In 90% of the population, the distance between the CR level of the opening is reached. Through a straighter path, the
and MIC is 1.25  ±  1  mm. The mandible moves from the path turns slightly toward the posterior. This formation is
maximum intercuspal position toward the edge-to-edge called the Posselt diagram (Fig. 8.24).
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 305

a b

1 1

Fig. 8.22 (a, b) Posterior opening boundary movement. (c) Anterior opening boundary movement

8.1.4.2 Border and Functional Movements
in the Horizontal Plane
The border and functional movements in the horizontal plane
form a rhomboid-shaped diagram (Fig. 8.25). There are four
components of movement (Table 8.5):
• Left lateral border movement
• Left lateral border movement with protrusion
• Right lateral border movement
• Right lateral border movement with the protrusion and
functional movements
Left Lateral Border Movement
The contraction of the right inferior lateral pterygoid
causes the movement of the right condyle toward the anterior
and medially. The left interior lateral pterygoid remains in
relaxed position. The left condyle is the working side that
performs a rotational movement. The right condyle is called
as the orbiting or the non-working side that performs orbital
movement and does not work (Fig. 8.26a).
Left Lateral Border Movement with Protrusion
Pterygoid begins to contract from the left lateral to the left
inferior (right contracted) and causes the left condyle to
move toward the anterior and right for maximum protrusion
(Fig. 8.26b).
Right Lateral Border Movement
Right lateral border movement is the exact opposite of left
lateral border movement (Fig. 8.26c).
Right Lateral Border Movement with Protrusion
Right lateral border movement with protrusion is the
exact opposite of the left lateral boundary movement, with
the addition of protrusion (Fig. 8.26d).
Functional movements occur in proximity of maximum
intercuspation. The external border of the movement is
306 Y. K. Ozkan

a b

ICP
SR

SR

g h

ICP

PP

Fig. 8.23 (a–h) The path of incisors from maximum intercuspidation to maximum protrusion
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 307

ICP CR
RCP

3 1

ICP

4 2

Fig. 8.25  The rhomboid-shaped diagram formed as a result of the

boundary and functional movements in the horizontal plane

Border and functional movements consist of four move-

Fig. 8.24  Posselt diagram ment components (Table 8.6):

• Left lateral superior border movement

Table 8.5  Border and functional movements in the horizontal plane
• Left lateral opening border movement
Border and functional movements in the horizontal plane • Right lateral superior border movement
Movement Action Notes
• Right lateral opening border and functional
Left lateral Right condyle Depending on the
border moves anteriorly contraction of the right
movements
movement and medially inferior lateral pterygoid, left
Left condyle makes is called working side, and Left Lateral Superior Border Movements
rotation right is called balancing side The mandible moves from maximum intercuspation to
Left lateral Left condyle moves When right is still the left side. The path is primarily determined by the mor-
border anteriorly and contracted, it is formed
movement with medially through depending on the contraction
phology and interarch relationship of the teeth. The maxi-
protrusion the maximum of left inferior lateral mum of the lateral border movement is determined by the
opening pterygoid ligaments of the condyle performing the rotation (Fig. 8.31a).
Right lateral Reverse of left Reverse of left lateral border Left Lateral Opening Border Movements
border lateral border movement
Left lateral opening border movements allow a lateral
movement movement
Right lateral Reverse of left Reverse of left lateral border convex path. As it approaches maximum opening, the liga-
border lateral border movement with protrusion ments will contract and cause medial shifting (Fig. 8.31b).
movement with movement with Right Lateral Superior Border Movements
protrusion protrusion Right lateral superior border movements involve move-
Functional Occur around MIP
movements
ments similar to the left lateral superior boundary move-
During the early stages of
mastication, outer border of ments (Fig. 8.31c).
the movement is larger Right Lateral Opening Border Movements
During the late stages of Right lateral opening border movements involve move-
mastication, outer border of ments similar to the left lateral opening boundary move-
the movement is smaller
ments (Figs. 8.31d and 8.32).

8.1.4.4 The Movement Envelope

broader during the early stages of chewing. The external bor-
der of the movement is smaller during the late stages of
chewing (Figs. 8.27, 8.28, and 8.29).
8.1.4.3 Border and Functional Movements
in the Frontal Plane
The border and functional movements in the frontal plane
form a shield-like pattern (Fig. 8.30).
The movement envelope is a three-dimensional shape. It
forms the combination of all border movements within the
three planes. Although the envelope changes from person to
person, it always possesses the same characteristic shape
(Fig. 8.33 and Table 8.7). The upper surface of the envelope
is determined by the contact points of the teeth. The other
limits are determined by the temporomandibular joint anat-
omy and ligaments. The features and aspects that have been
308 Y. K. Ozkan

3 1

4 2

3 1

a 4 2 b

c d

Fig. 8.26 (a) Left lateral border movement in the horizontal plane. (b) Left lateral border movement with protrusion in the horizontal plane. (c)
Right lateral border movement in the horizontal plane. (d) Right lateral border movement with protrusion in the horizontal plane

CR
ICP

LC
EC

EEP

Fig. 8.27  Functional movements in the horizontal plane

Fig. 8.28  The external border of the movement is broader during the
early stages of chewing
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 309

Table 8.6  Border and functional movements in the frontal plane

Border and functional movements in the frontal plane
Movement Action Notes
Left lateral From MIP to Determined by the morphology
superior border the left and the interarch relationship of
movement the teeth. Maximum is determined
by the ligaments of the rotating
condyle
Left lateral Lateral Coming closer to the minimum
opening border convex path opening, ligaments tighten and
movement medial sliding occur
Right lateral Similar to the Similar to the left lateral superior
superior border left lateral border
movement superior
border
Right lateral Similar to the Similar to the right lateral superior
opening border right lateral border
movement superior
Functional border Occur around MIP
movements Inside the outer border of border
movements

Fig. 8.29  The external border of the movement is smaller during the
later stages of chewing
ICP
3 1
4 2
Fig. 8.30  A shield-like pattern is formed by the border and functional
movements in the frontal plane
described until now are associated with the movements
observed in individuals with natural teeth, as well as the fac-
tors that act upon these movements. The following sections
cover the different movements and effects observed in eden-
tulous individuals.
8.1.5 Occlusion in Complete Dentures
Any contact between the cutting and chewing surfaces of
the maxillary and mandibular teeth is defined as occlusion.
Complete dentures must satisfy the following three basic
requirements: comfort, function, and esthetic appearance.
While occlusion represents a static relationship between
opposing teeth, articulation represents a dynamic relation-
ship. Occlusion is an important factor that affects the den-
ture stability and retention. In all departments of dentistry,
occlusion is defined as the most important, as well as the
most confusing, concept of dentistry. To understand the con-
cept of occlusion, it is necessary to have knowledge about
the mechanics, mathematics, and geometry of jaw move-
ments. Important differences between natural and artificial
teeth are reported below:
Natural Teeth
• Function independently from one another and are subject
to occlusal loads.
• Proprioceptive stimuli from the periodontium prevent
early occlusal contacts.
• Malocclusion may not lead to problems for years.
• Vertical forces are well tolerated.
• Bilateral balance is not required.
• The second molar is required for chewing.
Artificial Teeth
• Move as a group and occlusal forces are not handled one
by one.
• There is no feedback mechanism and the denture is in
CR. Any early contact may dislocate the denture base.
• Malocclusion brings about immediate problems.
• Non-vertical forces may harm the supporting tissues.
• Bilateral balance is required.
• Excessive forces on the second molar will cause the den-
ture base to bend.
310 Y. K. Ozkan

a b b

c d

Fig. 8.31 (a) Left lateral superior border movement in the frontal plane. (b) Left lateral opening border movement in the frontal plane. (c) Right
lateral superior border movement in the frontal plane. (d) Right lateral opening border movement in the frontal plane

Z
c

ICP

Y
d
X

Fig. 8.33  The combination of all border movements within the three
planes
Fig. 8.32  Functional movements in the frontal plane
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 311

Table 8.7  Envelope movements on the planes

Envelope movements on the planes
Sagittal plane
Superior contact

CO
CR

Posterior
opening

Anterior
opening

Functional
movements

Horizontal plane
CR
ICP

LC
EC

EEP

Frontal plane

(continued)
312
Table 8.7 (continued)
Envelope movements on the planes
3 Planes together
Z
a b
Fig. 8.34 (a, b) The appearance of resorbed ridges
To understand occlusion, first, it is necessary to under-
stand the movements and mechanics of the mandible.
Fundamentally, the positions of the mandible could be exam-
ined in four groups.
1. Resting Position (Postural Position and Resting Relation):
The position in which the muscles opening and closing
the jaw are in balance and in which the condyles are in a
neutral and non-tense state.
2. CO (Intercuspal Position): The position in which the
opposing occlusal surfaces are in maximum contact.
3. CR (Rear Position): The rearmost position of the mandi-
ble relative to the maxilla.
Y. K. Ozkan
4. Centric Occlusal Relation: The position in which the
jaws are in centric relation, while the teeth or occlusal
surfaces are in CO.
In cases where artificial teeth are used instead of natural
teeth, the functions of the artificial teeth must be compat-
ible with the jaw, joints, and muscles. When the teeth are
lost, their surrounding bones are resorbed, being replaced
with an alveolar bone of different shape and size that is
surrounded by a mucosa of varying quality and thickness
(Fig. 8.34a, b). When a denture is placed on such a struc-
ture, it will remain static only when the jaw is also static;
in other words, the denture will tend to move during func-
tion. One of the main goals in the preparation of complete
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
dentures is reducing such movement to the minimum and
allowing the patient to optimally control the denture. In
cases in which the teeth are in contact on only one side or
in cases only some of the teeth are in contact (as the case
with only the canines are in contact during lateral move-
ment of natural dentition), the denture will display tipping
movement, which is very difficult, or even impossible, for
the patient to control (Figs. 8.35 and 8.36a).
Previous studies on occlusion have determined that CO—
the position in which all of the teeth are in contact—is the
most commonly observed position during chewing, as well
as the position with the greatest chewing strength. Teeth con-
tact that occurs during swallowing is similar to the contacts
that occur during chewing; in other words, lateral move-
ments are always followed by CO.
CO is the most commonly used position not only in
chewing but also during swallowing. As swallowing occurs
over 1500 times in 24 h, it will lead to deviation in the CO
of dentures. To minimize the movement of the denture and
prevent disruptive forces from acting on the denture base,
these deviations that are observed during swallowing must
Fig. 8.35  If the teeth are in contact on only one side or if only some of
the teeth are in contact, the denture will display a tipping movement
a b
Fig. 8.36 (a) The teeth that are in contact on only one side. (b) To prevent any tipping, there should be contact between the teeth on both sides of
the arc
313
be balanced. The positioning of the denture base and artifi-
cial teeth in an ideal manner will prevent any movements
that may cause damage. As previously demonstrated, while
the total duration of which the teeth remain occluded during
chewing is approximatively 10 min over a period of 24 h,
the total duration of occlusions which occur for reasons
other than chewing is approximatively 2–4 h. If these con-
tacts unrelated to chewing are not stable, the dentures will
move and become more difficult for the patient to control.
These movements will eventually cause trauma to the bone
and mucosa underlying the denture. According to the “bolus
in, balance out” definition, which was introduced in the
mid-1960s, the movement will occur in dentures regardless
of the occlusal plane being used. This approach maintains
that balancing occlusions, which are observed even in natu-
ral dentition, are generated by various jaw movements
observed around the CO; however, in artificial dentition in
which the denture base is controlled only by muscle activity,
it is obligatory to form balanced contacts in CO and also
around and outside the CO. This action reduces any move-
ment of the denture base to a minimum (Table 8.8).
Even if the crests or muscle control of the patient prevents
the denture from tipping, the denture base will still continue
to move, causing pain, discomfort, and ulceration. If there is
contact on both sides between the teeth, in other words, if
contact on one side does not cause tipping until the teeth on
the other side also come into contact, the denture base will be
more stable. Therefore, to prevent any tipping as a result of
jaw movements during chewing, there should be contact
between the teeth on both sides of the arc (Fig.  8.36b).
Occlusion should be formed in which both arcs balance each
other and the anterior region balances the posterior region.
Such an occlusion is called balanced occlusion. Balanced
occlusion can also be observed in natural dentition that has
been subject to wear. In fact, even in unworn natural denti-
tion, it is possible to observe that the teeth on both sides of
314 Y. K. Ozkan

Table 8.8  The differences between natural and artificial dentition • Contact between the buccal and lingual tubercles of
Natural dentition Artificial dentition the upper and lower posterior teeth are desired. In case
Teeth are supported by the No periodontal ligament there is lingualized occlusion, the maxillary lingual
periodontal ligaments tubercles will be in contact with the mandibular lin-
Functions independently Functions as a group gual tubercles.
Malocclusion may not cause Malocclusion may cause problems
4. In Lateral Movements, on the Balancing Side
problems for years
Non-vertical forces are well Non-vertical forces may cause • Contact between the maxillary and mandibular ante-
tolerated damage in the supporting tissues rior teeth.
Biting does not affect posterior Biting effects all the teeth over the • The lingual tubercles of the upper posterior teeth are in
teeth base plate contact with the buccal tubercles of the lower posterior
Second molar is in proper Excessive chewing forces on the
teeth. It is the same for lingualized occlusion. For
position for chewing second molar region cause tilting
of the base plate monoplane balanced occlusion, generally second
Bilateral balance is rare; its Bilateral balance is required for molars or balance ramps are in contact. In case of
presence is accepted as the stability of the base plate monoplane and unbalanced occlusion, there may be
inhibition contacts on the balancing side; however, when the
Proprioceptive impulses give Since there is no proprioceptive
feedback in order to avoid impulse which will keep the base
mandible is directed toward the working side, these
inhibitions and premature plates in centric relation, there is contacts may disappear.
contacts and therefore acquired no feedback in case of inhibition
occlusion can be avoided and premature contacts During the construction of complete dentures, there are
only a limited number of references for determining the loca-
the arc come into contact simultaneously during chewing, tion where the teeth will be placed. The two most important
while the bolus is crushed between the teeth. of these references are the vertical and the horizontal rela-
The inevitable problems described above are ultimately tions of the mandible and the maxilla. When the mandible
caused by contact that occurs on the occlusal plane, CO, and performs a pure rotation in the horizontal plane, it only
the border movements of the complete denture. In complete moves vertically. This movement provides a repeatable man-
dentures, the quantity and strength of these contacts will dible position when determining the vertical dimension.
determine the quantity and direction of the forces being trans- At this occlusal height, the teeth are placed such that they
mitted by the denture base to the alveolar bone. Thus, deter- will remain stable during maximum tubercle contact.
mining the type of occlusion that is preferable for complete Therefore, during the preparation of a complete denture, the
dentures is of considerable importance. definition for CR requires that teeth that are occluding at a
predetermined, stable vertical dimension must have a proper
horizontal relation with the mandible.
8.1.6 Balanced Occlusion CR is the physiological relation in which the mandible is
positioned in the rearmost position relative to the maxilla. In
In the 1980s, Bonwill and Balkwill reported that all teeth this position, the individual can perform lateral movements.
must contact equally during both centric and eccentric move- Clinically, the CR is defined as the position in which the
ments. They also described the characteristics of balanced condyle-disc pieces are situated in their uppermost and fore-
occlusion in complete dentures as follows: most position relative to the articular eminence. CR is inde-
1. In Centric Relation pendent of the contacts between the teeth and can be observed
• Multiple uniform occlusal contacts on the posterior clinically when the mandible is directed both upward and
teeth forward.
• Very slight or no occlusal contacts on the anterior teeth
2. In Protrusive Relation 8.1.6.1 Articulation
• Contact between the upper and lower anterior teeth Articulation is the contact relation between the occlusal sur-
(incisal guidance). faces of teeth during function.
• In case there is a flat plane, a balance ramp should also
be present (protrusive balance cannot be achieved if Balanced Articulation
there is incisal vertical overlap or if there is no inclina- Balanced articulation is defined as the constant contact
tion or ramp without any inclination or ramp being between the large majority of the upper and lower teeth dur-
present). ing maximum tubercle contact and all eccentric movements.
3. In Lateral Movements, on the Working Side This definition can be used for all occlusal planes using teeth
• Contact between the maxillary and mandibular ante- with or without tubercles or using a combination of these
rior teeth. two types of teeth (Figs.  8.37 and 8.38a, b). Whether den-
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
tures should or should not have balanced occlusion has been
discussed for many years. Nowadays, there is still no objec-
tive study that fully supports the use of balanced occlusion.
In addition to this, the general view is that balanced occlu-
sion should be preferred especially for difficult denture
patients since parafunctional movements, such as bruxism or
lateral contacts, affect the stability and retention of dentures.
The answer to the question on why we consider balanced
occlusion as necessary for complete dentures is shown in
Table 8.1.
In the Glossary of Prosthodontic Terms, the concept of
balance is defined as the state of occlusion in which the
occlusal surfaces in all centric and eccentric positions exhibit
compatibility during chewing and swallowing. According to
the concept of balance, the buccal tubercles of the upper and
lower teeth on the working side, the lingual tubercles of the
upper and lower teeth on the working side, and the lingual
Working side Balancing side
Fig. 8.37  Balanced articulation
a b
Fig. 8.38 (a, b) Balanced articulation is defined as the constant contact between the large majority of the upper and lower teeth during maximum
tubercle contact and all eccentric movements
315
tubercles of the upper teeth and the buccal tubercles of the
lower teeth on the balancing side must be in contact
(Fig.  8.37). Owing to its characteristic structure, the tem-
poromandibular joint performs vertical as well as protrusive
and lateral movements during the various functional move-
ments of the mandible, especially during chewing. As
explained before, the mandible can move within certain bor-
ders without accomplishing a certain function. These move-
ments, which are different from the functional movements of
the mandible, are referred to as “mandibular border move-
ments.” Due to the characteristic structure of the temporo-
mandibular joint and the diversity of movements performed
by the mandible, it is necessary to consider the topic of “bal-
ance” in complete dentures. A bilateral balanced occlusion is
a form of occlusion that involves static contact between the
lower and upper teeth in any centric and eccentric position.
This occlusion was developed to prevent the tipping or rota-
tion of denture base plates. Balanced occlusion is mainly
arranged on the articulator. It is a concept based on the stud-
ies of Spee and Monson. Balanced occlusion is achieved by
ensuring contact between a maximum number of teeth dur-
ing each movement of the mandible. Bilateral balanced
occlusion in natural dentition is generally observed in indi-
viduals over the age of 50 with well-developed mandibular
muscles and in patients whose teeth have been abraded over
the years due to function. In bilateral balanced occlusion, no
lateral roaming is observed, and no disclusion occurs in the
posterior region during protrusive movements. The working
side is always in contact. There is also contact on the balanc-
ing side, which ensures the stabilization of complete den-
tures. Although this type of balance is not desired for natural
teeth or fixed dentures, it is suitable for complete dentures. In
complete dentures, eccentric balance in functional move-
ments can be ensured through three-point contact or contact
with all teeth. Both of these approaches involve bilateral
balance.
316
Fig. 8.39 (a) Three-point
contact observed in a b
protrusion. (b) Three-point
contact observed in lateral
movement
Three-Point Contact
Three-point contact is used in both protrusive and lateral
balance. When the patient brings his/her mandible to a pro-
truding position, the incisors will contact in the anterior,
while the second molars will contact in the posterior on both
sides. In this situation, the upper and lower dentures will
contact each other in a total of three points (one point on the
anterior and two points on the posterior), and balance is
achieved (Fig. 8.39a). The same is applicable for the lateral
movements of the mandible. When the mandible is moved to
the lateral direction, one contact will occur in the region of
the canines, while two other contacts will occur on each side
between the second molars. This will also allow the denture
to be balanced by having a contact at three points (Fig. 8.39b).
Full Balance
Full balance involves contact between all the occlusal sur-
faces of the upper and lower teeth during all eccentric move-
ments of the mandible. Since simultaneous contacts take
place between the teeth in both the centric and eccentric
positions, both sides will become balanced. Although full
balance may not be required for natural teeth, the consensus
among authorities is that complete dentures generally require
full balance.
Y. K. Ozkan
8.1.6.2 General Characteristics of Balanced
Occlusion
The purposes of balanced occlusion are to increase the sta-
bility of the denture, to decrease pain and the resorption of
residuals crests, and to increase the oral comfort of the
patient. To enhance these:
1. All the teeth on the working side must slide over the
opposing teeth with equal force. There should be no
obstruction or disocclusion on even a single tooth
(Fig.  8.40). There should be contacts on the balancing
side as well; however, this should not prevent the sliding
movement on the working side. During protrusion, con-
tacts between the teeth must be simultaneous.
2. Ideal balanced occlusion can be achieved with wide teeth,
and large crests and the teeth are arranged close to the
crest. Large crests and narrow teeth in the buccolingual
direction will ensure a better balance. Positioning the
teeth more toward the lingual side will further increase
the balance. Centering the occlusal forces more in the
anteroposterior direction will result in greater stability for
the denture base.
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 317

2. Bilateral Balanced Occlusion

The centric and eccentric positions involve simultaneous
occlusion between the teeth located on both sides. For mini-
mal occlusal balance, at least three contact points (two pos-
terior and one anterior) are necessary. Bilateral balanced
occlusion is affected by articulation and patient-­related fac-
tors. By controlling the articulation factors, the dentist can
ensure the development and the desired occlusal scheme.
Opening
The aim of articulation factors is the formation of chewing
surfaces for artificial and natural teeth to ensure bilateral
balanced occlusion and articulation.

Premature contact Protrusion

8.1.7 Concepts of Occlusion

Opening arch of the patient

1. Gysi concept
Fig. 8.40  If there is no premature contact in balanced occlusion, no
disclusion occur on the posterior region in lateral and protrusive
movements
General Considerations Regarding Balanced Occlusion
1. Wider and larger crests, as well as closer distances between
the teeth and the crest, will result in greater leverage.
2. Wide crest and narrow teeth will result in greater
balance.
3. Placing the teeth in a more lingual position relative to the
crest will result in greater balance.
4. Centering the occlusal forces more in the anteroposterior
direction will result in greater stability for the denture
base.
The Advantages of Balanced Occlusion
1. During swallowing, bilateral balance allows occlusion to
take place between the teeth without moving the denture
base plates away from the tissues.
2. In the final stage of the chewing movement, bilateral bal-
ance ensures that the base plate remains in a stable posi-
tion during closing.
3. Balanced occlusion prevents the formation of disruptive
lateral forces at the crests during parafunctional
movements.
Types of Balanced Occlusion
1. Unilateral Balanced Occlusion
Unilateral balanced occlusion involves simultaneous
occlusion between the occlusal surfaces of the teeth
located on one side.
The use of 33° anatomic teeth in various movements of the
articulator. In 1914, 33° cuspal form was introduced by Gysi.
Gysi gave an inclination of 33° to the cuspal inclines to har-
monize them with the condylar inclination of 33° to the hori-
zontal. In lateral mandibular movements, cusps contact
bilaterally to enhance the stability of the dentures. In centric
occlusion, the masticatory forces directed toward the ridges.
2. French concept
In this concept, the occlusal surface of the mandibular
posterior teeth had been reduced to increase the stability
of the dentures. The maxillary posterior teeth have slight
lingual occlusal inclines of 5° for first premolar, 10° for
second premolar, and 15° for first and second molars, so
that a balanced occlusion could be developed laterally as
well as anteroposteriorly by the arrangement of teeth on a
curved occlusal plane. In centric occlusion, half of width
of mandibular posterior teeth helps to direct the mastica-
tory forces in a buccal direction to the mandibular crest.
3. Sear concept
Balanced occlusion through the use of non-anatomic teeth
with anteroposterior and lateral inclinations. Sears in 1922
with his chewing members and in 1927 with channel teeth
(both were non-anatomic teeth) developed a balanced occlu-
sion by a curved occlusal plane anteroposteriorly and later-
ally or with the use of a second molar ramp. In centric
occlusion, non-anatomic teeth will exert contact forces
toward the ridges. In the right lateral position, the occlusal
contact forces directed toward the ridge on the working side
and toward the buccal side of the ridge on the balancing side.
4. Pleasure concept
Defines the pleasure curve or the posterior reverse lat-
eral curve. In 1937, Dr. Max Pleasure defined an occlu-
sal scheme called the “pleasure curve,” in which a
reverse curve is used in the bicuspid area for lever bal-
ance, a flat scheme of occlusion is set in the first molar
area, and a spherical scheme is set in the second molar
318 Y. K. Ozkan

area by raising the buccal incline to provide for a bal-

ancing contact in lateral position. The distal of the sec-

Inclination of plane of orientation

Inclination of condylar guidance
incisal guidance
ond molar can also be elevated to produce a compensating

Inclination of

compensating curve
Height of cusps

Prominence of
curve for protrusive balance. In
incis clinatio
al g n of
uid
anc
5. Frush concept Pro
min
enc
e of
e
nati
Incli r guida
f
on o ce
n
com n dyla
Involves the arrangement of the teeth in a one-­dimensional Incli
pen
sati
ng c
urve
c o

ne o
f ori
enta
tion

natio e
f pla curv
contact relationship. In 1967, Frush gave the “linear n of
plan
e of Incli
nati
on o
ens
atin
g
orie fc omp
occlusal concept,” which employed an arbitrary articula- Inclin
ation
ntat
ion inen
ce o
isal g
uidan
ce

Prom of inc
of co
ndyla ation
tor balance, followed by intraoral corrections to obtain r guid
ance Inclin
sps
Heig
ht of t of cu
Heigh
balance. A single mesiodistal ridge on the lower posterior cusp
s

teeth contacted a flat occlusal surface of the upper poste-

e
nc
e

In
rv

cli
of tion

ida
cu
pl
an incl

na
rior teeth set at an angle to the horizontal. The intention n

g
io ta

He
e ina

tio
in
at en

gu
at
lin ori of ti

n
ns
or on

Inc
c

of
ig
In of

l
pe
ie o

isa

co
was to eliminate deflective occlusal contacts and increased

ht
lin
e nt f

m
an

n
at

atio
co
pl

dy
inc
io

of
Pr
n

lar
of

no
om
sp

cu
e

of

gu
stability. In centric occlusion, contact forces directed

cu
nc

f in
ine

ida
sp
e

of
n
in

cis
nc
e dylar

nc
tio
m

ht

s
eo

al
o

e
ig
Pr
toward the ridges according to the linear occlusal

na

gu
fc
He

ida con

ida
om
cli

gu n of
nc

nc
pe
In

e
concept.

ns
atio

atin
lin

gc
Inc
6. Hanau’s Quint

urv
e
In 1926, Rudolph L. Hanau presented a discussion paper
entitled, “Articulation: Defined, Analyzed, and Fig. 8.41  Laws of articulation also named as Hanau’s Quint
Formulated.” He proposed nine factors for achieving the
articulation of artificial teeth. These were named as 7. Trapozzano concept
Hanau’s laws of articulation. These laws are listed below: De
cr se
• Horizontal condylar path inclination ea ea
se cr
De
• Compensating curve (Spee) Incisal
Decrease Condylar
• Protrusive incisal path inclination guidance Decrease
guidance
• Plane of orientation (plane of occlusion)
• Buccolingual inclination of the tooth axes Tubercle
inclination
• Sagittal condylar path inclination Increase
angle
Increase
• Sagittal incisal path inclination Incisal Condylar In
cr
• Tooth inclinations guidance guidance ea
se
se

• Relative tubercle height

ea
cr
In

• Hanau later combined these nine laws, reducing their

number to five and forming the currently accepted
Fig. 8.42  To ensure a balanced denture, articulation factors must be
laws of articulation (Hanau’s Quint) (Fig. 8.41).
compatible
These laws are:
1. Condylar path inclination
2. Incisal path inclination
3. Compensating curve (Spee)
4. Relative tubercle height
5. Plane of orientation
Condylar inclination and the incisal inclination are the
end control factors. To ensure a balanced denture, the
other three factors must be compatible with the end con-
trol factors (Figs.  8.41 and 8.42). For many years, the
laws of articulation have been accepted as a standard ref-
erence. Later on, some researchers made various scien-
tific contributions to these laws and performed minor
changes on them. Thielemann subsequently simplified
Hanau’s factors in a formula for balanced articulation:
[K × I]/[OP × C × OK]
where K  =  condyle guidance, I  =  incisal guidance,
C  =  cusp height inclinations, OP  =  inclination of the
occlusal plane, and OK  =  curvature of the occlusal
surfaces.
Trapozzano reviewed Hanau’s five factors and stated
that only three factors were actually concerned in obtain-
ing balanced occlusion. He omitted the plane of orienta-
tion since its location is highly variable within the
available inner ridge space. He also stated that the
­occlusal plane can be located at various heights to favor
a weaker ridge. He stated that there is no need for a com-
pensating curve, as it is obsolete since the cuspal angula-
tion will produce a balanced occlusion.
8. Boucher concept
There are three fixed factors:
• The orientation of the occlusal plane, the incisal guid-
ance, and the condylar guidance.
• The angulation of the cusp is more important than the
height of the cusp.
• The compensating curve enables one to increase the
effective height of the cusps without changing the
form of the teeth.
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
9. The Lott concept
Lott defined the laws as follows:
• The greater the angle of the condyle path, the greater
is the posterior separation.
• The greater the angle of the overbite (vertical over-
lap), the greater is the separation in the anterior region
and the posterior region regardless of the angle of the
condylar path.
• The greater the separation of the posterior teeth, the
greater, or higher, must be the compensation curve.
• Posterior separation compensation curve to balance
the occlusion requires the introduction of the plane of
orientation.
10. Bernard Levin’s concept
This concept is quite similar to Lott’s, but he eliminated
the plane of orientation. He has named the four factors
as Quad. The essentials are as follows:
• The condylar guidance is fixed and is recorded from
the patient. The balancing condylar guidance includes
the working condyle Bennett movement, which may
or may not affect lateral balance.
• The incisal guidance is usually obtained from the
patient’s esthetic and phonetic requirements.
However, it can be modified for special requirements,
e.g., a reduction of the incisal guidance is considered
to be helpful when the residual ridges are flat.
• The compensating curve is the most important factor
for obtaining balance. Monoplane or low cusp teeth
must employ the use of a compensating curve.
• Cusp teeth have the inclines necessary for obtaining
balanced occlusion but nearly always are used with a
compensating curve.
8.1.8 Laws of Articulation
Theory of Articulation
• The purpose of the theory of articulation is to associate
the current anatomic state of edentulous jaws with the
physical and mechanical state of dynamic chewing sys-
tems and also to provide an adequate solution for the
practical construction of a complete denture.
• To compare different ideas and views regarding cases,
individual measurements can be used to develop a basic
theory of articulation.
• Mandibular movements must be simulated.
• Articulators must be used.
• Lightly worn anatomic tooth shapes are necessary for
function.
• For static reasons, the teeth must be placed at the center of
the alveolar crest.
319
• The upper anterior teeth must be placed in front of the
alveolar crest. Overbite and overjet must be equal.
• To provide positional stability, the compensating curves
are reproduced, and three-point contact is achieved in
mandibular movements.
• The lower first molars, which constitute the strongest
chewing unit, must be located at the deepest point of the
alveolar crest at the chewing center.
• Tissues that support the denture must be properly
reflected.
• The five basic articulation factors must be prepared on the
articulator and then applied to the patient’s mouth.
8.1.8.1 Condylar Path Inclination
Mandibular guidance is generated by the condyle and the
articular disc within the glenoid fossa that supports move-
ment (Fig. 8.43a, b). The condyle moves not only toward the
CR position but also downward along the articular eminence.
Condylar guidance is generated depending on the path fol-
lowed by the condyle within the temporomandibular joint
(Fig. 8.43c, d).
The mechanical shape is located on the upper rear side of
the articulator, from where the movement is controlled
(Fig.  8.44). When all the natural teeth are lost, with the
exception of the condylar path inclination, all of the factors
explained above and associated with the laws of articulation
will be lost. During the construction of a complete denture,
these factors must be identified and arranged by the dentist.
Hanau described the condylar path inclination as an ana-
tomic concept. As the condylar path inclination is an ana-
tomic factor of the patient, it cannot be modified. With or
without teeth, there is always condylar path inclination (this
factor is unrelated to the teeth), which must be identified and
determined on the patient by the dentist and then transferred
to the articulator. Thus, the condylar path inclination is first
recorded on the patient, and the recorded information is then
transferred to the articulator. The angle of the condylar path
inclination will depend on the shape and bone contour of the
temporomandibular joint. The limits of movements are
determined by the muscles and ligaments attached to the
mandible.
The condylar path inclination is evaluated in two parts:
1. Straight Protrusive Condylar Path Inclination (Sagittal
Condylar Path Inclination, SCPI)
SCPI refers to the inclination between the horizontal
plane and the path followed by the condyles during the
pure protrusive movements of the mandible. The angle
that is formed when the condyle advances on the horizon-
tal plane is called the condylar path inclination angle. In
humans, this angle (inclination) is similar to the inclina-
320 Y. K. Ozkan

a b

c d -y
x

x
y

Saggital condylar
inclination
z

Fig. 8.43 (a, b) Mandibular guidance is generated by the condyle and the articular disc within the glenoid fossa that supports movement. (c, d)
Sagittal condylar path inclination

tion of the glenoid fossa’s upper wall inclination

Condylar
guidance
(Fig.  8.45). The amount of downward movement that
occurs during the protrusion movement of the mandible
depends on the angle of the articular eminence. If the sur-
face of the articular eminence is flat, the condyle will
trace a perpendicular course following this path. SCPI
occurs when the two condyles move downward and for-
ward over a straight line without sliding laterally. This
movement of the condyle heads is associated with the
Incisal shape of the bone protuberance known as the tuberculum
guidance articulare (articular eminence), which forms the upper
wall of the glenoid fossa. The shape of the condyle and
fossa shows that in all forward movements of the mandi-
ble, the mandible actually moves downward. The greater
inclination of the articular eminence is associated with
greater downward and anterior movement of the condyle.
A steeper condylar guidance is associated with the forma-
tion of a larger gap between the teeth when the mandible
Fig. 8.44  Condylar and incisal guidance on the articulator performs protrusive movements (Christensen phenome-
non). Condylar guidance is not under the control of the
dentist. The current guidance of the patient must be
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
Fig. 8.45  Sagittal condylar path inclination is similar to the inclination
of the glenoid fossa’s upper wall inclination
recorded and transferred to the articulator. This guidance
is entirely associated with the patient and cannot be modi-
fied. It depends on the temporomandibular joint’s bone
structure, as well as the muscle and ligament control. To
record the Christensen phenomenon, protrusive records
are taken and transferred to the articulator. The angle
value of the straight protrusive condylar path inclination
is approximately 33°.
However, this number is an average value, and the
actual condylar inclination value is affected by the factors
listed below:
(a) The shape of the temporomandibular joint’s bone
contour
(b) The activities of the muscles attached to the
mandible
(c) The limitation of joint movements by the ligaments
In addition, the specific method used to determine the
condylar path inclination also affects its angle value. If
the method used to determine the condylar path inclina-
tion is a method performed based on the denture base
plates, then, the fact that the resilience of soft tissues
causes them to change locations when faced with acting
forces may also lead to a change in the direction of incli-
nation. Hanau explained this phenomenon using the word
“REALEFF.” This term was derived by Hanau from the
words “REsilience and Like EFFect.” In other words, it
means, “the effect caused by resilience.” Following the
construction of dentures, the “REALEFF” effect can, in
practice, be remedied by abrasion. Transferring complete
321
Condylar path inclination
Incisal path inclination
Mandibular pathway
Fig. 8.46 (a) During the construction of complete dentures, transfer-
ring the dentures into articulators without first determining the straight
protrusive condylar path inclination and (b) the absence of contact in
the posterior region during protrusion
dentures into articulators without first determining the
straight protrusive condylar path inclination and then
aligning the teeth accordingly can lead to the Christensen
phenomenon, which is a very important phenomenon to
consider in prosthetic dentistry (Fig. 8.46).
As the condylar path inclination is an anatomic factor, it
is determined separately for the right and left sides. The
values for the two sides are not necessarily the same.
The straight protrusive condylar path inclination is one
of the most important articulation factors and is also
known as an end control factor. Identifying the straight
protrusive condylar path inclination and then transfer-
ring it to the articulator and positioning the teeth accord-
ingly not only ensure protrusive balance but also
eliminate the Christensen phenomenon. The common
view of all authors is that identifying the protrusive
condylar path inclination is important and that its deter-
mined value should be as close as possible to its actual
value.
Increasing the condylar path inclination will increase the
level of posterior disclusion during protrusion. As this
factor cannot be changed, the other four factors should be
modified to compensate the effects of the condylar path
inclination (Fig. 8.46). For example, if the condylar path
inclination is too high, the incisal path inclination should
322
30°
20°
10°
Fig. 8.47  If the condylar path inclination is too high, the incisal path
inclination should be decreased in order to reduce the disclusion which
forms on the posterior during protrusion
B B
WS
BS
Fig. 8.48  Working and balancing sides in the lateral movements
be decreased to reduce the disclusion that forms on the
posterior during protrusion (Fig.  8.47). There are two
determinants in the forward movements of the mandible,
which are the condylar path inclination of the sagittal
plane and the angle of the incisal path inclination.
2. Lateral Condyle Inclination (LCI)
When the mandible moves in a certain direction, the side
on the direction of the movement is called the working
side, while the opposing side on the other end of the
arch is called the non-working or balancing side. The
working side is the one where the bolus is located and
toward which the mandible is moving to chew (Figs. 8.17
and 8.48). The value of the condylar path angle is higher
in lateral movements. When the mandible moves later-
ally, the angle of the condylar path will, as a result of the
structure of the articular eminence, be larger than the
angle observed during protrusion. This is due to the
steeper angle of the medial wall of the mandibular fossa
in comparison to the wall of the articular eminence.
Y. K. Ozkan
The LCI is defined as the angle associated with the
condyle’s movement on the horizontal plane (anteropos-
terior movement) or the frontal plane (superior inferior
movement). The lateral condylar path, on the other hand,
is defined as the movement path of the condylar disc dur-
ing the lateral movement of the mandible. The lateral
movement of the mandible refers to its movement to the
left and right. During this movement, the paths of the con-
dyles on the right and left sides may be different. The
movements are named based on the direction in which the
mandible is moving. For example, lateral movements are
called right and left lateral movements. The direction in
which the mandible is moving is called the working side;
on the other hand, the opposing side is called the
­non-­working or balancing side. The condyles are simi-
larly referred to as the working condyle and the non-
working/balancing/orbiting condyle.
During the lateral movement of the mandible, the con-
dylar head on the non-working side will leave the centric
relational position and move forward, downward, and
inward, in front of the articular eminence.
Bennett Angle
The Bennett angle (which is generally between 10° and
20°) is the angle between the moving condylar path and the
sagittal plane during lateral movement. The Glossary of
Prosthodontic Terms defines Bennett angle as follows: “The
angle formed between the sagittal plane and the average path
of the advancing condyle as viewed in the horizontal plane
during lateral mandibular movements.”
On the side toward which the mandible is moving, the
condyle will perform a rotation from the medial to the lateral
around the vertical axis. While the condyles may perform a
pure rotation in certain individuals, in other individuals, they
may perform a certain amount of sliding motion in addition
to rotation. In this case, the mandible will be displaced as a
whole. This is known as the “immediate side shift.” This dis-
placement may occur in any direction within a cone with an
apical angle of 60° (Fig.  8.49). The displacement can take
place in nine directions; however, this direction remains the
same and does not change for a lifetime. It is important to
determine whether a condyle displays an immediate side
shift in addition to its rotational movement.
Bennett Movement
During lateral movement, the condyle of the working side
moves laterally in a three-dimensional manner. The condyle
can move sideways and upward (laterotrusion), sideways and
downward (laterodetrusion), and sideways and backward
(lateroretrusion). The extent of movement affects the Bennett
angle (Figs. 8.49 and 8.50). An increase in the Bennett angle
is associated with a high level of Bennett movement, while a
decrease in the Bennett angle is associated with a low level
of Bennett movement. The Bennett angle forms not due to
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 323

the movement of the condyle on the working side but rather
due to the movement of the condyle on the non-working
side. The Bennett angle is not related to the Bennett move-
ment. There is always a Bennett angle, regardless of whether
a Bennett movement is taking place.
60°
Fig. 8.49  Immediate side shift may occur in any direction within a
cone with an apical angle of 60°
According to the studies of Gysi, the average value for the
lateral movement of the mandible is 15°. In the Hanau Model
H articulator, this value is set to 15°, and for many years, this
value has been considered as normal and adequate.
Describing this 15° value for the Bennett angle as the lateral
condylar path inclination would be more accurate. The same
value is set as 20° in the Dentatus articulator. This value is
established by turning the graduated button on the vertical
arms located on the top of the articulator until the desired
number is obtained; however, researchers describe that in
non-arcon-type adjustable articulators, this value is generally
not exact. Nevertheless, in practice and the preparation of
complete dentures, these values do not lead to any problems.
The Bennett angle, which faces downward on the horizontal
plane, may not be the same as the angle of the straight pro-
trusive condylar path, which forms during protrusive move-
ment. In cases in which there is any difference between the
two, this difference will be called as the Fischer angle. In
other words, the Fischer angle is the difference between the
Bennett angle and the straight protrusive condylar path
angle. This angle is defined in the Glossary of Prosthodontic
Terms as “the angle formed by the intersection of the protru-
sive and non-working side condylar paths as viewed in the
sagittal plane.”

x x
RIGHT LEFT
y -y
Saggital plane

z z
Median

BENNETT-ANGLE

b
RIGHT LATERAL MOVEMENT ON FRONTAL PLANE
a RIGHT LATERAL MOVEMENT
x -y

y x
z
z

RIGHT LATERAL MOVEMENT ON HORIZONTAL PLANE

Fig. 8.50 (a–c) Bennett angle and Bennett movement

324 Y. K. Ozkan

Hanau previously provided a formula for calculating the

lateral condylar path inclination (Bennett angle). According
to this formula, if the patient’s straight protrusive condylar
path inclination is known, the angular value of the lateral
movement can be easily calculated. The condyle mechanism
of the articulator could be adjusted according to this value,
allowing the Bennett angle to be entered as a degree value
into the articulator.
Hanau’s formula for calculating the Bennett angle is
shown below:
H
L - + 12
8
L  = Lateral condylar path inclination (Bennett angle

value).
H = Angular value for the straight protrusive condylar
path.
Lateral movements cause a gap between the balancing
side and the teeth. Some authors refer to this gap as “the
Christensen phenomenon on the frontal plane.” To remedy
this, the articulator is set to the average values, and during
the arrangement of teeth, the articulator is moved laterally to
ensure contact on both sides. Once the dentures are com-
pleted, bilateral balance is ensured through the abrasion per-
formed in the mouth. Actually, lateral movements are
kinematically complex. They are consequently difficult to
record in the mouth or to duplicate in the articulator. As
described above, setting the lateral condylar path inclination
between 15 and 20° on the articulator allows good results to
be obtained with complete dentures. Thus, it may actually be
completely unnecessary to record the lateral condylar path
inclination on the patient and to transfer the obtained infor-
mation into the articulator by adjusting the device accord-
ingly. This is because semi-adjustable articulators using
average values for the lateral condylar path inclination can
effectively provide complete dentures of good quality.
8.1.8.2 Incisal Path Inclination (IPI)
Just as the condyles control the movement on the posterior
area of the mandible, the teeth control the movement of the
anterior area of the mandible. In the protrusive or lateral
movement of the mandible, the incisal edges of the mandibu-
lar teeth are in contact with the lingual surfaces of the ante-
rior maxillary teeth. The angle of the lingual surfaces
determines the extent of the movement of the mandible in the
vertical direction. The anterior guidance is considered to be
a highly variable factor, rather than a constant factor. The IPI
is the second of the end control factors. This inclination is
entirely under the initiative of the dentist. In other words, the
dentist must determine the level of inclination by taking cer-
tain factors into account. Foremost among these factors are
esthetic considerations. The contacting surfaces of the lower
and upper anterior teeth affect the movement of the mandi-
ble, while the guidance pin and the guidance table affect the
movements of the articulator (Fig.  8.51). The incisal guid-
Fig. 8.51  The effect of the contacting surfaces of the lower and upper
anterior teeth on the movements of the articulator
ance stems from the effect of the contact surfaces of the man-
dibular and maxillary anterior teeth on the movements of the
mandible. It has horizontal and vertical components, as well.
In dentures, the shape of the arch and the distance between
the crests affects the relationship between the esthetic-­
phonetic- and crest-related aspects. Esthetic and phonetic
considerations affect the location of the teeth, which is deter-
mined by the dentist. Variations in the incisal guidance con-
tribute to ensuring balanced occlusion. Increasing or reducing
balance has significant effects on the movement of the teeth
during lateral movements.
When the mandible performs protrusive or lateral move-
ments, the incisal edges of the lower teeth will contact the
lingual surfaces of the upper teeth. The steepness of the lin-
gual surfaces will determine the extent of the mandible’s ver-
tical movement. Anterior guidance can be changed with
dental procedures.
IPI can be evaluated in different two parts:
1. Sagittal Protrusive Incisal Path Inclination
The IPI angle is the angle that forms between the occlusal
plane and the occlusal line across the sagittal plane. When
the teeth are in contact, this angle is determined by the
incisal edges of the upper and lower central teeth. When
the teeth are in CO, the angle is determined by the angle
between the horizontal plane and the line on the sagittal
plane formed between the incisal edges of the lower and
upper first incisor teeth (Fig. 8.52).
The IPI angle arises from the vertical overlap (overbite)
between the teeth. This depends on the amount of horizon-
tal overlap, which does not provide guidance until the
teeth are fully occluded. In natural teeth, the level of over-
bite and overjet is determined by the position of the teeth;
in complete dentures, they are determined by other factors
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
such as esthetic, phonetic, and functional considerations
(Fig. 8.53a, b). Thus, in dentures, the level of overbite and
overjet is determined by the position of the teeth and is
fully controlled by the dentist within the frame of other
various factors. In the articulator, the anterior guidance
table is taken as a reference for forming the angle on the
sagittal plane. The dentist generally determines the angle
of the incisal path inclination; however, there are several
limitations, such as the crest relations, the arch shape, the
crest width, and the inter-crest distance. Depending on the
extent of these limitations, the dentist will attempt to sat-
isfy the phonetic and esthetic requirements of the patient
by changing the angle of the incisal path inclination. This
factor is also affected by the amount of horizontal and ver-
tical overlap. Decreasing the vertical overlap will involve
a decrease in the incisal path inclination angle.
From a conceptual perspective, the figure that best
describes the relationships between the incisors, in an
informative manner, is that which illustrates a right-­angled
triangle obtained by first joining the incisal points of the
Incisal path guidance angle
Overbite
Overjet
Fig. 8.52  The incisal path guidance angle arises from the vertical
overlap (overbite) between the teeth
a b
No Medium
horizontal Excessive
overlap HORIZONTAL OVERLAP horizontal
overlap
Fig. 8.53 (a, b) In full dentures the level of overbite and overjet is determined by factors such as esthetic, phonetic, and functional
considerations
325
upper and lower first incisors and then by drawing a per-
pendicular line from the top of the lower incisors toward
the horizontal plane. This vertical edge of this right-angled
triangle represents the overbite (a), while its horizontal
edge represents the overjet (b), and its hypotenuse repre-
sents the protrusive sagittal incisal path inclination
(Fig. 8.52).
The dentist needs to take certain factors into account
when attempting to determine this inclination:
(a) The relationships between the alveolar crests
(b) The shape of the alveolar arches
(c) The fullness of the alveolar crests
(d) The distance between the lower and the upper alveo-
lar crest
(e) The phonetic and esthetic state of the patient
Regarding this inclination, nearly all authors describe that
the emphasis should be on esthetic appearance. Esthetic
aspects generally cover the appearance of the incisors and
the level of overbite and overjet. Of course, the balance of
the denture also needs to be considered; however, the
esthetic aspects are given preeminence over balance, and
the denture is adjusted accordingly (Fig. 8.53).
In cases where teeth with tubercles are used, excessive
overbite will also result in an increase in tubercle heights,
leading to an increased possibility of tubercle incompati-
bility during the eccentric movements of the jaw, even if
balanced articulation is achieved. This, in turn, will
adversely affect the stability of the denture. This situation
becomes even more important for cases in which the crests
are highly atrophied. The level of overbite and overjet is
associated with this inclination. For example, if the amount
of overbite remains the same, the incisal path inclination
can be changed by increasing or decreasing the amount of
Slight vertical
overlap
Excessive
vertical overlap
VERTICAL OVERLAP
326
overjet. The lower incisors are aligned closer to the lingual
side, while the upper incisors are aligned closer to the ves-
tibule (or both). In all these processes, the first and fore-
most point to consider should be the patient’s esthetic
appearance. In cases of lower prognathism, the sagittal
protrusive incisal path inclination is not considered. This
inclination is adjusted to zero degrees.
In cases where a certain level of overjet is necessary, it is
undesirable to increase the incisal path inclination by
increasing the level of overbite as well because this situa-
tion may lead to lateral forces that harm the surrounding
tissues. However, as the incisal path inclination decreases
and approaches to zero degrees, the stability of the denture
increases. Thus, it is desirable for the incisal path inclina-
tion in dentures to be zero, but as detailed above, the incisal
path inclination must be adjusted by first considering the
esthetic appearance, and the stability of the denture must be
ensured by adjusting and modifying other factors. Anterior
guidance is the functional relation between the upper and
lower incisor teeth. Anterior guidance stems from the verti-
cal and horizontal overlap of the incisor teeth.
An increase in the horizontal overlap will lead to a
decrease in the anterior guidance angle, as well as a
decrease in the vertical component of the mandibular
movement and flatter posterior tubercles (Fig. 8.54). An
increase in the vertical overlap will lead to an increase in
the anterior guidance angle, an increase in the vertical
component of the mandibular movement, and steeper pos-
terior tubercles.
2. Lateral Incisal Path Inclination
The protrusive incisal path inclination only takes into
account the relations between the upper and lower incisor
teeth and is defined accordingly. The lateral incisal path
inclination includes the relation between the incisors as
well as the canines. The lateral incisal path inclination is
Fig. 8.54  An increase in the 41°
horizontal overlap will lead to
a decrease in the incisal path Same vertical overlap, different horizontal overlap
angle
Y. K. Ozkan
defined as the angle between the horizontal plane and the
path followed by the upper incisors and canines during
the lateral movement of the mandible.
8.1.8.3 Orientation of the Occlusal Plane
The plane of occlusion (plane of orientation) represents the
curvature (not an exact plane) of the occlusal surfaces. The
occlusal plane is an imaginary line that is considered as
touching the incisal edges of the upper anterior teeth and the
tubercles of the posterior teeth. The occlusal plane must be
nearly parallel to the crests and should not be above the level
of the retromolar pads.Raising the occlusal plane on the pos-
terior will minimize the separation of the teeth during eccen-
tric movements and contribute to balanced occlusion. Hence,
occlusal plane is a controlling factor. The relationship of this
plane with the articular eminence will affect the height of the
tubercles (Figs. 8.55 and 8.56). The occlusal plane is a tem-
porary relationship modified with the mediolateral (Wilson)
and anteroposterior (Spee) compensating curves, which is
obtained while determining the vertical dimension, and the
centric relation. The occlusal plane is formed temporarily
with wax using a retromolar pad and the edges of the patient’s
mouth. The orientation of the occlusal plane is fixed after the
proper positioning of the incisors (such that an esthetically
pleasing appearance is obtained) and the positioning of the
occlusal plane’s ending point at the level of the retromolar
triangle. Within the limits of the denture, the anterior and
posterior sides of the plane of occlusion have the beginning
and ending points. As described before, the plane begins at
the incisal edges of the incisors (the plane may pass through
either the lower or upper teeth, which is considered inconse-
quential). When determining the anterior limit of the plane of
occlusion, it is necessary to consider the proper esthetic
appearance and positioning of the incisors, although this
plane is modified by patient factors and other articulation
factors. The extension of the modifications is dependent on
38° 28°
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 327

With the face-bow transfer, which is used to attach the maxil-

45º
lary model to the articulator, the transfer process can result in
a model that is positioned too high or too low. When the face-­
bow transfer is used, any elevation that may occur on the
model will not change the condylar relation of the model. In
fact, if the distance between the crests is suitable, the level of
45º inclination of the orientation plane could be changed and
adjusted without affecting the incisal and condylar path
inclinations; however, this level of inclination will be associ-
ated with the tubercle inclination.According to Sharry, the
initial shape of the orientation plane could be changed as
necessary according to its intended purpose (Fig.  8.57). In
other words, the initial shape of the plane is temporary and
15º
could be modified when shaping the compensating curve.
According to Boucher, an occlusal plane that is located
60º
45º above or below relative to the crests may lead to both esthetic
and mechanical problems. If the soft tissues around the den-
ture fulfill the same role they did with natural teeth, the
25º occlusal plane should be positioned in the same way it was
with natural teeth. In this case, wax rims, which are used to
ensure that the incisors are placed in esthetically suitable
positions, will be adjusted accordingly. This will allow the
guidance point on the frontal part of the orientation plane to
be identified. It is now necessary to identify the ending point
Fig. 8.55  The relationship of occlusal plane with the articular emi- on the rear section of the plane. To determine the ending
nence will affect the height of the tubercles point at the rear section of the orientation plane, the Camper
plane will be taken into account. The Camper plane is also
known as the “nasoauricular plane.” The Camper lines on
both sides of the face form the Camper plane. The Camper
OPb
line is also called the ala-tragus line. The line extends from
15° the wings of the center of the external auditory canal
HRP 45° 60°
(Fig. 8.58) and is generally used as a reference for the orien-

25° OPa

Fig. 8.56  The relationship of occlusal plane with the articular emi-
nence will affect the height of the tubercles

the other articulation control factors (i.e., incisal guidance,

condylar guidance, and the tubercle inclination of the artifi-
cial teeth). The inclination of the orientation plane is a factor
that is located between two or three control factors and which
must be adjusted according to these factors.Hanau described
the plane of orientation as an entirely geometric factor. The
occlusal plane passes through three dental points, which are
the incisal point of the central tooth and the highest points of
the mesiobuccal tubercles of the molar teeth. Hanau used this
plane to determine the direction of chewing surfaces on the Fig. 8.57  The orientation plane can be changed as necessary, accord-
gaps of the dentures and to define the compensating curve. ing to its intended purpose
328
Fig. 8.58  Guide planes
1 4. Simon’s orbital plane
tation of the occlusal plane. In certain definitions, the rear
end of the Camper line is described as passing through the
center of the tragus. It is nonetheless necessary to note that
this difference in definitions is not very important. Essentially,
the teeth will be adjusted and corrected until the patient is
satisfied with their esthetic appearance. After a satisfying
result is obtained, it is possible to see that the plane of occlu-
sion and the ala-tragus line are very close to one another. It
should be emphasized that, when reporting the esthetic
appearance of the teeth, this specifically refers to the upper
teeth. Following this, depending on the level of resorption in
the lower crest, the plane can be moved closer to the lower
crest by reducing the vertical dimension.According to
Augsburger (1953), the localization of the occlusal plane of
natural teeth is strongly correlated with certain morphologi-
cal characteristics identified in lateral cephalograms. Sloane
and Cook (1953), on the other hand, have oriented the plane
according to anatomical reference points. One of these ana-
tomical reference points is in the anterior nasal spine, while
the second one is the hamular notch. These authors have also
developed a device that projects the plane of orientation on
an edentulous maxillary model. Balanced occlusion is also
associated with the superior and inferior positions of the
molars and is influenced by the frontal section of the plane of
orientation.The level of the orientation plane can vary within
the distance between the crests, and balanced occlusion can
be achieved at any level. In other words, the location of the
plane of orientation is not important to ensure balance. For
this reason, Trapozzano even argues that this factor should
not be considered important. In the region of the molars, the
level of the plane of orientation is considered not only with
regard to esthetic appearance but also with regard to stability
and the prevention of tipping. The jaw to which the occlusion
plane is more distant will have greater leverage forces exerted
Y. K. Ozkan
1. Frankfort horizontal plane
2. Camper plane
3. Occlusal plane
on its denture, which will cause more tipping. As upper den-
tures have higher retention, it is generally the lower denture
that is affected by this situation. Thus, the plane of occlusion
must be brought closer to the lower crests in the molar region,
especially in cases with advanced bone atrophy.The inclina-
tion of the plane of occlusion affects denture stability. If the
plane is too low on the rear side or too high on the front side,
chewing pressures may cause the lower denture to become
displaced anteriorly. On the other hand, if the plane is too
high on the rear side or too low on the front side, chewing
pressures may cause the upper denture to become displaced
anteriorly.The latest research regarding the location of the
plane of occlusion is a study on the plane’s relationship with
papilla located on the inner side of the cheek where the
Stenon duct opens. In this study conducted on 407 individu-
als with natural teeth, the parotid papilla was identified as
being on average 3.8 mm higher than the plane of occlusion.
However, it certainly should not be expected that this papilla,
which is an anatomic feature, is located at an equal height
and level on both sides, and it should be noted that the loca-
tion of the papilla does not vary with race or gender. Other
researchers have identified this same distance as 4  mm. In
light of esthetic and functional considerations, the identifica-
tion and localization of the plane appear to ultimately depend
on the clinical decision of the dentist. Thus, in a manner
similar to the vertical dimension, there is also a “sixth sense”
involved with regard to the plane of occlusion and its loca-
tion.Some authors utilize the dorsum of the tongue as a refer-
ence for the orientation of the occlusal plane. A lower base
plate with wax rim is placed inside the patient’s mouth, and
the patient is asked to keep his/her tongue still. The upper
side of the wax rim and the dorsum of the tongue must be at
the same level. This approach may serve as a useful guide for
the orientation of the occlusal plane.A study has recently
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
been performed by Prof. Brian D. Monteith in South Africa
regarding the identification of the plane of occlusion. In his
study, Prof. Monteith argued that the assumption that the
occlusal plane must be parallel to the Camper plane—which
has been hold since even before the 1920s—is actually inac-
curate, showing the disagreements regarding the rear end of
the Camper plane as evidence for this. Prof. Monteith further
described that the use of cephalometric methods would allow
the location of the plane of occlusion to be identified with
exactitude. As such, the angle forming between the Frankfort
plane and the lines joining the nasion porion points (the
PoNANS angle) is equal to the angle between the Frankfort
plane and the occlusion plane.If the PoNANS angle is deter-
mined, then the inclination of the occlusion plane could be
easily identified. Although determining the inclination and
location of the occlusion plane based on the PoNANS angle
is more accurate, it is practically not easy or straightforward.
The reference points proposed by various researchers that
are generally used to determine the location of the orienta-
tion plane (chewing plane) are listed below:
Concerning the Anteroposterior Inclination
Broomell: The Camper plane, which is also known as the
ala-tragus line
Gillis: The line extending from the edge of the lip toward the
earlobe
Schlosser: The line extending from the base of the nose
toward the condyle
McCollum: The ear-eye plane, also called the axis-orbital
plane
Sears: The line parallel to the alveolar crest
Boucher: The line extending from the top of the lower canine
to the distal half of the retromolar pad
Concerning the Buccolingual Position
Pound: Teeth in their natural position
Sears: The top or lingual side of the alveolar crest
Bloc: The neutral part between the tongue and the cheek
With Respect to Height
Wright: The level of the dorsum of the tongue
Standard: 4 mm below the parotid duct
De Van: The midpoint of the distance between the lower and
upper crests
Pleasure: Depending on whether the upper or lower alveolar
crests are weaker, the point closer to the weaker side
Hardy: The height of the lower canine
Determining the location of the plane
The upper wax rim is first positioned frontally parallel to
the pupillary plane. While the patient’s mandible is in the rest-
ing position, the upper wax rim must be carried by the upper
lip. This method is, however, applicable only for normal cases;
329
it cannot be performed on patients with very long or short
upper lips. Following this, the upper wax rim will be adjusted
parallel to the Camper line using a fox ruler or similar tools,
and the vertical dimension will be determined. After the verti-
cal dimension is determined, it becomes possible to see that
the position of the lower wax rim approximately corresponds
to the middle or top of the retromolar pad. In other words, the
location of the plane of orientation will become evident by
itself. After the plane is identified, the plane’s location will be
further controlled using the various reference points listed
above that have been proposed by different researchers.
In cases where the plane of occlusion needs to be brought
closer to the mandible, the upper teeth will have a pendulous
appearance, with their acrylic portions being visible. In such
cases, attempts are made to remedy this problem using lon-
ger molars on the maxilla; however, the length of the teeth
may be esthetically inconvenient. On the other hand, bring-
ing the plane of occlusion closer to the maxilla will cause
the lower teeth to become more visible, and the increasing
leverage forces will make the lower denture to tip easily.
8.1.8.4 Compensating Curves (Spee and Wilson
Curves)
The compensating curve is the anteroposterior and lateral
inclination of the alignment of incisal edges and occlusal
surfaces in complete dentures, which serve to ensure bal-
anced occlusion. Compensating curve is a controlling factor
and is fully under the control of the dentist.
The Spee curve is an anteroposterior curve extending
from the top of the lower canine to the buccal tubercles of the
mandibular posterior teeth. The inclination of this curve is
determined by the diameter of the curve (Figs.  8.59 and
8.60). The Spee curve is the inclination of occlusal surfaces
in the anteroposterior direction and begins at the top of the
lower canines, passing through the frontal edge of the rami
by following the buccal tubercles of the premolars and
molars and ending in the frontal section of the condyle.
Posterior teeth placed on this line will continue to occlude
during protrusion (Fig. 8.61).
A certain level of compensation is necessary to meet the
requirements of bilateral balanced occlusion. For artificial
teeth, the extensions of the mediolateral and anteroposte-
rior inclinations will depend on condylar guidance, the
steepness of incisal guidance, and the height of the tubercle
inclination. In a patient with steep incisal and condylar
guidance, the dentist must select teeth with lower compen-
sating curves and high tubercle angles. To ensure balanced
occlusion, the compensating curve must be increased in
case the condylar path inclination is high. It is a valuable
factor since it allows the tubercle height to be adjusted
without changing the morphology of the teeth. To improve
the end guidance factors, the external axes of the tubercles
could be given an inclination and rendered longer or shorter.
If the teeth lack tubercles, a compensating curve could be
used to balance this.
330 Y. K. Ozkan

Figs. 8.59 and

8.60  Compensating curve

CURVE OF SPEE

a b

Fig. 8.61 (a–c) Posterior teeth emplaced on curve of Spee will continue to occlude during protrusion
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
For a properly balanced occlusion, the compensating
curve must be rendered compatible with the other factors, as
described in Thielemans’ formula:
Condylar path inclination - incisal path inclination
Orientation plane – compensating curve – tubercle height
Wilson Curve
The Wilson curve is also known as the transversal (fron-
tal) compensating curve (Fig. 8.62). Also called the medio-
lateral curve, it passes through the top of the buccal and
lingual tubercles on both sides. In the mandible, Wilson
curve is formed by the inward inclination of the posterior
teeth and is positioned lower relative to the lingual and
buccal tubercles; it also has a concave inclination in the
mandible. On the other hand, in the maxilla, it is formed
by the outward inclination of the posterior teeth and is
positioned higher relative to the lingual and buccal tuber-
cles, and its inclination in the maxilla is convex. Teeth
aligned on this curve will form a lateral balance
(Fig. 8.63a–c). The lingual tubercles of the lower teeth are
shorter than their buccal tubercles. If a plane parallel to the
frontal plane passes through the lower right and left sec-
ond molars, it will form a curve, which is known as the
Wilson curve. When the same right and left molars of the
WILSON CURVE
Fig. 8.62  The Wilson curve, transversal (frontal) compensating curve
331
mandible are considered as a single plane, the top of the
tubercles will form curves of different depths. Thus, there
is no single Wilson curve that encompasses the tubercle of
all molars although an average curve can be used. The
Wilson curve is used to support Monson’s conical theory.
When aligning teeth on complete dentures, it is important
to pay attention to this curve on the frontal side. Taking
this curve into account will not only allow a more balanced
occlusion to be achieved but will also provide optimal con-
ditions for occlusion.
Monson Curve
The Monson curve is described as the ideal curve for
occlusion. Taking this curve into consideration, molars
and incisors will be aligned such that the tubercles of the
molar and the incisal edges of the incisors are all in contact
within a 20 cm (8 in.) diameter sphere. The center of the
sphere is the glabella region. All tubercles and incisal
edges will thus be in contact with the 20  cm diameter
sphere centered at the glabella, allowing them to be aligned
in a compatible and cohesive manner. As described by
Monson, one part (or arc) of the sphere will form a Spee
curve. The corners of the Bonwill triangle will also be in
contact with this sphere.
Pleasure Curve
The pleasure curve, which has a helical appearance when
examined from the frontal plane, is convex on its upper side
and does not encompass the last molar teeth.
The pleasure curve is associated with the occlusal
planes of the premolars and the first and second molars.
The occlusal surfaces of the lower teeth are inclined
facially, while those of the upper teeth are inclined
lingually.
8.1.8.5 The Tubercle Inclination/Tubercle Angle
of Teeth
Tubercle height refers to the shortest distance between the
top and base of a tubercle or to the shortest distance between
the central fossa of a posterior tooth and the line joining the
tubercles of this tooth.
The tubercle angle is defined as follows:
1. When measured mesiodistally or buccolingually, the
angle between the tubercle’s inclination and the plane
separating the tubercle perpendicularly into two (which
also passes through the tip of the tubercle)
2. When measured mesiodistally or buccolingually, the
angle between the tubercle’s inclination and the plane
separating the tubercle perpendicularly into two
3. Half of the angle between the mesial and distal inclina-
tions or of the angle between the buccal and lingual tuber-
cle inclinations
4. The closest distance between the tip and the base of the
tubercle
332 Y. K. Ozkan

a b

WILSON CURVE

Fig. 8.63  Teeth aligned on Wilson curve will form a lateral balance

5. The closest distance between the deepest part of a tooth’s

central fossa and the line joining the tubercles of the tooth
Tubercle angle provides the angle between the full
occlusal surface of the tooth and its tubercle inclination.
When the distal side of a lower tooth is positioned
higher than its mesial side, the tubercle inclination can
be made even steeper. A similar approach could also be
followed for the buccal and lingual tubercles. It is also 20º
the angle obtained through the mesiodistal or buccolin-
gual measurement of the tubercle inclination and tuber- Tubercle
angle
cle plane (Fig. 8.64).
Effective Tubercle Inclination Angle
The effective tubercle inclination angle refers to the angle Fig. 8.64  Measurement of tubercle angle
formed between the average tubercle inclination and the hor-
izontal reference plane (Fig.  8.65). The effective tubercle angles of tilted teeth (effective tubercle angles can form
angle is the sum of the tubercle angle and the orientation compensating curves) (Fig. 8.66).
plane angle. To ensure balanced occlusion, teeth should be Although the dentist should first design the teeth accord-
aligned such that the tubercle inclinations would be parallel ing to the characteristics of the case, the chewing effective-
to the movement path of the mandible. For example, bal- ness of the patients, the level of repositioning in the alveolar
anced occlusion can be achieved by correcting the tubercle crests, and the stability of the denture, it should be remem-
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 333

Inclination 5º 25º bered that it is, ultimately, the inclination given to the teeth
during alignment that is the most important. When abraded
(in other words, non-anatomic) teeth are used during the
alignment of the teeth, the tubercles and terms relating to
tubercles are not taken into consideration. In such cases, bal-
ance is achieved by adjusting the other factors.
When teeth with 20° tubercle inclinations are used in a
case whose incisal and condylar path inclinations are 20°,
Effective the forward movement of the mandible will be compatible
tubercle
inclination with the tubercle inclinations, and the teeth will be able to
angle slide over one another, thus ensuring protrusive balance.
When artificial teeth are described using numerical degree
values (e.g., a 20° tooth), the number refers to the tubercle
Fig. 8.65  Effective tubercle inclination angle angle. This angle cannot be changed by the teeth alignment;
however, the angles between the tubercle inclinations and the
30º
horizontal plane may vary.
When teeth with tubercle angles of 20° are aligned on an
orientation plane that has a 5° angle with the horizontal
plane, the inclination of these teeth will be 25°. This angle is
30º called relative tubercle angle. The balance will be achieved if
10º
this angle is in harmony with the mandibular movement path
angle (Figs. 8.67 and 8.68). An increase in the inclination of
the orientation plane is associated with an increase in the
relative tubercle angle of all the molars. On the other hand, a
decrease in the inclination of the orientation plane is associ-
ated with a decrease in the relative tubercle angle of all the
molars.
If 20° artificial teeth are used in a case with a condylar
path inclination of 30°, it will be necessary to give a 10°
Fig. 8.66  To ensure balanced occlusion, teeth should be aligned such
that the tubercle inclinations would be parallel to the movement path of inclination to the orientation plane to ensure balance because
the mandible proper balancing requires that the relative tubercle angles are

40° a 40° b

5° Inclination 5° Inclination

25°
20° 20° 25°

10°
10°

Fig. 8.67 (a, b) When artificial teeth are described using numerical degree values (e.g., a 20° tooth), the number refers to the tubercle angle. This
angle cannot be changed by the teeth alignment. However, the angles between the tubercle inclinations and the horizontal plane may vary
334
10° 5° 10°
10° 15° 20°
EFFECTIVE TUBERCLE ANGLE REAL TUBERCLE ANGLE
Fig. 8.68  The effective tubercle angle is the total of the tubercle and
orientation plane angles
equal to the condylar path inclinations. Consequently, the
tubercle angle and the orientation plane angle are summed.
However, the individual tubercle angles of the teeth and the
inclination of the orientation plane differ from one another in
one important respect; the inclination of the orientation plane
is determined at the clinic based on certain data obtained
from the patient, while the teeth are aligned and given their
inclination (for balancing purposes) in the laboratory. Thus,
relative tubercle angles are prepared in a laboratory environ-
ment with efforts focusing on ensuring that they are compat-
ible with the movements of the mandible.
In cases where the condylar path inclination is 30° and the
incisal inclination is 10°, the value of the tubercle inclination
must be at the midpoint of the values for these two end con-
trol factors, that is, at 20°, which will allow the balance to be
achieved. Even so, in these cases, the tubercles’ angles
toward the anterior will need to be smaller (as the incisal
inclination is lower), while tubercle angles toward the poste-
rior will need to be larger (as the condylar inclination is
higher). In other words, the tubercles are under the influence
of the end control factors and must be compatible with
whichever one is closer. If the dentist uses 20° teeth in the
case in question, during the process of aligning the teeth, the
technician must slightly abrade those on the anterior side to
reduce their tubercle angles and at the same time give more
inclination to those on the posterior side to increase their
tubercle angles (Fig.  8.69). Thus, a curve will be obtained
after inclinations are given to the teeth with the intention of
ensuring that their relative tubercle angles are compatible
with the movement of the mandible. This curve is called the
compensating curve (Spee). In this context, high sagittal
condylar path inclinations will require higher effective tuber-
cle angles through the posterior side. To ensure this, the
molars should be given a higher inclination that, in turn, will
give even more depth to the compensating curve. The oppo-
site will occur when the condylar path inclination is low.
As the relative tubercle angle is the total of the tubercle
and compensating angles, the same result could be obtained
by increasing the Spee without changing the angle. In this
case, the Spee curve and the tubercle angles will be inversely
proportional; one will decrease when the other increases.
Y. K. Ozkan
15° 20° 25°
10°
40°
17.5° 25° 32.5°
10°
Fig. 8.69  The technician can change the effective tubercle angles
The incisal path inclination is directly proportional with
the tubercle angles on the anterior, while the condylar path
inclination is directly proportional with the tubercle angles
on the posterior. Relative tubercle angles must be parallel
with the movement path of the mandible. Thus, technicians
will incline the teeth when aligning them to ensure that the
relative tubercle angles and the movement path of the man-
dible are compatible with one another. To ensure this com-
patibility, it may be necessary for certain circumstances to
abrade the teeth slightly during alignment.
The tubercle angle of the teeth is closely related to the
condylar path inclination because the condylar path incli-
nation itself is directly associated with the movement path
of the mandible. In cases with very high condylar path
inclinations, the use of artificial teeth with similarly high
tubercle inclinations is recommended. Alternatively, teeth
with low tubercles, or even teeth without any tubercles,
could be used. Nonetheless, with such teeth, the Spee
curve must be set deeper. Based on the definition for rela-
tive tubercle angles, this factor is also associated with the
plane of orientation. Thus, an increase in the plane of ori-
entation is associated with an increase in the relative tuber-
cle angles.
It should be remembered that the tubercle inclinations
are under the effect of the end control factors: the inclina-
tion of a tubercle must be compatible with the inclination
of its nearest end control factor. Conversely, tubercle incli-
nations have an inverse relation with the Spee curve: in
cases where teeth with very high tubercle inclinations (i.e.,
teeth with high tubercles) are used, a shallower Spee curve
will be obtained. Then again, using teeth with lower tuber-
cles is associated with an increase in the inclination of the
Spee curve. Although tubercle inclinations and the Spee
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
curve have an inverse relation with one another, both of
them are directly proportional to the condylar path inclina-
tion. In cases that they have high condylar path inclina-
tions, both of the inclinations will also be high. Lower
condylar path inclinations will lead to lower levels for both
of these inclinations.
The tubercle height is also associated with the amount of
overbite; as such, tubercle heights are generally equal to the
amount of overbite. The amount of overbite is closely asso-
ciated with the Spee curve. The Spee curve should be
increased for cases with a high overbite since an overbite is
indicative of a high incisal path inclination. The incisal path
and the Spee curve are directly proportional factors.
Therefore, it is necessary to make the Spee curve deeper for
cases with high levels of overbite. Thus, by applying
Hanau’s laws of articulation and by ensuring contact
between opposing teeth during eccentric movements, it
becomes possible to obtain the desired bilateral balanced
articulation in complete dentures.
In both centric and eccentric movements, there should be
an equal level of contact between the opposing teeth. In
other words, pressure should be distributed equally between
both sides. Thus, excessive contact on one side, along with
limited contact on the opposing side, is an undesirable
situation.
Among the different articulation factors, the only factor
that is outside the dentist’s initiative and cannot be changed
is the condylar path inclination because as stated several
times earlier, this factor is an anatomic factor that cannot be
modified or altered by the dentist. The other factors, how-
ever, could be modified as necessary.
When the mandible moves forward, it will first move pos-
teriorly on a raising arc under the effect of the 30° condylar
path inclination and then start to move anteriorly under the
effect of the 10° incisal path inclination. While the mandible
moves forward through the midpoint of the anterior and pos-
terior determinants, the teeth will continue to remain in con-
tact owing to their 20° tubercle inclination. In addition to
this, the distance between the teeth will increase in front of
and behind this midpoint since the tubercle angles will need
to move 10° to the front side and 30° on the back side (i.e.,
the tubercles, which ensure the continuity of contact are the
distal inclinations of the upper teeth and the mesial inclina-
tions of the lower teeth).
How can the tubercle inclination angles of the teeth be
changed? The teeth can be aligned to be parallel to the plane.
It is also possible to change the axis of the teeth relative to
the occlusal plane. If the teeth are inclined by only 4°, the
relative tubercle angle on the side toward which the teeth
were inclined will be 25°, while the angle on the other side
will be 15° (Figs. 8.68 and 8.69).
The procedure of inclining the teeth to correct their tuber-
cle inclination angle should be performed by ensuring that
335
the teeth remain in contact, while the mandible performs
protrusive movements. For example, when the incisal and
condylar path inclinations are adjusted using this approach,
the effective tubercle angle of the distal inclination of the
upper teeth tubercles must be 10° for the premolars and 30°
for the second molars. If the average tubercle inclination of
the teeth is 20°, the teeth should be inclined such that the
tubercle angle of the first premolar is 10° and the tubercle
angle of the second molar is 30° (Fig. 8.68). If the top of all
the tubercles is in relation, a plane will not be determined;
instead, a curve will be identified that is suitable for the man-
dible movement that is determined by the incisal and condy-
lar path inclination angles. This arc will then be compensated.
Changes in the factors that determine the movement path of
the mandible will also lead to changes in the compensating
curve.
As the condylar guidance increases, the tubercle height
could be increased to ensure balanced occlusion. The den-
tist may select half or fully anatomic teeth. In complete
dentures that are prepared instead of partial dentures or
natural dentition, teeth will be selected by ensuring that
they are compatible with the tubercle heights of the oppos-
ing arch.
In all eccentric movements, the morphological character-
istics of all posterior teeth must be compatible with the teeth
in the opposing arch. Thus, the morphology of a tooth will be
affected by the surface it contacts on the opposing side and
teeth. The closer a tooth is to the temporomandibular joint,
the more the joint will be affected by the movements of that
tooth.
8.1.8.6 Occlusal Surfaces of Posterior Teeth
These teeth are affected by anterior and condylar guidance in
two ways:
• Factors affecting the vertical component (height)
• Factors affecting the horizontal component (width)
8.1.8.7 Vertical Factors Affecting the Occlusal
Morphology
The vertical factors of occlusal morphology include the con-
dylar guidance, the anterior guidance, the occlusal plane, the
Spee curve, and the lateral translation movement (Table 8.9).
The following factors affect the height and fossa depths of
the tubercles:
1. The anterior controlling factor of the mandibular move-
ment (e.g., anterior guidance)
2. The posterior controlling factor of the mandibular move-
ment (e.g., condylar guidance)
3. The proximity of the tubercles to these controlling
factors
336 Y. K. Ozkan

Table 8.9  Vertical factors of occlusal morphology

45°
Factor Situation Effect
Condylar Steep guidance High posterior
guidance tubercle
Anterior guidance Excessive vertical overlap High posterior
tubercle
Excessive horizontal Shallow posterior 45°
overlap tubercle
Occlusal plane More parallel according to Shallow posterior
condylar guidance tubercle
Spee curve Exessive inclination The most posterior
tubercle is short
Lateral Exessive movement Shallow posterior
translation tubercle
movement The movement of the Shallow posterior
rotating condyle is more tubercle
45°
superior
45°
Exessive immediate side Shallow posterior
45°
shift tubercle 45°

Posterior centric tubercles are generally prepared in a way

that they will be in contact in the intercuspal position and
become unoccluded in eccentric movements. They should be Fig. 8.70  To prevent premolars from discluding during protrusive
long enough to be in contact in the intercuspal position and movements, the tubercle inclinations should be less than 45°
to be out of contact during eccentric movements.
When the anterior and posterior controlling factors are the 60°
same (45°), they move away from the mandible reference
plane at a 45° angle. To prevent premolars from discluding
during protrusive movements, the tubercle inclinations
should be less than 45°. When both the anterior and posterior
controlling factors are 60°, the tubercle angles should be less 60°
than 60° to prevent the disclusion of the premolars during
protrusive movements (Figs. 8.70 and 8.71).
After the teeth are placed and aligned in accordance with
esthetic and phonetic considerations, the level of vertical and
horizontal overlap between the lower and upper anterior
teeth can be corrected. Greater vertical overlap and lower
horizontal overjet will both be associated with greater incisal
guidance. Hence, to provide balanced occlusion, it is neces-
60° 60°
sary to increase the tubercle height (Fig.  8.72). In case of
limited vertical overlap or excessive horizontal overjet, a
minimum tubercle height will be necessary to ensure bal- 60°
anced occlusion (Fig. 8.73). 60°
In the articulator, the first molar is approximately at the
same distance from the incisal and condylar guidance, which
are both end control factors. Thus, determining the tubercle
height necessary for ensuring balance in lateral and protru-
sive movements can be viewed as a mathematical or mechan- Fig. 8.71  When both the condylar and incisal guidance angles are
ical method. For example, when the incisal guidance is 10° equal and 60°, the tubercle angles should be less than 60° to prevent the
and the condylar guidance is 30°, the tubercle height neces- disclusion of the premolars during protrusive movements
sary for ensuring balanced occlusion in the first molar region
must be 20° because the degree for the first molar is mechan- to ensure balanced occlusion into a mathematical and
ically half of the total degrees for the end control factors mechanical problem (Fig. 8.66).
(10 + 30 = 40 ÷ 2 = 20°). This situation transforms the ques- Within the mouth, the condylar inclination covers a
tion of how the posterior teeth should be placed and aligned greater distance between the first molar teeth than the incisal
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
Steep cusp height
Deep
incisal
guidance
Fig. 8.72  Greater vertical overlap and lower horizontal overjet will
both be associated with greater incisal guidance
Shallow tubercle height
Shallow
incisal
guidance
Fig. 8.73  In case of limited vertical overlap or excessive horizontal
overjet, a minimum tubercle height will be necessary to ensure bal-
anced occlusion
guidance, since the incisal guidance does not have a guiding
pin, with the posterior teeth serving as its “guide” instead.
Hence, since the incisal guidance is closer to the teeth than
the condylar inclination, the incisal guidance in the mouth
will play the most significant mechanical role when deter-
mining how occlusion will take place in the posterior teeth.
8.1.8.8 The Effect of Mandibular Translation
Movement on Tubercle Height
The Bennett Movement
The Bennett movement refers to the lateral translation
movement performed by the mandible during lateral move-
ment. During lateral movements, one of the condyles will
perform an orbital movement, moving downward, forward,
337
3 2 1
321
3 21
Fig. 8.74  The morphology of the mandibular fossa’s medial wall
affects the amount of lateral translation movement
3 21
3
2 1 3
2
1
Fig. 8.75  Larger lateral translation movement will be associated with
shorter posterior tubercles
and inward in the process. Meanwhile, the condyle on the
opposing side will rotate around the axis of the mandibular
fossa. The temporomandibular ligament of the rotating con-
dyle is very firm, and its medial wall is positioned very
closely to the orbiting condyle. The extent of inward move-
ment performed by the condyle will be determined by two
factors, which are the morphology of the mandibular fossa’s
medial wall and the internal horizontal section of the tem-
poromandibular ligament (Fig. 8.74).
A larger lateral translation movement will be associated
with shorter posterior tubercles (Fig. 8.75).
338
Similarly, a higher lateral translation movement will also
be associated with shorter posterior tubercles. When a lateral
translation movement is performed early and suddenly, a shift-
ing motion will occur at the condyle fossa even before it per-
forms a translation movement. If this motion occurs together
with an eccentric movement, it is also called a progressive lat-
eral translation movement or a progressive side shift.
Horizontal Factors Affecting Occlusal Morphology
The horizontal factors of occlusal morphology include the
distance to the rotating condyle, the distance to the midsagit-
tal plane, the distance to the rotating condyle and midsagittal
plane, the effect of the mandibular translation movement, the
intercondylar distance, and the relationship between anterior
and posterior controlling factors (Table 8.10).
Distance to the Rotating Condyle
A greater distance between the teeth and the rotating con-
dyle is associated with an increase in the angle that develops
during lateroretrusive and medioretrusive movements.
During lateral movements, there will be contact on the work-
ing side between the inner inclinations of the buccal tuber-
cles of the upper teeth and the outer inclinations of the buccal
tubercles of the lower teeth. These contacts are called latero-
retrusive contacts. During such movements, there will be a
contact on the balancing side between the inner inclinations
of the buccal tubercles of the upper teeth and the inner incli-
nations of the buccal tubercles of the lower teeth. These con-
tacts are called medioretrusive contacts.
The Distance to the Midsagittal Plane
A greater distance between the teeth and the midsagittal
plane is associated with an increase in the angle that devel-
ops during lateroretrusive and medioretrusive movements.
Distance to the Rotating Condyle and Midsagittal Plane
For a tooth, a more anterior position on the dental arch is
associated with an increase in the angle that develops during
lateroretrusive and medioretrusive movements.
The Effect of the Mandibular Translation Movement
An increase in the level of lateral translation movement is
associated with an increase in the angle between the laterore-
trusive and medioretrusive paths formed by the centric tuber-
cle ridges.
Table 8.10  Horizontal factors of occlusal morphology
Factor Situation Effect
Distance from the Excessive The angle between the
rotating condyle distance laterotrusive and mediotrusive
paths is excessive
Distance from the Excessive The angle between the
midsaggital plane distance laterotrusive and mediotrusive
paths is excessive
Lateral translation Excessive The angle between the
movement movement laterotrusive and mediotrusive
paths is excessive
Intercondylar Excessive The angle between the
distance distance laterotrusive and mediotrusive
paths is small
Y. K. Ozkan
The Effect of the Anterolateral and Posterolateral
Translation Movement of the Rotating Condyle
Greater anterolateral movements by the rotating condyle
are associated with a smaller angle between the lateroretru-
sive and medioretrusive paths. Greater posterolateral move-
ments by the rotating condyle are associated with a larger
angle between the lateroretrusive and medioretrusive paths.
Intercondylar Distance
A larger intercondylar distance is associated with a smaller
angle between the lateroretrusive and medioretrusive paths.
8.1.8.9 The Relationship Between Anterior
and Posterior Controlling Factors
The occlusion of complete dentures is a subject that dentists
have focused on for many years. Researchers from the early
period of studies on the occlusion of complete dentures were
the first developers of different posterior teeth forms and
arrangements. In recent years, many modifications have been
performed on these original forms. What is interesting is that
although none of these occlusal templates have ever gained
universal acceptance and despite the very short-termed stud-
ies and data regarding these templates, numerous dentists
have nevertheless adopted them. Furthermore, due to the
large level of variation observed in the studies on humans, it
seems nearly impossible to provide definite evidence. The
dentist should thus choose the suitable occlusion types for
his/her patients based on his/her own clinical experiences
and judgment.
In complete dentures, maintaining a broad occlusal spec-
trum is important for the range of different patients
(Table 8.11). The position of a patient on the patient spec-
trum will affect the selection of the occlusal template
(Table 8.12). The anatomic, mechanical, physiological, and
esthetic limitations of the patient limit the template selection.
The evaluation of the anatomy and the condition of the oral
tissues are not sufficient in themselves to permit the proper
selection of the occlusal template. So far, we have described
in detail the characteristics of balanced occlusion. From this
point onward, we will describe the other concepts of occlu-
sion (Fig. 8.76).
Table 8.11  Spectrum of patients
Young Middle-aged Old
Healthy Average health Pure health
Fine ridges Resorbed but enough Pure ridges
ridge
Firm mocosa Some movable tissue Mobile tissues
areas
Well oral Average oral awareness Poor oral awareness
awareness
Good oral skills Average oral skills Poor oral skills
Interested in Average interest in Little interest in
esthetics esthetics esthetics
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation 339

Table 8.12  Occlusal spectrum

Semi-balanced Neutrocentric
Anatomic occlusion (balanced) occlusion Lingualized occlusion Non-anatomic occlusion
Advantages
1. Better esthetics 1. Providing cross arch 1. Simple technique, less sensitive
balance record
2. Easiness in penetration (less vertical 2. Reducing lateral forces 2. Reduced lateral forces
stress)
3. Denture stability in parafunctional 3. Increasing chewing 3. Simple adjustment
movements efficacy 4. Allows closure area
5. Good in Class II and III jaw
relationships
6. Good stability, forces are in the
center and neutralized
Disadvantages
1. Good records and transfer to the 1. Less chewing than 1. Less esthetic
articulator is necessary balanced occlusion
2. More lateral forces in the 2. More abrasion of teeth 2. Low penetration (increased
inclinations (more bone vertical forces on the ridge)
deformation)
3. Difficult to make adjustments 3. Increased lateral chewing
components

8.1.9.1 Monoplane Occlusion (Neutrocentric

Concept)
Jones first proposed monoplane occlusion in 1972. This con-
cept involves the use of non-anatomic teeth, along with sev-
eral conceptual modifications. In this type of occlusion, the
vertical overlap is not formed between the upper and lower
teeth. On the other hand, the level of horizontal overlap is
determined according to the relationship with the jaw. First,
the upper posterior teeth will be aligned, and the occlusal
plane will be arranged according to all necessary conditions
and requirements:

1. The occlusal plane will first be formed such that there

Fig. 8.76  Concepts of occlusion
8.1.9 Unbalanced Occlusion
Unbalanced occlusion is an occlusion concept held by those
who do not believe in the necessity of balanced occlusion dur-
ing chewing; who disregard the lateral movement of the man-
dible during chewing movement, or consider such movements
as having very limited effect; and who believe that the main jaw
movements performed by humans are chewing, opening, and
closing movements. Other names for this concept include
monoplane or neutrocentric occlusion (Table 8.12). Unbalanced
occlusion involves the use of non-­ anatomic teeth. Non-
anatomic teeth have been used ever since Gysi first developed
anatomic teeth. Sears is one of the leading examples of dentists
who have used unbalanced occlusion with non-anatomic teeth.
is equal distance between both the upper and lower
crests.
2. The occlusal plane should be parallel to the denture
base.
3. The positioning of the occlusal plane must correspond to
the junction of the upper and central parts of the retromo-
lar triangle.
During the arrangement of the upper and lower teeth, all
of the teeth except for the second molars are positioned such
that they are in full contact. The second upper molar will be,
at the same time, parallel to and 2  mm above the occlusal
plane. In other words, the second upper molar will be placed
outside of the occlusion. This is because in this type of
arrangement, it is mainly the first and second premolars and
the first molars that take part in chewing and the second
molars are placed solely for the purpose of filling the gap and
do not take part in their function.
340
Indications of Monoplane Occlusion (Neutrocentric
Concept)
1. Flat crests
2. Class II jaw relation
3. Class III jaw relation
4. Maxillofacial patients
5. Handicapped patients
6. Cross bite
7. Suspicious or non-ideal centric relation
In unbalanced occlusion, full and simultaneous contact on
the anterior and posterior sides, as well as the left and right
sides, is expected only in the centric position. Such contacts are
not necessary for eccentric positions. It is believed that applying
this type of occlusion allows chewing forces to be concentrated
on the center of the alveolar crests, thus enabling the denture
base plates to become better established on the underlying tis-
sue, which in turn increases the stability of the denture.
The molars are aligned at a mediolateral position relative
to the alveolar crests, such that they would not limit the func-
tion of the tongue. During the procedures for the preparation
of the denture, the patient will be asked to not bite with his/
her anterior teeth. Consequently, it will not be necessary to
determine and consider the incisal path inclination. The
molars will be abraded, and there will be no extensions (i.e.,
tubercles) above or below the occlusal plane. As biting will
not be performed with the posterior teeth and due to the lack
of tubercles, the horizontal condylar path inclination on the
articulator will be set to zero. As the teeth are aligned such
that they would not balance during eccentric movements, the
lateral condylar path inclination is also set to zero. In this
case, the condylar elements of the articulator will be deter-
mined only for the opening and closing movements.
To direct forces toward the center and to also reduce fric-
tional forces, the buccolingual width of the teeth will be
reduced. In addition to this, the number of teeth will be
reduced, and the second molars may not be placed. Thus,
during the preparation and completion of the denture, the
incisal inclination will be set to zero, the molars will be
aligned parallel to the denture base, and the number and
width of the teeth will be reduced.
The first and foremost objective is to prevent tissue destruc-
tion and maintain the integrity of the crests. Many dentists
believe that using a monoplane occlusion that is mesiodistally
and buccolingually flat allows more stable dentures to be pre-
pared. This occlusion approach involves the elimination of the
anteroposterior of the teeth and mediolateral inclinations and
the focusing of occlusal forces toward the posterior teeth. The
position of the occlusal plane must be determined with hori-
zontal condylar guidance. In accordance with the form of the
posterior teeth, the occlusal plane must also be flat.
The horizontal and lateral condylar guidance must be set
to zero. The force will be directed toward the center of the
Y. K. Ozkan
support, thereby reducing frictional forces. The buccolingual
dimensions of the teeth are narrowed. The number of teeth is
reduced to direct forces toward the molar-premolar region.
Placing and aligning teeth on the crest inclination at the sec-
ond molar region should be avoided.
Benefits:
• More freedom in occlusion during transitions from cen-
tric movements to eccentric movements
• Elimination of the inclined plane forces that cause the dis-
placement of the denture base during function
• No conflicts while the denture is in place
Advantages:
• Better adaptation in Class II and Class III malocclusions.
• Easier to use for cross bites.
• As the mandible is not locked in a single position, it pro-
vides the patient with a sensation of freedom.
• Whether CR occurs at a particular point or area is not
important.
• Aligning the occlusion is easier and more rapid.
• It is more advantageous for cases with residual crest
resorption.
Disadvantages:
• Non-anatomic teeth can only engage in two-dimensional
occlusion (length and width), while the mandible can,
owing to the structure of the condyles, move in three
dimensions.
• They cannot provide the vertical component of chewing
and nonfunctional movement. Thus, the shearing effect is
reduced.
• Bilateral and protrusive balance is not possible with an
entirely flat occlusion.
• If there are no escape routes on the occlusal surfaces, the
flat teeth will not be able to function effectively.
• They cannot be corrected through occlusal abrasion with-
out also negatively affecting their activity.
• They appear uniform and artificial and may lead to physi-
ological problems.
With this occlusion concept, there is no need to eliminate
deflective occlusal contacts associated with lateral and pro-
trusive movements.
8.1.10 Linear Occlusion
The Glossary of Prosthodontic Terms defines linear occlu-
sion as “the occlusal arrangement of artificial teeth, as
viewed in the horizontal plane, wherein the masticatory sur-
faces of the mandibular posterior artificial teeth have a
straight, long, narrow occlusal form, resembling that of a
line, usually articulating with opposing monoplane teeth.”
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
The reasons why linear occlusion is an interesting method
are its simplicity, its successful implementation in practice,
and its ability to combine the chewing mechanism with lin-
ear stability. Linear occlusion ensures the stability of the
denture base plates during the function. In other words, it
increases denture stability by reducing the lateral forces act-
ing on it. Previous studies conducted on patients with severe
ridge resorption have demonstrated that complete dentures
with linear occlusion were more stable than complete den-
tures with anatomic occlusion and that linear occlusion was
also associated with less bone resorption. In addition to this,
there are studies that have also demonstrated that, during
lateral movements, complete dentures with anatomic occlu-
sion lead to a greater accumulation of stress in the mucosa
of the working side, while complete dentures with linear
occlusion ensure a more balanced distribution of stress
forces.
In complete dentures, occlusion is limited to three-­
dimensional (tubercled) and two-dimensional (flat/non-­
tubercled) occlusion. On the other hand, linear occlusion
enables the full geometric limitation of the occlusion, thus
allowing a one-dimensional occlusal design to be obtained.
This type of occlusion, which effectively eliminates pros-
thetic problems, is a valuable tool for clinicians.
In linear occlusion, the posterior teeth must have horizon-
tal overlap, but no vertical overlap. Bilateral contacts are
required to prevent any right, left, and protrusive conflicts;
ensuring protrusive balance is also necessary. All of the
lower teeth must be prepared and aligned on an occlusal
plane. The anterior level of the occlusal plane must be at the
level of the anterior teeth, while the posterior level of the
occlusal plane must be approximately at the highest level of
the retromolar pad. The occlusal surfaces of the lower poste-
rior teeth must be more or less at the same level. Thus, the
lingual tubercles of the first and second molars will be at the
same level as their buccal knife edge-shaped tubercles. This,
however, will not be applicable for the premolar occlusal
surfaces since the premolars have been designed more for
cutting food rather than crushing it. Hence, the occlusal sur-
faces of the premolars are not expected to participate in the
crushing processes to the same extent as the occlusal sur-
faces of the molars.
Fig. 8.77  Mortar and pestle
principle in lingualized
occlusion
341
The upper posterior teeth are placed at the level of the
occlusal plane. The teeth should be aligned such that the knife
edge-shaped buccal tubercles of the lower teeth will corre-
spond and contact with the central fossa of the upper teeth.
8.1.11 Lingualized Occlusion
The subject of ideal teeth alignment has been studied for a
long time with the objective of maximizing denture stability,
comfort, esthetic appearance, and function. Among the
various types of occlusal plane relations that have been
­
described to date, lingualized occlusion is one of the most
popular. Lingualized occlusion is suitable for cases with high
levels of incompatibility between the anteroposterior and
buccolingual crests, for cases in which denture stabilization
is difficult, and for cases with very severe resorption in the
alveolar crests of the mandible.
The concept of lingualized occlusion was first defined by
the Swiss researcher Dr. Alfred Gysi in 1927. At the begin-
ning of the 1900s, Gysi had reported crest incompatibility in
approximately 60% of his patients due to the resorption of
alveolar crests, and in 1927 he developed the concept of lin-
gualized occlusion along with “cross bite posterior” teeth. In
cross bite posterior teeth, posterior maxillary teeth with sin-
gle, linear tubercles are in contact with posterior mandibular
teeth with shallow fossa. Following this, French in 1935
obtained the patent for the “modified posterior” teeth he
developed. In the modified posterior teeth, the upper posterior
teeth have shallow fossa, while the lower posterior teeth have
narrow and flat occlusal surfaces. Although these posterior
teeth developed by Gysi and French allowed the vertical
transmission of forces through a “mortar and pestle” relation-
ship while also providing an acceptable esthetic appearance,
these teeth were only used for a limited period. Nevertheless,
this all changed when, in 1941, S. Howard Payne reported the
reshaping of Farmer’s posterior teeth (with 30° tubercle incli-
nations) in accordance with the concept of lingualized occlu-
sion and described that this new design was capable of
meeting the needs of edentulous patients. Payne had abraded
posterior teeth with 30° tubercle inclinations to create a mor-
tar and pestle relationship (Fig. 8.77).
342
In eccentric movements, the maxillary palatal tubercles
continue their contact with mandibular teeth, while no con-
tact takes place between the maxillary buccal tubercles and
the mandibular teeth. In the following years, Pound contin-
ued to advocate the concept of lingualized occlusion while
also performing certain changes in the teeth and matching
process he used. Different from Payne, he used posterior
mandibular teeth with 20° tubercle inclinations, in addition
to the posterior maxillary teeth with 30° tubercle inclina-
tions. Also, to eliminate the maxillary buccal tubercle con-
tact, he abraded and reduced the size of the buccal tubercles
of posterior mandibular teeth rather than positioning the buc-
cal tubercles at a higher position.
The concept of lingualized occlusion essentially involves
the contact of posterior maxillary teeth that have pronounced
lingual tubercles with posterior mandibular teeth that have
shallow central fossae (Fig.  8.78). It is believed that this
approach enables the adaptation of different types of crests,
increases chewing effectiveness, eliminates the conflicts that
occur between the teeth during lateral movements, and
ensures tubercle relationships without involving unbalanced
occlusion. In this type of denture occlusion, the lingual
tubercles of the maxillary teeth are related to the occlusal
surfaces of the mandibular teeth during all movements of the
mandible, on both the working and balancing sides
(Figs. 8.79, 8.80, 8.81, 8.82, and 8.83). Lingualized occlu-
sion was initially developed for the occlusion of complete
Fig. 8.78  The use of mandibular posterior teeth that have shallow cen-
tral fossae for lingualized occlusion
B B
Fig. 8.79  In lingualized occlusion, the buccal tubercles of the poste-
rior maxillary teeth are aligned at a level approximately 1 mm above the
occlusal plane
Y. K. Ozkan
dentures; however, as chewing forces in lingualized occlu-
sion are transmitted vertically to the alveolar crests, this type
of occlusion is suitable for all kinds of fixed and removable
dentures.
Initially, teeth with different characteristics were used in
combination at the maxillary and mandibular arches for
ensuring lingualized occlusion. Even so, none of these teeth
were developed or designed specifically for lingualized
occlusion. In recent years, various manufacturing companies
have begun to produce teeth developed specifically and
exclusively for lingualized occlusion.
In lingualized occlusion, the buccal tubercles of the pos-
terior maxillary teeth are aligned at a level approximately
1 mm above the occlusal plane (Fig. 8.79). Thus, the poste-
rior maxillary teeth do not assume a functional role in lin-
gualized occlusion. This alignment has the advantage of
providing an esthetically better appearance and to increase
the distance between the cheek and the occlusal plane by
pushing the cheek outward, thereby decreasing the patient’s
chance of biting the cheek. The popularity of lingualized
occlusion stems from its simplicity applicable and its wide-
spread clinical use.
In this concept, posterior maxillary teeth with pronounced
lingual tubercles and posterior mandibular teeth with shal-
low central fossae are used. These teeth and an alignment
performed in accordance with this concept are believed to
provide the following benefits:
• Enables the adaptation of different types of crests
• Increases chewing effectiveness
• Eliminates the conflicts that occur between the teeth dur-
ing lateral movements
• Ensures tubercle relations without involving unbalanced
occlusion
Basic principles of lingualized occlusion are as follows:
(a) The maxillary lingual tubercles are arranged sitting on
the fossa of the mandibular posterior teeth at the centric
position contacts.
(b) Teeth with flat planes and shallow tubercles are used in
the mandible as opposed to anatomic teeth in the
maxilla.
(c) Anterior overbite is not created to enhance the esthetics
and to ensure the eccentric contacts.
(d) There is a contact on both the working side and the bal-
ancing side of the denture in eccentric movements.
(e) During the posterior tooth arrangement, a number of
procedures, such as condylar guidance, occlusal plane
angle of incisal guidance, and the inclination of the
tubercle and the compensating curves, are performed,
and these procedures are involved in ensuring such
contacts.
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
Figs. 8.80–8.83  In lingualized occlusion, the lingual tubercles of the maxillary teeth are related to the occlusal surfaces of the mandibular teeth
during all movements of the mandible and on both the working and balancing sides
Occlusion, laterotrusion, and protrusion (all excursive
movements) should be checked with articulating paper in
each stage of tooth arrangement.
The following factors are considered in the arrangement
of lower posterior teeth:
• Lower posterior teeth are placed on the crest of the alveo-
lar ridge.
• The central grooves are located on the line joining the
canine apex and the retromolar triangle.
• The buccal tubercles are located tangentially to the
Bonwill circle extending from the buccal margin of the
first premolar to the buccal margin of the retromolar pad.
• The lingual tubercles are located on Pound’s line.
• The lingual tubercles are inclined lingually (the crown
inclination increases toward the distal).
The following factors are considered in the arrangement
of upper posterior teeth:
• Upper posterior teeth are placed on the crest of the alveo-
lar ridge.
• The central grooves are located on the elliptical line join-
ing the apex of the canines and the maxillary tuber.
343
Working
side
contacts
Balancing
side
contacts
• On the front view, the buccal surface decreases as it
advances from the first premolar toward the second molar,
thus creating the buccal corridor.
• They are inclined buccally.
The two first premolars are set according to the mandible.
The buccal tubercles must be in contact with the occlusal
plane. The lower first molar must be set on the deepest point
of the alveolar crest in consideration of the sagittal and trans-
versal compensating curve. The buccal tubercles are located
approximately 2 mm below the occlusal plane and are dis-
tally elevated. The lower second molars are set in the space
between the first premolar and the first molar and are
1–1.5 mm below the occlusal plane.
The upper first molar is brought into the optimal intercus-
pation. The upper second premolars are set in their proper
places. If there is sufficient space, the 4-second molars are
placed into their respective places. The distobuccal tubercles
of the final molars contact the occlusal plane in the mandible.
This may be performed with the premolars in case of very
limited space.
Anatomic posterior teeth with specific lingual tubercles
and an angle of 30–33° are used for the upper denture,
whereas non-anatomic or semi-anatomic teeth are used for
344
a b
c d
Fig. 8.84  Lingualized occlusion. (a) The appearance of buccal sur-
face, (b) the appearance of lingual surface, and (c, d) the buccal tuber-
cle of the lower first premolar should be set on the mesial fossa of the
the lower denture. The purpose of moving the upper poste-
rior teeth with a specific tubercle height within the fossa of
the lower posterior teeth with a shallower tubercle inclina-
tion is to achieve the “mortar and pestle” effect. Thereby, the
masticatory forces are transmitted perpendicularly to the
alveolar crest (Fig. 8.77).
These teeth should be arranged in a way that only a single
contact point should be created for each tooth: the buccal
tubercle of the lower first premolar should be set on the
mesial fossa of the upper first premolar. Furthermore, the lin-
gual tubercles of the upper teeth must be in contact with the
central fossa of the lower teeth for all other teeth
(Fig. 8.84a–d).
Where necessary, the setting may be performed in a way
that there is a slight concavity on the occlusal surfaces of the
lower posterior teeth. If the mandibular crest is severely
resorbed, the occlusal planes of the posterior teeth may be
narrowed.
Y. K. Ozkan
upper first premolar. Furthermore, the lingual tubercles of the upper
teeth must be in contact with the central fossa of the lower teeth for all
other teeth
For CO, the lingual tubercles of the upper posterior teeth
are in contact with the central fossa of the lower posterior
teeth; however, the buccal tubercles of the upper posterior
teeth should not be in contact with the lower posterior teeth.
To achieve this, the upper posterior teeth should be arranged
slightly inclined buccally. Where necessary, a slight abrasion
may be performed from the inclination of the buccal tuber-
cles of the lower posterior teeth. Setting the upper posterior
teeth as inclined to the buccal will eliminate the risk of cheek
bite during chewing for the patient. It will also contribute to
the esthetic appearance. These contacts are also provided for
the lateral movements created during chewing; however, care
should be taken not to create a contact in the buccal tubercles
of the upper posterior teeth. Balance is provided with the
lingual tubercles of the upper molars while executing lateral
movements, whereas the premolars on both the working side
and the balancing side move by sliding within the bowl-­
shaped fossae of the lower teeth. Positioning the occlusal
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
forces lingually and pushing toward the center of the lower
teeth will reduce the lateral movements of the lower denture,
contributing to denture stabilization.
During protrusive movement, contact should also be cre-
ated between only the maxillary lingual tubercles and the
mandibular teeth. In case of forward and backward move-
ments, the lingual tubercles of the upper second premolar
and molar teeth remain in contact with the bowl-shaped
fossae of the lower teeth. The buccal tubercle of the lower
first premolar remains in contact with the bowl-shaped
fossa of the upper first premolar. The abrasions occur only
from the mandibular teeth for protrusive movements;
thereby, the lateral balancing contacts and the vertical size
remain unchanged. Turning the right and left second molars
slightly toward the front results in a more perpendicular
angle in the central fossa on the distal side. Therefore, bal-
ance is created for the forward movement, as well as
between the angles of the anterior teeth and the second
molars during articulation.
Advantages of Lingualized Occlusion
The tooth arrangement used in the lingualized occlusion
provides the cross arch balance. Since the masticatory forces
are created more slightly on the lingual side in the mandibu-
lar denture, this will contribute to the stabilization of the
mandibular denture. This feature of the lingualized occlusion
is highly advantageous for patients with a severely resorbed
alveolar crest or with a difference in length between the alve-
olar crests. The improved stabilization of the mandibular
denture positively affects the patient comfort.
Disabling the tips of the mandibular tubercle and shorter
buccal tubercles of the maxillary posterior teeth compared
with the lingual tubercles minimize the lateral forces that
impair denture stabilization and cause destructive effects on
the alveolar crest. This is because the single point of contact
of the mandibular posterior teeth in a tooth arrangement pre-
pared according to the lingualized occlusion is the palatal
tubercles of the maxillary posterior teeth.
The occlusal contacts on the posterior teeth are created in
a more limited area, and this makes the force distribution
more balanced. In addition to the balanced force distribution,
the mortar and pestle relationship between the upper and the
lower posterior teeth minimizes the lateral forces and also
allows for vertical forces produced during chewing to be
generated at the center of the mandibular teeth. Thereby, the
vertical forces applied are transmitted directly to the man-
dibular crest. The vertical forces produced during chewing
are very advantageous for denture stability and the mainte-
nance of both hard and soft tissue support.
The mortar and pestle relation among the posterior teeth
improved chewing efficacy due to the increased food pene-
tration. A denture that is prepared according to the ­lingualized
occlusion principles will improve patient satisfaction through
improved denture stabilization.
345
It is much easier to arrange the teeth according to the lin-
gualized occlusion principles in the laboratory stage. Setting
the maxillary buccal tubercles with no contact with the man-
dibular teeth for the centric and eccentric movements allows
for ease of application for the centric and eccentric move-
ments and also provides a great advantage for both the labo-
ratory technician and the physician.
There are currently artificial tooth sets that are specially
shaped for lingualized occlusion; however, almost all of the
artificial teeth of anatomic nature may be used if modified
through selective grinding. Using the maxillary anatomic
teeth that are modified to comply with lingualized occlusion
will positively affect the esthetics and improve the patient
satisfaction.
Lingualized Occlusion-Jaw Relationships
For Class I Jaw Relationship
The anterior teeth are arranged based on routine esthetic
and phonetic guidance. The maxillary teeth are set more labi-
ally than the mandibular teeth with the distal edge of the
maxillary canine slightly posterior to the mandibular canine.
To the extent allowed by the esthetic and phonetic require-
ments, the aim is to minimize the incisor path inclination,
and thereby the inclination and the tubercle heights of the
posterior teeth are kept at a minimum to create a balanced
occlusion on the posterior teeth.
After the arrangement of anterior teeth, the mandibular
posterior teeth are arranged in accordance with the estab-
lished principles. The height of the lower anterior teeth is
established according to esthetics and phonetics, and the
occlusal plane is determined based on the localization of the
retromolar triangle. The lingual tubercles of the mandibular
posterior teeth should remain within the triangle created
between the distal segment of the mandibular canine and the
buccal and lingual surfaces of the retromolar triangle. A
guide plane of 20° may be used in such a way that the antero-
posterior and mediolateral compensating curves are
shallow.
While setting the maxillary posterior teeth that will create
lingualized occlusion, the maxillary posterior teeth with spe-
cific lingual tubercles are slightly set to the buccal side of the
mandibular teeth. Thereby, the maxillary posterior teeth are
set more slightly to the buccal side of the alveolar crest where
bone support is strong. The resorption in the mandibular
crest is from inside toward outside, and the mandibular pos-
terior teeth must be precisely set on the ridge of the crest.
The posterior tooth arrangement in accordance with the man-
dibular canine tooth and retromolar triangle guidance will
fully provide this desired feature.
The buccal tubercles of the maxillary posterior teeth are
elevated in such a manner that will be above the occlusal
plane and become increased toward the posterior. For the
Class I jaw relationship, the buccal tubercle of the maxillary
first molar tooth is located to correspond to the fossa between
346
the mesiobuccal and distobuccal tubercles of the mandibular
first molar, as in a typical Class I relationship.
For the balanced lingualized occlusion, the balance
should be created in the opposite arch for all eccentric
movements. After finishing a denture prepared in lingual-
ized occlusion, it should be primarily determined if the
maxillary buccal tubercles have a contact in any position
at the first control of the mouth. If there is any, such con-
tact should be removed by abrading the inclination of the
buccal tubercles. All abrasions required afterward should
be performed only from the mandibular teeth with no con-
tact with the lingual tubercles of the maxillary posterior
teeth.
For Class II Jaw Relationship
For a Class II jaw relationship, the mandible is smaller
than the maxilla or located more backward in these patients.
The maxilla is generally “V”-shaped, and the palatine vault
is deep; the anterior teeth are crowded. The mandibular inci-
sors are elevated. There is a significant horizontal and verti-
cal overlap between the anterior teeth. After tooth loss, there
is a significant loss in the alveolar crest and a severe reduc-
tion in the occlusal vertical size of the patients. For the indi-
viduals with a Class II jaw relationship, first, the maxillary
and the mandibular anterior teeth are set according to the
established principles. Due to the excessive overlap in the
anterior teeth, a slight overlap is created to the extent that
will not produce overturning forces in the anterior region
during the protrusive movements to achieve the esthetics.
The incisor path inclination should be adjusted in such a way
that will not exceed 20°. If the balanced lingualized occlu-
sion is planned on the posterior teeth, the incisor path incli-
nation should not be reduced to 0° due to the esthetic and
phonetic requirements. When a positive guidance angle that
is no more than 20° is required, it will not be possible to
achieve a proper balance without creating an extreme com-
pensating curve at the posterior. An unbalanced lingualized
occlusion should be created if the incisor path inclination is
adjusted to 0°.
The mandibular posterior teeth should be set before the
maxillary posterior teeth. The mandibular first premolar
tooth is removed to compensate for the posterior position of
the mandible. Finally, the maxillary posterior teeth are set.
With the exclusion of the mandibular first premolar tooth, a
tooth arrangement that is close to the normal Class I jaw rela-
tionship is provided. To facilitate the protrusive balance,
mesiodistal abrasion may be required from the fossa of the
mandibular posterior teeth, as is the case in Class I patients.
Such abrasion may be required in higher amounts in Class II
patients for whom the horizontal distance between the CR
and the habitual functional area is longer.
Y. K. Ozkan
For a Class III Jaw Relationship
In this relationship, the mandible is greater than the max-
illa, and the mandibular anterior alveolar crest is at the same
level with the maxillary anterior crest or may be located more
anteriorly. Due to this anatomic relationship, the mandibular
anterior teeth are set on an edge-to-edge position with the
maxillary anterior teeth or more slightly to the labial side.
Because of this setting, there is an incorrect positioning in the
canine relation. To minimize this error and the complications
that may occur in the occlusion at the posterior; the maxillary
teeth may be inclined slightly to the palatine; large and short
mandibular anterior teeth may be used, or diastema may be
created at the distal of the mandibular canine. One of the pos-
terior maxillary teeth may be removed to eliminate the incom-
patibility in the mandibular and maxillary posterior arch
length.
Although the bilateral balanced occlusion and the lingual-
ized occlusion applied in complete dentures have superiori-
ties over each other, the most important common point of
both concepts is the balance determination and good chew-
ing efficacy. This means that there are no big differences in
terms of the patient satisfaction. When the previous studies
are reviewed, it is seen that both concepts are parallel but
superior to other concepts.
The study by Rehmann et al. evaluated the effect of the
complete dentures prepared with different occlusal con-
cepts on patient satisfaction after the first application. In
their study, one maxillary denture and two mandibular den-
tures with bilateral balanced occlusion and canine-protec-
tive occlusion were applied to 32 patients. The patients
used the mandibular dentures by changing them every day
for the first 2 weeks. At the end of week 2, satisfaction tests
were administered to the patients, and the occlusion types
of the mandibular dentures were interchanged. The patients
used the dentures in this manner for 2 weeks. The satisfac-
tion tests were administered again by the end of week 4.
The satisfaction tests revealed that the patients were more
satisfied with the dentures that had bilateral balanced
occlusion.
Kimoto et al. prepared 14 complete dentures with lingual-
ized occlusion and 14 complete dentures with bilateral bal-
anced occlusion for 28 patients in their study. The subjective
data (i.e., general satisfaction, chewing capacity, stabiliza-
tion, and denture attachment) and the objective data (i.e.,
chewing performance and number of adaptation) of the
patients were evaluated. There was no difference in general
between the groups, and no positive correlation was found
between the alveolar crest and the chewing performance.
The satisfaction was higher regarding the denture retention
in the patients who had complete dentures with lingualized
8  Movements and Mechanics of Mandible Occlusion Concepts and Laws of Articulation
occlusion. It was observed that the denture retention was
higher as the alveolar crest height increased.
Sutton et al. prepared three sets of (45) dentures with lin-
gualized, monoplane, and bilateral balanced occlusion for 15
patients in their study. At the end of the study, the patients
who had dentures prepared with the lingualized and ana-
tomic teeth were more satisfied compared to those with
monoplane occlusion.
Clough et  al. prepared two sets of dentures with mono-
plane and lingualized occlusion for 15 patients in their study
and had the patients use these dentures, each for 3 weeks.
Twenty of the patients preferred using the denture with the
lingualized occlusion.
The concepts reported in this section will be discussed in
detail in the posterior tooth arrangement section with shapes
and tooth arrangement application.
All things considered, the adjustment of occlusion is a
critical technical step in preparing complete dentures.
Occlusion is closely related to the distribution of applied
forces and the retention and stabilization of the denture.
Despite the biomechanical significance of occlusion, techni-
cally good preparation of the denture has a minor effect on the
success of the treatment. Physiological factors have a greater
effect on patient satisfaction compared to prosthetic factors.
Therefore, the success of the dental treatment is not simply
based on the physical state of the oral cavity. Furthermore,
knowing the patient’s extensive medical and psychological
condition and identifying the patient needs and expectations
are very effective for successful treatment. The role of the
dentist is to help the patient to adjust to the denture through
giving the impression that the dentures used are natural
dentition.
347
Further Reading
1. Bosman F, Erkelens CJ. Computer simulation of mandibular move-
ments. J Biomech. 1985;18:528–9.
2. Chen DC, Lai YL, Chi LY, Lee SY. Contributing factors of man-
dibular deformation during mouth opening. J Dent. 2000;28:583–8.
3. Clough HE, Knodle JM, Leeper SH, Pudwill ML, Taylor DT.  A
comparison of lingualized occlusion and monoplane occlusion in
complete dentures. J Prosthet Dent. 1983;50:176–9.
4. Gordon SR, Stoffer WM, Connor SA.  Location of the terminal
hinge axis and its effect on the second molar cusp positioning. J
Prosthet Dent. 1984;52:99–105.
5. Keshvad A, Winstanley RB. Comparison of the replicability or rou-
tinely used centric relation registration techniques. J Prosthodont.
2003;12:90–101.
6. Kinderknecht KE, Wong GK, Billy EJ, Li SH.  The effect of a
deprogrammer on the position of the terminal transverse horizontal
axis of the mandible. J Prosthet Dent. 1992;68:123–31.
7. Koolstra JH, van Eijden TMGJ. The jaw open-close movements pre-
dicted by biomechanical modelling. J Biomech. 1997;30:943–50.
8. BR L. Complete denture occlusion. Dent Clin N Am. 2004;3:641–65.
9. Nimmo A, Kratochvil FJ.  Balancing ramps in nonanatomic com-
plete denture occlusion. J Prosthet Dent. 1985;53(3):431–3.
10. Parr GR, Loft GH. The occlusal spectrum and complete dentures.
Compend Contin Educ Dent. 1982;3:241–50.
11. Peck CC, Langenbach GEJ, Hannam AG. Dynamic simulation of
muscle and articular properties during human wide jaw opening.
Arch Oral Biol. 2000;45:963–82.
12. Rangarajan V, Gajapathi B, Yogesh PB, Ibrahim MM, Kumar RG,
Karthik M.  Concepts of occlusion in prosthodontics: a literature
review, part I. J Indian Prosthodont Soc. 2015;15:200–5.
13. Rangarajan V, Yogesh PB, Gajapathi B, Ibrahim MM, Kumar RG,
Karthik M.  Concepts of occlusion in prosthodontics: a literature
review, Part II. J Indian Prosthodont Soc. 2016;16:8–14.
14. Taylor TD, Wiens J, Carr A.  Evidence-based considerations for
removable and dental implant occlusion: a literature review. J
Prosthet Dent. 2005;94:555–60.
15. Zarb GA, Bolender CL, Hickey JC, Carlsson GE. Boucher’s prosth-
odontics treatment for edentulous patients. 10th ed. St. Louis: CV
Mosby; 1990. p. 330–51.