Sem - 9 ROTH PHLOSOPHY

ROTH
PHILOSOPHY
1
CONTENTS
 INTRODUCTION:
• ROTH AND GNATHOLOGY
 HISTORY:
• MOVING FROM STATIC TO DYNAMIC
 EVOLUTION OF CONCEPT OF FUNCTIONAL

OCCLUSION
• MUTUALLY PROTECTED OCCLUSION
• GROUP FUNCTION OCCLUSION
 NEUROMUSCULAR AVOIDANCE
MECHANISM: 2
 GNATHOLOGIC CONCEPT:
• CENTRIC RELATION: PRESENT AND
HISTORICAL PERSPECTIVE
• CENTRIC SLIDE: CONCEPT OF MOLAR
FULCRUM(ROTH)
• ROTH SET UP
• BRACKET PRESCRIPTION
• BRACKET POSITIONING
 CONCLUSION
 REFERENCES
3
 In 1968, R . H ROTH was
introduced to Dr. L.F. ANDREWS
of San Diego.
 Roth started using straight wire

appliance in his practice in 1970
when Andrews gave him the first
set of prototype brackets that
were welded into pinched band
material and had been machined
at great expense. .
 Many fixed appliances bear the name, and
‘THE ROTH PRESCRIPTION’ HAS BECOME
AN ORTHODONTIC HOUSEHOLD TERM.
 One of Roth’s CHIEF CONTRIBUTION was

his ever present insistence on FUNCTIONAL
DIAGNOSIS and correction of malocclusion
to a properly functioning occlusion.
 This included an almost passionate

insistence on harmonious functioning of
TMJ.
Kufinec. In Memoriam.Am J Ortho Dentofacial Ortho 5

THE ROTH Rx
 In 1979, Roth
introduced a bracket
setup containing
modifications of the tip,
torque, rotations and
in out movement of the
Andrews standard setup
brackets.
Ronald H. Roth
• The major difference between the Andrews
philosophy and the Roth approach to the use of
the straight wire appliance has to do with the
manner in which the teeth are moved and not
necessarily the desired end result or the result
attained.
 ANDREWS attempts to translate teeth throughout
treatment without ever tipping teeth. This leads to
the necessity of utilizing sliding mechanics and
number of different series of brackets to solve the
problem of translating teeth depending on how far
the teeth must be moved.
 In the ROTH approach, tipping of teeth is allowed,

by using round wires in the initial phase of the
treatment, but the attempt is to keep the tipping
to a minimum wherein it is not necessary to resort
to complex mechanics to do the uprighting.
8
 Andrews' occlusion study was based purely
upon anatomical measurements of tooth
positions on untreated normals.
 According to him teeth should be positioned
from an “ANATOMICAL STANDPOINT’”
 Roth’s occlusion study was based purely upon
pantographically recorded and mounted a
large number of post-treatment orthodontic
cases on the Stuart articulator
 According to him natural teeth should be
positioned from a “GNATHOLOGICAL
STANDPOINT”
ROTH AND GNATHOLOGY
 Born on 14 September, 1933
 Completed orthodontic training under Joseph

Jarabak – started private practice.
 Met criteria of successful orthodontic

treatment .

Why gnathology?
The techniques and The philosophy and

procedures being taught rationale for
by this group offered an treatment fit well with
occlusal scheme that some of his early
appeared to meet the research, and the
needs of the orthodontic results that they were
patient better than that able to achieve met
which he had learned the goals that he
during his training. sought.
11
 Early researchers in Gnathology such as Dr.
CHARLES STUART and PETER K. THOMAS helped Dr.
ROTH to better understand the principles upon
which the gnathic system functions.
 Dr. Ronald H. Roth and Dr. Thomas Basta, a

restorative dentist and Gnathologist in 1975 found
‘THE FOUNDATION FOR ADVANCED
CONTINUING DENTAL EDUCATION’ {FACE} in
Burlingame, California.
12
 Dr. RH Roth and Dr. Robert Williams(Roth’s student)
together founded ROTH WILLIAMS CENTER, a
clinic and training institution in Burlingame,
California – a 2 year continuum to learn how to
implement the concepts of functional occlusion into
their practice.
 Died on 24 jan,2005 – from an aggressive form of

cancer.

History
FR OM
STATIC T O
DY NA M IC
14
• LAWRENCE F. ANDREWS in 1972 complemented this
concept while evaluating the natural occlusion of 120
patients. He observed the presence of SIX COMMON
CHARACTERISTICS, which were denominated “SIX
KEYS TO NORMAL OCCLUSION”
1. INTERARCH RELATIONSHIP
2. CROWN ANGULATION
15
3. CROWN INCLINATION
4. ROTATIONS
5. TIGHT CONTACTS
Andrews LF. The keys to normal occlusion. Am J Orthod 16

6. CURVE OF SPEE:
 These SIX PARAMETERS

described by LF. Andrews
became the AIMS of
orthodontic treatment. But,
these therapeutic goals consist
of STATIC CHARACTERISTICS,
without considering
FUNCTIONAL ASPECTS of
occlusion.
17
 BEVERLY B. MC CULLUM : Father of Modern
Occlusion and Founder Of Gnathological Society:
 Introduced more DYNAMIC CONCEPT of occlusion.
 His concept of occlusion, along with that of Stallard,

Stuart, and Regenos – focussed on Cusp contact
during functional movement.
 Dynamic concept readily adopted by

Prosthodontists and Restorative dentists whose
challenge was to restore teeth to anatomic form.
18
 The concept provided practical guidelines for
building cusp height and placing grooves to
facilitate functional jaw movement without
functional interferences.
 Dynamic concept though has greater acceptance;

but the concept remains controversial.
Occlusion: An Orthodontic Perspective:Paul M. Kasrovi, Michael Meyer,

19
CUSP- FOSSA VS. CUSP EMBRASSURE
OCCLUSION:
 CHARLES STUART: stated mesial and distal limit
to a well functioning occlusion.
 Mesial limit: tooth to tooth
occlusion
 Distal limit: tooth to 2 teeth

occlusion
 HUFFMAN AND REGENOS: summarized the two

types of occlusion described by Stuart, referring to
them as ‘cusp fossa’ and ‘cusp embrassure’
occlusion.
Ronald R Roth. Functional Occlusion For The Orthodontist- Part- 20

CUSP FOSSA OCCLUSION:
 Each mandibular buccal cusp occludes into the fossa
of maxillary counterpart and each maxillary lingual
cusp occludes into the fossa of mandibular
counterpart.
 This occlusal scheme, which places the maxillary

teeth slightly mesial of Angle’s Class I
relationship, very effectively directs forces along the
long axis of teeth.

 Cusp fossa occlusion: an
arrangement that encourages:
1. Positional stability
2. Food impaction minimized since no cusp tips

strike opposing embrassures.
3. Less tendency for wear of cusp tips and occlusal

attrition.

 DISADVANTAGES:
1. If buccal segments of natural teeth

placed in cusp fossa arrangement, to
gain ANTERIOR COUPLING the maxillary
anterior teeth must be:
 tipped lingually:
 eliminates glide path and
 imparts a steep protrusive and

cuspid lift
 In either case the result is less than ideal
Gnathologically, and unsightly orthodontically.

CUSP EMBRASSURE
OCCLUSION:
 All teeth except mandibular central incisor and

maxillary third molar, have tooth to two teeth
contact.
 Each maxillary tooth is distal and facial to

mandibular counterpart.
25
 Excellent anterior guidance can be gained by
placing the posterior teeth in solid Class I
relationship of the buccal segments.
 Current orthodontic goals of incisor overlap and

overjet and of interincisal angle lead the
orthodontist to prefer cusp embrassure scheme as
the goal.
 This scheme provides for freedom of movement in

lateral and protrusive excursions with protective
cuspid and incisor function
ARGUMENTS AGAINST:
1. Plunger cusp to marginal ridge relationship:
 lower buccal cusp tips rest on only one opposing

marginal ridge.
2. Ability to hold centric without tripodization:
 In occlusal contacts of natural teeth there are

more than enough cusp-fossa relationships to
hold centric in Class I.

GOALS OF IDEAL DYNAMIC
OCCLUSION:
 From static occlusal standpoint, Stuart’s distal

limit(tooth to two teeth), also referred to as
Angle’s Class I occlusion, is the typical goal in
orthodontic treatment.
 Dynamic occlusion requires that the teeth

function during jaw movement free from
premature contacts and interferences.
 To achieve :
 Static tooth positions

 Condylar position upon closure into
28
 ROTH has demonstrated that if the orthodontist
is able to finish cases to :
ANDREW’S SIX KEYS + MAXIMUM

INTERCUSPATION WITH CONDYLES IN CR
STUART’S goal of ideal functional occlusion can be

achieved
29
EVOLUTION OF THE
CONCEPT OF
FUNCTIONAL
OCCLUSION
30
BILATERAL BALANCED
OCCLUSION:
 Lack of knowledge and materials necessary to
restore diseased teeth led to an EXTRACTION
ERA in dentistry’s early years.
 In the latter part of 19th century and the

early part of 20th century such men as
BONWILL, GYSI, MONSON, SPEE and others
contributed valuable knowledge to aid in the
construction of artificial dentures.
31
There became established a PROSTHETIC
CONCEPT OF BALANCED OCCLUSION
during this “FULL DENTURE PERIOD”.
 This concept was accepted and applied

to the natural dentition as well.
32
GROUP FUNCTION OCCLUSION:
• Concept introduced by SCHUYLER in 1929.
• Evolution of the philosophy of balanced

occlusion(bilateral replaced by unilateral balanced
occlusion).
• In 1935, SCHUYLER presented a classic paper on

‘The Correction Of Occlusal Disharmonies’ – he
believed that it was more important to have a
balanced occlusion in the natural dentition than
in the artificial dentures. 33
 SCHUYLER demonstrated with diagram a technique
for EQUILIBRATING (GRINDING) THE CANINE
TEETH TO ELIMINATE THEIR OVERLAP in order
to establish a ‘BALANCED OCCLUSION’.
Schuyler C. H.: Fundamental principles in the correction of 34

 Since, Schuyler’s article and up until the 1960’s,
most articles dealing with the equilibration of teeth
described similar methods of reducing canine
overlap to establish a balanced occlusion.
 During this BALANCED OCCLUSION PERIOD many

orthodontists INTRUDED THE CANINE TEETH
to promote this type of occlusion with the hope of
preventing relapse and crowding of the lower
anterior teeth.
 Orthodontic BANDS were PLACED MORE INCISALLY

on the CANINE crowns, and BRACKETS were offset
INCISALLY on the canine bands.
Schuyler C. H.: Fundamental principles in the correction of 35
 Several of the teeth on the working side
contact during the laterotrusive movement.
 Most desirable group function consists of the

canine, premolars, and sometimes the
mesiobuccal cusp of the first molar.
36
• Group function occlusion as described by
BEYRON following his observations on
Australian aborigines implies contact and stress
on several teeth in lateral occlusion and
indicates ABRASION as a positive and
inevitable adjustment.
37
MUTUALLY PROTECTED OCCLUSION:
 ANGELO D’AMICO in 1958: challenged the

balanced occlusion concept in his monograph
entitled “THE CANINE TEETH”.
 He contended that the natural teeth of man are

not designed for the wide range of lateral and
protrusive movements associated with the
balanced occlusion theory.
D’Amico. A.: The canine teeth: Normal functional relation of 38

 He believed that the teeth of man are designed and
arranged so as to best resist vertical forces in line
with their long axes and the NATURAL VERTICAL
AND HORIZONTAL OVERLAP OF THE UPPER
CANINES prevents detrimental horizontal
movement from occurring.
39
 Since D’AMICO’S article there has been a trend
away from the long established Balanced Occlusion
Concept to one of a “MUTUALLY PROTECTED
OCCLUSION”
D’Amico. A.: The canine teeth: Normal functional relation of 40

 Is an occlusal scheme in which anterior teeth
protect the posterior teeth during excursive
movements of the mandible and the posterior
teeth protect the anterior teeth of any contact in
the static jaw position.
41
ESTABLISHMENT OF ANTERIOR
GUIDANCE:
 Ideally, during excursive jaw movements, the
posterior teeth must not participate in occlusion.
Robert L Lee. Advances In Occlusion, Post Graduate 42

DURING JAW PROTRUSIVE MOVEMENT:
PROTRUSIVE LOAD SPREAD OVER 14

TEETH

 Gentle and immediate disclusion of the posteriors
 Glide in harmony with mandibular movements
44
 There must be sufficient overbite and overjet
at the maxillary incisor tips to allow for gentle
glide path.
45
DURING LATERAL MOVEMENT: the canine must
perform the disclusion.
 REASON: establishment of CANINE

GUIDANCE aimed in orthodontic
completion:
1. Strategic positioning of canine in the arch.
2. Favorable root anatomy

3. Presence of BETTER CROWN-ROOT
proportion.
4. Presence of DENSE and COMPACT BONE

around the root; which better tolerates the
occlusal forces compared with the medullary
bone of the posterior teeth.
5. Sensorial pulse that activates less

muscles when the canine teeth are in contact
than when posterior teeth contact each other.

 In lateroprotrusive movement, U/L canines are the
APPROPRIATE TEETH to contact and to dissipate
the horizontal forces, while promoting the
disclusion of the posterior teeth.
6. Achievement of CANINE GUIDANCE in orthodontics

easier than GROUP FUNCTION:
 Mechanically much easier to establish the

contact in a single tooth than to distribute the
contacts simultaneously in all the posterior
teeth.
 Canine protection as described by D’AMICO is said
to favor a vertical chewing pattern and to
prevent wear of teeth as in lateral occlusion
where the canine guides the mandibular
movement.

CANINE GUIDANCE OR GROUP
FUNCTION??
 COMMON THEME: absence of contact on non-
working side during lateral excursion and absence of
posterior occlusal contacts during mandibular
protrusion.
 Presence of canine guidance reduces the

opportunity for generating high interarch
forces, and it may therefore reduce normal tooth
wear and parafunctional loads.
 Canine Guidance may therefore offer some

advantage over Group Function.
50
GROUP FUNCTION: must be established:
When canine teeth do not present an appropriate

position to accept horizontal forces:
1. Periodontal problems in canines
2. Cases of atypical upper LATERAL

INCISOR AGENESIS
3. Lateral incisor extraction
4. Any case that FIRST PREMOLAR

replaces canine:
Establishment of lateral guide should be
avoided in order to prevent development
of traumatic occlusion – premolar not 51
CANINE PROTECTED
OCCLUSION: beneficial
 Posterior teeth have significant bone loss
 Considerable occlusal wear/ number of

cracks
 Patient clenches or grinds the teeth

ANTERIORS PROTECTING THE
POSTERIORS IN ALL EXCURSIVE
MOVEMENTS OF THE MANDIBLE:
HOW???
 Mechanics of occlusion:
Anterior teeth have mechanical advantage

over posterior teeth as they are farther
from the FULCRUM, and this positioning
gives them better leverage to offset the closing
muscles of Advances
Robert L Lee. mastication.
In Occlusion, Post Graduate 53
Occlusion involves more than
mechanics
• Anterior guidance on a purely mechanical basis is quite

limited.
• Keen proprioception + strategic location = anterior

protection
• Teeth most sensitive to pressure change(Kawamura

et al):
CI > LI > CUSPID > BICUSPID >

MOLARS(most insensitive)
“GNATHOLOGIC” SCHOOL OF
THOUGHT
 In 1920’s Mc Collum and Stallard researched the
mandibulocranial position and Centric Relation and
founded the “GNATHOLOGIC” school of thought.
 Until the 1950’s, the pioneers of gnathology, followed

by others, such as Stuart, subscribed to the theory of
BILATERAL BALANCED OCCLUSION in NATURAL
AND PROSTHETIC TEETH in order to obtain harmony
between the condylar path and occlusal surfaces
during mandibular movement.
55
 At the end of 1950’s, the gnathologic researchers
arrived at the concept of MUTUALLY
PROTECTED OCCLUSION, influenced
primarily by the observation of D’AMICO
regarding Canine Guidance during eccentric
movements of the mandible.
56
 In most individuals with natural dentition
there’s a short path of movement between
RCP and ICP in antero- posterior direction.
 Both these occlusal positions are used

frequently during function.
 Discrepancy of 0.5-1.5mm exists

between RCP and ICP as measured at the
lower incisor point in adults and children.
57
SECOND MOLAR INTERFERENCE
 Most interferences cause disclusion of expected

anterior guidance and thus become the anterior
determinants of mandibular movement.
58
 IDEAL FUNCTIONAL
OCCLUSION:
 The criteria that denote an “Ideal”

functional occlusion have not been
conclusively established.
 Following features must be assumed to be

compatible with an “Ideal” functional
occlusion:
1. Bilateral occlusal contacts in RCP.
2. Coincidence in position of RCP and ICP 59

3. Contact between the opposing teeth on the
working side during lateral jaw movements.
Contact may be limited to the canines(Canine
Protection) or extend posteriorly to include one
or more pairs of adjacent posterior teeth(Group
Function).
4. No contact between teeth on the non-working

side between lateral excursions.
60
CONDYLAR SUBLUXATION AND
MOLAR FULCRUM
NM avoidance mechanism
Deceptive intraoral picture Condylar subluxation
 The more pronounced the interference, the more

the mandible will have to rotate out of position to
fit the teeth together, which usually creates a
fulcrum effect around the interference, subluxating
the condyle.
Roth RH. Temporomandibular Pain-dysfunction And 61

 According to a study done by ROTH,
subluxation of the condyles is one of the
MAJOR FACTORS contributing to the severity
of the TMJ Pain Dysfunction Syndrome.
 Tooth fulcrums are probably more common

after orthodontic treatment than is
realized. They are masked by the NM
avoidance mechanism, but have a great
potential for destruction of the teeth and joints.
 These fulcrum create a lever effect with the

mandible, similar to that of the common see-
saw.
Roth RH. Temporomandibular Pain-dysfunction And 62
GNATHOLOGIC
CONCEPT OF
OCCLUSION
63
 Dr Beverly B. McCollum established the
Gnathologic Society in 1926.
 Gnathology is defined as ‘‘the science that treats

the biology of the masticatory mechanism as
a whole: that is, the morphology, anatomy,
histology, physiology, and the therapeutics of the
jaws or masticatory system and the teeth as they
relate to the health of the whole body, including
applicable diagnostic, therapeutic, and
rehabilitation procedures.’
64
 The Gnathological Objectives are
aimed at harmonizing the occlusal
morphology or natural tooth positions
with closure of the mandible in
CENTRIC RELATION, and with border
excursions of the mandible.
65
CENTRIC RELATION: PRESENT
AND HISTORICAL PERSPECTIVE
 Centric relation (CR) has been a controversial
subject in dentistry for more than a century.
 The definition of CR has changed over the past

half-century from a retruded, posterior and, for
the most part, superior condyle position to an
anterior-superior condyle position.
66
 Presently: maxillo-mandibular relation in which
the condyles articulate with the thinner avascular
portion of their respective discs with the complex in
the antero- superior position against the slopes of
the articular eminence, regardless of tooth contact.
 According to ROTH(1981): the condyle must also

be centralized transversally in the respective
mandibular fossae.
 The displacement of the condyles from the

above position caused by intercuspation of
teeth( ie. CR- MI discrepancy ) should ideally be
< 1mm vertically and horizontally and 67 <
CENTRIC SLIDE
 From an anatomical standpoint, the condyle cannot

move forward or backward from CR without moving
downward : any CENTRIC SLIDE results in
downward displacement of the condyles.
 Most often there is also a DISTAL COMPONENT

with the downward displacement of the condyle as
the mandible FULCRUMS over the most posterior
tooth position and rotates the body of the mandible
FORWARD into MI.
Rinchuse DJ, Kandasamy S. Centric relation: a historical and 68

DIRECTION OF CENTRIC SLIDE:
 HISTORICALLY: considered that ‘Centric Slide’ is

an anterior shift of condyles from CR to MI
because in mouth the mandibular teeth shift
forward.
 PRESENT CONCEPT: inferior and posterior

movement of condyle from CR to MI :
Frank E Cordray. Centric Relation Treatment And Articulator 69

 BUT HOW THE MANDIBULAR TEETH
SHIFT FORWARD???
REASON: CONCEPT OF MOLAR FULCRUM BY

ROTH:
• The initial tooth contact is on the most posterior tooth
• When condyles seated comfortably in CR and if there

exists an occlusal prematurity on a posterior tooth : 2
conditions:
Fulcrum: condyles
Condyles in CR : distracted inferiorly and
lateral and anterior posteriorly – mandibular
open bite teeth shift forward- MI
70
 For functional reasons, the molar fulcrum will
prevail to obtain MI.
 Mandibular repositioning device – lateral and

anterior open bite occurs – molar fulcrum still
present but the splint normalizes muscles and
ligaments such that finding MI becomes
difficult.
 The orthodontist will not be aware of the

presence of the MOLAR FULCRUM unless
he/she is using a MOUNTED DIAGNOSTIC
CASTS.
71
Traditional mechanics( CERVICAL HEADGEAR, CLASS II
ELASTICS)
Molar fulcrum made worse(extrusion)
Greater condylar distraction from CR- MI
 when the patient’s musculature will not allow the

condyles to distract enough to achieve MI, THE
CONDYLES OFTEN SEAT
 REASON: Clinicians often report an unexplained

open bite, increased overjet and possibly TMJ
symptoms occurring a few months into treatment
72
BASIC TENETS OF
GNATHOLOGICAL OBJECTIVES:
 FIRST OBJECTIVE:
• To obtain a stable CR of the mandible and have the
teeth intercusp maximally at this mandibular
position.

 All centric stops should hit equally and
simultaneously and the stress of closure should
be directed, as nearly as possible, down the long
axes of posterior teeth.
 There should be no actual contact of the anterior

teeth in centric closure(.005 inch clearance).
74
 SECOND OBJECTIVE:
 Establishing a “MUTUALLY PROTECTIVE

OCCLUSAL SCHEME”
 The posterior occlusion must be organized in

harmony with mandibular movement, so that
very little lift is necessary to keep the
posterior teeth from colliding.

EXCURSIVE OCCLUSAL SCHEME:
 The gentle lateral and protrusive lift not only

necessary from the standpoint of mandibular
movement, but necessary from the orthodontist’s
point of view in terms of post-treatment stability of
toothRpositions.
Ronald Roth. Functional Occlusion For The Orthodontist- Part- 76
 When teeth in MI with condyles in
CR, there must be:
 4mm vertical overbite
 2-3mm overjet from incisal edges of maxillary

incisors to facial surfaces of mandibular incisors.
 1mm of overjet from tip of maxillary canine to

facial surface of mandibular canine.
77
 THIRD OBJECTIVE:
 To mount pretreatment diagnostic casts on a

fully adjustable articulator( with some also
recommending pantographic tracings and
many recommending deprogramming before
taking centric- bite registration.
78
CR MOUNTED STUDY CASTS
1. Relate position of maxilla to cranial base.
2. Relate mandible to maxilla with condyles

seated in CR.
3. Plan treatment to a reproducible condylar

position, allowing examination of excursive
mandibular movement.
4. Detect point of initial tooth contact,

unmasking occlusal interferences and
evaluating the cant of the occlusal plane.
79
 Determination of CR-MI discrepancy using
Condylar Position Indicator(CPI)
 Transfer of CR record
on to the tracing of
lateral cephalogram
(in MI):
80
CENTRIC RELATION AND
ORTHODONTICS AND TMD:
 The possible role of occlusion in the etiology of
temporomandibular disorders (TMD) also has
been the subject of debate.
 Much of the occlusion/TMD debate involves

issues surrounding centric relation (CR),
including definition, recording and measurement
, use of articulators and deprogramming splints,
and possible relationship to either
stomatognathic health or disease.
81
 A focus of gnathologic orthodontic view was to
establish a retruded, posterior-superior “seated”
CR position when the interdigitating occlusion
was in CO (that is, CR-CO).
 The thinking then was that if a posterior-

superior seated CR position was not an
established goal of orthodontic treatment,
patients would be prone to develop TMJ
symptoms.
 The attainment of a retruded, posterior-superior

CR position would mitigate the development
of TMD. 82
CONDYLE POSITION AND CENTRIC
SLIDE:
 The findings in the 1960s that centric slides

caused TMD were based on incorrect
information from descriptive studies that lacked
control/comparison groups.
 McNamara and colleagues found TMJ

arthropathies associated with centric slides
greater than 4 millimeters; however, they
contended that the slides were the result of
the TMD rather than the cause.
 The preponderance of evidence available

83
 Keim said, “The neuromuscular school tells us
that there is a range of acceptable positions
(centric) … If we clinicians continue to place
emphasis on establishing ‘harmony’ between CO
and some mythical concept of CR, we are doing
ourselves a disservice.”
84
 Dr Lysle Johnston sarcastically stated that
‘‘gnathology is the science of how
articulators chew.’’
 In the 1970s, Roth formally introduced the classic

principles of clinical gnathology to orthodontics
(ORTHODONTIC GNATHOLOGY).
 Gnathologists believe that failure to achieve at

least 1 of the objectives will predispose patients to
signs and symptoms of temporomandibular
disorders (TMDs).
85
ROTH’S
FUNCTIONAL
OCCLUSION
CONCEPT
86
 The call for orthodontists to consider the
functional aspects of the dentition dates
back to atleast the 1930s; several of the
prominent pioneers were Brodie , Perry, Moyer,
Thompson and Ricketts.
 In the 1970s, Roth, a gnathologic

orthodontist, suggested that orthodontists
should embrace the principles of gnathology
that had long been held by eminent
prosthodontists and restorative dentists.
87
 If one were to choose one phrase to describe the
philosophy of the late Dr Ronald Roth, it would be
summed up by the phrase:
 CLEARLY DEFINED
TREATMENT GOALS
 Clear treatment goals increase DIAGNOSTIC

ABILITY -- reducing the risk of treatment failure.
 MISDIAGNOSIS usual culprit of treatment

failure.
88
 Failed orthodontic result can take
the form of:
TMJ symptoms
Instability
Worn teeth
Periodontal
decline
Facial balance
decline
Roth Williams International Society Of Orthodontics(rwiso) 89

 Dr Roth regarded CONDYLAR DISPLACEMENT as
major factor contributing to UNSTABLE RESULTS.
 He said: “you find out the fruits of your

orthodontic treatment labor 10 years after
the treatment is complete.”
90
must have goals for
 Believed that we
all areas influenced by
orthodontic treatment:
1. Facial aesthetics
2. Dental aesthetics
3. Functional occlusion
4. Periodontal health
5. Healthy TMJ(correct condyle-fossa

relationship)
Orthodontic Products Sep 2007: An Explanation Of Roth/ William 91
 TREATMENT OBJECTIVES:
1. Pleasing facial esthetics, evaluated by soft
tissue and skeletal measurements
cephalometrically.
2.Molar relation and tooth alignment,

evaluated by Angle’s description of
anatomical occlusion.
3.Functional occlusion, evaluated

gnathologically on an articulator.
Roth RH. Functional occlusion for the orthodontist. Part I. J Clin
92
4. Stability of post- treatment tooth positions
and alignment.
5. Comfort, efficiency and longevity of the

dentition, supporting structures, and the TMJ.
93
 RECOGNIZING OCCLUSAL
DISHARMONY:
1. Occlusal wear
2. Excessive tooth mobility
3. TMJ sounds
4. Limitation of opening or closing

movement
Roth RH. Functional occlusion for the orthodontist. Part I. J Clin
94
5. Myofascial pain
6. Contracture of mandibular musculature,

making manipulation difficult or
impossible.
7. Some types of tongue thrust swallow.
95
THE REPOSITIONING
SPLINTS:
 Eugene Dyer popularized the use of

repositioning splints (craniomandibular
orthopedic appliance).
Roth RH, Rolls DA. Functional occlusion for the 96

 USES :
1. Alleviation of pain dysfunction
symptoms:
 Relaxation of mandibular
musculature
 Resolution of inflammatory
changes within the joint capsule.
2. Allows remodelling of the joints

to occur, if there have been some
previous degenerative changes(not
entirely reversible therapeutic
Roth RH, Rollsprocedure).
DA. Functional occlusion for the 97
3. Tests the patient’s response to occlusal
changes without actually changing the occlusion.
4. Allows the operator to know if the mandibular

position can be stabilized and the extent
of discrepancy that needs to be corrected.
5. Allows the patient to know what he might expect,

in terms of comfort; if the complete correction of
the occlusion is undertaken.

 OBJECTIVES OF USING
REPOSITIONING SPLINT:
1. Relief of symptoms: anything that disengages

occlusion.
2. To seat the condyles in the most superior

position possible on every visit, and to adjust the
occlusal surface of the splint to achieve maximum
intercuspation at this position of the mandible at
the most closed vertical dimension obtainable.

 It is therefore, a REMOVABLE “MUTUALLY
PROTECTED”, OCCLUSAL SCHEME, that
can be used to test the patient’s response to a
change in the occlusion without really doing
something that is not reversible.
 The repositioner should be adjusted as soon as

change in mandibular position becomes evident.
 The adjustment usually done by relining the

occlusal surface of the splint with a self curing
acrylic resin.

 The mandibular postural changes
during splint therapy are of 3 different
types:
1. Changes to relaxation of the

due
musculature that postures the mandible
incorrectly due to muscle contracture or
spasms.
2. Changes due to elimination of intracapsular

inflammatory fluid.
3. Changes due to remodelling/

recontouring
Roth RH, Rolls of for
DA. Functional occlusion thethe bony parts of the
101
Tooth by tooth requirements of
IDEAL OCCLUSION: ROTH
 Lower incisors at the cephalometric goal (+1 to A-

Pog)

 Tips of the upper incisors 2-2.5mm below the
lip embrasure of the upper and lower lips,
when the lips are closed with no strain.
 No more than 1 mm of attached gingiva

showing upon a full smile.

 Approximately 2.5mm overjet-overbite
relationship at the tip of upper incisors in its
relationship to the lower incisor.
Over Bite Over
Jet
0.005”
2.5 mm 2.5 mm

 A level or nearly level occlusal plane.
 A curve of Wilson that would allow seating of

centric cusps, but clearance upon excursions.
 As much divergence as possible of the occlusal

plane from the angle of the eminence for
excursive clearance.

 Lower incisors aligned contact point-to-contact
point with the roots in the same plane, when
observed from the occlusal, and a mesioaxial
inclination of 2 degrees.
 Lower cuspid crowns angulated mesially 5

degrees, with the cusp tip 1mm higher than the
incisal edge of the lateral incisors.

 The lower bicuspids should be uprighted 1
degree from their normal mesial inclination
and should have a slight distal rotation(4
degree).
 The lower molars should be uprighted 1 degree

from their normal 2-degree mesial inclination,
and should have a slight distal rotation.

 The lower buccal segment should have progressive
torque close to Andrews' measurements – to
establish the Curve Of Wilson and there should
be no rotations or spaces.
 The upper bicuspids should be uprighted to 0

degrees from their normal 2-degree mesial
inclination, with no rotation, except for some distal
rotation in an extraction case.

 The upper cuspid must have its contact points
adjacent to the contact points of the upper
bicuspid and lateral incisor, to establish proper
length for cuspid guidance.
 The upper lateral and central incisors should be

almost equal in incisal edge length, with no
more than 0.5mm height differential.

 The upper first molar should have sufficient distal
rotation, mesioaxial inclination and buccal root
torque, so as to fit the lower first molar, as
described by Andrews.
 There should be no rotations (other than those for

overcorrection) or spaces in the upper arch, and
the buccal segments from the cuspids distally
should have 14 degrees nonprogressive buccal
root torque.

• The arch formshould be a MODIFIED
CATENARY CURVE consisting of 5 separate
radii– widest point of the lower arch would be
at the MB cusp of the mandibular first molars
and at the first bicuspids.
• The widest point of the maxillary arch would be

at the MB cusps of the first molars.

END OF MECHANOTHERAPY GOAL
 A place to be at with tooth positions at appliance

removal, so that settling into CR and its ideal
intercuspation is most likely to occur. This is necessary:
1. Teeth will move after appliance removal, no

matter where they are placed.
2. The curve of Spee will return or deepen after

appliance removal.

3. Teeth that are slightly tipped distally in the
buccal segments will tend to settle better than
the teeth that are already mesially inclined.
4. As teeth in the buccal segments settle they will

tip and rotate mesially.
5. As band spaces close, there is a corresponding

loss of torque of the anterior teeth.

6. Teeth adjacent to an extraction sites will tend
to rotate towards the extraction sites.
7. Maxillary lingual cusps will tend to migrate

downward until they find an occlusal stop
against the opposing teeth.

 Logical to plan for these things to happen during
treatment and set up a detailing or finishing goal
that will overcome these factors.
 ROTH: OVERCORRECTION built in for

all areas EXCEPT for buccolingual
torque of the lower buccal segment.
 The lower buccal segment torque MUST BE

CORRECT, to act as a TEMPLATE for
the maxillary teeth to occlude with and to
settle to.
 Splint therapy to be continued until there has
been no change in mandibular positioning in CR
for atleast THREE MONTHS.
 Patients with TMD/ radiological evidence of

recotouring of the bony parts of the joints: SIX
MONTHS.
 If comfort/ stability cannot be achieved with the

splint, no reason to believe that it can be
obtained by altering the occlusion permanently:
ELIMINATES TREATMENT FAILURES
BEFORE
Ronald THEOcclusion
R Roth. Functional FACT.For The Orthodontist- Part-
116
THE GNATHOLOGICAL
TOOTH POSITIONER:
 For the final seating and finishing of the occlusion:
use of FINISHING APPLIANCE : GNATHO-
POSITIONER.
Roth RH, Gordon WW. Functional occlusion for the orthodontist. 117
 PURPOSE:
1. To guide the case closer to
centric during the settling process and to
control the manner in which the case
settles in terms of minor tooth positions
that may effect CR closure or excursive
tooth relationships
2. To aid in providing better anterior

guidance and posterior disclusion
upon mandibular movement.
3. To maintain centric during most of the

Roth RH, Gordon WW. Functional occlusion for the orthodontist. 118
 The case must be within certain boundaries
at the conclusion of appliance therapy to
warrant the use of this type of appliance:
 Discrepancy between CR and

habitual CO:
 Should not be > 3.5 degree at the incisal

guide pin of the articulator,
 Not > 1.5mm anteroposteriorly or

horizontally
 Not > 2mm in the transverse plane or

Roth RH, Gordonlaterally.
WW. Functional occlusion for the orthodontist. 119
What made Roth to modify Andrews SW
appliance
 Inventory problem-To treat different cases

clinicians were to buy band kits for all Andrews
sets and series. They are very extensive
inventory on the self.
 Anchorage loss -When mesially angulated

brackets are placed on the posterior teeth, the
teeth tend to tip mesially and migrate forward
that resulted is anchorage loss.
 Problem in finishing-To achieve desired
tooth positions with the standard SWA, it was
necessary to finish the mechanotherapy phase
of treatment by placing compensating and
reverse curve in the upper and lower archwire.
121
Roth RH, Gordon WW. Functional occlusion for the orthodontist.
Roth's rationale for his bracket set up.
 The purpose of the Roth setup was to provide
over corrected tooth positions prior to
appliance removal that would allow the teeth in
most instances to settle to what was found is
non orthodontic normals studied by Andrews.
ROTH SETUP
 Roth setup is available in both 0.018 and 0.022 slot
 Roth preferred 0.022 slot brackets because it offered

more advantages:
 In terms of wire size selection,
 In terms of stabilizing arches as anchor units and

for orthognathic surgery
 For control of torque in the buccal segments, which

is very important from the standpoint of functional
occlusion.
 The Roth setup incorporated into it a member
of hooks for various types of elastic
configuration and also double triple and lip
bumper tube for the use of auxillary wires and
attachments.
Bracket positioning with Roth set
up
 The bracket placement vary slightly from the

position advocated by Andrews, thus a flat,
unbent, rectangular, full sized wire can be used
as the finishing wire rather than one with
reverse and compensating curve.
 Ideally the center of the bracket should
be placed at the center of the clinical
crown.
Molars(upper/lower)
From the buccal
From the occlusal
MB
Both the right and left bands should be checked to

ensure that they are in the same relative position on
the crowns
Premolars(upper/lower)
From the buccal From the occlusal
Upper premolar bracket placement is the most variable

because of tooth size. The most common error is not
placing the bracket gingival enough, especially on smaller
sized teeth.
Upper and lower Canine
From the buccal From the
occlusal
Upper and lower incisors
Upper arch
Central tip torque
rotation
Andrews 5 7
0
Roth 5 12
0
Lateral 9 3
0
9 8
0
 Tip- If it is increased the resultant axial is esthetically
and functionally undesirable
 The 5° torque increase in improves
 Esthetics by preventing flattened profile, straight
upper lip and obtuse nasolabial angle.
Upper canine
tip torque
rotation
Andrews 11 -7
0
Roth 13 -2
4M(mesial)
 Tip is Increased because they are being

retracted in most treatment.
 Less negative torque to offset the reciprocal
effect of building more positive torque into the
incisors.
I&II PM tip torque
rotation
(A) 2 -7
0
(R) 0 -7
2D
IM &IIM (A) 5 -9
10
(R) 0 -14
14D
 Elimination of the mesial tip on all buccal segment
teeth strengthened anchorage control significantly
(but burning anchorage can be difficult).
 To offset mesial the rotation that accompanies distal
traction
 The distal rotation of mesiobuccal
LOWER ARCH
CENTRAL &LATERAL
tip torque
rotation
(A) 2 -1
0
(R) 2 -1
0
CANINE
(A) 5 -11
0
(R) 7 -11
2M
I PM tip torque
rotation
(A) 2 -17
0
(R) -1 -17
4D
II PM 2 -22
0
-1 -22
4D
IM 2 -30
0
-1 -30
4D
II M 2 -35
ROTH TRU-ARCH FORM
 The Roth Tru-Arch form actually overcorrects

the arch width slightly.
 In the front part of the arch, the widest part is at
the bicuspids, not at the cuspids.
 The widest point in the entire arch is at
the first molars region,(mesiobuccal cusp of I
molar).
Ronald R Roth. Functional Occlusion For The Orthodontist- Part-

.
There are actually five arcs in

the Arch
 A curve across the front
 A Curve in cuspid-bicuspid area
 A uniform curve in the buccal
segment to allow for proper
rotational position of the buccal
segment teeth.
SEQUENCING OF TREATMENT
OBJECTIVES:
1.Eliminating cross bite
2.Correcting jaw relationship
3.Eliminating severe crowding creating

space in the dental arches for severely
malposed, impacted or blocked teeth,
4.Aligning the teeth in the individual

arches,
6. Finishing the lower arch.
7. Achieving class I relationship of buccal
segment,
8. Retracting and as if necessary intruding
maxillary arterior teeth.
9.Detailing and finalizing the tooth position
and the occlusion.

THE THREE PHASES OF TREATING
MALOCCLUSION INCLUDES
Phase I unlocking the

malocclusion
Phase II Working phase.
Phase III Finalization or detailing

of occlusion
Phase I treatment
 Helical loop archwires, Jarabak fashion
made from 0.016”
Elgiloy green wire(crowding) or
0.015” braided archwire(routinely)
or
Nitinol(severe rotation)
0.019” braided wire

 0.018”Australian special plus.(finalisation of
any stuborn rotation)
 0.019” square blue Elgiloy utility arches are
used in case of intrusion of incisor teeth.
Second phase of treatment.
 Anterior teeth are generally retracted en masse as
a group of 6 second molars are routinely banded
at the outset of treatment in the permanent
dentition.
 Double keyhole loop wire mechanics (0.019 x
0.026” round edge rectangular)- In case of
minimum and moderate anchorage cases-
 Modified Asher facebow- used in cases that need
maximum anchorage and retraction.
At the end of space closure:
Double keyhole loop wire mechanics
Replaced by
0.018x0.025” blue elgiloy incorporating

exaggerated R & C curve with special torque
adjustments(to offset the the undesirable effect to
provide
 Rapid root paralleling
 Leveling of Curve of spee &
 Maxillary incisors lingual root torque

 During extraction space closure, faster the
space is closed, regardless of wire size, the
more tipping there will be into the extraction
space.
 So it is the force and rate at which the

extraction space is closed determines the
type of tooth movement(tipping or bodily)
and not the dimension of the wire used.
ROTH’S CONCLUDING
STATEMENT:
“I have tried to present a philosophy of

treatment with the concept of
overcorrection, based on the specific
set of goals stated at the outset, taking
in to account existing conditions, facial
types, and reaction to treatment
mechanics.
Naturally there are always exceptions to
the way one approaches treatment”
Orthodontic Appliance
Prescription For Anterior
Teeth
Palatally placed lateral incisor- invert the lateral bracket-

At the start of treatment - maintains the crown angulation-
boosts labial torque by reversing slot inclination
 Torque difference Andrews -6ᵒ,Roth – 16ᵒ,MBT- 20ᵒ
Space closure in Absent lateral incisor case- canine bracket

on the canine tooth- 7ᵒ labial root torque becomes 7ᵒ of
palatal root torque for both MBT and Andrews prescription,
but slightly less for Roth brackets due to the prescription
 Roth bracket (with 13ᵒof tip when inverted onto a canine
replacing a lateral incisor) delivers 4ᵒ of additional tip
beyond the norm for a lateral incisor .
Eleanor Thickett, Nigel G. Taylor, Trevor Hodge. Choosing a pre- 145

Canine angulation in Class III cases- contra-lateral
canine brackets on the lower canines encourage the
crowns to tip distally.
Andrews prescription 5ᵒ tip becomes a 10ᵒ
difference; with MBT 8ᵒ becomes a 16ᵒ difference.
Labial movement of palatal canine- invert the lower

contra-lateral canine bracket onto the upper canine
Roth and Andrews prescriptions- provide a small beneﬁt,
as there is a difference of 9ᵒ and 4ᵒ, respectively
Eleanor Thickett, Nigel G. Taylor, Trevor Hodge. Choosing a pre- 146

Roth versus MBT: does bracket
prescription have an effect on the
subjective outcome of pre-adjusted
 Aim – to determine if bracket prescription has
edgewise treatment?
any effect on the subjective outcome of pre-
adjusted edgewise treatment as judged by
professionals
Method - retrospective observational
assessment study- in the Orthodontic
Department of the Charles Clifford Dental
Hospital, Shefﬁeld, UK.
 Forty sets of post-treatment study models
from patients treated using a pre-adjusted
edgewise appliance (20 Roth and 20 MBT)
were selected.
 The models were masked and shown in a
Bopelo Moesi , Fiona Dyer, Philip E.Benson .Roth versus MBT: does bracket
random order to nine experienced 147
According to Kattner et al, Six Keys Analysis
showed that the angulation and inclination of
the maxillary posterior teeth were better with
the Roth appliance.
But success in achieving some components of
the six keys did not translate into an increased
percentage of ideal tooth contacts .
 Despite using the Roth appliance, experienced
clinicians still found it difficult to achieve all six
keys to normal occlusion
Paul F. Kattner,Bernard J. Schneider. Comparison of Roth 148

Conclusion-
Bracket prescription had no effect on the subjective
aesthetic judgements made by nine experienced
orthodontists from the post-treatment study models
of patients treated with premolar extractions and a
pre-adjusted edgewise fixed appliance system using
either a Roth or a M BT prescription.
In the majority of cases , the ability of the clinicians
to determine which bracket prescription was used
was no better than chance in the majority of cases.
Bopelo Moesi , Fiona Dyer, Philip E.Benson .Roth versus MBT: does bracket
149
CONCLUSIO
N
 Ronald Roth was not afraid of testing

new concepts and new ideas.
 He was among the first to recognize the

value and the importance of Larry
Andrews Straight Wire Appliance
concepts.
150
 It does not happen often that a LUMINARY
develops in a speciality: RON ROTH was
undoubtedly one.
 His requirement that diagnostic casts be

mounted on adjustable articulators has
not been uniformly accepted; however,
the excellence in finishing orthodontic
treatment and obtaining esthetically and
functionally optimal results that mounting
produces cannot be disputed.
151
REFERENCES:
TEXTBOOKS:
1. Robert L Lee. Advances In Occlusion, Post
Graduate Dental Handbook Series, Volume
14, Chapter 3, Pg no 54-79
2. Jeffrey P. Okeson. Management Of Temperomandibular
Disorders And Occlusion, 6th Edition, Elvesier. Inc. 2009.
152
ARTICLES:
1. Kufinec. In Memoriam.Am J Ortho Dentofacial Ortho
2005:128-136
2. Andrews LF. The Keys To Normal Occlusion. Am J Orthod
1972;62:296-309.
3. Occlusion: An Orthodontic Perspective:Paul M. Kasrovi,
Michael Meyer, Gerald D. Nelson: 2000 Journal of the
California Dental Association
4. Schuyler C. H.: Fundamental principles in the correction of
occlusal disharmony, natural and artificial J. Am. Dent.
Assoc. 22: 1193-1202, 1935.
5. D’Amico. A.: The canine teeth: Normal functional relation
of the natural teeth of man, J. S. Calif. Dental Assoc. 26:
1-7. 1958.
6. Rinchuse DJ, Kandasamy S. Centric relation: a historical
and contemporary orthodontic perspective. J Am Dent
Assoc 2006;137:494-501.
153
7. Ronald R Roth. Functional Occlusion For The
Orthodontist- Part-3. JCO,1981 March; pg no-
174- 198
8. Roth RH. Temporomandibular Pain-
dysfunction And Occlusal Relationships. Angle
Orthod 1973;43:136-53. 2
9. Roth RH, Rolls DA. Functional occlusion for the
orthodontist. Part II. J Clin Orthod
1981;15:100-23.
10.Roth RH, Gordon WW. Functional occlusion for
the orthodontist. Part IV. J Clin Orthod
1981;15:246-65
11.Frank E Cordray. Centric Relation Treatment
And Articulator Mounting In Orthodontics. The
Angle Orthodontist. 1996 Vol 66 No 2
12.Orthodontic Products Sep 2007: An
Explanation Of Roth/ William Philosophy Part 154
II
13.Eleanor Thickett, Nigel G. Taylor, Trevor Hodge.
Choosing a pre-adjusted orthodontic appliance
prescription for anterior teeth. Journal of
orthodontics · July Vol. 34, 2007, 95–100.
14.Bopelo Moesi , Fiona Dyer, Philip E.Benson .Roth
versus MBT: does bracket prescription have an effect
on the subjective outcome of pre-adjusted edgewise
treatment? European Journal of Orthodontics 35
(2013) 236–243
15.Paula Vanessa Pedron, F Carvalho :Importance Of
Occlusion Aspects In The Completion Of Orthodontic
Treatment: Braz. Dent. J (2007); 18(1); 78-82
16.David Wood: Effect of incisal bite force on condyle
seating: AO 1994; Vol 64, No. 1
17.R. Clark & R. D. Evans (2001) Functional Occlusion: I.
A Review, Journal of Orthodontics, 28:1, 76-81
155
18.Paul F. Kattner,Bernard J. Schneider.
Comparison of Roth appliance and standard
edgewise appliance treatment results. AM J
ORTHOD DENTOFAC ORTHOP 1993;103:24-32
156

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ROTH

 EVOLUTION OF CONCEPT OF FUNCTIONAL

 Roth started using straight wire

 One of Roth’s CHIEF CONTRIBUTION was

 This included an almost passionate

Kufinec. In Memoriam.Am J Ortho Dentofacial Ortho 5

 In the ROTH approach, tipping of teeth is allowed,

 Born on 14 September, 1933

 Completed orthodontic training under Joseph

 Met criteria of successful orthodontic

Kufinec. In Memoriam.Am J Ortho Dentofacial Ortho 10

The techniques and The philosophy and

 Dr. Ronald H. Roth and Dr. Thomas Basta, a

 Died on 24 jan,2005 – from an aggressive form of

Kufinec. In Memoriam.Am J Ortho Dentofacial Ortho 13

Andrews LF. The keys to normal occlusion. Am J Orthod 16

 These SIX PARAMETERS

 Introduced more DYNAMIC CONCEPT of occlusion.

 His concept of occlusion, along with that of Stallard,

 Dynamic concept readily adopted by

 Dynamic concept though has greater acceptance;

Occlusion: An Orthodontic Perspective:Paul M. Kasrovi, Michael Meyer,

 Distal limit: tooth to 2 teeth

 HUFFMAN AND REGENOS: summarized the two

Ronald R Roth. Functional Occlusion For The Orthodontist- Part- 20

 This occlusal scheme, which places the maxillary

Ronald R Roth. Functional Occlusion For The Orthodontist- Part- 21

2. Food impaction minimized since no cusp tips

3. Less tendency for wear of cusp tips and occlusal

Ronald R Roth. Functional Occlusion For The Orthodontist- Part- 22

1. If buccal segments of natural teeth

 eliminates glide path and

 imparts a steep protrusive and

Ronald R Roth. Functional Occlusion For The Orthodontist- Part- 24

 All teeth except mandibular central incisor and

 Each maxillary tooth is distal and facial to

 Current orthodontic goals of incisor overlap and

 This scheme provides for freedom of movement in

1. Plunger cusp to marginal ridge relationship:

 lower buccal cusp tips rest on only one opposing

2. Ability to hold centric without tripodization:

 In occlusal contacts of natural teeth there are

Ronald R Roth. Functional Occlusion For The Orthodontist- Part- 27

 From static occlusal standpoint, Stuart’s distal

 Dynamic occlusion requires that the teeth

 Static tooth positions

ANDREW’S SIX KEYS + MAXIMUM

STUART’S goal of ideal functional occlusion can be

 In the latter part of 19th century and the

 This concept was accepted and applied

• Concept introduced by SCHUYLER in 1929.

• Evolution of the philosophy of balanced

• In 1935, SCHUYLER presented a classic paper on

Schuyler C. H.: Fundamental principles in the correction of 34

 During this BALANCED OCCLUSION PERIOD many

 Orthodontic BANDS were PLACED MORE INCISALLY

 Most desirable group function consists of the

 ANGELO D’AMICO in 1958: challenged the

 He contended that the natural teeth of man are

D’Amico. A.: The canine teeth: Normal functional relation of 38

D’Amico. A.: The canine teeth: Normal functional relation of 40

Robert L Lee. Advances In Occlusion, Post Graduate 42

PROTRUSIVE LOAD SPREAD OVER 14