DEVELOPMENT OF OCCLUSION

Dr. Rashi Singh

CONTENTS
 Introduction
 Definition :occlusion
 Periods of occlusal development
 Pre-dental period
 Mouth of neonate

 Gum pads

 Precociously erupted primary teeth

CONTENTS
– Deciduous dentition period
 Normal signs of primary dentition
 Mixed dentition period
 First transitional period

 Second transitional period

 Permanent dentition period

 Bibliography
INTRODUCTION
 Childhood is a mirror in which are reflected the
propensities of adulthood. Similarly, ideal primary
dentition is the indicator of future ideal permanent
dentition.

 Thevarious functions of the deciduous dentition are

to provide mastication as well as maintain the
occlusion and space for permanent dentition.
INTRODUCTION
Occlusion
 The term occlusion is derived from the Latin word
“occlusio” defined as the relationship between all
the components of the masticatory system in normal
function, dysfunction and parafunction.

 An ideal occlusion is the perfect interdigitation of

the upper and lower teeth.
OCCLUSION
 Occlusion is the normal relation of the occlusal inclined
planes of the teeth when the jaws are closed.-Angle

 Occlusion is the changing interrelationship of the

opposing surfaces of the maxillary and mandibular teeth,
which occurs during movements of the mandible and the
terminal full contact of the maxillary and mandibular
dental arches.-Gregory
PERIODS OF OCCLUSAL DEVELOPMENT
 Occlusal development can be divided into following
developmental periods:
☺ Pre-dental period (neonate’s mouth)
☺ The deciduous dentition period
☺ The mixed dentition period (transitional period)
☺ The permanent dentition period
PRE-DENTAL PERIOD
 It is the period after birth during which the neonate does
not have any teeth.

 It usually lasts for 6 months after birth.

 MOUTH OF NEONATE:
0-6 MONTHS
The gum pads:
 The alveolar arches of an infant at the time of birth are called
Gum Pads.
 These are greatly thickened oral mucous membrane of the
gums, which soon become segmented.
 Each segment is a developing tooth site.
 They are pink in color and firm in consistency.
 MOUTH OF NEONATE:
0-6 MONTHS
The gum pads:
 The pad gets divided into a labio / buccal

(differentiates first) and a lingual portion

(differentiates later).
 Transverse grooves separate the gum pads into 10
segments.
 The groove between the canine and the first molar
region is called the lateral sulcus , it helps judge the
inter-arch relationship.
 MOUTH OF NEONATE:
0-6 MONTHS
The upper gum pad:
 Is horse shoe shaped and shows: Transverse
groove
 Gingival groove: separates gum
pad from the palate.
 Dental groove : starts at incisive
Lateral
papilla, extends backward to Sulcus
touch the gingival groove in the
canine region and then moves
Dental
laterally to end in the molar groove
region.
 Lateral sulcus : deepened groove
separating canine and deciduous
first molar segments. Gingival
groove
 MOUTH OF NEONATE:
0-6 MONTHS
The lower gum pad:
 It is U-shaped and rectangular,
with anterior portion everted
labially and characterized by:
 Gingival groove: demarcates Dental groove
lingual extensions of the gum
Tongue
pads.
Gingival
 Dental groove: joins gingival groove
groove in the canine region. Lateral Sulcus

Transverse
 Lateral sulcus: deepened groove groove
separating canine and deciduous
first molar segments.
 MOUTH OF NEONATE:
0-6 MONTHS
Relationship of gum pads:
 The maxillary gum pad is more prominent exhibiting a class II pattern.
 Mandibular lateral sulci lie posterior to maxillary lateral sulci.
 The range of this distal variation is from 0 to 7mm, on an average
2.7mm in males and 2.5mm in females.
 Complete overjet.
 At rest anterior open bite is seen with contact in the
molar region.
 Tongue protrudes anteriorly through this space.
 The intermaxillary space closure, occurs with the eruption of primary
teeth.
 MOUTH OF NEONATE:
0-6 MONTHS

Relationship of gum pads:

 Mandibular functional movements are mainly vertical.

 Limited antero-posterior movement.
 Lateral movements are absent.
 With increased distal relationship of the jaws the dimensions of the
mandibular gum pads seem to be affected. The length and anterior
width shows an increase, while the posterior width shows a decrease.
J.H.Sillman.
American Journal of Orthodontics and Oral Surgery 1938.
Vol 24, Issue 5, 409-424.
RELATIONSHIP OF UPPER AND LOWER GUM
PADS
 MOUTH OF NEONATE:
0-6 MONTHS
Tongue
 It is comparatively large in relation to small mouth.
 It is flat, thin and blunt tipped, probably due to short frenum.
 The tongue at this stage performs only one function, i.e., acts as a
piston while suckling.
 MOUTH OF NEONATE:
0-6 MONTHS
 Oral function
 The new born infant’s priority is to obtain milk and transfer it
into gastrointestinal system.
 This is achieved by two : suckling and swallowing.
 The milk ducts of lactating mammals are surrounded by
smooth muscle, which contracts to force out milk.
 The infant’s role is to stimulate the smooth muscle to contract
and squirt milk into the mouth.
 This is done by suckling, consisting of small nibbling
movements of the lips, a reflex action in infants.
 MOUTH OF NEONATE:
0-6 MONTHS
 Oral function
 Milk when squirted into the mouth, it is only necessary for
infant to groove the tongue and allow milk to flow posteriorly
into the pharynx and esophagus.
 The tongue however, must be placed anteriorly in contact
with the lower lip, so that milk in fact is deposited on tongue.
 MOUTH OF NEONATE:
0-6 MONTHS
 Oral function
 This sequence of events defines infantile swallow,
characterized by active contraction of the musculature of lips,
a tongue tip brought forward in contact with lower lip, and
little activity of the posterior tongue or pharyngeal
musculature.

 The suckling and the infantile swallow normally disappear

during the first year of life.
 MOUTH OF NEONATE:
0-6 MONTHS
Precociously erupted primary teeth:
Spouge and Feasby (1966) differentiated natal and neonatal teeth
based on the maturity of the structures, suggesting the term
"premature teeth".
The teeth or group of teeth which are present at birth are denoted
as natal dentition,
neonatal teeth are those which erupt during the first month of life
(Massler and Savara, 1950).
 MOUTH OF NEONATE:
0-6 MONTHS
 The occurrence of either natal or neonatal teeth is relatively rare.
 Its prevalence has been reported to be around 1 in 2000 to 3500 live
births (Massler and Savara, 1950; Bodenhoff and Gorlin, 1963; Spouge
and Feasby, 1966) varying from 1:6000 to 1:800 (Rusmah, 1991), with
females, in general, being more affected (Allwright, 1958; Chow, 1980).
 Fatima Andelo

 Braz Dent J (1998) 9(1): 53-56

 MOUTH OF NEONATE:
0-6 MONTHS
 Natal teeth are more frequent than neonatal teeth (Massler and Savara,
1950; Spouge and Feasby, 1966; Ronk, 1982) with the most common
localization being the mandibular region of central incisors (85%).
 11% are maxillary incisors, 3% mandibular cuspids or molars and only
1% are maxillary cuspids or molars.
 Natal or neonatal cuspids are extremely rare (Massler and Savara,
1950; Bodenhoff and Gorlin, 1963; Southam, 1968; Ronk, 1982; Kates
et al., 1984; Rusmah, 1991)
 Fatima Andelo

 Braz Dent J (1998) 9(1): 53-56

 Neonatal teeth

Natal teeth
 MOUTH OF NEONATE:
0-6 MONTHS
 At birth both maxilla and mandible are small as compared to the
face.
 Overjet diminishes markedly during the first 6 months.
 Eruption of deciduous teeth commences at about 6 months.
 Occlusion starts developing posteriorly when deciduous first molars
attain contact.
 By the time the first molars settled, occlusion in posterior is
established.
THE DECIDUOUS DENTITION STAGE

 The deciduous dentition starts from the eruption of the first

deciduous tooth, usually the deciduous mandibular central incisors
and ends with the eruption of first permanent molars.
 From 6 months to 6 years of postnatal life.
 By 2 ½ years of age, deciduous dentition is usually complete and
full in function.
 Root formation of all teeth is complete by 3 years.
 CHRONOLOGY PRIMARY TOOTH
Tooth Calcification Crown Eruption Root
Upper (weeks in completed(m (months) completed
utero) onths) (years)
I1 14 1½ 10 1½
I2 16 2½ 11 2
C 17 9 19 3¼
M1 15 6 16 2½
M2 19 11 29 3
 CHRONOLOGY PRIMARY TOOTH
Tooth Calcification Crown Eruption Root
Lower (weeks in completed(m (months) completed
utero) onths) (years)
I1 14 2½ 8 1½
I2 16 3 13 1½
C 17 9 20 3¼
M1 15 ½ 5½ 16 2¼
M2 18 10 27 3
 THE DECIDUOUS DENTITION
5 months in
utero 2 yrs
(± 6 mos.)
7 months in
utero
3 yrs
PRENATAL
(± 6 mos.)
Birth
6 mos. 4 years
(± 2 mos.) (± 9 mos.)
9 mos.
(± 2 mos.) 5 yrs
(± 9 mos.)
1 year
(± 3 mos.)
6 years
(± 9 mos.)
18 months
(± 3 mos.)
EARLY CHILDHOOD
INFANCY
(Pre-school age)
NORMAL SIGNS OF PRIMARY DENTITION
a. Physiologic spaces
 It is very common to find physiologic spaces in primary
dentition .
 The prevelance of spaced dentitions varies between different
ethnic groups, ranging from 42% (Treimann 1961) to 98% (Byoko
1968).
 Spacing often presents between all anterior primary teeth.
 The most marked spaces are present mesial to the maxillary
canines and distal to the mandibular canines. These are called
primate or anthropoid spaces.(Baume 1950).
NORMAL SIGNS OF PRIMARY DENTITION
a. Physiologic spaces
 Alhaija ES, Qudeimat MA. (2003) studied to assess tooth and arch
dimensions, occlusal relationships and the presence of spacing or crowding
in primary dentition of Jordanian children. Anthropoid spaces were found
in 70% of the upper arches and in 51% of the lower arches.
NORMAL SIGNS OF PRIMARY DENTITION
a. Physiologic spaces
 Another type of space in the primary dentition is the secondary or
developmental spaces, which are usually found between the
incisors (Fried 1954).
Abu Alhaija
Int J Paed Dent 2003
NORMAL SIGNS OF PRIMARY DENTITION
c. Shallow overjet and overbite
 --An average overbite, calculated as a percentage of the clinical crown
height of the mandibular incisors, is shallow (10-25%) in the primary
dentition and sometimes nonexistent with an edge-to-edge incisor
relationship.
 Moorrees (1963) reported averages of 36.6% (males) and 39.3% (females)
in the age interval 5-6 years, and averages of 37.9% (males) and 40.8%
(females) in the age interval 16-18 years; however, surprising changes may
occur in the degree of overbite during the occlusal development of a child,
despite relatively high degrees of association for overbite at successive age
levels.
NORMAL SIGNS OF PRIMARY DENTITION
c. Shallow overjet and overbite
 Farsi NM and Salama FS (1996) studied about various occlusal
parameters in 520, 3-5 year olds. The degree of overbite was significantly
less in 5 year olds than in 3 year old. The majority of the children (76%)
had an overjet of 0-2mm but the prevalence of 0-1 mm overjet was
significantly higher and that of 2-3 mm significantly lower in the elder age
group.

 Graber TM (1983) conducted a study with parameters of arch

dimension,spacing and occlusion from 2.5 to 5.5 yeas of age. decreased
with age whereas openbite relatively frequent in the ages from 2.5 to 3.4
but disappeared completely by 4.5 years.
NORMAL SIGNS OF PRIMARY DENTITION
c. Almost vertical inclination of anteriors
The interincisal angle between the maxillary and mandibular incisors is
150* in the primary dentition
d. Ovoid arch form
e. Straight/ terminal plane relationship
NORMAL SIGNS OF PRIMARY DENTITION

Terminal plane relationship

 The primary dentition is complete after eruption of the second
primary molars.
 The mesial-distal relation between the distal surface of the upper and
lower second primary molars is called the terminal plane when the
primary teeth contact in centric occlusion.
 The terminal plane has been classified according to Baume (1950)
into three types:
 Flush terminal plane
 Mesial step
 Distal step
Alexander S.
JCPD 1998
 TERMINAL PLANE RELATIONSHIP

FLUSH PLANE MESIAL STEP DISTAL STEP

TYPE TYPE TYPE
NORMAL SIGNS OF PRIMARY
DENTITION
 Flush terminal plane:
 The distal surfaces of the maxillary and mandibular second molars
are in the same vertical plane.
 This is the normal molar relationship in the primary dentition
because the mesio-distal width of the mandibular molar is greater
than the mesio-distal width of the maxillary molar.
NORMAL SIGNS OF PRIMARY
DENTITION
 Mesial step:
 The distal surface of the mandibular deciduous second molar is
mesial to the distal surface of the maxillary deciduous second
molar.
NORMAL SIGNS OF PRIMARY
DENTITION
 Distal step:
 The distal surface of the mandibular deciduous second molar is
more distal than the distal surface of the maxillary deciduous
second molar.
 The upper molar occludes with two opposing teeth.
THE MIXED DENTITION STAGE
 This is the period when the both deciduous and permanent
teeth are seen.
 It extends from 6 to 12 years of age.
 This stage is divided into two transitional periods:
 First transitional period
 Second transitional period
FIRST TRANSITIONAL PERIOD
 It is the period of emergence of first permanent molars and
transition of incisors.
FIRST TRANSITIONAL PERIOD
Eruption of permanent first molar
 The first permanent molars erupt at 6 years of age.
 They play an important role in the establishing and
functioning of occlusion, in permanent dentition.
 The location and relationship of the first permanent
molar depends much upon the distal surface
relationship between the upper and lower second
deciduous molars.
DECIDUOUS DENTITION WITH FIRST
PERMANENT MOLAR
FIRST TRANSITIONAL PERIOD
 Antero-posterior positioning of the permanent
molars is influenced by:
– Terminal plane relationship
– Early mesial shift
– Late mesial shift
– Differential growth of maxilla and mandible
FIRST TRANSITIONAL PERIOD
 The first permanent molars are guided into the
dental arch by the distal surface of the second
deciduous molars.
 The mesio-distal relation between the distal surfaces
of the upper and lower second deciduous molars can
be of three types:
A. Flush terminal plane
B. Mesial step terminal plane
C. Distal step terminal plane
FIRST TRANSITIONAL PERIOD
 Flush terminal plane
 The distal surface of the upper and lower second deciduous
molars are in one vertical plane. This type of relationship is called
flush or vertical terminal plane.
 It is a normal feature of deciduous dentition.
 The erupting first permanent molars may also be in a flush or end
on relationship.
FIRST TRANSITIONAL PERIOD
 Flush terminal plane
 Transition of an end on relationship to a Class I molar relation,
requires 3-5 mm of space for lower molar to move forward.

 This is achieved by utilization of physiologic spaces and leeway

space in lower arch and by differential forward growth of
mandible.
FIRST TRANSITIONAL PERIOD
 Flush terminal plane
 The shift from a flush terminal plane to a class I relation can occur
in two ways:
 Early mesial shift
 Late mesial shift
FIRST TRANSITIONAL PERIOD
 Early mesial shift
 It occurs during early mixed dentition period.

 The eruptive forces of the first permanent molars are sufficient to

push the deciduous first and second molars forward in the arch to
close the primate space and thereby establish a Class I molar
relationship.
EARLY MESIAL SHIFT
FIRST TRANSITIONAL PERIOD
 Late mesial shift
 Many children lack the primate space and thus the erupting
permanent molars are unable to move forward to establish Class I
relationship.

 In these cases, when the deciduous second molars exfoliate the

permanent first molars drift mesially utilizing the leeway space.
FIRST TRANSITIONAL PERIOD
 Late mesial shift
 This occurs in the late mixed dentition period and thus it is called
the late mesial shift.
LATE MESIAL SHIFT
FIRST TRANSITIONAL PERIOD
 Mesial step terminal plane
 In this type of relationship the distal surface of the lower second
deciduous molar is more mesial than that of the upper.
 The permanent molars erupt directly into Angle’s Class I
occlusion.
 This type of mesial step terminal plane most commonly occurs
due to early forward growth of the mandible.
FIRST TRANSITIONAL PERIOD
 Mesial step terminal plane
 If the differential growth of the mandible in a forward direction
persists, it can lead to Class III molar relation.

 If the forward growth is minimal, it can establish a Class I molar

relationship.
FIRST TRANSITIONAL PERIOD
 Distal step terminal plane
 This is characterized by the distal surface of the lower second
deciduous molar being more distal to that of the upper molar

 The erupting permanent molars may therefore be in Angle’s class

II occlusion
 Abu Bishara et al(1988) studied the changes in the
molar relationship from the deciduous dentition to the
permanent dentition in 121 subjects from Iowa.
 The findings indicate that of the 242 sides evaluated in
the deciduous dentition, 61.6% developed into a Class I
molar relationship, 34.3% into Class II, and 4.1% into
Class III.
 Those sides that started with a distal step in the
deciduous dentition proceeded to develop into a Class II
molar relationship in the permanent dentition.
 Of the sides with a flush terminal plane relationship in
the deciduous dentition, 56% progressed to a Class I
molar relationship and 44% to Class II in the permanent
dentition.
 The presence of a mesial step in the deciduous dentition
indicates a greater probability for a Class I molar
relationship and a lesser probability for a Class II molar
relationship.
FIRST TRANSITIONAL PERIOD
 Incisor Eruption
 During the first transitional period the deciduous incisors are
replaced by the permanent incisors.
 The mandibular central incisors are usually the first to erupt.
 The permanent teeth are considerably larger than the deciduous
teeth they replace.
FIRST TRANSITIONAL PERIOD
 Incisor eruption
 The difference between the amount of space needed and the
amount of space available is called as incisal liability.
 This incisal liability is roughly about –
 7mm in maxillary arch
 5mm in mandibular arch

 The incisal liability is over come by following factors:

A. Utilization of interdental spaces
B. Increase in inter-canine width
C. Change in incisor inclination
FIRST TRANSITIONAL PERIOD
 Utilization of interdental spaces in primary dentition
 The physiologic or the developmental spaces that exist in
the primary dentition are utilized to partly account for
incisal liability.
 4mm in maxillary arch and 3mm in mandibular arch.
 Permanent central incisors are much more easily
accommodated in normal alignment in cases exhibiting
adequate inter-dental spaces than in arch that has no
space.
FIRST TRANSITIONAL PERIOD
 Increase in inter-canine width
 During transition from primary to permanent incisors there is an
increase in the inter-canine width both in the maxillary and the
mandibular arch.
 This increase is an important factor which allows the much larger
permanent incisors to be accommodated in the arch previously
occupied by the deciduous incisors.
FIRST TRANSITIONAL PERIOD
 Change in incisor inclination
 The primary incisors are more upright than the permanent
incisors.
 There is decrease in the inter-incisal angle from about 150° in
deciduous dentition to 123° in the permanent dentition.
 The permanent incisors erupt more labially inclined thus, tend to
increase the dental arch perimeter.
CHANGE IN INCISOR INCLINATION
INTER-TRANSITIONAL
PERIOD
 In this period the maxillary and the mandibular
arches consist of sets of deciduous and permanent
teeth.
 Between the permanent incisors and the first
permanent molars lie the deciduous molars and
canines.
 This phase of mixed dentition period is relatively
stable and no change occurs.
 It usually lasts for about 1.5 years.
INTER-TRANSITIONAL
PERIOD
 The asymmetry in emergence and associated
differences in height levels and lengths is made up .
 Under influence of tongue, the mandibular lateral
incisors attain proper sites within the dental arch and
their initial lingual position is eliminated.
 Small rotation is corrected by the pressure exerted
by tongue and lips.
SECOND-TRANSITIONAL
PERIOD
 The second transitional period is characterized by
the replacement of the deciduous molars and canines
by the premolars and the permanent cuspids.
SECOND-TRANSITIONAL
PERIOD
 Leeway space of Nance
 The combined mesio-distal width of the permanent canines and
premolars is usually less than that of the deciduous canines and
premolars .
 This surplus space is called as the leeway space of Nance.
SECOND-TRANSITIONAL
PERIOD
 Leeway space of Nance
 Maxillary arch- 1.8 mm(0.9mm each side)
 Mandibular arch- 3.4 mm(1.7mm each side)

 This excess space is utilized for mesial drift of

mandibular molars to establish class I molar relation.
LEEWAY SPACE OF NANCE
SECOND-TRANSITIONAL
PERIOD
 The Ugly Duckling Stage
 A transient or self correcting malocclusion is sometimes seen in
the maxillary incisor region between 8-9 yrs of age.

 Particularly seen during the eruption of permanent canines.

SECOND-TRANSITIONAL
PERIOD
 The Ugly Duckling Stage
 Eruption of the developing permanent canines displaces the roots
of lateral incisors mesially
 This results in transmitting of the force on to the roots of the
central incisors which also get displaced mesially
 There is a resultant divergence of the two central incisors causing
a midline spacing.
SECOND-TRANSITIONAL
PERIOD
 The Ugly Duckling Stage
 As the laterals erupt further, narrow portions of their roots are in
proximity to the developing canines causing bulging of maxilla in
the canine region, as the alveolar process develops around the
forming canine.

 Margolis described alveolar process as the servant of the

developing tooth.
SECOND-TRANSITIONAL
PERIOD
 The Ugly Duckling Stage
 Broadbent described this situation as ugly duckling stage as
children tend to look ugly during this phase of development , it is
also known as the Broadbent phenomenon.

 The condition is usually self correcting as when the canines

erupt , the pressure is transferred from the roots to the coronal
area of the incisors.
UGLY DUCKLING STAGE
UGLY DUCKLING STAGE
 7 years old 9 years old 14 years old

Changes in the axial inclination due to the eruption of the maxillary anterior teeth
(Broadbent, 1957).
THE PERMANENT DENTITION
PERIOD
 The permanent dentition forms within the jaws soon
after birth, except for the cusps of the first
permanent molars which form before birth.
 The permanent incisors develop palatal or lingual to
the deciduous molars and move labially as they
erupt.
 The premolars develop between the diverging roots
of the deciduous molars .
 .
THE PERMANENT DENTITION
PERIOD
 Calcification begins at birth with the calcification of
the cusps of the first permanent molar and extends
as late as 25th year of life.
 Complete calcification of incisor crowns takes place
by 4 to 5 years and other permanent teeth by 6 to 8
years except third molars.
 Total calcification period is about 10 years.
THE PERMANENT DENTITION
PERIOD
 The sequence of eruption of permanent dentition :
Maxillary arch –
6 – 1 – 2 – 4 – 3 – 5 – 7 or
6–1–2–3–4–5–7

Mandibular arch –
6 – 1 – 2 – 3 – 4 – 5 – 7 or
6–1–2–4–3–5–7
 CHRONOLOGY
Calcification Crown Eruption Root completed
begins completed
Tooth Max. Mand. Max. Mand. Max. Mand. Max. Mand.

Central 3 mo. 3 mo. 4 ½ yr. 3 ½ yr. 7 ¼ yr. 6 ¼ yr. 10 ½ yr. 9 ½ yr.

Lateral 11 mo. 3 mo. 5 ½ yr. 4 yr. 8 ¼ yr. 7 ½ yr. 11 yr. 10 yr.

Canine 4 mo. 4 mo. 6 yr. 5 ¾ yr. 11 ½ yr. 10 ½ yr. 13 ½ yr. 12 ¾ yr.

1st Pre 20 mo. 22 mo. 7 yr. 6 ¾ yr. 10 ¼ yr. 10 ½ yr. 13 ½ yr. 13 ½ yr.
Molar

2nd Pre 27 mo. 28 mo. 7 ¾ yr. 7 ½ yr. 11 yr. 11 ¼ yr. 14 ½ yr. 15 yr.
Molar

1st Molar 32 wk. 32 wk. 4 ¼ yr. 3 ¾ yr. 6 ¼ yr. 6 yr. 10 ½ yr. 10 ¾ yr.
in utero in utero

2nd Molar 27 mo. 27 mo. 7 ¾ yr. 7 ½ yr. 12 ½ yr. 12 yr. 15 ¾ yr. 16 yr.

3rd Molar 8 yr. 9 yr. 14 yr. 14 yr. 20 yr. 20 yr. 22 yr. 22 yr.
THE PERMANENT DENTITION
PERIOD
 Features of permanent dentition:
 Coinciding midline
 Class I molar relationship of the permanent first molar
 Vertical overbite of about 1/3rd the clinical crown height of
mandibular central incisors.
 Overjet
 Curve of spee
BIBLIOGRAPHY
 Contemporary orthodontics- Proffit
 Orthodontics- T.M.Graber

 Clinical Pedodontics- Finn

 Dentistry for child and adolescent- Mcdonalds

 Wheeler’s :Dental anatomy, Phisiology, and Occlusion-

Ash, Nelson
 Pediatric dentistry-Pinkham

 Textbook of Orthodontics- Gurkeerat Singh

BIBLIOGRAPHY
 Textbook of Pedodontics- Shobha Tandon
 Orthodontics: The art and science- S.I.Balajhi

 Pediatric dentistry- Muthu

 American Journal of orthodontics and oral surgery 1938;

vol 24(5): 409-424.
 Fatima Andelo.Braz Dent J (1998) 9(1): 53-56
 Abu Alhaija. Occlusion and tooth/arch dimensions in the
primary dentition of preschool Jordanian children.
Int J Paed Dent.2003;13:230-239
 Bishara SE, Hoppens BJ, Jakobsen JR, Kohout FJ Changes in the
molar relationship between the deciduous and permanent dentitions: a
longitudinal study. Am J Orthod Dentofacial Orthop. 1988; 93(1): 19-
28.
BIBLIOGRAPHY
 Farsi NM, Salama FS. Characteristics of primary dentition occlusion
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