DEVELOPMENT OF OCCLUSION Introduction

Ideal occlusion is not easy to learn as it is not a static condition but a changing function process, undergoing continued modifications and adjustments during the whole life of deciduous and permanent dentition. The achievement of normal occlusion is the result of so many interrelated variables starting from the prenatal developmental stages. The multiplicity and complexity of these factors are such that often malocclusion exists but occasionally there can be found a mouth without orthodontic problems. The active supervision of the developing dentition is a responsibility of the pedodontists. Seeing things from the beginning is the most advantageous. By making a detailed studies of dentition from initiation through eruption till functional occlusion, we may be able to obtain a clear concept of how occlusion develops and how its development can be guided. cclusion is the approximation of upper and lower teeth, centric occlusion is the maximum intercuspation between upper and lower

teeth. "entric relation is defined as the contact of teeth #$ % &' in most retruded position of the mandible so that condyle is in its most posterior position with respect to glenoid fossa for the maximum comfort of the patient. The development of the concepts of occlusion There are various trends in the development of the concept of occlusion. the trend ranges from static to dynamic. The various periods in the development of concept of occlusion are( ) ) ) *ictional period. +ypothetical period. *actual period.

Fiction!l period " #$th centur% ,ccording to Talbot, concept of normal occlusion was that it was a historical event and passed in the decline of the species this hardly served as an inspirator for those to follow who were helpful of preventing, intercepting and treating developing malocclusion.

&%pothetic!l period a. Edward H. Angle in 1899 .ut a hypothesis stating that in the normal occlusion, it will be seen that each dental arch describes a graceful curve, and that all the teeth in the arches are so arranged as to be in harmony with their follows int eh same arch, as well as with opposite arch. /ach tooth helps to maintain every other tooth in these harmonies relations for the cusps to interlock and each inclined plane serves to prevent each tooth from sliding out of position. This basis created the impression of static relationship. b. Mathew Cryer and Calvin Case: 1905 ,ccording to them occlusion refers to the closure of the teeth, one upon the other, and normal dental relations, normal occlusion and typical occlusion refers to the standard anatomical occlusion. +e rejected the first molar for the basis of normal occlusion. +e told normal occlusion and normal facial lines are inseparable. +e used nose, chin button areas in reference to the relative position of the teeth.

c.

Lischer and Pa l !i"#n: They broadened the concept of occlusion by relating the teeth to

the rest of the face and cranium. &ischer introduced the act of mastication as re1uisite part of the definition. Sinon made an approach to normal occlusion only through biometry i.e. the anthropometric approach. d. Mil# Hell"an +e showed a racial variations in normal occlusion. he studied the number of skulls. But this still remained as static occlusion. F!ctu!l period This concept divides the line between static and dynamic concept of occlusion. In !203, Broadbent introduced an accurate techni1ue of roentgenographic cephalometry, which eliminated most of the disadvantages of anthropologic measurements. +e followed

longitudinally the orofacial developmental pattern, tooth formation, eruption and adjustment.

In his concept, he considered the psychologic rest position, which means that it is the position of mandible, where the muscles are in a relaxed position. It is constant throughout life. n the other hand, it may become smaller even disappear entirely. This is of utmost importance, because once it reduces, patients often complains atleast the tiredness in chewing muscles. The patients often complain of clicking of the joint too. This gives a concept of dynamic occlusion. This shows the evolutionary changes of occlusion

,nthrolopithecus Evolution!r% ch!n'es

5amapithicus

The primitive cartilage of the jawless fish developed into the jaws of the palacoderm, and as evolution continued it developed into jaws of modern mammals.

The mammalian dentition goes back to 76 million years. The dental formula of the early primates consisted of - incisors, ! canine, 4 premolars, 0 molars. The theories behind this are( a. Theory of concrescence i.e. mammalian dentition was produced by the fusion of - or more primitive conical teeth. b. Theory of trituberculy /ach mammalian tooth was derived from single reptilian tooth by a secondary differentiations of the tubercles and roots. c. Theory of multituberculy: The mammalian dentition is the result of reduction and condensation of primitive multituberculate teeth. 8olla " #!293' studied different stages of the permanent tooth development. +e arbitrarily divided the development of each tooth into ten stages( 3 absence of crypt. ! .resence of crypt.

- Initial calcification. 0 !:0rd crown completion. 4 -:0rd crown completion. 6 "rown almost completed. 9 "rown completed. 7 !:0rd root formed. ; -:0rd root formed. 2 5oot almost completed but open apex. !3 5oot completed. In stage 9 most teeth being eruptive movements and in stage ; most teeth pierce alveolar crest. The humans have two sets of teeth( a. .rimary teeth. b. .ermanent teeth. The dental formulae for primary dentition is -!3- and permanent teeth is -!-0. St!'es of occlus!l development Acc#rding t# $arnett 19%8 a. Ist stage #0years' < primary dentition. b. -nd stage #9 years' < eruption of first permanent molars. c. 0rd stage #9)2 years' < exchange of incisors.
7

d. 4th stage #2)!- years' exchange of canine and premolars. e. 6th stage #!- years' < eruption of -nd molars. Post n!t!l development of occlusion "an be divided into #according to =ander &inden' !. Birth to complete primary dentition. -. *irst intertransitional period. 0. *irst transitional period. 4. Second intertransitional period. 6. Second transitional period. 9. ,dult dentition. (irth to Complete eruption of prim!r% dentition ,t birth the alveolar processes are covered by gumpads, which are firm and pink. The basic form of the arches is determined in intra) uterine life around 4 months. Thus the gumpads are alveolar arches at the time of birth. They develop in two distinct parts, a labio)buccal and a lingual portion of these labiobuccal part is differentiated first and grows more rapidly and gets divided into ten segments by transverse grooves. &ingual portion which is differentiated later remains entirely smooth.

The buccal part is divided into ten segment by transverse grooves, each corresponding to a deciduous tooth sac. It is papillomatous at first. The groove between canine and first deciduous molar crypts is important in assessing the relation of two pads. Their groove is referred to as lateral sulcus.

The lingual groove portion which develops later is separated by dental groove which is the site of origin of dental lamina. &ingual portion is limited lingually by gingival groove. In the upper jaw, gingival groove separates from the palate and is related to inner alveolar plane. The grooves are more clear in upper arch than the lower arch.

The dental groove of the upper gum pad passes from the incisive papilla and moves laterally and lingually, to join the gingival groove in canine region and then continues distally and buccally across the segment of the gum pads corresponding to the first deciduous molar tooth crypt. The lower gum pad is $)shaped and is limited on the lingual aspect by a continuous groove. The gum pad is divided by transverse grooves into ten segments not as clearly as upper anteriorly gum pad is slightly everted. The lateral sulcus again passes at canine region. The si>e of the gumpads at birth is determined by the following factors( ) ) ) ) State of maturity of infant at birth. Si>e at birth as expressed by birth weight. Si>e of the developing primary teeth. .urely genetic factors. The mandibular gum pad is distal to maxillary gum pad average -.7mm in males and -.6mm in females. The labial frenum varies in its attachment at birth and may be found at the crest of gum pad, high above the crest or even continuous with the incisive papilla.

!3

?uring the first year, gumpads grow rapidly in the lateral direction, with development of deciduous teeth, there is an increase in labio)lingual dimensions of the gum pad. )el!tionship of 'ump!ds ,t rest gumpads are separated by the tongue and protrudes over the lower gum pad to lie immediately behind lower lip. ,t this age, upper lip appears very short. The gum pads do not have a definite relationship when occluded. The antero)posterior movements vary and there are no lateral movement. The upper gum pad is wider than lower and when two are approximated, there is a complete overjet all around the lower gum pad. The lateral sulcus of lower is usually posterior to that of upper. The contact is only seen in first deciduous molar region. It is common for a vertical space to exist between upper and lower incisor segment even when they are pressed into occlusion. this appears to be linked with the position of tongue. ,t birth, the incisors are crowded and rotated in their crypts and as the gumpads grow during first year of life now they are in good alignment and spaced. Inspite of this incisors may erupt in irregular relation to each other. But, this however is temporary and later gets corrected by the tongue and lip pressure.

!!

"linch #!204' in @r of

rthodontics demonstrated the increase in

the si>e of the alveolar arches from birth to the time just before the eruption of the incisors. The arches increase in both length and breadth. ,t birth no teeth are visible usually. The upper gum pad usually overlaps the lower anterior pad by about 3.6mm. ,t birth, the tooth buds of all primary teeth are present and in various stages of development. The incisors are somewhat crowded at this time for two reasons. !. The arches have not yet complete rounded out anteriorly. nly

during the first ;)!- after the birth are the jaws are capable of significant anterior apposition thereafter posterior growth and anterior displacement accounts for the increase in jaw si>e. -. The development of posterior teeth takes later hence follicles are slower in achieving their complete si>e. $sually, by the end of first year, sufficient jaw growth has occurred that the primary teeth are seldom crowded or overlapped. Infact a normal desirable dentition at this stage will exhibit spacing. The extensive early transverse development of both jaws can be reali>ed as mainly because of the presence of mid)palatine suture in maxilla and in mandible, the mandibular synchondroses.
!-

The

mandibular

synchondrosis calcifies at around ! year of life but maxilla maintain its transverse growth potential till about !- years of age. The growth in the both arches is not coordinated till the occlusion is established in the posterior region after which the development of both dental arches are coordinated. Ch!r!cteristics of Prim!r% dentition The cardinal feature of primary dentition in contrast to the permanent teeth is that they drop almost vertically into the mouth re1uiring very little mesiodistal or bucco)lingual adjustments in their eruptive movement. ,t this age, the roots of primary cuspids and molars are not yet complete and the crowns of the permanent central incisors, lateral incisors, cuspids and first molars are in various stages of formation. By 03 months of age, 73A of all children have their primary dentition fully erupted but a great deal of variation exists. /ruption se1uence of primary dentition according to BBjorkC.

!0

"I, &I, Ist molars, canines, -nd molars.

"I $pper &ower #mth' 7!:9 &I #mth' 2 7 " #mth' !; !9 ID #mth' !4 !IID #mth' -4 -3 ,ccording to &ogen and Eronfeld

.rimary dentition can be broadly classified into two types( a. Spaced arches. b. "losed arches. Spacing was first described by ?ellabarre in the year !;!2 in the deciduous dentition between the ages of 4)9 years. The absence of spacing in the primary dentition is an indication that crowding of teeth can occur later when larger teeth erupt. If 9mm of total space is there no crowding develops. If 0)9mm, -3A may develop crowding. If less than 6mm, 63A may develop crowding. If no spaces, 73A may develop crowding. If crowding, !33A develop crowding. Sp!ces in prim!r% dentition It is very common to find the physiological spaces in the primary dentition, with the most prevalent spaces mesial to the primary canines in maxilla and distal to the primary canine in the mandible. These spaces

!4

are called the primate spaces or simian spaces as they are commonly seen in the primates and are characteristics of the primary dentition. Boyko #!29;' in ,merican @r. of rthodontics found that 7;A

had bilateral primate spaces in both upper and lower arches, 2;A of boys had bilateral primate spaces in the maxilla and ;9A in the mandible. The primate #simian or primate' space is about -mm and generali>ed interdental spacing is seen between teeth which measures about. These are also called as developmental or physiological spacs. Occlus!l rel!tionships of the second prim!r% mol!rs The primary dentition is complete after the eruption of the - nd primary molars. This means that the location for the eruption of the permanent teeth in the future has already been determined at this stage. The relation of the distal surface of the maxillary and mandibular second primary molar is, therefore, one of the most important factors that influence the future occlusion of the permanent dentition. The mesio) 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 the centric occlusion. the terminal plane can be classified into three types(

!6

Flush or vertic!l pl!ne t%pe The distal surfaces of the upper and lower teeth are on the same vertical plane. This plane would produce end)on relationship of the first permanent molars. The change from a flush terminal plane to a mesial step plane is desirable. *or the transition from end)on to "lass I relation, the lower molars have to move forward by 0)6mm. This is achieved by two principles. !. /arly mesial shift ( ccurs in children with spaced arches.

/ruptive force of the first permanent molar is sufficient to mesiali>e the / and ? in the arch to close the primate space. This occur in the early mixed dentition stage. -. &ate mesial shift ( ccurs in children with closed arches. The first permanent molar drifts mesially by utili>ing lee)way space of nance. This occurs in the late mixed dentition stage. Mesi!l step The distal surface of the lower molar is more mesial to that of the upper. This is highly desirable as it would permit an immediate "lass I first permanent molar relationship upon eruption. The mesial step most

!9

commonly occurs due to the early forward growth of the mandible, if the differential growth of the mandible continues it can lead to ,ngleCs "lass II molar relation and if the forward mandibular growth is minimal it can establish ,ngleCs "lass I molar relationship. Dist!l step The distal step of the lower molar is more distal to that of the upper. The persistence of distal step would be consistent with establishing an ,ngles "lass II first permanent molar relationship. ,mong @apanese children, the vertical type is the most prevalent and also "aucasian children. ,lexander and .rabhu #!22;', I@ of .ed. ?entistry, conducted a study on !3-9, 0)4 years old children to assess the profile, occlusal relationships and presence of spacing or crowding of teeth in South India males had a higher incidence of straight profiles, but it was not statistically significant. 76A of both sexes had both physiologic and primate spaces and 0A population were devoid of spacing. The convex profiles were significantly correlated with flush and distal step terminal planes in both sexes. *oster T.?. and +amilton in !292 in Br. ?ent. @r. stated after the completion of the primary dentition, the ideal features are the following(
!7

) ) ) )

Spacing of incisor teeth. ,nthropoidal spaces. *lush terminal plane. ?eep bite and decreased overjet.

First intertr!nsition!l period This period is between the completion of primary dentition and the emergence of first permanent teeth and is marked by little obvious intraoral changes and multiple intrabony activities. The arches by this time are capable of significant growth leading to space for the first permanent molars, which is achieved posteriorly by tuberosity apposition in the maxilla and ramal resorpting in the mandible. ?uring the early part of this period, the tooth buds for ! st and -nd premolar begin to form between furcations of the primary molar roots. The first permanent molar crowns are fully developed and roots are starting to form. ,t the stage there is some indication of the future occlusion. There may be excessive overbite and retrognathic tendency of the mandible.

!;

,t 6)9 years of age, just before shedding of deciduous incisors, there are more teeth in the jaws than any other time. Description of occlus!l cont!cts in prim!r% dentition ,ll the maxillary teeth except the maxillary second molars occlude with two opposite teeth in the mandibular arch. The maxillary second molar only occludes with the mandibular second molar. ,ll mandibular teeth except the central incisors occlude with two opposite teeth in the maxillary arch. The lower central incisors only occlude with the maxillary centrals. /ach mandibular tooth is one)half cusp mesial to the corresponding maxillary tooth, there by establishing the following dental relationship. The primary maxillary cuspid occludes distally to the mandibular cuspid and mesially to the mandibular first primar molar. The maxillary first primary molar occludes between the distal aspect of the mandibular second primary molar. The contacts between the upper and lower teeth can be described as surface contact, or as cusp point contact with a fossa, groove or embrasure, or ridge contact with embrasure, or ridge contact with groove.

!2

F!ctors 'uidin' norm!l occlusion in prim!r% The achievement of a normal occlusion is dependent upon a number of factors. Neuro*muscul!r consider!tions The action of the muscles of mastication on TD@ and also tongue and cheek muscles are largely responsible for this relationship. These masticatory muscles are controlled by a system of complex)neuronal circuit consisting of sensory input to the "8S, and formation, generation of appropriate motor responses. Interdigitation occurs se1uentially from the first teeth to erupt i.e. central incisors. ,s other new teeth appear the muscles learn to effect the necessary function occlusal movements. Since the primary occlusion is established during periods of ready developmental adaptation, there is less variability in occlusal relationship in primary when compared the permanent. The primary teeth are guided into their occlusal position by the functional matrix or muscles during very active growth of facial skeleton. The low cuspal height and ease of occlusal wear also make the primary occlusion more adaptable.

-3

Fhen teeth are erupted and muscles are functioning, the arch formed by the crowns of the teeth is altered by muscular activities, although original arch form is not probably determined by the muscles. First tr!nsition!l period The first exchange of teeth begins around six years of age and is usually completed within two years. ?uring this time span the permanent first molars erupt posterior to the primary teeth and this change usually goes unnoticed and the obvious exchange of eight incisors occurs. The chronology of exfoliation can be determinant of maturation in children and se1uence of exfoliation can influence the order of eruption of succedaneous teeth. There is bilateral symmetry of tooth loss and the mandibular teeth exfoliate earlier than maxillary only the -nd molars exfoliate at the same time. In girls, teeth exfoliate earlier than boys. This difference is greatest for canines especially. In the mandibular arch #!3 months' and least for maxillary incisors #!)0 months'. The rank of exfoliation of each tooth is the same for both sexes. In the mandibular arch the teeth are lost in order from anterior to posterior part of mouth but in maxillary, the posterior progression is disrupted by the canines which exfoliate after the first deciduous molars

-!

with the eruption of first permanent molars first of the three assaults on the excessive overbite occurs. ,s the upper and lower first permanent molars erupt, the pad of tissue overlying them creates a premature contact. The proprioceptive response leads to the increased eruption of deciduous teeth anterior to first permanent molar, thus reducing the overbite. The upper and lower first permanent molars display contrast pathways of eruption. The tooth buds of the lower first permanent molars are mesially and lingually inclined. The upper permanent first molar bud develop with a buccal and distal orientation. The mesiodistal relationship of the permanent molars is determined by the alignment of distal surfaces of -nd primary molars. The later mesial shift occurs because of &ee)way space of 8ance. The mesiodistal dimension of the primary molars is more than the mesiodistal dimensions of premolars. This difference of !.7mm unilaterally in mandible and 3.2mm unilaterally in the maxilla. ,ccording to Doyers !.4mm mandible unilaterally. The permanent incisors will start erupting in the early mixed dentition period. ,t 4 G years the crowns of permanent central incisors

--

will be fully developed and located above and slightly lingual to the roots of primary incisors. $sually mandibular central incisors erupt first, followed by maxillary permanent central incisors. The mandibular incisors erupt lingual to the deciduous counterparts, while the maxillary permanent incisors appear as large bulges in the muco)buccal vestibule above the deciduous incisors before they erupt. Since the permanent incisors are larger than the primary incisors, inorder for the anterior tooth buds to fit within the jaws lingual to their antecedents, they must overlap and assume different vertical levels. In the maxilla, particularly the lateral incisors are situated behind the centrals and cuspids in addition to their labial position are located furthest from the occlusal plane. #The longer the root, the more away from the occlusal plane is the tooth bud'. In the lower jaw, the cuspids are so inferior as to be almost at the mandibular border. The labial movement of the anterior teeth effects on the obli1ue resorption of the roots of the primary teeth. Fithin few months of appearance of the first permanent molars, the lower central incisors erupt. The upper centrals emerge a few months

-0

late followed by lower lateral incisors. The upper centrals are the last teeth to appear in the fist transitional phase. Because of the discrepancy in the mesiodistal crown width between the primary and permanent incisors, space available for the permanent teeth after the exfoliation of the antecedents is barely sufficient Dayne in !292 has coined the term HIncisal liabilityI for this difference. It is 7.!;mm in the maxilla and 6.39mm in mandible. This will be compensated by( ) ) The inter dental spacing of primary incisors. Increase in the intercanine width #0mm by eruption of &I in maxilla and mandible and in maxilla further !.6m by eruption of canines'. ) The average arch position of the maxillary central are -.-mm anterior to the primary incisors. ) "hange of tooth axis of incisors. The interincisal angle is !63J in the primary dentition !-0J in permanent dentition. Fhen the mandibular lateral incisors emerge, not only they push the primary lateral incisors labially but also more the primary cuspids distally and laterally, closing the primate space or an unusual resorption

-4

of the primary cuspid root. Fhen the mandibular primary cuspids are lost prematurely, the anterior arch loses its stability and incisors may tip lingually by the hyperactivity of the mentalis muscle. This lingual tipping of incisors permits the developing cuspid to slide labially where it may erupt later in labioversion. In maxilla, there is a diastema often found between central incisors this may be because the central incisors often erupt with a slight distal inclination. The maxillary lateral incisors on the other hand, experience more difficulty in assuming their normal position, for as they are erupting, the developing crown of the maxillary cuspids lies just labial and distal to their roots. This position often causes the lateral incisors to erupt more palatally than central incisors. ,fter the erupting cuspid has changed its course the lateral incisors correct itself and come into position besides the central incisors. Thus, as the end of first transitional phase the incisors are present sometimes slightly crowded in the mandible and spaced in the maxilla with more labial inclination than their antecedents. The first permanent molars are erupted usually with an end on relationship.

-6

Kellin and +aley #!2;-' Int. @. ?ent. "hild conducted a clinical study to determine if removal of the corresponding primary tooth is necessary when the lingual eruption pattern of permanent incisor is identified. They monitored 67 lingually positioned permanent central or lateral incisors in 44 children. They concluded that the spontaneous correction of lingually erupted mandibular incisor occurred in 26A of cases by the age ; years, - months to 4 months. U'l% duc+lin' st!'e "hildren tend to look ensued during the time of exchange of their incisors, especially in the upper arch. Because of the presence of diastema the parents become worriedL and often frenum is sacrificed in an effort to remove the cause of the space between the centrals. This transitional malalignment during the exchange period of upper incisors is called as ugly duckling stage, the term coined by Broadbent in !207. This is corrected later when the canines erupted and the pressure is transferred from the roots to the crown of the incisors. If diastema is very much abnormal #M 4mm' investigations has to be carried out to rule out the presence of midline pathologies.

-9

,nd intertr!nsition period ,lmost ! year gap between !st and -nd transitional period. ?uring this in space dentition the end)on will correct to the "lass I molar relation. &o and Doyers in !260, ,merican @r. f rthodontics, studied

the se1uence of eruption of maxillary and mandibular permanent teeth on a sample of -09 children. The most fre1uent in the maxilla was 9!-4607 appeared 4;.7-A of the time. There were !; possible se1uences. ) ) 9!-4067 !9.3!A 9!-4670 !!.;7A

In mandible, !7 different se1uences were noted( ) ) ) 9!-0467 was found in 46.77A 9!-0476 were found in !;.94A 9!-4067 were found in ;.47A They reported the combination of eruption se1uences of 9!-4607 in maxilla and 9!-0467 in mandible provides the greatest incidence of normal molar relationship.

-7

8anda #!270' in @r. of ?ental 5esearch, reported that most common se1uence of tooth emergence is 9!-4067 in maxillary arch and 9!-0467 in the mandibular arch( The factors affecting the se1uence of eruption( ) ) ) /ndocrine #K+, T+'. *amilial tendency. Dental development.

Second tr!nsition!l period The primary cuspids and molars are shed and permanent cuspids and premolars erupt and -nd permanent molars erupt. It is commonly occurs between the ages !3)!- years. ccasionally maxillary cuspid and second premolar will erupt simultaneously and mandibular cuspid and first premolar erupt simultaneously. The maxillary and mandibular -nd permanent molars are the last teeth to erupt. They start erupting at the age of !-)!0 years and this delay may be due to lack of space.

-;

The maxillary -nd molar is tilled distally and buccally and mandibular -nd molar is tilted mesially and lingually with the emergence of teeth, they are guided into occlusion by the Hcone funnelI mechanism and not until contact is attained do these teeth start to upright. If the -nd molar erupts before -nd premolar, there is tipping of first molar thus reducing space for the erupting second premolar. The eruptive force of the -nd molar helps in late mesial shift and it also acts as bite)opener. -dult dentition ,lthough after the exfoliation of last primary tooth, the dentition is considered as adult, it is only around the -3 th years when the 0rd molars have erupted and finished root development, the adult dentition is completed. 0rd molars show more variability in calcification and eruption than do any other teeth. There is evidence of ethnic differences. The finnish a1uire their 0rd molars, later than middle ,merican whites and south Indians show eruption as early as !0)!4 years.

-2

,ndrews < 9 keys to normal occlusion( ,ndrew during !273s put forward 9 keys to normal occlusion. +e considered the presence of these features essential to achieve an optimal occlusion. !. Dolar inter arch relationship. -. Desio)distal crown angulation. 0. &abio)lingual crown inclination. 4. ,bsence of rotation. 6. Tight contacts. 9. "urve of spee. Mol!r inter*!rch rel!tionship The mesio)buccal cusp of the upper first molar should occlude in the groove between mesial and medial buccal cusp of the lower firt molar. The mesio)lingual cusp of upper first molar must be angulated so that the distal marginal ridge occludes with the mesial marginal ridge of lower second molar. Mesiodist!l cro.n !n'ul!tion It is the line that passes along the long axis of the crown through the most prominent part in the center of labial or buccal surface. *or the normal occlusion, the gingival part of long axis of the crown must be
03

distal to the occlusal part of line. ?ifferent teeth exhibit different crown angulation. The l!/io*lin'u!l cro.n inclin!tion The crown inclination is determined from a mesial or distal view. If the gingival area as the crown is more lingually placed from the occlusal area, it is referred to as positive crown inclination and the opposite is referred to as negative crown inclination. The maxillary incisors exhibit a positive crown inclination, while the mandibular incisors show a very mild negative crown inclination. The maxillary and mandibular posterior have a negative crown inclination. -/sence of rot!tion 8ormal occlusion is characteri>ed by absence of any rotation. 5otated posterior teeth occupy more space on the dental arch while rotated incisors occupy less space in the arch. Ti'ht cont!cts To consider an occlusion as normal, should be light contact between adjacent tooth.

0!

Curve of spee , normal occlusal plane according to ,ndrew should be flat, with the curve of spee not exceeding !.6mm.

Summ!r% !nd Conclusion

Kuidance of eruption and development of the primary and permanent dentitions is an integral part of the speciality of pediatric dentistry. /arly diagnosis and successful treatment of developing malocclusion can have both short term and long term benefits while achieving the goal of occlusal harmony, function and dental facial esthetics. The understanding of the normal occlusion indicate whether prevalence and interceptive orthodontic procedures can be applied or not.

)eferences
!. Fhite % Kardner < Book of orthodontics. -. Doyers. 0. =ander &indon < ?evelopment of occlusion. 4. Dc?onald < Text book of children through adolescence. 6. Kraber < Text book of orthodontics. 9. Fheeler < Text book of ?ental anatomy.

0-

CONTENTS
I8T5 ?$"TI 8 ?/=/& .D/8T * " 8"/.TS * ""&$SI 8

a. *ictional .eriod b. +ypothetical .eriod c. *actual .eriod

/= &$TI 8,5N "+,8K/S ST,K/S * ""&$S,& ?/=/& .D/8T . ST 8,T,& ?/=/& .D/8T * ""&$SI 8 BI5T+ T " D.&/T/ ?/=/& .D/8T * .5ID,5N ?/8TITI 8 5/&,TI 8S+I. * K$D.,?S "+,5,"T/5ISTI"S * .5ID,5N ?/8TITI 8 S.,"/S I8 .5ID,5N ?/8TITI 8 ""&$S,& 5/&,TI 8S+I. * -8? .5ID,5N D &,5S

a. *lush r =ertical .lane Type b. Desial Step c. ?istal Step

*I5ST I8T/5T5,8SITI 8,& ./5I ? ?/S"5I.TI 8 * ""&$S,& " 8T,"TS I8 .5ID,5N ?/8TITI 8 *,"T 5S K$I?I8K 8 5D,& ""&$SI 8 I8 .5ID,5N ?/8TITI 8

a. 8euromuscular "o)ordinations
*I5ST T5,8SITI 8,& ./5I ? $K&N ?$"E&I8K ST,K/ S/" 8? I8T/5T5,8SITI 8,& ./5I ? S/" 8? T5,8SITI 8,& ./5I ? ,?$&T ?/8TITI 8 ,8?5/FCS SIO E/NS 8 8 5D,& ""&$SI 8

00