Journal of Oral Rehabilitation
Journal of Oral Rehabilitation 2016 43; 205–214
Review
Biomechanics of occlusion – implications for oral
rehabilitation
C. C. PECK Faculty of Dentistry, The University of Sydney, Sydney, NSW, Australia
SUMMARY The dental occlusion is an important
aspect of clinical dentistry; there are diverse
functional demands ranging from highly precise
tooth contacts to large crushing forces. Further,
there are dogmatic, passionate and often diverging
views on the relationship between the dental
occlusion and various diseases and disorders
including temporomandibular disorders, non-
carious cervical lesions and tooth movement. This
study provides an overview of the biomechanics of
the masticatory system in the context of the dental
occlusion’s role in function. It explores
the adaptation and precision of dental occlusion, its
role in bite force, jaw movement, masticatory
performance and its influence on the oro-facial
musculoskeletal system. Biomechanics helps
us better understand the structure and function
of biological systems and consequently an
understanding of the forces on, and displacements
of, the dental occlusion. Biomechanics provides
Introduction
This study outlines a presentation at the 2013
Colloquium on Oral Rehabilitation (CORE) in China,
which explored the biomechanics of dental occlusion,
including the structure–function relationships
between the occlusion and the temporomandibular
joint and jaw muscles. Further, it describes how the
dental occlusion and biomechanical concepts are
important in influencing adaptation of the masticatory
system and how we may use this in oral rehabilita-
tion.
The Glossary of Prosthodontic Terms defines dental
occlusion as the static relationship between the
© 2015 John Wiley & Sons Ltd
insight into the relationships between the
dentition, jaws, temporomandibular joints, and
muscles. Direct measurements of tooth contacts and
forces are difficult, and biomechanical models have
been developed to better understand the
relationship between the occlusion and function.
Importantly, biomechanical research will provide
knowledge to help correct clinical misperceptions
and inform better patient care. The masticatory
system demonstrates a remarkable ability to adapt
to a changing biomechanical environment and
changes to the dental occlusion or other
components of the musculoskeletal system tend to
be well tolerated.
KEYWORDS: dental occlusion, bite force, biomechanics,
temporomandibular disorders, stomatognathic
system, temporomandibular joint
Accepted for publication 5 August 2015
incising or masticating surfaces of the maxillary or
mandibular teeth or tooth analogues (1). This aligns
with much of clinical practice in which assessment
and description of the occlusion is of interarch tooth
relationships in static jaw positions, such as in inter-
cuspal, lateral or protrusive jaw positions. Whilst sta-
tic positions are relatively easy to describe and
assess, teeth contacts need to be assessed from a
functional perspective and a more fitting definition
of dental occlusion is the dynamic biological relation-
ship of the components of the masticatory system
that determine tooth relationships (2). Any definition
needs to encompass the enormous individual varia-
tion in the human population, and it must be
doi: 10.1111/joor.12345
206 C. C. PECK
emphasised that stable occlusal relationships are the
norm (2).
The discipline of biomechanics enables us to better
understand the dental occlusion through an under-
standing of structure–function relationships. Biome-
chanics explores the mechanical characteristics, such
as forces and motion, of biological systems and utilises
direct assessment when possible or, for instance,
mathematical modelling to help derive the mechanical
properties. For example, it is currently very difficult
or impossible to measure all biomechanical variables
directly such as the muscle and dental occlusal forces
during normal jaw function. Furthermore, measuring
devices such as force gauges and motion recorders
will alter and likely influence the biological environ-
ment being studied. Take for example, gauges used
between the teeth to measure bite force which
increase interincisal gape and prevent normal func-
tion.
The masticatory system is functionally complex
with six degrees of movement possible (i.e. movement
anywhere in space described as translation along and
rotation about three mutually orthogonal axes) and
coactivation of sixteen jaw muscle groups resulting in
complex force interactions at the teeth. This jaw sys-
tem is indeterminate, and theoretically, there are infi-
nite muscle coactivation patterns to produce a desired
bite force or jaw movement. However, reproducible
tooth contact movements (3) and rhythmic jaw
movements are common during function with a regu-
lar motor command pattern generated in the brain-
stem (4).
Occlusion: a system of adaptation and
precision
There are few areas in dentistry that engender the
level of heated debate as does the area of dental occlu-
sion. Whilst no one will argue about Posselt’s state-
ment that ‘occlusion is a basic principle in dentistry’
(5), there is limited evidence for the definition and
evaluation of occlusion among dental procedures (6)
and there is confusion regarding the optimal occlusal
relationship (7). Reasons for this include the large
variation in dental occlusions in the population, the
lack of validated diagnostic criteria for many occlusal
problems and the term malocclusion which suggests
something is wrong even though 70% of American
youths have a malocclusion (8). It is important to note
that a particular occlusal scheme is not a predictor of
disease, and there is significant overlap of occlusal fea-
tures between individuals with and without jaw disor-
ders (9, 10). Indeed, the diversity in occlusal patterns
in populations has likely increased markedly with the
advent of farming and industrialisation and conse-
quent reduction in selective pressures that cause
genetic adaptation (11). Studies of Australian Aborigi-
nal populations who lived traditionally demonstrate a
high frequency of bimaxillary protrusion, significant
occlusal and interproximal tooth wear and balanced
occlusion (bilateral posterior dental contacts during
lateral movement, 1) and group function (multiple
tooth contacts on the working side during lateral jaw
movement, 1) which are related largely to functional
demands (12). More recent changes are demonstrated
in Finland where occlusal schemes have been com-
pared over the past 400 years (13). In the 17th cen-
tury, distal bites, deep bites, posterior cross-bites and
maxillary crowding occurred in less than 5% of a Fin-
nish community; this has increased to prevalences of
between 15 and 25% in the 1950s, reportedly as a
result to changing functional demands, viz. the dietary
transition from hard to soft food. These occlusal
changes, exemplified above in Australian Aboriginal
and Finnish populations, are likely a result of contin-
ual adaptation to functional demands. Indeed, anterior
guided occlusions, which currently predominate in
many societies, were likely present in these earlier
societies as a transient phase during an individual’s
development (14). Furthermore, whilst there is no evi-
dence to suggest one occlusal scheme predominates
over another (15), it has been suggested that in oral
rehabilitation, canine guidance is frequently favoured
over group function (16), and this is likely because of
its relative ease in design and fabrication and relatively
lower muscle activity and consequently lower forces
on the dentition (16). Another frequent structure–
function relationship encountered relates to the
orientation of the dentition; the Curves of Spee and of
Wilson (1). They are likely formed to ensure teeth are
aligned parallel to jaw-closing forces so that the forces
are transmitted along the tooth axis and thus minimise
any damage to the dentition and periodontium. As
well, the occlusal scheme can influence muscle struc-
ture by altering mitochondrial content, cross-sectional
area of muscle fibres, fibre-type composition jaw-
closing muscle size and ultimately may enhance masti-
catory ability (17).
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 BIOMECHANICS IN ORAL REHABILITATION
Occlusal perception is great, with most individuals
being able to detect thicknesses of 10–35 lm between
the teeth (18). Furthermore, we are able to precisely
grasp and position a food bolus between our teeth
and the forces needed for this are largely regulated by
periodontal mechanoreceptors (19). These receptors
are particularly sensitive for such light ‘holding’ forces
and demonstrate highest sensitivity for forces below 1
Newton applied to the anterior teeth and 4 Newtons
for the posterior teeth (20). Loss of periodontal
attachment, dental anaesthesia and dental implants
all impair this functional ability (19, 21–24). Con-
versely, it may be expected that disturbance of the
periodontium (e.g. trauma) could result in a persistent
sensitisation of the periodontal mechanoreceptors and
a heightened occlusal awareness. Importantly, such
phenomena may be influenced by psychological and
social aspects as is the case with sensitisation and
chronic pain (25).
Occlusion and bite force
Today, a functional dental occlusion is required pri-
marily for mastication by providing the ‘tools’ within
the masticatory system through which to apply mus-
cle forces to incise and comminute foods. Whilst the
teeth can be used for other tasks such as prehension
or as weapons, this is not the norm in modern human
society. Bite forces are generated by the coactivation
of predominantly the masseter, medial pterygoid and
temporalis muscles (the primary jaw closer muscles).
These jaw closer muscles’ potential force generation is
related to their cross-sectional size and muscle length
(27). A muscle can generate in the order of
37 N cm 2 at its optimal length which lies somewhere
between a shortened and fully extended muscle (27).
For the jaw closer muscles, this optimal length lies at
a position between jaw closed and wide gape posi-
tions, and for each of the closer muscles, this optimal
position is not necessarily at the same gape. Conse-
quently, when all jaw closer muscles’ optimal length
are considered, humans can generate maximum clos-
ing force not with the teeth intercuspating, but at two
gapes: an interincisal gape at approximately 20 mm
and again at 40 mm (28).
The modern occlusal pattern is largely dictated by
the forces applied to the jaw system. Whilst bite forces
tend to be predominantly aligned vertically and paral-
lel with the long axis of the teeth, with grinding of
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207
foods, there are sheering forces between the teeth with
forces directed laterally and/or anteroposteriorly. To
measure these is not trivial as sensors need to be able
to detect such three dimensional forces and not inter-
fere with the dental occlusion or function. Methods
have been developed for this in the research setting;
for example, telemetry has been used with an eight-
channel force transmitter in a removable fixed partial
denture (29). However, simple bite force gauges are
commonly used in which typically uniaxial vertical
forces are measured between pairs of opposing teeth
or across the whole dental arch with pressure-sensitive
sheets that cover all teeth (30). Of note is that these
tools may influence bite force as they increase the
occlusal vertical dimension, the closing muscle lengths
and consequently their muscle tensions. Further, bite
force depends on a subject’s cooperation and motiva-
tion. Notwithstanding these limitations, simple bite
force instruments provide a quick method of measur-
ing interocclusal forces to assess the functional state of
the masticatory system and loading on the teeth (30).
Force levels vary greatly between individuals with
full-arch maximum force measurements varying
between 600N and 1200N (31) and anterior teeth
maximum bite forces only reaching 20% of this level
(30). Functional forces during mastication and swal-
lowing are relatively high at approximately 40% of
maximum bite force (32). The large variation in bite
force can be accounted for by a number of variables
including subject motivation and cooperation, jaw
muscle size, presence of pain (correlated with lower
bite force), jaw gape (see above), age (maximum dur-
ing 20–40 years), sex (males with greater muscle size
and fibre differences) and craniofacial morphology
(long face individuals generate up to half the bite
force of square face individuals) (30).
Whilst there is significant correlation between bite
force and number of teeth (33), the number of tooth
contacts is a stronger determinant of bite force level
(34). Approximately 80% of the total bite force is dis-
tributed across the molar teeth (35), and simple
mechanics of bite point proximity to the muscle force
helps explain larger bite forces on the molars than
anterior teeth (31). In addition, biomechanical analy-
ses demonstrate the combined moment produced by
the jaw muscles was the largest for vertical bites, the
smallest for posteriorly directed bites and intermediate
for anteriorly directed bites (36). This may suggest
that any planning for occlusal modification by
208 C. C. PECK
orthodontics or oral rehabilitation should focus on
tooth contacts which facilitate vertically directed
occlusal forces.
Occlusal forces have been implicated in the devel-
opment and progression of abfraction lesions, and
wedge-shaped defects at the cervical region of teeth
(37). Biomechanical studies suggest non-axial loading
of teeth leads to stress concentration at the cervical
region and possibly fracture and loss of tooth struc-
ture (38). Whilst there are associations between
occlusal loading scenarios such as wear facets, brux-
ism and premature tooth contacts, this does not con-
firm any causal relationship. Interestingly, abfraction
lesions have not been reported in pre-contemporary
populations (11), and it is suggested there is multifac-
torial aetiology to these lesions and that occlusal
adjustments or other irreversible treatments be
avoided (11, 37).
Adaptation is the norm with changes to dental
occlusal forces. Changing functional loads in an ani-
mal model demonstrate adaptive changes to the peri-
odontium including alterations to periodontal
ligament orientation, periodontal ligament turnover
rate, apical cementum resorption, mineral composi-
tion, and alveolar bone and secondary cementum
hardness (39, 40). These multiple effects help explain
the overall biomechanical effects of altered loading
and are important when trying to understand when
the adaptive capacity is exceeded particularly with
dental (e.g. orthodontics, prosthodontics) or disease
(e.g. periodontal disease) influences (41, 42).
Occlusion and jaw movement
Jaw movement has been studied extensively at the
occlusal interface, with Ulf Posselt being one of the
first to describe it accurately in three dimensions (43).
The horizontal range of movement (i.e. occlusal paths)
of the incisor and molar teeth is similar, but vertical
range is markedly different with the incisor teeth
movement greater than that at the molar (44). The
occlusal paths are, by definition, dictated by anterior
determinants such as anterior dental overbite and
other tooth contact relationships and the posterior
determinants such as the condylar guidance of the
temporomandibular joints (45). From a biomechanical
perspective, the anterior determinants, compared to
posterior determinants, will have a greater influence
on tooth contact patterns because of their proximity to
the teeth. For example, consider a deep anterior dental
overbite (anterior determinant) which will likely cause
posterior dental disclusion in protrusive or lateral jaw
movements. Condylar guidance will influence tooth
contacts in cases where molar teeth contact, or are
close to contact, during jaw movements (45). It is
important in such clinical cases to assess carefully
tooth contacts and measurements for posterior dental
articulator settings to minimise the risk of introducing
occlusal interferences during oral rehabilitation. These
occlusal and temporomandibular joint relationships
are expected as the mandible, in this context, is a rigid
body, and movement at one point (e.g. tooth) will be
related to another point (e.g. condyle).
As outlined above, occlusal perception is in the
order of tens of microns and individual tooth move-
ment in function is approximately 100 microns (44).
Tooth movement is not unidimensional and thus for
accurate assessment, one needs to measure the move-
ment in three dimensional space. There is instrumen-
tation available to measure with this accuracy and
precision and this in turn could lead to the develop-
ment of complex occlusal assessment tools that utilise
high precision jaw and tooth movement data and
have resolution in the order of microns (44). Whilst
work in this area is currently in the research domain,
such tools could be particularly useful in patients with
very acute occlusal perception.
Occlusion and masticatory performance
One must place the role of the dental occlusion in
jaw function into context. In normal function, teeth
contact during mastication and swallowing. During
mastication, approximately only 20% of the time is
spent with possible tooth contacts and this varies with
the consistency of foods, and harder foods resulted in
less tooth contact. The total duration of this contact is
in the vicinity of 10–20 min daily, and as such, the
pathogenicity of occlusal imbalance and malfunction
due to tooth contact during mastication should be dis-
puted (46).
A functional dental occlusion is important for gen-
eral health, and masticatory performance (as deter-
mined by breakdown of food) is closely correlated
with occlusal contact area, with larger contact areas
in those subjects demonstrating better performance
(47). The loss of teeth leads to reduced ability to com-
minute foods and has been associated with reduced
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 BIOMECHANICS IN ORAL REHABILITATION
intake of fruits and vegetables and lower systemic bio-
chemical levels, nutrients and dietary fibre and
increased gastritis, diabetes and obesity (48).
A World Health Organization workshop held in
1982 on community oral health services concluded a
goal for oral health is ‘the retention throughout life of
a functional, aesthetic, natural dentition of not less
than 20 teeth and not requiring recourse to a prosthe-
sis’ (49). Masticatory ability closely correlates with the
number of teeth and is impaired when there are fewer
than 20 uniformly distributed teeth in the mouth (50).
Whilst a full complement of occluding teeth is prefer-
able, the shortened dental arch scenario, comprising
the anterior and premolar regions, meets the require-
ments of a functional dentition (51). Any reported dif-
ficulty of mastication is inversely related to the
number of pairs of occluding teeth, and masticatory
ability is maintained if the premolar regions are intact
and there is at least one pair of occluding molars. Mas-
ticatory ability is severely impaired, particularly in
comminuting hard foods, with fewer occluding premo-
lars and/or asymmetric arches/unevenly distributed
teeth (52). Impaired masticatory ability and resulting
changes in the types of foods selected tend to occur
only when there are less than 10 pairs of occluding
teeth (53). In shortened dental arches, occlusal con-
tacts tend to change, with distal tooth migration result-
ing in increased anterior dentition load and contacts.
These structural and functional adaptations tend to
stabilize maintaining satisfactory oral function (54).
Whilst the biomechanical environment changes with a
change to a shortened dental arch, it appears to be one
of adaptation and not pathology. Despite a greater
prevalence of joint sounds, there are no differences in
pain, mandibular mobility, maximum mouth opening,
or articular crepitus between shorted and full dental
arch scenarios (55, 56). To explore the biomechanical
consequences of shortened dental arches, a finite ele-
ment model of the jaw has been developed and vali-
dated with human bite force data. The model
calculates data that cannot be readily obtained in vivo
including muscle, joint and periodontal forces for dif-
ferent occlusal scenarios in which posterior teeth were
sequentially ‘removed’ (57). The tooth contacts influ-
enced these forces in the masticatory system; when
molar contacts were removed, the overall bite force
decreased, bite force on each tooth increased and the
force always remained greatest on the most posterior
tooth. Joint loads decreased with missing molar
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209
occlusal contact and periodontal loading on the most
distal tooth remained reasonably constant irrespective
of number of occluding posterior teeth. This modelling
suggests the masticatory system adapts to structural
changes of the dental occlusion and protects the tem-
poromandibular joints and dentition by regulating
their loads by adjusting muscle activity patterns. The
shortened dental arch comprising the anterior and pre-
molar regions appears to ensure good oral function
and patient comfort and suggests extensive oral reha-
bilitation to regain a full complement of occluding
teeth is not always necessary.
Occlusion and the musculoskeletal
system
From a clinical perspective, changes to the temporo-
mandibular joint including intracapsular exudate and
loss of articular tissue may result in occlusal changes
such as anterior or posterior open bites (58). Con-
versely, occlusal changes can result in articular
changes such as altered movement paths. Experimen-
tally altering occlusal contacts results in condylar
movement and position changes. The addition of a
working side interference resulted in more anteroinfe-
rior working condyle movement (59) and balancing
side occlusal contacts appear to reduce balancing side
condylar displacement (60). Compared to canine
guided occlusions, simulated group function occlusion
caused smaller working side condylar displacement
and simulated bilateral balanced occlusion caused sig-
nificantly smaller non-working side and working side
condylar displacements (61). These condylar displace-
ment changes are small and, in isolation, may have
no clinical significance. Further research is warranted
to determine whether or not such changes together
with other factors (e.g. condylar loading) contribute
to scenarios that exceed the adaptive potential of the
system (e.g. osteoarthritis).
There has been much mathematical modelling of
the masticatory system to understand better struc-
ture–function relationships. The simplest, static math-
ematical modelling suggests that in the sagittal plane
(where occlusal contacts and muscle activity are
assumed the same on left and right sides of the jaw),
there is no alterations to the dental occlusion which
will result in ‘unloading’ of the joint, a clinical desir-
able outcome with an inflamed joint. The reason for
this is that because the closing muscle forces are
210 C. C. PECK
always posterior to any occlusal contacts (62), the jaw
acts as a lever with the condyle as a fulcrum. The
consequence is that with any tooth contact scheme,
there will always be compressive condylar forces. This
modelling refutes the ‘condylar unloading’ premise of
oral appliances which provide only molar contacts
about which the jaw pivots and ‘distracts’ the con-
dyle. Note that this modelling is two dimensional and
it is likely possible to cause differential condylar load-
ing with only unilateral bite points. Differential
condylar loading would depend on bite point and
working and balancing side muscle activities (62).
Nevertheless, it is important to consider what scenar-
ios reduced condylar loading may be warranted and
these may include acute arthralgia and arthritis. If
reduced condylar loading is warranted, then other
management strategies such as reducing function and
other behavioural strategies rather than dental occlu-
sal modification should be considered.
Dynamic jaw models provide opportunity to assess
scenarios with changing jaw muscle activities or jaw
motions and have the advantage of assessing the mas-
ticatory system whilst simulating function. A dynamic
mathematical model of the jaw which includes a rigid
mandible, 16 force vectors representing the
masticatory muscles, multiple occlusal contacts and
curvilinear disc/fossa boundaries representing the
temporomandibular joints has been used to explore
different occlusal schemes and their effects on tem-
poromandibular joint force magnitude and direction
(63). Balanced molar contact (Angle’s Class II molar
relationship), anterior open bite, unilateral crossbite
and missing posterior teeth scenarios were investi-
gated as these have demonstrated associations (albeit
low) with temporomandibular disorders (64). The
model simulates a dynamic clenching task in which
the jaw elevators are maximally activated linearly in
time. Individual teeth were rigid and, to represent
periodontal influence, could displace within the
mandible and maxilla. In the balanced molar occlusal
support case, in which molar teeth on both sides of
the dental arch made contact evenly during the
clenching task, dental contacts commence anteriorly
with posterior coupling as muscle activity is increased.
The joint reaction force is initially posteriorly directed
but rotates forwards as clenching increases (Fig. 1).
In the anterior open bite case, the forces generated at
the TMJ are more posterior at the commencement
of the task and with increasing elevator activity
remain more posteriorly directed than the balanced
molar support case. The unilateral cross-bite case
demonstrates similar condylar force directions but of
greater magnitude when compared to the balanced
molar case. The missing posterior teeth model gener-
ates much higher condylar forces than the balanced
occlusal case. Modelling has limitations as there are
assumptions particularly when biological data are
needed, but not available, to construct the model.
Nevertheless, they provide insight into structure–
function relationships which is not possible any other
way. It is to be expected that movement changes at
one site of the mandible will influence other sites and
these experiments suggest altering the dental occlu-
sion may change condylar movement and loading.
Notwithstanding the limitations, these set of experi-
ments support the case for occlusal contacts in both
the anterior and posterior segments (at a minimum
rehabilitate an individual to a shortened dental arch)
and the need for evenly distributed contacting teeth.
There is evidence that changes to the dental occlu-
sion such as the introduction of occlusal interferences
increases postural activity in the jaw closers, which is
reversed when the occlusal interference is removed
(65). In a temporomandibular disorders group, occlu-
sal interferences increased clinical signs compared to
healthy controls. In the healthy controls, no temporo-
mandibular disorder developed and initially jaw closer
muscle activity decreased but then increased as did
occlusal contacts (66). It appears that healthy subjects
demonstrate adaptation, whereas temporomandibular
disorder subjects do not and their response may be
partly explained by psychosocial factors (67). Further-
more, whilst there are data confirming some relation-
ships between occlusion and temporomandibular
disorders, it should not be overstated and the clinical
implications need to be carefully considered (10).
Although many dental practitioners agree that
occlusion is one of the most important factors to con-
sider in successful patient management, there is very
limited evidence for the definition and evaluation of
occlusion among dental procedures (6). This is likely
due in part to the lack of sensitive and specific diag-
nostic tests in the assessment of the dental occlusion.
It is important to realise that from a biomechanical
perspective dental supracontacts and an overclosed
vertical dimension are the two common occlusal
disorders that can impact function, and whilst an
occlusal examination is important, the patient’s self-
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 BIOMECHANICS IN ORAL REHABILITATION 211

Occlusal model Condylar reaction force vector (dash-

initial tooth contact; solid-maximum)

150N

Angle Class II molar occlusion

130N

Anterior open bite

Fig. 1. Results of dynamic

mathematical modelling of
temporomandibular joint condylar
reaction forces resulting from tooth
165N ipsilateral
clenching. Four dental occlusal
contact scenarios were modelled:
225N contralateral
Angle class II molar occlusion
(upper diagram), anterior open bite
(2nd diagram), unilateral cross-bite
(3rd diagram) and missing posterior Unilateral cross-bite
teeth (bottom diagram). Teeth
which made contact during
clenching are shaded. Arrows
represent initial (dashed) and final
(solid) condylar force vector
(direction and magnitude) in sagittal
plane with the left side of figure 270N
posterior direction, right side
anterior direction and upper side
superior direction. Maximum
condylar forces are noted. Missing posterior teeth

report of the problem is a key reason for any manage-
ment (6).
Structure–function relationships in the masticatory
system are important, and there is much evidence
demonstrating structural changes to the dentition can
alter jaw function. It must be emphasised that any
changes to the biomechanical environment tend to
lead to adaptation of the system (whether adaptive
remodelling of structural components or of function).
There are cases where the adaptive capacity of the
system is exceeded and this is likely a result of multi-
ple factors which may include not only biological but
also psychosocial factors. Further research is war-
ranted, and biomechanical modelling can play a role
in this as it helps to deconstruct the system and assess
individual variables. In the interim from the biome-
chanics evidence, one can develop clinical recommen-
dations (Table 1).

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212 C. C. PECK
Table 1. Evidence-based jaw structure–function relationships and suggested clinical recommendations
Evidence base
In developed societies, foods are softer and require less
chewing, and consequently, group function and balanced
occlusions are less common than in those societies with
harder and tougher foods
Curves of Spee and Wilson align teeth so that occlusal
forces are aligned to the long axis of the teeth to minimise
damage to teeth and periodontium. Combined moment
produced by the jaw muscles was the largest for vertical
bites, the smallest for posteriorly directed bites and
intermediate for anteriorly directed bites
Periodontal mechanoreceptors provide ability to regulate
light occlusal forces. Loss of mechanoreceptors (dental
implants, loss of periodontal attachment) may alter this
Bite force may be influenced by jaw muscle size, presence
of pain, age, sex and craniofacial morphology
Condylar guidance will influence tooth contacts in cases
where molar teeth contact, or are close to contact, during
jaw movements
Occlusal perception is in the order of tens of microns
Shortened dental arch (anterior and premolar teeth) and
10 pairs of occluding teeth often meet the requirements of
a functional dentition
Temporomandibular joint compression is the norm and
changing occlusal schemes will likely not alter this
Management of occlusal problems needs to include
stable bilateral tooth contacts in intercuspal position
and centric relation, well-distributed contacts in maxi-
mal intercuspation, providing axially directed forces,
multidirectional freedom of contact movements radi-
ating from maximal intercuspation and no disturbing
or harmful intermaxillary contacts during lateral or
protrusive excursions (68). These guidelines are based
on the concept put forward by Beyron in 1954 (69)
and have stood the test of time.
Conclusion
The dental occlusion has enormous functional
demands placed upon it, from the precise positioning
of teeth and light holding forces to the generation of
large bite forces. The masticatory system demonstrates
a remarkable ability to adapt to a changing biomechan-
ical environment, whether it be changes in structure
or in functional demands. Biomechanics is important
Clinical recommendations
Consider rehabilitating to anterior guided dental occlusions
(e.g. canine guidance)
Design occlusal form to orient forces along tooth long axis
but consider damaging sheering forces (directed laterally
and/or anteroposteriorly) in jaw parafunction (e.g.
bruxism) cases
Consider possible increased occlusal forces and reduced bite
force sensitivity in cases of reduced/lost periodontium
Comprehensively assess patients prior to oral rehabilitation
to assess for potentially high bite forces
Where there are posterior tooth contacts during functional
movements, assess carefully tooth contacts and
measurements for posterior dental articulator settings to
minimise the risk of introducing occlusal interferences
during oral rehabilitation
Comprehensively assess patients and assess for heightened
occlusal perception, for example nervous system
sensitisation such as with pain and/or somatic focus
Consider restoring to at least a shortened dental arch and/
or 10 pairs of uniformly distributed occluding teeth
In cases of acute temporomandibular joint inflammation
and pain, focus on reducing jaw function rather than
changing the occlusal scheme
in understanding better the role of the occlusion in the
masticatory system and how it may contribute to
health and disease. The relationship between the den-
tal occlusion and disorders is not a straightforward
biomechanical issue, and consequently, it is worth-
while to heed the recommendation of Dworkin to
include a biobehavioural focus in patient care (70).
Disclosure and Acknowledgments
There are no conflicts of interest. I would like to
acknowledge Professor Alan Hannam and his cranio-
facial biology research laboratory.
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Correspondence: Christopher C. Peck, Faculty of Dentistry, The
University of Sydney, Sydney, NSW 2006 Australia. E-mail:
dentistry.dean@sydney.edu.au
© 2015 John Wiley & Sons Ltd