A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary...
Transcript of A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary...
![Page 1: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/1.jpg)
OcclusionOcclusionThe KEY to dentistry.
The KEY to total health.The KEY to this website.
A1
![Page 2: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/2.jpg)
Basics of Occlusion
A2
Simplistic definition of occlusion: The way teeth meet and function.
![Page 3: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/3.jpg)
A3
The BEST textbook on dentistry. Every dentist
should read.
Peter E. Dawson. Evaluation, Diagnosis, and Treatment of
Occlusal Problems, 2nd ed.. Mosby.
![Page 4: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/4.jpg)
A4
I am standing beside, in my opinion, one of the
best dentists in the world, Dr. Peter Dawson.
![Page 5: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/5.jpg)
Centric Relation (CR)Refers to the RELATIONSHIP of the
MANDIBLE TO THE SKULL as it rotates around the ‘hinge-axis” before any
translatory movement of the condyles from their “upper-most and mid-most position”.
It is irrespective of tooth position or vertical dimension.
A5Peter E. Dawson. Evaluation, Diagnosis, and Treatment
of Occlusal Problems, 2nd ed.. Mosby.
![Page 6: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/6.jpg)
Transcranial radiograph of TMJ.
Condyles in socket. Condyles advanced.
Right TMJ
Left TMJ
White arrows: Articular tubercle.Green arrows: Head of condyle.
Red arrows: Glenoid fossa.A6
![Page 7: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/7.jpg)
Condyle: The rounded articular surface at the end of the mandible (lower jaw).
Glenoid fossa: A deep concavity in the temporal bone a the root of the zygomatic arch that receives the condyle of the mandible.
Tubercle: A slight elevation from the surface of the bone giving attachment to a muscle or ligament.
A7
![Page 8: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/8.jpg)
Mandible &TMJ
Working side.Condyle pivots.
Balancing side.Condyle has downward path.
A8
![Page 9: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/9.jpg)
Working side: (Mandible moving toward the cheek)
Balancing side: (Mandible moving toward the tongue)
Working side condyle pivots within the socket and is better supported.
Balancing side condyle has a downward orbiting path. It is traveling a greater distance in ‘space’
and is more prone to injury or damage.
A9
![Page 10: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/10.jpg)
Centric Occlusion (CO)Refers to the RELATIONSHIP of the
MANDIBLE TO THE MAXILLA when the teeth are in maximum occlusal
contact, irrespective of the position or alignment of the condyle-disk
assemblies.
A10Peter E. Dawson. Evaluation, Diagnosis, and Treatment
of Occlusal Problems, 2nd ed.. Mosby.
![Page 11: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/11.jpg)
Five requirementsof a stable occlusion.
A11
Peter E. Dawson. Evaluation, Diagnosis, and Treatment of Occlusal Problems, 2nd ed.. Mosby. Chapter 27, p470-476.
![Page 12: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/12.jpg)
1. Stable stops on all the teethwhen the condyles are in Centric Relation (CR).
A12
![Page 13: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/13.jpg)
Centric Stops
Note ‘U’ shape of dental arches.
Point contacts are on lingual cusp tips of maxillary posterior teeth, buccal cusp tips of mandibular posterior teeth, central pits or marginal ridges on posterior teeth, incisals of lower anteriors and linguals of upper anteriors.
A13
![Page 14: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/14.jpg)
Teeth are designed to absorb heavy forces in the direction of
the long axis of the tooth.
Most teeth are not designed to absorb damaging lateral forces.
A14
![Page 15: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/15.jpg)
Ideal bite
• Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central fossa or marginal ridges of opposing posterior teeth.
• Forces exerted on the posterior teeth should be directed through the long axis of the teeth.
• ‘Normal’ buccal positioning of the maxillary buccal cusps should be ‘outside’ or buccal to the mandibular teeth.
A15
![Page 16: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/16.jpg)
A16
Note ‘U’ shape of dental arches.
To naturally accommodate all the teeth in an ideal bite relationship,
the arches need to have a ‘U’ shape (as apposed to a ‘V’
shape).
![Page 17: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/17.jpg)
2. Anterior Guidance in harmony with the border movements of the Envelope of Function.
A17
![Page 18: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/18.jpg)
Envelope of function
Note angulation of the maxillary anterior tooth
(red arrow).Most normal chewing stays within the red area, but the lower teeth have the range of the black line.
Lower teeth are ‘guided’ by a gentle slanted slope of the
upper lingual surfaces.
A18
![Page 19: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/19.jpg)
Too upright. Should have position of
dotted tooth.
Mal-aligned cuspid.
A too upright tooth interferes with the
“Envelope of Function”.A19
![Page 20: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/20.jpg)
3. Disclusion (separation) of all the posterior (back) teeth in protrusive (forward) movements by the MOST ANTERIOR (front) teeth (Anterior Guidance).
A20
Ideally this should be the 6 front teeth, but in some cases of an open bite for example, the
most anterior tooth could be a bicuspid.
![Page 21: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/21.jpg)
In this case, the bicuspid is the most anterior tooth.
Anterior open bite.
A21
![Page 22: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/22.jpg)
A22Correct excursive marks (green).
Note that there are no green excursive marks
made during lateral movements on any of
the posterior teeth.
![Page 23: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/23.jpg)
4. Disclusion of all the posterior teethon the non-working or balancing side (side where the lower teeth are moving toward the tongue).
A23
![Page 24: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/24.jpg)
5. Disclusion of all the posterior teethon the working side during excursions (side where the lower teeth are moving toward the cheek).
A24
![Page 25: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/25.jpg)
A25
Excursive interferences
These markings are indicators of occlusal trauma.
![Page 26: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/26.jpg)
A light lateral force can loosen a post, just as it can loosen a tooth. It
could also make a tooth sensitive.
A26
![Page 27: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/27.jpg)
Exception for rule 5.
• Teeth may be in GROUP FUNCTIONif they are in precise harmony with anterior and condylar guidance.
A27
![Page 28: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/28.jpg)
A28
Group function.
Balanced working stroke.
![Page 29: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/29.jpg)
Other exception:• The patient provides a substitute
• i.e.- If a tongue thrust holds the teeth apart.
A29
![Page 30: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/30.jpg)
An anterior tongue thrust.A30
![Page 31: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/31.jpg)
Other exception:• The patient eliminates the need:
–i.e. – People with a Class III occlusion usually have a “chop-chop” bite and the mandible is already forward.
A31
![Page 32: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/32.jpg)
Class III malocclusion (Lateral view)A32
![Page 33: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/33.jpg)
Key Points:
• Teeth could loosen.• Teeth could wear excessively.• Teeth could move out of alignment.• Teeth could get sore.• Teeth could get cervical notching – abfractions.• Open contact could develop.• TMJ could break down.• Bone loss could occur.• Tori could develop.
All five requirements must be fulfilled or one or more signs of instability will be seen in time.
A33
![Page 34: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/34.jpg)
Williamson EH.,Lundquist DO., Anterior guidance: its effect on electromyographic activity of the temporal and masseter muscles. J. Prosthetic Dentistry.49(6):816-23, 1983 June.
Summary of article by Williamson and Lundquist:“The elimination of posterior contacts by an
appropriate anterior guidance reduces the elevating activity of the temporal muscles.”
A34
![Page 35: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/35.jpg)
Curve of Spee:Allows for the normal functional
protrusive movement of the mandible.
Curve of Wilson:Allows for those exquisite movements which are used in chewing functions..
A35Peter E. Dawson. Evaluation, Diagnosis, and
Treatment of Occlusal Problems, 2nd ed.. Mosby.
![Page 36: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/36.jpg)
Curve of Spee.
Anteroposterior curvature of the occlusal surfaces.
4” radius
Peter E. Dawson. Evaluation, Diagnosis, and Treatment of Occlusal Problems, 2nd ed.. Mosby. P85.
A36
![Page 37: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/37.jpg)
Curve of SpeeThe curve of Spee begins at the tip of the lower
cuspid and touches the buccal cusp tips of all the mandibular posterior teeth and continues to the
anterior border of the ramus. (p85)
An ideal curve of Spee is aligned so that a continuation of this arc would extend through the
condyles.
The curvature of this arc would relate, on average, to part of a circle with a 4-inch radius.
Peter E. Dawson. Evaluation, Diagnosis, and Treatment of Occlusal Problems, 2nd ed.. Mosby. P85-91.
A37
![Page 38: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/38.jpg)
Curve of Wilson.
Buccal - Lingual Curvature.
For mastication.
A38
![Page 39: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/39.jpg)
Curve of Wilson.
The curve of Wilson is the mediolateral curve that contacts the buccal and lingual cusp tips of each side of the arch. It results from the inward inclination of the lower posterior teeth, making the lingual cusps lower than the buccal cups on the mandibular arch; the buccal cusps are higher than the lingual cusps on the maxillary arch because of the outward inclination of the upper posterior teeth.
Peter E. Dawson. Evaluation, Diagnosis, and Treatment of Occlusal Problems, 2nd ed.. Mosby. P88.
A39
![Page 40: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/40.jpg)
Curve of Wilson. Impact on chewing.
The lingual inclination of the lower posterior teeth positions the lingual cusps lower than the buccal cusps. This design permits easy access to the occlusal table. As the tongue lays the food on the occlusal surfaces, it is stopped from going past the chewing position by the taller buccal cusps.
Peter E. Dawson. Evaluation, Diagnosis, and Treatment of Occlusal Problems, 2nd ed.. Mosby. P89.
A40
![Page 41: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/41.jpg)
One of the functions of our tongue:
Dump food into our mouth.
A41
![Page 42: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/42.jpg)
Functions of the tongue.
Dumps food down our throat after having ‘mashed’ the
food against our palate during mastication.
Dumps food laterally onto our teeth during mastication.
Note importance of curve of Wilson here.
Also note man squirting digestive enzymes onto the food.A42
![Page 43: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/43.jpg)
A 13 year-old who is severely tongue-tied. He has stomach pains, irregular stools and trouble saying some words.
A43
![Page 44: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/44.jpg)
He has trouble directing food for proper chewing and swallowing.Would have difficulty mashing food against his palate.
A44
![Page 45: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/45.jpg)
Tight frenum limits elevation of tongue in this 13-year-old boy.
Tight frenum makes ‘mashing of food’
against palate difficult, plus impacts ability to
enunciate.A45
![Page 46: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/46.jpg)
26-year-old with classic ankyloglossia. She has digestive problems as well.A46
![Page 47: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/47.jpg)
Restricted lateral movement. Age 26. A47
![Page 48: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/48.jpg)
Ineffective dumping of food onto teeth due to restricted lateral movement of tongue.A48
![Page 49: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/49.jpg)
Restricted lateral movement. Age 26. A49
![Page 50: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/50.jpg)
Ineffective dumping of food onto teeth due to restricted lateral movement of tongue.A50
![Page 51: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/51.jpg)
Beautiful illustration demonstrating limited movement of an ankylosed tongue.
A51
![Page 52: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/52.jpg)
Curve of Wilson
Curve of Spee
A52Reverse Curve of Wilson
![Page 53: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/53.jpg)
A53 A prehistoric skull with a reverse curve of Wilson.
Looks like the jaw had been broken.
![Page 54: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/54.jpg)
A54 Another skull with a reverse curve of Wilson.
See next 3 slides.
![Page 55: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/55.jpg)
A55 Close up of same skull - right side. See next 2 slides.
![Page 56: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/56.jpg)
A56 Close up of same skull - left side. See next slide.
![Page 57: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/57.jpg)
A57 Maxillary arch of same skull.
![Page 58: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/58.jpg)
The ‘Neutral Zone’
A58
![Page 59: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/59.jpg)
Tongue, teeth and cheeks are at rest in a “neutral”position. There are no abnormal forces within the mouth. This allows for the proper alignment of the teeth and dental
arches.
This also allows for normal facial development.
A59
![Page 60: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/60.jpg)
The jaw is like a nutcracker.• Strongest muscle forces are exerted
close to the hinge.• The force diminishes as the distance
from the fulcrum increases.• Strong anterior stops protect the
posterior teeth.
A60
![Page 61: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/61.jpg)
Jaw as a nutcracker.
A61
![Page 62: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/62.jpg)
A62 Square jaw demonstrating strong masseters.
![Page 63: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/63.jpg)
A63 Square jaw demonstrating strong masseters.
![Page 64: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/64.jpg)
A64 Strong muscle attachment stimulated bone development.
![Page 65: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/65.jpg)
Important Dental Concept
Cuspid Rise / Anterior Guidance
A65
![Page 66: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/66.jpg)
A66 Nicely aligned teeth. (Class I occlusion)
![Page 67: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/67.jpg)
A67 Cuspid rise - right side. No posterior teeth in contact.
![Page 68: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/68.jpg)
A68 During crossover, guidance is from anterior teeth.
![Page 69: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/69.jpg)
A69During crossover, none of the posterior teeth on other side are contacting either.
![Page 70: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/70.jpg)
A70Cuspid rise going in other direction. No posterior contacts.
![Page 71: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/71.jpg)
A71Crossover going in other direction. No posterior contacts.
![Page 72: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/72.jpg)
Traumatic Occlusion
Malocclusion
A72
![Page 73: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/73.jpg)
A73 Anterior view during closure.
![Page 74: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/74.jpg)
A74
Guidance coming from posterior tooth during excursion.
![Page 75: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/75.jpg)
A75 Problem tooth causing interference and discomfort.
![Page 76: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/76.jpg)
Maxillary lingual cusp tip below the Curve of Wilson. Interferes during excursions.
Curve of Wilson
Curve of Wilson
A76
![Page 77: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/77.jpg)
“X” Factors that effect breakdown.• Emotional stress• Physical stress• Ability to cope• Heredity• Age• Diet• Growth and Development• Illness and disease• Physical environment• Habits• Factors still unknown.
A77
![Page 78: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/78.jpg)
Possible consequences if principals not followed:
• Bone loss / loose teeth / lost teeth. • Abfractions / recession / clefts.• Tori.• Flattened occlusion.• Cracked teeth.• TMJ breakdown.
A78
![Page 79: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/79.jpg)
Occlusion Terms
• Overjet / Overbite.• Class I occlusion: Adult and Pedo.• Class II malocclusion, Div 1 & 2.• Class III malocclusion.• Cross-bite.
A79
![Page 80: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/80.jpg)
Overjet is a horizontal measurement.
Overbite is a vertical measurement.
A80
![Page 81: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/81.jpg)
Class I occlusion.
Best occlusion.
Breastfed individual have the best chance of having this ideal occlusion.
A81
![Page 82: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/82.jpg)
Adult Class I (Lateral view)
Arrows are where they should be.
Has ideal overjet and overbite.
A82
![Page 83: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/83.jpg)
Adult Class I (Anterior view)
Mid-line is in the middle of the mouth / smile.
A83
![Page 84: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/84.jpg)
Adult Class IBest occlusion.
A84
![Page 85: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/85.jpg)
Child’s Class I (Lateral view)A85
![Page 86: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/86.jpg)
Child’s Class I (Anterior view)A86
![Page 87: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/87.jpg)
Child’s Class I
A87
![Page 88: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/88.jpg)
Class II malocclusion.
Retrognathic - ‘pushed back jaw’- malocclusion.
Potentially deadly if it contributes to, or is a causative factor in, the development obstructive sleep apnea (OSA). It is the
most common malocclusion in individuals with OSA.
Major contributors to this malocclusion are: bottle feeding, pacifier use, excessive noxious habits and early obstruction / airway resistance of the airway.
A88
![Page 89: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/89.jpg)
Class II - retrognathic malocclusionA89
Arrows should be aligned opposite to each other.
![Page 90: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/90.jpg)
Previous models positioned to a Class I occlusionA90
Models hand articulated so arrows better approximate where they
should be in a Class I relationship.
![Page 91: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/91.jpg)
Class II, Division I (Lateral view)
Red arrows should line up opposite each other.
Overjet
A91
![Page 92: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/92.jpg)
Class II, Division I (Anterior view)A92
![Page 93: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/93.jpg)
Class II, Division 1
Upper anterior teeth flare out.
A93
![Page 94: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/94.jpg)
Class II, Division 2 (Lateral view)
Arrows should line up opposite each other.
A94
![Page 95: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/95.jpg)
Class II, Division 2 (Anterior view)
Note slant of upper 4 anterior teeth.A95
![Page 96: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/96.jpg)
Class II, Division 2
Central 2 teeth slant inward, adjacent lateral teeth slant out.
A96
![Page 97: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/97.jpg)
Note significant overbite on this Class II malocclusion.
A97
![Page 98: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/98.jpg)
Class III malocclusion.
The ‘bulldog look’.
A98
![Page 99: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/99.jpg)
Class III (Lateral view)
Arrows should line up.
A99
![Page 100: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/100.jpg)
Class III (Anterior view)A100
![Page 101: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/101.jpg)
Class III malocclusion.
Sometimes called an ‘under-bite’.
A101
![Page 102: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/102.jpg)
Infant with Class III malocclusion.A102
![Page 103: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/103.jpg)
Cross-bite
A103
![Page 104: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/104.jpg)
In ‘B’, upper teeth are ‘inside’ lower teeth - due to a narrow arch. A104
![Page 105: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/105.jpg)
Models demonstrating an example of a high palate and narrow upper arch.
A105
![Page 106: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/106.jpg)
Models demonstrating a cross-bite.
Cross-bite
A106
![Page 107: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/107.jpg)
Close-up of a cross-bite malocclusion.A107
![Page 108: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/108.jpg)
Cross-bite has contributed to development of abfractions / recession and small tori developing on buccal #31.
A108
![Page 109: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/109.jpg)
AAPD Vision Statement (1996)
• “89% of youth, ages 12 - 17 years, have some occlusal disharmony.”
• “16% of youth have a severe handicapping malocclusion that requires mandatory treatment.”
Pediatr Dent, (J Amer Acad Pediatr Dent), Spec Issue:Reference Manual 1995-96,17(6).
A109
![Page 110: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/110.jpg)
Pacifier use (1997)
• 85% of children in her study used pacifiers by age one month. Children weaned from breastfeeding early use a pacifier more often than those who are breastfed longer.
Victora CG, Behague DP, et al. Pacifier use and short breastfeeding duration: cause, consequence, or coincidence? Pediatr. 1997 Mar;99(3):445-53.
A110
![Page 111: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/111.jpg)
Craniofacial Development
• Largest increment occurs within the first 4 years of life.
• Is 90% complete by 12 years of age
Shepard J, et al. Evaluation of the upper airway in patients with OSA, Sleep 1991;14(4):361-71.
A111
![Page 112: A-Occlusion - Principles [Read-Only]Ideal bite • Should have point contacts of the maxillary posterior lingual cusp tips and the mandibular posterior buccal cusp tips to the central](https://reader035.fdocuments.net/reader035/viewer/2022071608/6145d4958f9ff812541fe028/html5/thumbnails/112.jpg)
End of section A
Brian Palmer, D.D.S. Leawood, Kansas December 2004.