RESEARCH AND EDUCATION

%CTION EI>ITC)R

JOHN J. SHARRY

Nonfunctional and functional occlusal contacts:

A review of the literature
Alain Woda, D.S.O., D.S.,* Pierre Vigneron, D. C. D., and Douglas Kay, D.C. D. **
Facultk de Chirurgie Dent&e, Paris, France

T herapeutic
are supported
acts which modify occlusal anatomy
by various concepts which all refer to
Anderson
contacts.
and Myers” took into account the near-

an “ideal occlusion.” This ideal occlusion has been These two studies also appear to demonstrate that
described in several ways but rarely on an experi- posterior contacts escape any classification. Fol
mental basis. The principal experimental results MacNamara and Henry there was an average of 18
bearing on occlusal contacts are assembled in this posterior contacts, whereas for Anderson and Myers
review of occlusal relationships of dentitions only 4% of posterior teeth presented no contact.
subjected to neither iatrogenic nor pathologic primarily the third moiar with or without antago-
factors. Therefore, the question of occlusal contacts is nist. The main result of the latter seems to be that
treated not with respect to an “ideal occlusion” but none of the 947 teeth examined conformed to an
from a statistical point of view applied to static “ideal occlusion.” Notably, the morphologic disorder
maxillomandibular relationships as well as to masti- demonstrated in these studies does not imply
cation and swallowing. dysfunction. This seems to indicate the role of
compensator-y factors such as dental migration,
OCCLUSAL CONTACTS IN neuromuscular adjustments, and abrasion.
NONFUNCTIQNAL OCCLUSAL
RELATIONSHIPS Occlusal contacts during voluntary lateral
Occlusal contacts in centric occlusion (maximal movement
intercuspal position) Occlusal contacts occurring during voluntary
Ideal centric occlusion has been defined by several lateral jaw movements vary in regard 10 location and
authors. but the origins of these definitions were not number. These variations are reflected in therapeu-
clearly indicated.‘-’ In addition, these descriptions of tic techniques through the two well-known but
tooth contacts in centric occlusion are largely contra- opposed concepts: canine protection and group func-
dictory. One of the few studies on the number, tion.
location, and form of occlusal contacts found in Five studies have been conducted on normal
adult subjects is that of Anderson and Myers.’ Their human dentitions. Beyron’ ’ found that group funr-
results based on 32 subjects show that 18% of the tion constitutes normal articulation for Europeans as
anterior teeth do not contact their antagonists, well as for the Australian aborigines. Weinberg”
whereas 82% have at least one tooth contact. Howev- observed that 81% of his subjects presented group
er, MacNamara and Henry,” in a similar study of 15 function and the remaining 19”1 canine protection.
patients, indicated only one or two contacts for all Ingervall” described 2% of the patients as having
anterior teeth. This inconsistency is apparently due bilateral canine protection and 18’; unilateral
to a difference in methodologic convention, since the canine protection. Finally, Scaife and Holt”’ found
definition of tooth contacts differs between the two that 57% of their patients presented bilateral canine
studies. From the technique they used it seems that protection, 16.4% unilateral canine protection, and
26.6% bilateral group function.
.4lthough these results appear contradictory, a
*Professor, Department of Operative Dentistry, FacultC de
Chirurgie Dent&e, Clermont-Ferrand, France. closer examination reveals that it is not the results so
**Student. much as the methods and interpretation that may

002!!-3913/79/090335 + 07%00.70/O d 1979 The C. V. Mosby Co. THE JOURNAL OF PROSTHETIC IWNTISTRY 335
 WODA, VIGNERON, AND KAY

vary. Ideally, it would be necessary to consider the another. MacNamara and Henry6 believe this occlu-
entire sliding trajectory, the multiplicity of possible sion is established by an average of two or three
lateral directions, and the amplitude of the l&era1 posterior contacts, vs. the eight of Gillings and
movement. Ingervall” responds to this third impera- associates.lX Certain authors describe a small number
tive, since he imposes a 3 mm lateral displacement at of subjects having identical positions for centric
the incisors (and thus avoids choosing an arbitrary occlusion and centric relation: 8% for Reynolds,”
position). The direction of movement is chosen by 12% for Posselt.‘” Other authors have constantly
the subject and the final position is recorded. The determined two distinct occlusal positions.“. “. I’;. ”
results pertain to both the working and nonworking Various gaps have been determined between these
sides. On the working side Ingervall observed the two positions. However, the approximate value is 1
aforementioned small percentage of canine protec- mm for the trajectory measured at the molar or
tion. However, the average number of working incisor, and this varies with the method of registering
dental contacts on individual teeth was only two centric relation.‘> MacNama&and Henry” observed
(between none and four), which is a long way from that for most of the 15 subjects they studied, the
group function advocated by some clinicians. If all retrusive movement was not parallel to the sagittal
the individual tooth contacts are added, those occur- plane.
ring between antagonist canines are by far the most
frequent. On the nonworking side, 64% of the Occlusal contacts during propulsion
patients observed presented contacts on both Although less interesting than the intermediary
hemiarcades and 20% presented contacts on a single positions, the incisal “end-to-end” occlusion has
hemiarcade. When a nonworking contact was pres- been the only one studied. Scaife and Holt”’ have
ent, it generally involved a single contact between determined that the upper canine participated in
the most posterior teeth. this propulsive position in only 4.7% of the patients
These observations evoke two comments. First, studied. Most often this end-to-end occlusion is
“balancing” contacts seem to be the general rule in made possible by mandibular lowering compensat-
the populations of contemporary civilizations. This ing for the overbite, which discludes the molars. In
does not seem to be the case for the Australian very worn dentitions “end-to-end” incisal occlusion
aborigines.” Second, pure canine protection or pure is found with centric occlusion; in this instance, the
group function rarely exists. However, a modified propulsion trajectory does not generally necessitate
group function, with fewer overall contacts and the lowering of the mandible.
prolonged canine contacts, is predominant. When
there is only one contact it occurs primarily (89%) OCCLUSAL CONTACTS DURING
between the antagonist canines.” MASTICATION
Does the occurrence of canine protection or group Evidence of occlusal contacts during mastication
function differ in relation to age and abrasion? The As early as 1939 Hildebrand’!’ published a graph
Scaife and Holt study”’ seems to indicate the rela- which indicated the existence of tooth contacts
tionship between abrasion and lateral movement occurring at the end of the masticatory cycle. He
contacts, since only 13.8% of the patients with canine maintained that the mandible attains centric occlu-
protection presented visible facets of abrasion, sion by the lower teeth sliding on the upper teeth.
whereas 52.8% of the patients without canine protec- Jankelson and associates”’ in 1953 affirmed that
tion did so. In addition, Weinberg” determined that tooth contacts during mastication did not exist.
the canines and premolars were most often worn in a However, shortcomings in technique and the small
full dentition. size of the sample lessen the importance of that
In conclusion, since abrasion could lead from one study. Presently, most authors, regardless of the
type of contact during lateral movement to another, technique used, believe that tooth contacts exist
one can consider that both group function and during mastication.
canine protection can provide normal tooth Direct proof of occlusal contacts during mastica-
contacts. tion has been established by several authors with
telemetric techniques.“-“’ For the limitations of this
Occlusal contacts in centric relation and during technique see Miihlemann:“’ Other authors, using
retraction the electric circuit technique, have also established
The number and location of occlusal contacts in the existence of tooth contacts during mastica-
centric relation are not constant from one subject to tion.1:’ 131.‘31

336 SEPTEMBER 1979 VOLUME 42 NUMBER 3

NONFUNCTIONAL AND FUNCTIONAL OCCLUSAL CONTACTS

Other techniques (graphic, cinematographic, ra- niques allow the study of occlusal contacts in only a
diographic, cinefluorographic, or modern techniques restricted area of the arcades. Thus underestimation
for recording mandibular movement) have also indi- of sliding contacts is highly possible, and this would
cated the existence of occlusal contacts, (cf. following explain the higher percentage of contacts observed
paragraph), although the proofs derived from these by other authors: Shsrer and Stallard.- 72%; Ai and
techniques must be considered as indirect. Ischiwara;” 60%. Beyron,’ while studying the
Australian aborigines, found cusp guiding in almost
Occlusal sliding during mastication every cvcle.
Evidence of occlusal sliding and its relationship to The frequency of sliding tooth contacts appears to
occlusal morphology. Direct proofs of occlusal slid- var) according to (1) the individual con-
ing were obtained in studies using telemetric tech- cerned,‘,’ l” ,‘I. .” (2) the type of food chewed,” ”
niques.” ?.I iii-” Indirect proofs were also obtained and (3) the situation of the cycle in the total act of
by several authors using various techniques like chewing, with tooth sliding becoming more frequent
cinematographic,’ .‘.> ii graphic,“” or other mandibu- at the end of the chewing act.“. ,.’ ’
lar trajectory recording techniques.“‘, .li. 1F These Amplitude of cusp guiding. The amplitude of
indirect proofs can be summarized as follows: cusp guiding has been estimated to be between
1. There is an abrupt change in the direction of 1 and 4 mm at the incisor by several au-
movement at the end of mandibular elevation when thors 8 II 215.117.*I)-42 Hildebrand’!’ observed that
the mandibular teeth contact the maxillary teeth. subjects with less pronounced cusps present a more
2. The terminal part of the cycle is remarkably ample guiding than those with more pronounced
constant (may be superimposed despite otherwise cusps.
variable cycles). Lateral sliding at the beginning and at the end of
3. The terminal part of the masticatory cycle can the chewing cycle. Hildebrand”’ noted that cusp
be superimposed on the tooth sliding occurring sliding occurs at both the beginning and the end of
during voluntary lateral mandibular movements. the chewing cycle (jaw opening and ,jaw closing).
Another proof for occlusal sliding in its relation- Adams and Zander’? observed that contacts in
ship to occlusal morpholo<gy is provided by Clay- centric occlusion occur during but near the end of
ton, ” who uses the pantographic method to record the electromyographic (EMG) activity; however,
mandibular positions in three different conditions: some lateral contacts occur after all EMG activity of
(1) lateral movements, starting from centric relation, the elevator muscles has ceased. This evidence,
guided by the experimenter: (2) lateral movements, coupled with cinematographic observation per-
starting from centric occlusion, guided by the formed in the same study, allows the classification of
subjects’ teeth alone; and (3) movements during lateral contacts into two categories: 65 occurring
mastication of different foods. In this latter case during jaw closing (before centric occlusion is
chewing trajectories were tangential and in front of attained) and 38% occurring during jaw opening
tracings obtained from centric occlusion. Later an (after centric occlusion). Glickman and associates”’
occlusal adjustment was performed so that centric in a study of sliding in the frontal plane observed
relation and centric occlusion coincided, and man- that 11% of the contacts were made \vith both the
dibular positions were again recorded during masti- buccal and lingual surfaces of the central fossae of
cation. Chewing trajectories were then tangent to the superior molars. Gilling and associates’ found
tracings obtained from centric occlusion. This exper- that in three out of four sub.jects observed. occlusal
imental modification of the occlusal anatomy gives sliding existed for both jaw closing and jaw opening.
good support to the fundamental role of tooth If we consider that sliding during jaw closing occurs
guiding during mastication. on working cusp surfaces and that sliding during jaw
Variability in occlusal sliding. Telemetric studies opening occurs on nonworking cusp surfaces. then
indicate that cusp guiding does not intervene for these findings demonstrate that cusp guiding occurs
each cycle. Adams and Zander’” found that lateral on nonworking as well as working cusp surfaces.
contacts occurred in 4% to 63% of the cycles, This means that during chewing on the left side,
depending on the food chewed and the subject under the mandible makes a lateral movement to the left,
study. Pamei.jer and associates” found a transverse causing working contacts. Later the mandible crosses
sliding component in 31% of the patients and an the median sagjttal plane and, due to a slight lateral
anteroposterior sliding component in 46%. As has movement on the right, permits the teelh on the left
been pointed out by Miihlmann;“’ telemetric tech- side to establish nonworkmg contacts. whereas bv the

THE JOURNAL OF PROSTHETIC DENTISTRY 337


/ mandibular positions. Adams and Zander” observed
1 2
@ them in 8% of the chewing strokes.Ai and Ishiwara:”
\c!z?4
Fig. 1. Frontal view of the arcades at the molars. On the
left (I and 3) is the left hemiarcade, and on the right (2 and
4) the right hemiarcade. On top (I and 2) the mandible
makes a left lateral movement. On the bottom (3 and 4)
the mandible makes a right lateral movement. The stip-
pled area represents the bolus. According to the habitual
terminology the situation I, 2, 3, and 4 are called,
respectively: I, the working side, 2, the nonworking
(balancing) side, 3, the working side from a functional
point of view (bolus) and the nonworking side from a
kinematic point of view, and 4, the nonworking side from
a functional point of view (bolus) and the working side
from a kinematic point of view. In the proposed terminol-
ogy these situations are called: I, the working and
chewingside,2, the nonworking and nonchewingside, 3,
the nonworking and chewingside,and 4, the working and
nonchewingside.
position of the bolus, the left side can still be defined
as the working side. In fact, all the cusp surfaces on
the side of the bolus participate in the mastication of
food regardlessof their kinematic situation (working
or nonworking). Here there is a problem of confusing
terminology to describe these phenomena. Thus, to
distinguish the kinematic from the functional aspects
of mastication, we propose the application of the
terms working and nonworking in their habitual kine-
matic meaning only, whereas the physical notion of
work linked to the placement of the bolus (function)
should be expressed by the terms chewing and
nonchewing.
Thus, during a functional left lateral mandibular
movement, from a kinematic point of view there is a
working relationship of the cuspson the left side and
a nonworking relationship on the right side, whereas
from a functional point of view the side where the
bolus is found should be called the chewing side and
the other side the nonchewing side (Fig. I).
Nonchewing contacts. Nonchewing contacts (gen-
erally called balancing contacts) can occur on work-
ing as well as nonworking surfaces. They can occur
338
WODA, VIGNERON, AND KAY
during the passage of the teeth through centric
occlusion. In this situation the two hemiarcades
present occlusal contacts.“. ‘I
Nonchewing contacts also exist during eccentric
observed sliding nonworking contacts. Ramfjord and
Ash” affirmed their existence, adding that they are
not functionally necessaryand that they can consti-
tute a pathologic interference if they are not mini-
mal.
Relationships between cusp guiding and abrasion
facets. Ahlgren and Owall’( simultaneously recorded
the movements of the mandible, the force developed,
and the EMG activity of the elevator muscles.They
stated that the maximal force is developed in centric
occlusion. This finding agreeswith those of Atkinson
and Shepherd”’ and Gibbs.+’ However, the surpris-
ing observation is that the force developed by the
elevator muscleson the chewing side continues for 86
msecafter the beginning of jaw opening. They state
that this force accompanies tooth contacts. More-
over, this force lastsbeyond the EMG activity, which
itself can still be recorded after the passageto centric
occlusion. Thus the occlusal surfaces concerned
during the jaw opening are on the nonworking but
chewing side. This explains the development of
nonworking but chewing (and generally called
balancing) abrasion facets found in subjects with
normal dental arcades.
Ai and Ishiwara.‘7 compared the orientation of
lateral excursions during mastication and during
voluntary lateral movement with the inclination of
abrasion facets on posterior teeth. They concluded
that these values are closely related. This finding
again confirms that during mastication the abrasion
facets guide the lateral movement, which in turn is
the cause of the abrasion. This double relationship
was already perceived by Hildebrand.“’
A number of these facets could be the result of
parafunctional movements. However, the extremely
abraded dentitions of the Australian aborigines and
the precolonial American Indians, who probably
presented no more bruxism than Western popula-
tions, is not in support of this hypothesis.“‘. ‘;
Contacts and tooth sliding in the sagittal plane.
The observation in the sagittal plane of contacts and
tooth sliding movements relies on studies giving
indirect’:+. .I’ ii,, a\ or direct”. ?liproofs. Most of these
studies report that during mastication the most
frequently encountered position is centric occlusion,
centric relation being rarely observed. Pameijer and
SEPTEMBER 1979 VOLUME 42 NUMBER 3
NONFUNCTIONAL AND FUNCTIONAL OCCLUSAL CONTACTS

associates’* state that out of 681 contacts observed in

mastication, 588 involved centric occlusion, and only
15 involved centric relation. Sliding movements are
described in the sagittal plane and are produced at
the beginning and at the end of the cycle.
Occlusal field of mastication. In the habitual
description of the masticator)/ cycle viewed from the
frontal plane, the last phase of jaw closing is lateral
to the first phase of jaw opening. However, the work
of Pameijer and associates” seems to indicate that
there is no rule in this regard and that it is impossi-
ble, knowing the occlusion at a given moment, to
predict the occlusion for the following instant. The
data show a great frequency of use for centric
occlusion and the existence of an occlusal field
during mastication centered on centric occlusion. In
this field the initial occlusal contact can occur at any
point, and the cusp sliding movements can occur in
any direction, somewhat like the action of a pestle in
a mortar (Fig. 2’~

OCCLUSAL CONTACTS DURING

SWALLOWING Fig. 2. A schematic representation of the different possi-
bilities of occlusal contact or sliding observed by I’ameijer
The existence of tooth contacts during swallowing and associatesl” on a subject wearing a fixed partial
is generally recognized. However, there is no general denture equipped for telemetric recording. Left, In the
agreement on their location, due perhaps to the sagittal plane the contacts are recorded in centric occlu-
sion (0), 0.75 mm posteriorly (P), 0.75 mm anteriorly (A);
variety and complexity of techniques used with an
the arrows indicate the location and the chronology of the
accompanying small number of observations. contacts. Thick arrows indicate the initial contact. The
Certain authors have observed occlusal contact in numbers on the right of each contact configuration
centric relation during swallowing.“‘. “‘I Graf and indicate the number of this type of contact found in the
Zander” in their study of swallowing observed population studied. Right, In the frontal plane the contacts
contacts in centric relation in 8070 of the patients, are recorded in centric occlusion (0) 0.75 mm vestihuiar-
ly (V), (buccal), 0.75 mm lingually (L). Note the large
but in addition they observed that centric occlusion number of possibilities.
was attained as often and for a much longer time,
seemingly due to a better stabilization.
In the study of swallowing made by Pameijer and sion which may include movements in two other
associates.“” out of 182 recorded deglutitions, 162 planes: vertical and lateral. Mdller” believes tooth
presented tooth contacts in centric occlusion and five contact occurs first with the incisors and then with
in centric relation, and the rest were distributed the molars. He describes a posterior sliding and
erratically in the horizontal plane around centric believes that posterior movements described by
occlusion. Hickey and associates.” found contacts in others”’ agree with his observation concerning the
centric occlusion only. It seems then that centric displacement between incisal occlusion and molar
occlusion is the most frequent and most long-lasting occlusion.
occlusal position during swallowing. Scharer and Stallard’,’ observed sliding move-
A certain amount of diversity is also found in the ments of long duration both toward and away from
study of the direction and origin of tooth sliding centric occlusion during the swallowing of both
during swallowing, whereas the existence and func- solids and liquids. Pameijer and associatesJ’. “”
tional importance is generally agreed upon. Graf and observed sliding contacts in the sagittal and frontal
Zander” suggested the existence of sliding from planes. These sliding movements converged toward
centric relation toward centric occlusion. On the centric occlusion for the most part, although they did
contrary, Kydd and Sanders”‘3 affirmed the existence not necessarily attain it.
of a posterior sliding movement from centric occlu- Thus, considering the diversity of the foregoing

THE JOURNAL OF PROSTHETIC DENTISTRY 339

 WODA, VIGNERON, AND KAY

results and in spite of the classic belief, it does not at 9. Weinberg, L. A.: A cinematic study of centric and eccentric
present seem justified to situate the occlusal field of occlusions. J PROPHET DENT 14:290, 1964.
10. Scaife, R. R., and Holt, J. E.: Natural occurrence of cusp
swallowing posterior to the occlusal field of mastica-
guidance. J PROSTHET DENT 22:225, 1969.
tion. Ingervall, B.: Tooth contacts on the functional and nonfunc-
11.
tional side in children and young adults. Arch Oral Biol
SUMMARY AND CONCLUSION 17:191, 1972.
A review of the literature on occlusal contacts 12. Weinberg, L. A.: The prevalence of tooth contact in eccen-
tric movements of the jaw. Its clinical implications. J Am
emphasizes the following points.
Dent Assoc 62:402, 1961.
1. Contacts in centric occlusion do not correspond 13. Gillings, B. R. D., Graham, C. M., and Duckmanton, N. A.:
to any ideal occlusal diagram. Jaw movement in young adult man during chewing. J
2. Canine protection and group function appear to PROSTHET DENT 29~616, 1973.
correspond to two successive states of the evolving 14. Reynolds, J. M.: Occlusal wear facets. J PROSTHET DENT
24~367, 1970.
dentition under the effect of abrasion. In most lateral
15. Posselt, U.: Physiology of Occlusion and Rehabilitation.
occlusions, two maxillary teeth, of which one is the Oxford, 1964, Blackwell Scientific Publications.
canine, are involved. 16. Kydd, W. L., and Sanders, A. A.: Study of posterior
3. During mastication, tooth contacts exist. They mandibular movements from intercuspal occlusal position. J
occur most often during a sliding movement in Dent Res 4Or419, 1961.
17. Saizar, P.: Le mouvement mandibulaire tetrusif. Actual
which the direction and the origin are variable. This
Odontostomat 58:187, 1962.
justifies the concept of an occlusal field of mastica- 18. Ziebert, G. J., and Knap, F. J.: Effect of jaw guidance on
tion. retruded stroke as recorded in the sagittal plane. J PROSTHET
4. During unilateral mastication, the chewing of DENT 29:262, 1973.
the food is performed by working as well as nonwork- 19. Hildebrand, G. Y.: Studies in mandibular kinematics. Dent
Cosmos 78:449, 1936.
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20. Jankelson, B., Hoffman, G. M., and Hendron, J. A.: The
the chewing and nonchewing sides (functional) and physiology of the stomatognatic system. J Am Dent Assoc
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24. Scott, I., and Ash, M. M.: A six channel intraoral transmitter
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Journal adopts new policy for illustrations in color

The Editorial Council and publisher of THE JOURNAL OF PROSTHETIC DENTISTRY have agreed to publish articles
that contain color illustrations at a reduced cost to authors. Authors will pay only $225 per color page, or part
thereof, and can present from one to eight illustrations on each page.
Two high-quality 35 mm color transparencies (an original and duplicate) must be submitted for each
illustration, and manuscript length cannot exceed IO to 12 double-spaced typewritten pages. The Editor and his
reviewers have final authority to determine if color illustrations afford the most effective presentation.
Articles containing color will appear in selected issues beginning in 1980. Authors are requested to include a
statement when they submit their manuscript agreeing to pay $225 for each page of color. Billing will come from
the publisher after the author has approved color proofs and the article is scheduled for publication. Manuscripts
and illustrations will be accepted immediately for evaluation.

THE IOlJRNAL OF PROSTHETIC DENTISTRY 341