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Development of
occlusion
Dr Lamis Elsharkasi
occlusion
• Occlusion simply means “contact between teeth”
The human dentition is in dynamic state constantly changing
throughout life.
Period of occlusion :
• Pre-dental period
• Deciduous dentition period
• Mixed dentition period
• Permanent dentition period
Pre-dental period
• The period after birth which the
neonate does not have teeth
• Lasts for 6 months
• The alveolar processes at the
time of birth are known as gum
pads
Gum pad
Gum pad are:
• Pink
• Firm
• Horse-shoe shaped
• Covered by a dense layer of fibrous periosteum
• Developed in two parts labio-buccal portion and lingual portion
• Dental groove separates the two portions
Gum pad
• The gum pad is divided into 10 segments by transverse grooves
• Each segment consists of one developing deciduous tooth sac
• Gum pad are separated from the palate and the floor of the mouth
by gingival grooves
• Lateral sulcus: present between the canine and 1st molar
Transverse groove
Gingival groove
Lateral sulcus
Gum pad
• The upper gum pad is larger and wider than the lower, so when
approximated there is a complete overjet all around.
• Contact between upper and lower gum pad occurs in the molar
region
• A space is exist in the anterior region (infantile open bite). It is
normal and helps in suckling
Gum pad
State of dentition:
• At birth the gum pad are not sufficiently wide to accommodate the
developing incisors
• During the first year of life a rapid growth happened which permits the
incisors to erupt in good alignment
Gum pad
• Natal teeth : presents at time
of birth
• Neonatal teeth: erupts during
the first month of age
• Both located in the mandibular
incisor region
Deciduous dentition period
• Initiation of primary tooth buds occurs during the first 6 weeks of
intra-uterine life
• Eruption of primary teeth begin around 6 months
• Establishment of primary dentition is usually by the age of 3years
• 3-5 years – no significant change
• Sequence of eruption: A-B-D-C-E
Decidous teeth development and
eruption time
MAXILLARY
TEETH
A B C D E
HARD TISSUE
FORMATION( months
intrauterine)
13-16 15-17 15-18 15-17 17-20
CROWN
FORMATION
1.5
months
2.5
months
9
months
6
months
11
months
ERUPTION 8
months
9
months
2
years
1.5
years
2.5
years
ROOT
FORMATION
3
years
3
years
3.5
years
3
years
4
years
MANDIBULAR
TEETH
A B C D E
HARD TISSUE
FORMATION( months
intrauterine)
13-16 15-17 16-18 15-17 17-20
CROWN
FORMATION
2
months
3
months
9
months
6
months
10
months
ERUPTION 6
months
10
months
2
years
1.5
years
2.5
years
ROOT
FORMATION
2.5-3
years
2.5
years
3.5
years
2.8
years
3.5
years
Variation in eruption of deciduous teeth +/- 6 months
Molar relation ship in
deciduous dentition
Flash terminal Distal step Mesial step
Characteristics of deciduous
dentition
• Flash terminal plane
• Deep bite: may occur in the initial stage of
deciduous dentition .
• This is later reduced by these factors:
Eruption of deciduous molars
Attrition of primary incisors
Forward movement of mandible
due to growth
• Upright inclination of incisors
• Spacing in deciduous teeth
Spacing in deciduous dentition
• 1. interdental spaces: also called physiological spaces and
developmental spaces
• These spaces are important for normal development of permanent
dentition
• Absence of spaces in deciduous dentition, leads to crowding in
permanent dentition
Spacing in deciduous dentition
• 2. primate space(arthropoid space):
• Spacing seen mesial to the maxillary deciduous canine (1.7 mm)
and distal to the Mandibular canine (1.5 mm).
• Importance: early mesial shift
Mixed dentition
• Begin around 6 years of age with the eruption of the first permanent
molars
• Mixed dentition = deciduous teeth + permanent teeth
• Divided into 3 phases:
1st transitional period
Inter-transitional period
2nd transitional period
1st transitional period
• Characterized by the eruption of 1st permanent molar and
exchange of deciduous incisors with permanent incisors
• 1st permanent molar erupts at 6 yrs. and its location depends on the
deciduous molar relation ship
Class I molar
If excess mandibular
growth –class Ⅲ
Edge to edge
Class I
Class Ⅱ
Mesial step Flash terminal Distal step
Early mesial shift
• Early shift occurs during early mixed dentition period
• Eruption force of 1st permanent molar is sufficient to push deciduous
1st & 2nd molar forward to close the primate space
Exchange of incisors
• During the 1st transitional period the
deciduous incisors are replaced by the
permanent incisors
• Mandibular incisors erupt first
• The permanent incisors are larger than
the deciduous teeth they replace
• The amount needed for the
accommodation of the permanent
incisors and the amount available for
this is called Incisal liability
• 7mm in maxilla
• 5mm in mandible
Incisal liability
• The incisal liability is overcomed by the following factors:
• Interdental dental spaces
• Inter canine width
• Incisor inclination
Incisal liability
• 1. utilization of interdental spaces:
• Physiological spaces that exist in deciduous dentition are utilized to
account for incisal liability
• In spaced deciduous dentition, alignment of permanent teeth in arch
is easier than in closed dentition
•
• 2. intercanine width:
• Width growth creates more room for the permanent incisors
• 3. incisor inclination:
• Permanent incisors erupt more labially which tend to increase the
dental arch perimeter
Inter-transitional period
• this period started when 1st permanent molar & permanent incisors
are erupted
• Consists of set of deciduous and permanent teeth
• This period is relatively stable and no change occur
6 E D C 2 1
6 E D C 2 1
1 2 C D E 6
1 2 C D E 6
2nd transitional period
• This period characterized by the replacement of deciduous molar
and canine by the premolars and permanent canine respectively
• Late shift of permanent molar occur in this period by utilizing leeway
space to establish class Ⅰmolar.
Late mesial shift
• In cases when the primate space is
absent, the permanent 1st molar shift drift
mesially utilizing the leeway space.
• Premolars are smaller than primary molar
teeth they replace
• The extra space is called leeway space
• C+D+E > 3+4+5
• Maxilla : 1.5mm
• Mandible: 2.5mm
Ugly duckling stage
• Characterized by spacing between
maxillary central incisors
• Parents often apprehensive during
this stage and consult the dentist
• It is a transient or self correcting
malocclusion which seen between 8-9
yrs. During the eruption of permanent
canine
Ugly duckling stage
• As the developing canines erupt, they
displace the roots of the lateral
incisors mesially
• This results in transmitting the force
on to the roots of central incisors
which also displaced mesially.
Permanent dentition
• Permanent dentition forms within the jaw soon after birth except the
cusps of the first permanent molar which forms before birth
• Permanent incisors develop lingual or palatal to the deciduous teeth
and move labially as they erupt
• Premolars develop below the diverging roots of deciduous molars
Permanent dentition
• Sequences of eruption of permanent teeth:
• Maxilla : 6 – 1 – 2 – 4 – 3 – 5 – 7
Or : 6 – 1 – 2 – 3 – 4 – 5 – 7
• Mandible: 6 – 1 – 2 – 3 – 4 – 5 – 7
or : 6 – 1 – 2 – 4 – 3 – 5 – 7
Permanent teeth development and
eruption time
MAXILLARY
TEETH
1 2 3 4 5 6 7 8
HARD TISSUE
FORMATION
4
months
11
months
5
months
20
months
26
months
7
months
intra-
uterine
3
years
8
years
CROWN
FORMATION
3.5
years
4.5
years
5
years
6.5
years
7
years
2.5-3
years
7
years
13
years
ERUPTION 7-8
years
8
years
11
years
10
years
10.5
years
6
years
12
years
18
years
ROOT
FORMATION
9-10
years
10-11
years
12.5
years
12-13
years
12-14
years
9.5
years
13-15
years
21.5
years
MANDIBULAR
TEETH
1 2 3 4 5 6 7 8
HARD TISSUE
FORMATION
4
months
4
months
5
months
20
months
26
months
7
months
intra-
uterine
8
years
9
years
CROWN
FORMATION
4.5
years
4.5
years
4.5
years
6.5
years
7
years
2.5
years
7
years
13
years
ERUPTION 6-7
years
7-8
years
10
years
10-11
years
11
years
6
years
12
years
18
years
ROOT
FORMATION
8-9
years
9-10
years
11-13
years
11-13
years
12-14
years
8-10
years
14-15
years
20
years
Variation in eruption of permanent teeth +/- 2 years
Characteristics of permanent
dentition
• Class i molar relationship ( mesiobuccal cusp of upper 1st molar
occludes with the mesiobuccal groove of lower 1st molar)
• No crowding
• No rotated teeth
• No spacing
• Appropriate inclination of teeth
• The occlusal plane should be flat or have only a mild curve of spee (
1.3mm)
Essential factors of smooth transition
from primary to permanent dentition
• Primate space
• Physiological spacing
• Preservation of leeway space
• Tooth size and jaw in harmony
Development of Occlusion: Key Stages and Transitions

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Development of Occlusion: Key Stages and Transitions

  • 2. occlusion • Occlusion simply means “contact between teeth” The human dentition is in dynamic state constantly changing throughout life. Period of occlusion : • Pre-dental period • Deciduous dentition period • Mixed dentition period • Permanent dentition period
  • 3. Pre-dental period • The period after birth which the neonate does not have teeth • Lasts for 6 months • The alveolar processes at the time of birth are known as gum pads
  • 4. Gum pad Gum pad are: • Pink • Firm • Horse-shoe shaped • Covered by a dense layer of fibrous periosteum • Developed in two parts labio-buccal portion and lingual portion • Dental groove separates the two portions
  • 5. Gum pad • The gum pad is divided into 10 segments by transverse grooves • Each segment consists of one developing deciduous tooth sac • Gum pad are separated from the palate and the floor of the mouth by gingival grooves • Lateral sulcus: present between the canine and 1st molar Transverse groove Gingival groove Lateral sulcus
  • 6. Gum pad • The upper gum pad is larger and wider than the lower, so when approximated there is a complete overjet all around. • Contact between upper and lower gum pad occurs in the molar region • A space is exist in the anterior region (infantile open bite). It is normal and helps in suckling
  • 7. Gum pad State of dentition: • At birth the gum pad are not sufficiently wide to accommodate the developing incisors • During the first year of life a rapid growth happened which permits the incisors to erupt in good alignment
  • 8. Gum pad • Natal teeth : presents at time of birth • Neonatal teeth: erupts during the first month of age • Both located in the mandibular incisor region
  • 9. Deciduous dentition period • Initiation of primary tooth buds occurs during the first 6 weeks of intra-uterine life • Eruption of primary teeth begin around 6 months • Establishment of primary dentition is usually by the age of 3years • 3-5 years – no significant change • Sequence of eruption: A-B-D-C-E
  • 10. Decidous teeth development and eruption time MAXILLARY TEETH A B C D E HARD TISSUE FORMATION( months intrauterine) 13-16 15-17 15-18 15-17 17-20 CROWN FORMATION 1.5 months 2.5 months 9 months 6 months 11 months ERUPTION 8 months 9 months 2 years 1.5 years 2.5 years ROOT FORMATION 3 years 3 years 3.5 years 3 years 4 years
  • 11. MANDIBULAR TEETH A B C D E HARD TISSUE FORMATION( months intrauterine) 13-16 15-17 16-18 15-17 17-20 CROWN FORMATION 2 months 3 months 9 months 6 months 10 months ERUPTION 6 months 10 months 2 years 1.5 years 2.5 years ROOT FORMATION 2.5-3 years 2.5 years 3.5 years 2.8 years 3.5 years Variation in eruption of deciduous teeth +/- 6 months
  • 12. Molar relation ship in deciduous dentition Flash terminal Distal step Mesial step
  • 13. Characteristics of deciduous dentition • Flash terminal plane • Deep bite: may occur in the initial stage of deciduous dentition . • This is later reduced by these factors: Eruption of deciduous molars Attrition of primary incisors Forward movement of mandible due to growth • Upright inclination of incisors • Spacing in deciduous teeth
  • 14. Spacing in deciduous dentition • 1. interdental spaces: also called physiological spaces and developmental spaces • These spaces are important for normal development of permanent dentition • Absence of spaces in deciduous dentition, leads to crowding in permanent dentition
  • 15. Spacing in deciduous dentition • 2. primate space(arthropoid space): • Spacing seen mesial to the maxillary deciduous canine (1.7 mm) and distal to the Mandibular canine (1.5 mm). • Importance: early mesial shift
  • 16. Mixed dentition • Begin around 6 years of age with the eruption of the first permanent molars • Mixed dentition = deciduous teeth + permanent teeth • Divided into 3 phases: 1st transitional period Inter-transitional period 2nd transitional period
  • 17. 1st transitional period • Characterized by the eruption of 1st permanent molar and exchange of deciduous incisors with permanent incisors • 1st permanent molar erupts at 6 yrs. and its location depends on the deciduous molar relation ship Class I molar If excess mandibular growth –class Ⅲ Edge to edge Class I Class Ⅱ Mesial step Flash terminal Distal step
  • 18. Early mesial shift • Early shift occurs during early mixed dentition period • Eruption force of 1st permanent molar is sufficient to push deciduous 1st & 2nd molar forward to close the primate space
  • 19. Exchange of incisors • During the 1st transitional period the deciduous incisors are replaced by the permanent incisors • Mandibular incisors erupt first • The permanent incisors are larger than the deciduous teeth they replace • The amount needed for the accommodation of the permanent incisors and the amount available for this is called Incisal liability • 7mm in maxilla • 5mm in mandible
  • 20. Incisal liability • The incisal liability is overcomed by the following factors: • Interdental dental spaces • Inter canine width • Incisor inclination
  • 21. Incisal liability • 1. utilization of interdental spaces: • Physiological spaces that exist in deciduous dentition are utilized to account for incisal liability • In spaced deciduous dentition, alignment of permanent teeth in arch is easier than in closed dentition • • 2. intercanine width: • Width growth creates more room for the permanent incisors • 3. incisor inclination: • Permanent incisors erupt more labially which tend to increase the dental arch perimeter
  • 22. Inter-transitional period • this period started when 1st permanent molar & permanent incisors are erupted • Consists of set of deciduous and permanent teeth • This period is relatively stable and no change occur 6 E D C 2 1 6 E D C 2 1 1 2 C D E 6 1 2 C D E 6
  • 23. 2nd transitional period • This period characterized by the replacement of deciduous molar and canine by the premolars and permanent canine respectively • Late shift of permanent molar occur in this period by utilizing leeway space to establish class Ⅰmolar.
  • 24. Late mesial shift • In cases when the primate space is absent, the permanent 1st molar shift drift mesially utilizing the leeway space. • Premolars are smaller than primary molar teeth they replace • The extra space is called leeway space • C+D+E > 3+4+5 • Maxilla : 1.5mm • Mandible: 2.5mm
  • 25. Ugly duckling stage • Characterized by spacing between maxillary central incisors • Parents often apprehensive during this stage and consult the dentist • It is a transient or self correcting malocclusion which seen between 8-9 yrs. During the eruption of permanent canine
  • 26. Ugly duckling stage • As the developing canines erupt, they displace the roots of the lateral incisors mesially • This results in transmitting the force on to the roots of central incisors which also displaced mesially.
  • 27. Permanent dentition • Permanent dentition forms within the jaw soon after birth except the cusps of the first permanent molar which forms before birth • Permanent incisors develop lingual or palatal to the deciduous teeth and move labially as they erupt • Premolars develop below the diverging roots of deciduous molars
  • 28. Permanent dentition • Sequences of eruption of permanent teeth: • Maxilla : 6 – 1 – 2 – 4 – 3 – 5 – 7 Or : 6 – 1 – 2 – 3 – 4 – 5 – 7 • Mandible: 6 – 1 – 2 – 3 – 4 – 5 – 7 or : 6 – 1 – 2 – 4 – 3 – 5 – 7
  • 29. Permanent teeth development and eruption time MAXILLARY TEETH 1 2 3 4 5 6 7 8 HARD TISSUE FORMATION 4 months 11 months 5 months 20 months 26 months 7 months intra- uterine 3 years 8 years CROWN FORMATION 3.5 years 4.5 years 5 years 6.5 years 7 years 2.5-3 years 7 years 13 years ERUPTION 7-8 years 8 years 11 years 10 years 10.5 years 6 years 12 years 18 years ROOT FORMATION 9-10 years 10-11 years 12.5 years 12-13 years 12-14 years 9.5 years 13-15 years 21.5 years
  • 30. MANDIBULAR TEETH 1 2 3 4 5 6 7 8 HARD TISSUE FORMATION 4 months 4 months 5 months 20 months 26 months 7 months intra- uterine 8 years 9 years CROWN FORMATION 4.5 years 4.5 years 4.5 years 6.5 years 7 years 2.5 years 7 years 13 years ERUPTION 6-7 years 7-8 years 10 years 10-11 years 11 years 6 years 12 years 18 years ROOT FORMATION 8-9 years 9-10 years 11-13 years 11-13 years 12-14 years 8-10 years 14-15 years 20 years Variation in eruption of permanent teeth +/- 2 years
  • 31. Characteristics of permanent dentition • Class i molar relationship ( mesiobuccal cusp of upper 1st molar occludes with the mesiobuccal groove of lower 1st molar) • No crowding • No rotated teeth • No spacing • Appropriate inclination of teeth • The occlusal plane should be flat or have only a mild curve of spee ( 1.3mm)
  • 32. Essential factors of smooth transition from primary to permanent dentition • Primate space • Physiological spacing • Preservation of leeway space • Tooth size and jaw in harmony