Fundamentals of Dental Occlusion
Fundamentals of Dental Occlusion
Fro m the Division of Facia l Plastic Surger y. Departm ent of Otolaryngology and Co mmunica tion Disorders. SUNY Upstate College of Medici ne,
Syracuse, N.Y.
Figure 2. The Angle classification is based 0 11 molar occlusion. Adap ted with perm ission fro m Kellman RM, Tatum SA. Com plex
facia l trauma with plating. In: Bailey B1, ed. Head and Neck Surgery-Otolaryngo logy, 2nd ed. Philadelph ia: Lippincott-R aven
Publishers, 1998; 1051.
an increased ove rjet, In division II, the central incisors are • An overbite or deep bite describes an increased vertical
palatall y tilted to compensate for the skeletal abnormality, overlap of the incisor teeth. Normally, the maxillary incisors
resulting in a norm al or near-normal anterior relationship. overlap the mandibular incisors by I to 3 mm.' When this
The class III malocclu sion is typicall y associated with an distance increases, the maxillary incisor teeth obscure the
anterior cross bite. mandibul ar incisors. In the transverse dimension, the molar
In the vertical dimension, two clinical situations may teeth intercus pate in such a way that the buccal cusps of
be encountered: the maxillary teeth are lateral or buccal to the buccal cusps
of their mandibul ar counterparts. Th is norm al situation is
• An open-bite deformit y is seen when the occlusal or altered when there is a posterior cross bite.'
incisal surfaces of the teeth do not meet in the same plane
durin g jaw movem ent. If there is unilateral premature con- Malocclusion can have a profound effect on both func-
tact between the posterior teeth, a posterior open bite will tion and appeara nce. It contributes to several conditions
occur contralatera lly. Thi s is commo nly see n in unilateral for which patient s seek evaluation, including sleep apnea,
subco ndylar frac tures. co ngenital cra niofac ial anomalies, and aesthetic concerns.
The documentation of occlusion is an essenti al part of the
diagnosis of these dent al-skeletal anomal ies.
~ References
~ I. Zide BM, Pfeifer TM, Longa ker MT. Chin surgery: I. Augmenta -
tion-The allures and the alerts. Plast Recons tr Surg 1999; I 04:
1843-53.
2. Brand RW, Isselh ard DE . Anatomy of Orofacial Structures. 4th ed.
'"
~
SI. Louis: Mosby ; 1990:213-80.
3. Tatum SA. Correction of post-traumatic max illofacial defor mities
f Edge to involving occlusion. Facia l Plast Surg Clin North Am 1998;6:
edge bite 535-56 .