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In this foundational article, Drs. H. Clayton Stallard and Charles E. Stuart explore the evolving concepts of occlusion in dentistry. Originally published during a pivotal period in dental thought, the article presents a clear, systematic analysis of the principles that should guide the development of a healthy, stable occlusal relationship. The authors lay out their biologically informed perspective—arguing that centric relation, anterior guidance, and cusp-fossa relationships must be carefully respected to ensure long-term function, patient comfort, and restorative predictability.
Occlusion as a Biologic and Mechanical System
Stallard and Stuart begin by defining occlusion as both a mechanical contact system and a biologic relationship between teeth, joints, and musculature. They caution that focusing on tooth alignment alone—without regard for joint position or muscle balance—can lead to failure. True occlusal harmony must integrate all components of the stomatognathic system.
The authors argue that biologic function is the most reliable guide to successful occlusal design. Teeth should support, not oppose, the movements and relationships dictated by the joints and neuromuscular system.
Centric Relation as the Foundation of Occlusion
A core theme of the article is the primacy of centric relation (CR)—the repeatable, ligament-guided position of the condyles in the glenoid fossae. The authors define CR as a non-tooth-determined position that should be used as the starting point for diagnosis and restorative design.
Stallard and Stuart explain that CR allows for predictable mandibular movement, minimal muscle strain, and maximum joint stability. Deviating from CR to conform to habitual or intercuspal positions may temporarily satisfy esthetic or functional goals but will ultimately lead to instability, discomfort, or breakdown.
The Role of Anterior Guidance
Anterior guidance is presented as a dynamic control system that directs mandibular movements and protects the posterior teeth. According to the authors, a properly designed anterior guidance ensures disclusion during excursive movements and limits lateral forces on the posteriors, thereby preserving both tooth structure and joint health.
They highlight that canine rise and incisal edge design must be tailored to the envelope of function and muscular patterns of the individual. Flat or overly steep guidance, if improperly integrated, can contribute to parafunction, TMJ disorders, or posterior interferences.
Posterior Tooth Morphology and Cusp-Fossa Design
Stallard and Stuart place strong emphasis on preserving or replicating natural cusp-fossa anatomy in restorative work. Posterior teeth should allow for smooth, unobstructed closure into centric stops, with careful attention to occlusal pathways that mirror natural mandibular movement.
They warn against the use of flat occlusal tables or over-simplified contacts, which may initially reduce chairside adjustments but will ultimately compromise long-term function. Cusp inclines should match functional pathways dictated by condylar movement and anterior guidance.
Clinical Applications and Restorative Recommendations
The article includes practical guidelines for implementing these concepts into restorative practice. This includes mounting models in CR, using diagnostic wax-ups to evaluate occlusion, and designing restorations that integrate anterior guidance and functional occlusal surfaces.
Stallard and Stuart advocate for careful provisionalization and functional testing before final restoration. They encourage clinicians to treat each case as a unique biologic system and to avoid relying solely on esthetic preferences or occlusal norms divorced from function.
The Evolution of Occlusal Philosophy
Finally, the authors reflect on how concepts of occlusion have changed over time—from purely mechanical theories to more holistic, biologically integrated models. They argue that the future of restorative success lies in embracing occlusion as a functional system rooted in natural design, not just a set of idealized contacts or textbook diagrams.
This perspective laid the groundwork for what would later be known as gnathology and influenced future schools of thought such as Bioesthetic Dentistry, which share a similar reverence for the role of biologic form and joint function in creating lasting, comfortable occlusion.
Key Clinical Takeaways
- Occlusion is a biologic system involving teeth, joints, and muscles—not just a static relationship between teeth.
- Centric relation (CR) provides a repeatable, joint-guided position that should be the starting point for diagnosis and treatment planning.
- Anterior guidance must be carefully designed to control mandibular movement and protect posterior teeth from harmful lateral forces.
- Cusp-fossa morphology in posterior teeth supports natural movement paths and should not be compromised by over-simplification.
- Restorative success depends on mounting models in CR, using diagnostic wax-ups, and testing occlusion before finalizing restorations.
- True occlusal harmony respects biologic design, accommodates joint position, and integrates function and esthetics.
This article remains a cornerstone of occlusal education, establishing principles that continue to guide biologically sound restorative dentistry. Drs. Stallard and Stuart challenge clinicians to think systemically, plan precisely, and respect the intricate relationships that define functional oral health.
Read the full article here.