03 Christensen 1958 Cusp Angulation For Full Complete Dentures
03 Christensen 1958 Cusp Angulation For Full Complete Dentures
03 Christensen 1958 Cusp Angulation For Full Complete Dentures
The distance between the occlusion rims increases in size from the front toward
the molar region by the amount of the Christensen angle (Fig. 2).
Received for publication Nov. 4, 1957.
*Assistant Professor, Norwegian State Dental School, Oslo, Norway.
910
CUSP ANGULATION FOR COMPLETE DENTURES 911
Fig. Z.-The Christensen angle (y) and the Christensen distance (Sm) at the distobuccal cusp of
the last mandibular molar
The distance from a point (M, Fig. 2) on the mandibular occlusion rim to
a point perpendicular to the maxillary occlusion rim is called the Christensen
distance. This distance in the premolar region is thus smaller than in the molar
region. The Christensen distance (S, Fig. 2) is found by multiplying the sine of
the Christensen angle (y) by the distance from the incisal point to the point in
question from which the Christensen distance is to be measured (M, Fig. 2).
Fig. 4.-Schematic reproduction of the relation between the incisal point !A), the summit
of the distobuccal cusp of the last mandibular molar (Cj, and the condylar axis (Lj. The projec-
tion is in the median plane. Centric occlusion is represented by ACL, protrusive relation by
A,C?L%
a, The height of Bonwill’s triangle, that is, the perpendicular from the incisal point to
the condylar axis = AL = AILI = AILS.
A-AI, The size of protrusion, that is, the length of the ventral movement of the incisal
point by protrusive movement = LLI = C Cz =p.
A-L, See a.
AI-LX, Auxiliary line, parallel-shifting of the line AL, ventral displacement by a condylar
guide inclination (8) = 0 degrees.
,8, Condylar guide inclination.
C, The tips of the distobuccal cusps of the last mandibular molar in the centric occlusion.
Cz, The tips of the distobuccal cusps of the last mandibular mol’ar after protrusive
movement.
7, The Christensen angle = 71.
K-KI, The mandibular plane of occlusion after protrusive movement.
L-LI, See A-AI.
L-Lz, The length of the movement of the condylar axis in the condylar path by a move-
ment of the incisal point from A to AI.
O-O, The plane of occlusion.
p, See A-AI.
, Balkwill’s angle.
Assuming this distance to be 1, the Formula for the Christensen distance is:
S = 1 sine -1 (Formula I)
where y is the Christensen angle.
Taking the occlusal relief sagittal length as 50 mm., the Christensen distance
at the end of the occlusion rim can be expressed by the formula:
Sm = 50 sine y
Volume 8 CUSP ANGULATION FOR COMPLETE DENTURES 913
Number 6
In order to calculate the Christensen distance and, thus, measure the height
of the cusps, it is necessary to determine the size of the Christensen angle.” To
simplify the calculation concerning the Christensen angle, the sides of Bonwill’s
triangle (Fig. 3, AFB) are assumed to be 100 mm. (properly 4 inches) .4 Bonwill’s
triangle is an equilateral triangle, the angles of which are formed, respectively, by
the incisal point and the two mandibular condyles. The height in Bonwill’s triangle
(u in Figs. 4 and 5) is 100 mm. X sine 60 degrees. In clinical work, it will prove
advantageous to make the dorsal line of Bonwill’s triangle identical with the condylar
3x1s.
It is assumed that the line which forms the dorsal limit of Bonwill’s triangle
coincides with the condylar axis and that this line is perpendicular to the median
plane. The plane in which Bonwill’s triangle is situated is called Bonwill’s plane.
The Balkwill angle is the angle between the plane of occlusion and Bonwill’s plane
projected on the median plane (Fig. 3, B). This angle, according to Balkwill’s
calculations,5 is assessed at an average equal to 26 degrees. The calculations of the
Christensen angle in this investigation are based on the following assumptions :
The condylar path is straight, and the inclination of the condylar guidance
is identical on each side.
By inclination of the condylar guidance is meant the inclination of the sagittal
condylar guidance to the plane of occlusion, which is an imaginary plane, passing
through the incisal point and the tips of the distobuccal cusps of the last molar
on each side.
By firotrmion is meant forward protrusion, and when using protrusive move-
ments in connection with the Christensen angle, the incisal point is assumed to be
dispIaced into, or parallel with, the maxillary occlusion rim (Fig. 4, where A-A,
is on the line O-O,).
CHRISTENSEN J. Pros. Den.
914 Nov..Dec., 1958
Assuming the lower jaw (ACL, Fig. 4) to be protruded forward along the
plane of occlusion (O-O,) a distance equal to the length of the protrusion (P),
this distance equals a movement of A to A, and IL to L, with an inclination of the
condylar guidance of 0 degrees. The new position of the lower jaw becomes then
A,C,L, (Fig. 4). The Christensen angle (y ) is found by allowing this triangle
to rotate on the incisal point A, (Figs. 4 and 5), so that point L, (the projection
of the condylar axis) comes into contact with the condyle path LL,. L is thus dis-
placed to L, and C, to C,. It is clearly seen from Fig. 5 that the Christensen angle
y equals yl. A number of additional letters are added to Fig. 5 for extra clarity.
From Fig. 5, through a series of mathematical calculations, Formula II is developed :
sine [(p + P) f y] = sine (/3 f ‘F) + p/a sine /3
Using this formula, the Christensen angle (7) can be calculated using various
inclinations of condylar guidances (p) and different sizes of Bonwill’s triangle
(a) and Balkwill’s angle ( p). Similarly, we are able to calculate y for protrusions
of varying length (p). In Table I, the Christensen distance at the distobuccal
cusp of the third molar (S,) is calculated using Formula I.
B i 5” j 10” 15” 1 20” ( 2.5” 30” 35” / 40” ~ 45” 50” 55” ~ ii:-
Y 0.30” 0.60” 0.87” 1.14” 1.40” 1.66” 1.92” 2.20” ! 2.50” 2.80” 3.15” i 3.53”
___-
S, 0.25 0.50 0.72 0.95 1.15 1.38 1.59 1.82 2.07 2.32 2.61 2.93
__-...-----__-__.
By plotting the graph of Table I (Fig. 6), the size of the Christensen angle
(7) can be read on the left vertical column (ordinate) of the table at a protrusion
of 5 mm. The ordinate on the right gives the Christensen distance at the distobuc-
cal cusp of the third molar. The abscissa gives the size of the condylar guide in-
clination (p) .
As is shown by Table I, the size of the Christensen angle does not increase
proportionally with the inclination of the condylar path. The difference is small
and is shown in the graph of Table I as a slightly curved line connecting those
points which define the size of the Christensen angle (Fig. 6). This same curve
shows that the Christensen angle is relatively smallest at 25 to 30 degrees. This
phenomenon is due to the Balkwill angle.
According to Table I, the Christensen angle increases by approximately 0.5
to 0.6 degrees for every increase of 10 degrees in the inclination of the condylar
CUSP ANGULATION FOR COMPLETE DENTURES 91.5
o”x $9
0’
0. 5 /o N PO 25 30 35 40 45 50 5.9 60’
Fig. K-Graphic reproduction of Table I. The graph shows the Christensen angle by 5 mm.
of protrusion and average values for Bonwill’s triangle and Balkwill’s angle. The line connect-
ing the dots forms a flat curve. The value of the Christensen angle is relatively smallest by
condylar guide inclinations that are about 25 to 30 degrees.
Yx = Yl l P
where -,+ is the desired angle, and y1 is Christensen’s angle using a protrusion equal
to 1 mm., and p is the length of the protrusion expressed in millimeters. If Table
I is combined with the results of Table II, that is, that Christensen’s angle increases
proportionally with increasing forward displacement, Table III and the graphic
J. Pros. Den.
916 CHRISTENSEN
Nov.-Dec.. 1958
reproduction of Table III (Fig. 8) are obtained. For example, with a condylar
guide angle of 4.5 degrees and a forward protrusion equal to 7 mm., Christensen’s
angle as taken from Table III is 3.5 degrees. If the condylar guide angle equals
20 degrees and the forward protrusion equals 6 mm., Christensen’s angle equals
1.37 degrees.
Fig. 7.-Graphic reproduction of Table II. The graph shows the size of the Christensen
angle by various lengths of protrusion in connection with condylar guide inclinations (j3) of
15 and 45 degrees, respectively.
TABLE III. THE CHRISTENSEN ANGLE BY DIFFERENT LENGTHS OF PROTRUSION AND VARIOUS
CONDYLAR GUIDE INCLINATIONS
T--i--
>‘\ @ 5” I 10” I 15” 20" 5.5" 1 60"
P \, /
2 mm. : 0.12 I o.24 I o.38 1:0.46 0.56 10.66 IO.76 / 0.88 1.00 1.12 1.26 11.40
3 mm. ~ 0.18 IO.36 1 0.57 1 0.69 0.84 10.99 1 1.14 j 1.32 1.50 1.68 1.89 12.11
4 mm. 0.24 i 0.48 0.76 0.92 1.12 ~1.32 1.53 1.76 2.00 2.24 2.52 2.82
__-- --_I __. ____
5 mm. 0.31 0.62 ' 0.87 1.14 1.39 j 1.66 1.92 2.20 2.50 2.80 3.15 3.53
--I------ _____ .I-
6 mm. 0.37 0.74 1.06 1.37 1.67 1.99 2.30 2.64 3.00 3.36 3.78 4.23
7 mm. 0.43 0.86 1.25 1.60 1.95 2.32 2.68 3.08 3.50 3.92 4.41 / 4.93
-_____----___ -I--
8 mm. 0.49 0.98 1.44 1.83 5.04 / 5.64
__. .I-
9 mm. 0.55 1.11 1.64 2.06 5.67 6.35
-. _-__-
10mm. 0.62 1.24 1.74 2.28 2.78 j 3.32 j 3.84 j 4.40 j 5.00 / 5.60 6.30 7.06
The cusp height (C) for the distobuccal cusp at the third molar (C M,d) sl10~11tl
be half of the Christensen distance (S,, Table I), since the cusp height is cal-
culated assuming that the protrusion equals 2.5 mm.
According to the “Glossary of Prosthodontic Terms,“l” the CM@ height is
“the shortest distance between the summit of a cusp and its base plane” (K/z, Fig.
lo), and the cusp angle is defined as “the angle made by the sides of a cusp with
the plane which passes through the summit of the cusp and which is perpendicular
to a line bisecting the cusp, measured mesiodistally or buccolingually” ( e, Fig. 10).
BG
In accordance with Fig. 7, tangents to the cusp angle (E ) are like + where
AG,
BG = half of the Christensen distance (S) by 5 mm. of protrusion, and AG = 2.5
mm. Consequently, tangents to the cusp angle
s
(e) =B”-%S=S=-
AG - 2.5 5 p’
S
tg. e = + (Formula IV)
P
That is, tg. to the msp angle is equal to the Christenselt distmtre divided hy the COT-
responding length of protrusion.
From the incisal point to the summit of the distobuccal cusp of the third molar,
the distance is 50 mm. - 2.5 mm. = 47.5 mm. According to Formula I. the
Christensen distance (S) for the distobuccal cusp of the mandibular third molar
= 47.5 mm. sine y, where y is the Christensen angle. Ry means of Formulas I and
CUSP ANGULATION FOR COMPLETE DENTURES 919
15”
/O’
5’
0”
- Protrusion -
Fig. S.-Graphic reproduction of Table III. The graph shows the size of the Christensen
angle by various lengths of protrusion and different sizes of the condylar guide inclination (,5).
A protrusion of 5 mm. is entered on the abscissa, and a perpendicular is erected from this point.
Having found the condylar guide inclination (81 equal to 50 degrees, the intersection point of
the perpendicular and the line marking @ = 50 degrees is entered on the ordinate (left). By
this example, with 5 mm. of protrusion and a 50-degree condylar guide inclination, a Christensen
angle of about 2.8 degrees is indicated on the ordinate (left side).
IV, it is possible to calculate the cusp angle for each and all cusps by varying con-
dylar guide inclinations (Table IV).
The cusp angle (E) for third molar (M,) can, from Table IV, be expressed
for approximate values by means of Formula V :
P
e M, = -
2
That is, the cusp angle at the distobuccal cusp of the third molar can be taken as
approximately equal to half the condylar path angle, if the incisal path angle and
the occlusion curve are ignored.
In Table V the relationship between the cusp angle ( e) and the condylar guide
inclination (p) is expressed by the following simple ratio (approximate values) :
6 M, = S/lop
E M, = 4/1Op
6 M, = 3/1Op
E P,-P, = 2/1op
c = l/lop
This relationship is shown graphically in Fig. 11.
TARLE V. THE RELATION BETWEEN THE CONDYLARGUIDE INCLINATION @)~ND THE CUSP
ANGLE (E)OFTHE~ARIOUS MANDIBULAR BUCCAL CUSPS(APPROXIMATEVALUES)
\
P IO" 20” 30” 40” SO” 1 60”
E \
-____. \ _- --_- __----
Fig. lo.-Schematic drawing of the height of the cusps (Kh), the cusp angle (E), and the sagit-
tal size of the cusp (AC and GE).
32’
30 M3
28
26 i//
24 Hz
22
/
20
M/
e A
0” /O 20 30 40 50 60
Fig. Il.-Graphic reproduction of Table V. The graph shows the cusp angulation necessary
(ordinate left) for the third molar (Ma), the second molar (MS), the first molar (MI), the premolars
(P2 and Pa) and the cuspid CC) to be in harmony with the different degrees of the condylar guide
inclinations.
When comparing the approximate values in Table V, with the exact values
found in Table IV, the difference between the respective angles is found to be
less than 1 degree, that is, a difference in cusp height of less than 0.1 mm.
The cusp angle is calculated by assuming a protrusion equalling 2.5 mm. In
order to obtain balanced occlusion for protrusive movements of greater length, the
compensating curve of occlusion can be used, or sliding contact can be maintained
by increasing the length of the protrusion facets of the cusps (BE, Fig. 10). Cusps
with common cusp angulation of the protrusion facets, therefore, can be of vary-
ing heights. In this case, the retrusion facetll (FE, Fig. 10) will be steeper as
the cusp height increases. It is, therefore, more correct to say cusp angle rather
than cusp height.
When setting up cttspless posterior teeth, with the intention of attaining a
smooth-running balanced occlusion, it is necessary to regard the entire occlusal
surface of the cuspless tooth as one single protrusion facet. The inclination of this
surface to the plane of occlusion is equivalent to the cusp angle. The inclination
between the occlusal surface and the plane of occlusion have to be angulated in
accordance with Table V. In the instance mentioned, the occlusal surfaces appear
as a curve of occlusion which coincides with the inclination of the condylar guidance.
REFERENCES
1. Christensen, C.: A Rational Articulator, Ash’s Quarterly Circular, pp. 409-420, 1901.
2. Walker, E.: The Facial Line of Angles in Prosthetic Dentistry, D. Cosmos 39:789-800,
1897.
3. Christensen, F. T.: Kjeveleddsvinkelens Forhold ved Bittforandringer pa Kraniet og i
Artikulator, og Dets Betydning for “the Check-bite,” Odont. Tidsskr. 56:392-409,
1948.
Volume 8 CUSP ANGULATION FOR COMPLETE DENTURES 923
Number 6
4. Bonwill W. G.: The Scientific Articulation of the Human Teeth as Founded on Geomet-
rical, Mathematical, and Mechanical Laws, D. Item Int. 21:617-643, 873-880, 1899.
5. Balkwill, F. H.: The Best Form and Arrangement of Artificial Teeth for Mastication, Brit.
J. D. SC. 9:278-282, 1886.
6. Hanau, R. L.: Full Denture Prosthesis: Intraoral Technique for Hanau Articulator
Model H, ed. 4, Buffalo! 1930, the author, p. 34.
7. Thielemann, K.: Biomechamk der Paradentose, ed. 1, Berlin, 1938, Hermann Meusser
Verlag, p. 24.
8. Miihlreiter : Anatomie des Manschlichen Gebisses, ed. 3, Leipzig, 1927, Arthur Felix
Verlag, p, 146.
9. Ibid: p. 168.
10. Glossary of Prosthodontic Terms, ed. 1, J. PROS. DEN. 6:11, 1956.
11. Arstad, T. : The Capsular Ligaments of the Temporomandibular Joint and Retrusion
Facets of the Dentition in Relationship to Mandibular Movements, Oslo, 1954, Akade-
misk Forlag, p. 28.
KA~TNIK(~ATEN 13
STAVANGEK, NORWAY