4. Maximal Intercuspal Position.pdf

§ MAXIMAL INTERCUSPAL POSITION (MIP)
People’s Teacher
Prof. Hoàng Tử Hùng, DDS, PhD
E: tuhung.hoang@gmail.com
W: hoangtuhung.com
Contents
Occlusal surfaces of posterior teeth
Dividing into inner and outer aspect of a cusp
Occlusal table
The landmarks of the occlusal surfaces
The relation of the occlusal landmarks in the MIP
Suppor9ng and guiding cusps
The outer aspect of the suppor9ng cusps
The characteristic of the maximal intercuspal position

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Occlusal surfaces of posterior teeth M
Dividing into inner and outer aspects of a cusp B L

Examining the occlusal surface of a posterior tooth:
The cusp ridges of buccal and lingual cusps [which extend
in a mesial and distal direcEon from cusp Eps] trace
buccoocclusal and linguoocclusal line angles D
à divide the occlusal surface of a posterior
tooth into inner and outer aspects
4 inclines of a cusp
1- mesial outer aspect of the buccal cusp

2- distal outer aspect of the buccal cusp
3- mesial inner aspect of the buccal cusp
4- distal inner aspect of the buccal cusp
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Occlusal surfaces of posterior teeth (cont’d)
Occlusal table
the occlusal table of a posterior tooth is composed of
inner aspects of buccal and lingual cusps
The occlusal table is the recipient of biting force:

• generally only 50 – 60% of overall buccolingual diameter
• posiEoned over the center of root support
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The landmarks of the occlusal surfaces
The bucco-occlusal line

The line angle form by the juncEon of the buccal and occlusal
surfaces (juncEon of inner and outer aspects of the
mandibular posterior buccal cusps). In a well-aligned arch,
forms a conEnuous imaginary line
The linguo-occlusal line
The line angle form by the junction of the lingual and

occlusal surfaces (junction of outer and inner aspects of the
maxillary posterior lingual cusps). In a well-aligned arch,
forms a continuous imaginary line
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The landmarks of the occlusal surfaces (cont’d)
The lower and upper central fossa lines
An imaginary line connects all the central developmental

grooves of the posterior teeth. In a well-aligned arch,
forms a continuous line
The cusp Ep
A circular area with the cusp apex as a center and

with a radius of 0.5 mm
The central fossa
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The landmarks of the occlusal surfaces (cont’d)
The interproximal marginal ridge areas

The plaXorm, diamond shape areas created by
adjacent marginal ridges which well designed to cradle
a supporEng cusp
The central fossa
The fossa in the central portion of the occlusal table of the

molars, well designed to cradle a supporting cusp
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MAXIMAL INTERCUSPAL POSITION (MIP)
Definition
the complete intercuspa8on (or the best ﬁt) of the opposing teeth regardless
(independent) of condylar posi8on.
Syn.: Intercuspal posiEon* maximal intercuspaEon (MIP‫ ٭‬or MIᵠ)

intercuspal occlusion* maximum intercuspaEon (MI) ᵠ
acquired occlusal posiEon* intercuspal contact (IC) ᵠ
acquired occlusion* intercuspal contact posiEon (ICP) ᵠ
habitual centric* centric occlusion (CO)ᶧ
habitual occlusion*
* GPT 2017; ‫ ٭‬P.E. Dawson, 2007; ᵠ M. Gross, 2015; ᶧ M.M. Ash, 1995
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The rela9on of the occlusal landmarks in the MIP
The bucco-occlusal line of the lower teeth is

related to the central fossa line of the upper teeth
The linguo-occlusal line of the upper teeth is

related to the central fossa line of the lower teeth
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Maximal Intercuspal Posi9on (MIP)
In the normal alignment of denEEon, the buccal cusps of lower arch and
the lingual cusps of the upper arch arEculate within the opposing occlusal tables
In a quadrant:
Distobuccal cusps of lower molars
are cradled in opposing central
fossae of its counterpart
Mesiolingual cusps of upper molars

are cradled in opposing central fossae
of its counterpart
Other buccal cusps of lower posterior teeth and lingual cusps of upper
posterior teeth are cradled in opposing adjacent marginal ridge areas
or triangular fossae
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MIP Supporting and guiding cusps
In the intercuspal posiEon, the buccal cusps on the lower teeth

and lingual cusps on the upper teeth have contact on all sides
Since these cusps are responsible for supporEng the verEcal

dimension of occlusion* in the intercuspal posiEon,
they are referred to as supporEng cusps
The buccal upper cusps and the lingual lower cusps:

Make contact on their occlusal sides only (inner asp.)
Have potenEal for occlusal contact only when the
mandible is performing horizontal glide movements
(contact mov.): they provide guidance for such
movement à the guiding cusps
* Syn.: Occlusal Ver1cal Dimension
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Supporting and guiding cusps (cont’d)
Similarity of supporting cusps Similarity of guiding cusps

1- ArEculate within an opposing 1- ArEculate outside of the
occlusal table, support occlusal opposing occlusal tables. Contact
verEcal dimension in intercuspal only when the mandible is in glide
posiEon movement
2- From the occlusal view: outer 2- From the occlusal view: outer
aspect of supporting cusps are aspect of guiding cusps are
greater than those of guiding smaller than those of supporEng
cusps cusps
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Supporting and guiding cusps (cont’d)
Similarity of supporting cusps Similarity of guiding cusps
3- outer aspect of supporEng 3- outer aspect of guiding cusps

cusps have potenEal for do not have potenEal for
occlusal contact occlusal contact
4- the supporting cusps: 4- the guiding cusps: generally

generally rounder than sharper than the supporEng
the guiding cusps cusps
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MIP The outer aspect of the supporting cusps
Outer aspect of supporEng cusps have occlusal contact,

maintain the necessary horizontal overlap for
protecEon of the lip-cheek-tongue system
In case of complete contact [abnormal]
à “loss of horizontal overlap”
The important functional role of outer aspect of supporting cusps:
In normal support of intercuspal position: outer aspect enables the

tip of the cusp to be cradled within the opposing occlusal table
The necessary amount of outer aspect: ≈ 1 mm
à “func2onal outer aspect”
Functional outer aspect (FOA): the portion of supporting cusp that
contact with the inner incline of guiding cusp in lateral movements
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The outer aspect of the suppor9ng cusps – a general view
The funcEonal outer aspect (FOA) of mandibular dental

arch can be described as a conEnuous ribbon (≈ 1mm)
that run from the buccal of leg second (or third) molar
to the buccal of right second (or third) molar, cover the
labioincisal edges of anterior teeth
The funcEonal outer aspect (FOA) of maxillary dental arch

is consisted of two ribbons that run on the outer aspects
of supporEng cusps of posterior teeth
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The anterior teeth in MIP and in protruding movement
In MIP the lower incisors make either very light or no contact
à Lower incisal ridges do not support of OVD in MIP
Overjet (overjut): horizontal projec5on of upper teeth
beyond the lower teeth
Overbite: ver5cal overlapping of upper teeth over the
lower teeth
When the mandible engages in horizontal glide movements,
the labioincisal edge has potential for contact with lingual
inclines of the maxillary anterior teeth
The contacEng porEon of the lower incisal edge
is considered to be a funcEonal outer aspect
The lingual surfaces of the maxillary incisors provide
incisal/anterior guidance for the mandibular teeth in
protruding movements HoangTuHung.com
The characteris9c of the maximal intercuspal posi9on
1- A tooth-to-tooth determined relation of the jaw which is guided by the occlusal surfaces
of the teeth (“tooth-guided” position)
2- There is maximal contact between the upper and lower occlusal surfaces
à create the maximum mechanical stability for mandible
3- The cusps of the mandibular and maxillary teeth to interrelate maximally, i.e. the
most closed posiEon à the smallest occlusal verEcal dimension (OVD)*
4- A subject to change gradually as a result of alterations in occlusal surfaces by reason

of tooth wear, caries…
• OVD: the distance measured between two points (one in upper and one in lower jaw)
when occluding members are in contact
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The characteristic of the maximal intercuspal position:
(1) A tooth-to-tooth determined relation of the jaw

which is guided by the occlusal surfaces of the teeth
(“tooth-guided” position)
In MIP of a normal, young,

unworn denEEon,
the contacts are not at
the very Ep of the
supporEng cusps, nor
are they at the deepest
part of opposing fossa
or at the embrasure
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The characteris9c of the maximal intercuspal posi9on:
(2) There is maximal contact between the upper and lower

occlusal surfaces
à create the maximum mechanical stability for

mandible
The contact points are called

“holding contacts”
because they serve to hold the
teeth in a stable position
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(3) The cusps of the mandibular and maxillary teeth to interrelate maximally,
i.e., the most closed posiEon
à the smallest occlusal verEcal dimension (OVD)*
13 mm
15,8 ± 1,2 mm
HoangTuHung.com
* OVD: the distance measured between two points when occluding members are in contact
(4) A subject to change gradually as a result of alteraEons in occlusal surfaces by reason
of tooth wear, caries…
HoangTuHung.com

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§ MAXIMAL INTERCUSPAL POSITION (MIP)

The relation of the occlusal landmarks in the MIP

Suppor9ng and guiding cusps

The outer aspect of the suppor9ng cusps

The characteristic of the maximal intercuspal position

Dividing into inner and outer aspects of a cusp B L

1- mesial outer aspect of the buccal cusp

The occlusal table is the recipient of biting force:

• posiEoned over the center of root support

The bucco-occlusal line

The linguo-occlusal line

The line angle form by the junction of the lingual and

The lower and upper central fossa lines

An imaginary line connects all the central developmental

A circular area with the cusp apex as a center and

The interproximal marginal ridge areas

The central fossa

The fossa in the central portion of the occlusal table of the

Syn.: Intercuspal posiEon* maximal intercuspaEon (MIP‫ ٭‬or MIᵠ)

The bucco-occlusal line of the lower teeth is

The linguo-occlusal line of the upper teeth is

Mesiolingual cusps of upper molars

In the intercuspal posiEon, the buccal cusps on the lower teeth

Since these cusps are responsible for supporEng the verEcal

The buccal upper cusps and the lingual lower cusps:

Similarity of supporting cusps Similarity of guiding cusps

Similarity of supporting cusps Similarity of guiding cusps

3- outer aspect of supporEng 3- outer aspect of guiding cusps

4- the supporting cusps: 4- the guiding cusps: generally

Outer aspect of supporEng cusps have occlusal contact,

The important functional role of outer aspect of supporting cusps:

In normal support of intercuspal position: outer aspect enables the

The funcEonal outer aspect (FOA) of mandibular dental

The funcEonal outer aspect (FOA) of maxillary dental arch

4- A subject to change gradually as a result of alterations in occlusal surfaces by reason

(1) A tooth-to-tooth determined relation of the jaw

In MIP of a normal, young,

(2) There is maximal contact between the upper and lower

à create the maximum mechanical stability for

The contact points are called

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