Development of the curve of Spee

Introduction: Ferdinand Graf von Spee is credited with characterizing human occlusal curvature viewed in the sagittal plane. This naturally occurring phenomenon has clinical importance in orthodontics and restorative dentistry, yet we have little understanding of when, how, or why it develops. The purpose of this study was to expand our understanding by examining the development of the curve of Spee longitudinally in a sample of untreated subjects with normal occlusion from the deciduous dentition to adulthood. Methods: Records of 16 male and 17 female subjects from the Iowa Facial Growth Study were selected and examined. The depth of the curve of Spee was measured on their study models at 7 time points from ages 4 (deciduous dentition) to 26 (adult dentition) years. The Wilcoxon signed rank test was used to compare changes in the curve of Spee depth between time points. For each subject, the relative eruption of the mandibular teeth was measured from corresponding cephalometric radiographs, and its contribution to the developing curve of Spee was ascertained. Results: In the deciduous dentition, the curve of Spee is minimal. At mean ages of 4.05 and 5.27 years, the average curve of Spee depths are 0.24 and 0.25 mm, respectively. With change to the transitional dentition, corresponding to the eruption of the mandibular permanent first molars and central incisors (mean age, 6.91 years), the curve of Spee depth increases significantly (P < 0.0001) to a mean maximum depth of 1.32 mm. The curve of Spee then remains essentially unchanged until eruption of the second molars (mean age, 12.38 years), when the depth increases (P < 0.0001) to a mean maximum depth of 2.17 mm. In the adolescent dentition (mean age, 16.21 years), the depth decreases slightly (P = 0.0009) to a mean maximum depth of 1.98 mm, and, in the adult dentition (mean age 26.98 years), the curve remains unchanged (P = 0.66), with a mean maximum depth of 2.02 mm. No significant differences in curve of Spee development were found between either the right and left sides of the mandibular arch or the sexes. Radiographic measurements of tooth eruption confirm that the greatest increases in the curve of Spee occur as the mandibular permanent incisors, first molars, or second molars erupt above the pre-existing occlusal plane. Conclusions: On average, the curve of Spee initially develops as a result of mandibular permanent first molar and incisor eruption. The curve of Spee maintains this depth until the mandibular permanent second molars erupt above the occlusal plane, when it again deepens. During the adolescent dentition stage, the curve depth decreases slightly and then remains relatively stable into early adulthood.