20. Functinal examination data

Question 1

20. Functinal examination data

Importance of evaluating oral functions related to muscle groups and TMJ during clinical examination

Answer 1

• Understanding functional status of mandible in physiologic rest position=>
• Helps identify abnormalities in muscle function and joint mechanics=>
• Can affect chewing, swallowing, breathing, and speech

Question 2

20. Functinal examination data

How swallowing evaluated during a functional examination

Answer 2

• Clinician’s index and middle fingers under inner margin of mandibular body
• Patient swallows saliva
• If contraction of extrinsic muscles of the tongue=>
• Tongue thrusts against anterior teeth and protrusion of neck=>
• Infantile swallowing

Question 3

20. Functinal examination data

Tests performed to differentiate mouth breathing from nasal breathing

Answer 3

• Physiological rest position=>close mouth while paper or cotton pad under nostrils
• If the paper or cotton moves=>can breathe through nose
• Hold mouthful of water for 1 minute without swallowing or spitting
• If possible=>nasal breathing not obstructed
• Several squats w/ mouth closed=>
• If mouth closed during exercise=> nasal breathing confirmed

Question 4

20. Functinal examination data

What clinician should observe during the evaluation of speech

Answer 4

• Pay attention to patient’s phonation to identify any speech impediments caused by malocclusion=>
• Referred to speech therapist for further consultation

Question 5

20. Functinal examination data

How midline deviation assessed during a clinical examination

Answer 5

• Examining movement of mandible=> maximally open mouth then slowly close it=>
• Clinician observes facial symmetry=>
• Timing of asymmetry occurrence during opening and closing is noted=>
• To differentiate between morphological discrepancy (laterognathia) and functional deviation (laterodeviation)

Question 6

20. Functinal examination data

How Class II malocclusion evaluated using the Eschler-Bittner-Test

Answer 6

• In Class II malocclusion w/ prognathic profile and severe overjet=>
• Protrude mandible to achieve Class I molar relationship
• Clinician observes changes in facial profile
• If profile improves=>maxilla correctly positioned and mandible retruded
• If worsens=>maxilla protruded w/ excessive growth
• If profile initially improves but then worsens=>both maxilla and mandible have sagittal discrepancies

Question 7

20. Functinal examination data

How Class III malocclusion assessed

Answer 7

• Manual retrusion of mandible to distal position=>
• If possible and results in edge-to-edge bite in anterior area=>
• Anterior cross-bite
• If impossible=>
• Mandible prognathic and further evaluation of jaw relationships is necessary

Question 8

20. Functinal examination data

Tests performed for deep bite cases

Answer 8

• Assess whether frontal segment suprapositioned or posterior segment infrapositioned
• Distance between maxillary and mandibular posterior teeth measured in mandible’s physiological rest position
• If 2 mm=>frontal segment suprapositioned
• If 4 mm or more=>posterior segment is infrapositioned