recording the occlusion

Question 1

why do you need to record the occlusion?

Answer 1

need to know:
position of teeth in relation to each other
what is normal for px to keep same
if planning to change occlusion
to facilitate denture design
ensuring loading forces applied correctly to teeth and underlying mucosa/bone
help tech set up teeth
ensure denture stable and not dislodged in function

Question 2

when can you record the occlusion?

Answer 2

primary registration
secondary registration
framework registration

Question 3

why should you record occlusion at primary registration stage?

Answer 3

to examine the occlusion
to facilitate denture design
to mount surveyed primary casts
to position denture components w/o occlusal interference

Question 4

why would you record occlusion at primary stage?

Answer 4

prior to denture design if you cant hand articulate

-helps mount casts

Question 5

why would you record occlusion at secondary stage?

Answer 5

helps mount casts on framework design
wax record blocks on master casts
if primary was incorrect
if you plan to change the occlusion
the case is complex w/ extended edentulous spaces
to replace multiple anterior teeth

Question 6

why would you record occlusion at framework registration?

Answer 6

further trial on framework, esp in extended anterior saddle for good aesthetics
if no primary
to accurately mount master casts
to replace multiple anterior teeth
plan to change occlusion
error with prev registration
extended edentulous spaces

Question 7

what is the aim when recording occlusion?

Answer 7

inform tech where you want artificial teeth to be positioned, shade and mould with info on how teeth occlude

Question 8

what should be established when recording occlusion?

Answer 8

inter-cuspal relationship to articulate casts
OCD
buccal/labial contours of wax record block
-lip support
-incisal plane
-occlusal plane
tooth shade and mould
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Question 9

what equipment is needed?

Answer 9

perform
-disinfect record blocks before try in
-after contamination anything goint to lab-cast/record blocks
bowl cold water
-chill blocks to avoid distortion when inserted/removed/adjusted
to put out fires
willis bite guage/dividers
-record OVD
-in ICP
knife & bunsen
-to adjust blocks
-palette for height/buccal surfaces
-wax/ash no. 5 to remove wax when shaping arch form/add notches
pink wax/registration paste
-join blocks together

Question 10

what is the 2 dot method?

Answer 10

to record OVD
point on nose & chin with minimal movement
teeth in ICP
distance between divider arms=ovd

Question 11

how do you use a willis bite guage?

Answer 11

teeth in ICP
fixed arm naso labial position
sliding arm under chin
distance =ovd

Question 12

how many mm should OVD be?

Answer 12

2-3mm

-freeway space

Question 13

how do you calculate freeway space?

Answer 13

RVD-OVD

Question 14

how should you adjust the blocks?

Answer 14

one at a time
blocks must stay in place
modify to produce stability
wax knife
adjust upper fist
occlusal, buccal and lingual/palatal

Question 15

what problems can cause displacement?

Answer 15

overextension of peripheries =drop

too much lip support

Question 16

what reference points can be used when adjusting?

Answer 16

teeth present
dento-facial midline
inter-pupillary line
ala-tragus line
curvature of lower lip
smile line
gingival margins of existing anterior teeth
previous dentures

Question 17

how to use ala-tragus line?

Answer 17

adjust upper occlusal rim so occlusal plane is oriented in relation to upper teeth/ala-tragus line
if posteriors present follow

Question 18

how is dento-facial midline used?

Answer 18

dental centre line coincident with facial midline
when multiple anteriors missing
may not have naturally occuring

Question 19

what is interupillary line used for?

Answer 19

a guide to where upper incisal plane should be

Question 20

what is incisal plane for?

Answer 20

follow curvature of lower lip/teeth present

Question 21

what can skew reference points?

Answer 21

drifting of anterior teeth

over-eruption out of occlusal plane

Question 22

what does foxes occlusal plane guide help?

Answer 22

recreate occlusal and incisal planes on record block when extended edentulous spaces

Question 23

how should you adjust upper blocks?

Answer 23

upper occlusal rim so plane is appropriately oriented
if anterior saddle ensure rim indicates appropriate incisal level and degree lip support
check occlusal stop when px occludes
if tooth surfaces separated trim offending part of rim until occlusal stop re-established

Question 24

how should you adjust the lower blocks?

Answer 24

trim lower rim until occlusal stop established
add/remove wax from buccal/lingual until centre of rim lies over lower ridge and is same width as replacement teeth
upper should be harmonised w/ lower in accordance with skeletal relationship

Question 25

how do you register the occlusion?

Answer 25

modify u&L rims so small space between occlusal surface of rim and opposing
reocord max intercuspation using registration material
occlude casts using occlusal rims and check tooth relationship on casts is same as mouth
is premature contact eliminate

Question 26

how do you achieve good aesthetics in an extended anterior saddle?

Answer 26

make sure index teeth in occlusion
mark centreline
mark canine positions if missing
mark high smile line

Question 27

what helps to select tooth shade?

Answer 27

existing teeth
previous denture
px preference

Question 28

what helps to select tooth mould?

Answer 28

existing teeth
previous denture
measure

Question 29

what are the steps for recording occlusion?

Answer 29

adjust upper block
adjust lower block
maintained ICP
join blocks together w/ registration medium
put in perform
pick teeth