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Clinical Occlusion Flashcards

(41 cards)

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1
Q

OIA Masseter

A

O: inferior border and medial surface of zygomatic arch
I: Lateral surface of ramus and angle of md
A: Elevate and protrude md

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2
Q

OIA Lat pterygoid

A

O: 2 heads- upper: sphenoid
lower head: lateral surface of lateral pterygoid plate

I: pterygoid fovea on neck of md, capsule and articular disc of TMJ

A: Depresses and protrudes MD

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3
Q

OIA Med pterygoid

A

O: 2 heads- superficial head: tuberosity
Deep head- medial surface of lateral pterygoid plate

I: Medial surface of angle of md

A: Elevates and protrudes

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4
Q

OIA Temporalis

A

O: floor of temporal fossa
I: coronoid process
A: Elevate and retract md

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5
Q

What is curve of spee

A

Curved line in occlusal table from anterior teeth to posterior teeth

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6
Q

What is curve of wilson

A

transverse occlusal curve that goes from left to right when viewed from posterior

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7
Q

What must be considered when building VDO?

A

Curve of Spee

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8
Q

What is balanced occlusion

A

the bilateral, simultaenous, anterior AND posterior occlusal contact of teeth in centric and eccentric position

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9
Q

When is the only time you actually want to have balanced occlusion?

A

Complete dentures
- so that retention isnt unbalanced and falls off

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10
Q

What is mutually protected occlusion? (theory)

A

Anterior teeth protect the posteriors in eccentric movements (canine guidance)

Posterior teeth protect the anteriors in maximal intercuspation

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11
Q

How do anterior teeth support posterior teeth? (4)

A

Canine disclude posteriors in lateral movements

Incisors disclude in protrusive movements

When contact point is away from hinge axis, less force is applied on teeth

When posteriors are separated, less muscle activity during mastication

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12
Q

How do posterior teeth support anterior teeth? (3)

A

Can endure vertical forces better by:

  • More roots
  • More surface area
  • Orientation of force is along long axis

But.. not good for lateral forces. Thats why anteriors are important

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13
Q

Describe the movement of condyle within the TMJ

A

First 20-25mm- only rotational mvmt

> 20mm- condyle and disk move forward and down of articular eminence- **translation **

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14
Q

3 planes of movement in posselts envelope

A

sagittal
frontal
horizontal

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15
Q

CR aka?

A

Retruded axis position
Terminal position

Most anterior and superior position of the condyle in the glenoid fossa

Most reproducible position

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16
Q

What is RCP?

A

Retruded Contact Position

  • First point of contact in CR/RAP
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17
Q

When to restore teeth in ICP?

Study These Flashcards
A

Fully dentate patients with no VDO changes (majority of patients)

18
Q

Should you restore in ICP or CR in partially dentate patients?

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A

If ICP = CR, ICP. (Doesnt matter?)

If ICP doesnt equal CR, but well-defined, ICP.

If ICP doesnt equal CR but is not welldefined, CR

Missing posterior teeth? CR.

19
Q

What is “condylar angle”

Study These Flashcards
A

During lateral excursion, the head of the condyle on non-working side moves forward, medially, and downward

  • angle between downward movement and horizontal plane is the condylar angle
20
Q

What is “Bennet movement” aka “immediate side shift”

Study These Flashcards
A

During lateral excursion, the working-side condyle makes an initial immediate lateral movement

21
Q

contact vs interference

Study These Flashcards
A

when contacts interrupt normal function / occlusion - interference

22
Q

Role of anterior guidance on protrusion

Study These Flashcards
A

Too shallow might be from class 2, or perio path migration

23
Q

How to develop ideal anterior guidance?

Study These Flashcards
A

Provisional crowns and bridges by adding or grinding palatal acrylic

24
Q

When may anterior guidance be impossible?

Study These Flashcards
A

Class 3 or edge to edge

25
What does ideal occlusion look like at an articulatory level (4)
CO = CR (rare) Freedom in CO Anterior guidance Canine guidance
26
What does ideal occlusion look like at a patient level
Within neuromuscular tolerance of the patient at that age
27
What does ideal occlusion look like on the tooth level (5)
Multiple simultaneous contact- cusp tip to fossa No cuspal incline contacts (likely to frac) Occ forces directed along long axis of tooth Smooth anterior guidance is possible Mutually protected
28
What is a facebow used for
Transfers the relationship between maxillary arch and TMJ which enables mounting of mx cast on adjustable articulator
29
Ways of putting pt into RCP / CR (4)
Schuyler technique - tongue to back of palate operator guided method - chin point guidance - Dawson method **Lucia Jig (best)**
30
Describe the chin-point guidance method of establishing RCP
**Operator guided method** Pt seated upright Soft 2-layer wax is pushed against mx for indentations Registration material (pvs) placed on md surface Operators thumb and index guide jaw posteriorly and superiorly until md occlusion indent the wax Risk- condyles can be over-retruded
31
Describe the bimanual manipulation (Dawson method) of establishing RCP
**Operator guided method** - Pt supine - Pinky placed behind angle of md - ring fingers in front of angle - middle fingers placed inferior to body of md - indexs submentally - thumbs lateral to symphysis Open/close a few times so pt can relax, then registration can be taken
32
What is a Lucia Jig? How does it work?
Method of de-programming and relaxing MMoM to RCP record can be taken. Anterior guidance. - Useful for bruxirs, where masseter is very strong and cant relax enough for operator guided methods - Acrylic device that covers central incisors designed to disclude the posteriors - When posteriors arent in contact, muscles can relax - Repeated contact on splint breaks down programmed paths of closure and allows operator to guide md into RCP - BEST WAY / most accurate TO TAKE RCP- poyan
33
What is this and what is it used for?
Leaf Gauge used for anterior guidance - Allows for taking more accurate RCP positions - Leafs help achieve disclusion of anteriors so MMoM arent working so hard, can take RCP - Same principle as lucia jig but not as accurate
34
How to mount study cast/models into SAA
1. Upper model placed in first using facebow record 2. Mix plaster and add it to the space btw cast and mounting plate 3. Close the SAA so pin contacts table 4. Wait 20-30 min before cleaning 5. Add occlusal record (bite reg) to maxilla 6. Mount the lower cast/model against the opposing bite reg + maxilla
35
What is MODJAW? Pros (3) and cons (2)
Digital tech of visualising and recording occlusion, articulation Pros: - more efficient (faster) - Communication with pts easier - Storage of models Cons: - Cost - lack of evidence and availability of compatible systems in local labs
36
What happens when you open the posterior by 1mm
1mm in posterior = 2-3 mm in anterior For each 3mm opening in anterior = 2mm horizontal change / increased overjet
37
Why should you build new OVD less than the point of RCP with condyle in CR?
It will provide the necessary interocclusal space without altering the contracted length of elevator muscles HOWEVER Sometimes you don't need to open the bite up that much, remember that 1mm posterior = 3mm anterior - Use this approach in cases with mild-mod tooth surface loss (not that much VDO lost)
38
What is a "transitional phase"
When changing the occlusion, VDO, must "test drive" the new bite with provisionals for around 6 months. If no problems, move to crowns and onlays
39
What must be done for severe / excessive wear and flattened posterior teeth? (collapsed dentition) when building up VDO
Build the new OVD **more than** the point of RCP with condyle in CR, provides interocclusal space via increasing the length of elevator muscles if very collapsed, and pt is fine after 6 months of provisionals, repeat process of occlusion recording the exisiting provisions with imp, as well as imp of preps, then jack up the occlusion some more
40
What material should be used for long term provisionals (6 months)
Acrylics like PMMA, PEMA NOT luxatemp
41
What is the most common restorative approach when building up in CR
Building the new OVD at the point of RCP with condyle in CR position - Provides interocclusal space without altering contracted length of elevator muscles - For occlusion with decent amount of tooth surface loss

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