Exam 1 Flashcards
(36 cards)
List the 5 patient treatment descriptions that would require the “complex” diagnosis and treatment planning procedure covered in this class
4 or more fixed restorations RPD Immediate denture opposed by natural teeth FPD Implant restoration
What is the importance of an accurate diagnostic cast?
Accurate casts transferred to an articulator permit:
- Static and dynamic relationships of the teeth to be examines without interferences from the neuromuscular reflexes
- Unencumbered views from all directions reveal aspects of occlusion not always detectable intraorally
- Occlusocervicl dimension of edentulous spaces can be examined, as well as the relative alignment and angulation of proposed abutment teeth, and detailed analysis of the occlusal plain
List the pertinent information considered when formulating a treatment plan
Patient History Chief Complaint Personal details Medical History Dental History General Exam
What is a diagnosis
A typical diagnosis will condense the information obtained during the clinical history taking and exam
Differential diagnosis
The most likely cause of condition and are recorded in order of their probability
Definitive diagnosis
The actual cause of the condition
Developed after supporting evidence has been assembled
What are the General factors that influence the prognosis of treatment
Age of pt
Lowered resistance of the oral environment
Patient’s understanding and comprehension of plaque control measures
Physical ability to perform tasks
Systemic problems analyzed with patient’s age
Diabetes
Hx of success of previous dental procedures
What are the Local Factors that influence the prognosis of treatment?
Forces applied to a given tooth
Access for oral hygeine measures
Observed vertical overlap of how anterior teeth impact on load distribution
Tooth mobility, root angulations, tooth morphology, C-R ratios, etc.
Describe the facebow procedure in relation to the transverse horizontal axis
Facebows record the A-P and M-L spatial position of the maxillary occlusal surfaces relative to this transverse opening and closing axis of the patient’s mandible.
The facebow is then attached to the articulator to transfer the relationship of the patient’s maxilla to their mandible, and the mandible is attached in relation to the maxilla
What type of facebow do we use at OSU?
Denar Slidematice Quick Mount arbitraty hinge axis facebow (not kinematic)
Uses a 43mm superior to the incisal edge of maxillary central incisor as an anterior reference point
Describe the arbitrary hinge axis facebow
These facebows approximate the horizontal transverse axis
The relationship to the true axis falls within an acceptable degree of error
An easy landmark such as the external acoustic meatus stabilizes the bow, and is aligned with the ear pieces that go in the ear
They are self centering and give an accurate relationship for most diagnostic and restorative procedures
A minimum of 5 mm error from axis can be expected
Arbitrary facebows are less accurate than the kinematic ones, but they suffice for most routine dental procedures
What is the puropose of an anterior reference point?
It enables the clinician to duplicate the recorded position on the articulator at future appointments, thus saving time
Points such as the inner canthus of they eye or a freckle, or mole on the skin can be used
You can mount other casts without having to redo the facebow process and average values for posterior articulator controls can be used without having to readjust the instrument
Non-adjustable articulator
Does not reproduce the full range of mandibular movements
The distance between the hinge and the tooth to be restored is significantly less in the patient
Arcing on the non-adjustable articulator results in steeper travel
Error when set with protrusive interocclusal records because the condylar path is not fixed in relation to the maxillary occlusal plane
Semi-adjustable articulator
Articulated casts can be positioned with sufficient accuracy so that arcing errors are minimal
Adjustable condylar inclination/side shift mimic patient movements
Error when set with protrusive interocclusal record, that is the maxillary occlusal plane and condylar inclination can become more parallel
What are the two designs of semi-adjustable articulators?
Arcon
Non-arcon
Arcon semi-adjustable articulators
Condylar spheres are attached to lower conponent and mechanical fossae are attached to the upper member
Angulation of mechanical fossa is fixed in relation to the occlusal plane of the maxillary cast
More anatomically correct
Non-Arcon semi-adjustable articulators
Led to some inaccuracies because the movements are “backward” (angulation of the mechanical fossae is fixed in relation to the occlusal plane of the mandibular cast)
What do we use to determine if we should use a semi-adjustable or non-adjustable
It depends on the type/complexity of treatment needs, demands for procedural accuracy, and general expediency
What procedures can we use a Semi-adjustable articulator for?
Most routine fixed prostheses
What procedures can we use a Non-adjustable articulator?
Many cast restorations
Why is it essential that the teeth do no perforate the CR record?
Any tooth contact during record fabrication can cause mandibular translation because of neuromuscular reflexes, rendering the articulation useless
Describe the bimanual manipulation technique for making a CR record
Dental chair is reclined
Patient’s head cradled with both thumbs on the chin and fingers resting firmly on inferior border of the mandible
Downward pressure on thumbs
Upward pressure on the fingers
(These pressures manipulate the condyle-disk assemblies into their fully seated positions in the mandibular fossae)
Next, the mandible is hinged along the arc of the terminal hinge closure
Why is it recommended that CR records be trimmed before articulating casts?
An untrimmed record makes assessment of proper cast seating much more difficult than a properly trimmed record
What are examples of anterior programming devices?
Cotton rolls
Leaf gauge
Lucia jig
