Final Exam Flashcards
In patients with an intracapsular restriction, what type of alterations will be seen in range of motion of eccentric movements?
A. Contralateral movement will be normal, and ipsilateral movement will be restricted
B. Both contralateral and ipsilateral eccentric movements will be greatly restricted
C. Contralateral movements will be restricted, and ipsilateral movement will be normal
D. No change in range of motion will be seen
C
In cases of heterotopic pain presentation, what clinical observations will follow local provocation and anesthetic blockage at the SITE of the pain (not the source)?
A. Local provocation at site - no reduction or effect on pain; Anesthetic blockade at site - no noticeable pain reduction
B. Local provocation at site - increased pain at the source; Anesthetic blockade at site - elimination of pain at the source
C. Local provocation at site - increased pain at the site; Anesthetic blockade at site - elimination of pain at both the source & site
D. Local provocation at site - increased pain across entire face; Anesthetic blockade at site - elimination of all bodily pain
A
Which of the following are among the 6 general rules for diagnostic injections discussed in Chapter 10?
A. The clinician should have a sound knowledge of the anatomy of all structures in the region
B. The clinician should have a sound knowledge of the pharmacology of all solutions to be used
C. The clinician should avoid injecting into inflamed or diseased tissues
D. The clinician should maintain strict asepsis at all times
E. The clinician should always aspirate before injecting all of the solution
F. All of the above are among the rules for diagnostic injections
F
What is the most commonly fractured cusp in the mouth due to laterotrusive interferences?
A. Distolingual cusp of mandibular first molar
B. Distolingual cusp of mandibular second molar
C. Mesiolingual cusp of mandibular first molar
D. Mesiolingual cusp of mandibular second molar
B
Generally, for every 1 mm of interocclusal separation between the maxillary and mandibular posterior teeth, the anterior teeth separate:
A. 2 mm
B. 3 mm
C. 4 mm
D. 5 mm
B
Which of the following statements is true?
A. Patients can generally detect differences as slight as .0005 to .001 inches (10-20 microns)
B. If pain is present in the right joint due to an interference, the interference is probably on the left
C. Ethyl chloride is helpful in relieving muscle spasms
D. A mandibular appliance doesn’t impact speech as much as a maxillary appliance
E. All of the above are true
E
If a restricting muscle is located _________ to the TMJ (as with the masseter), deflection upon opening will be to the _________ side; whereas, if the restricting muscle is located _________ to the TMJ (as with the medial pterygoid), deflection will be to the __________ side.
A. Medial, ipsilateral; lateral, contralateral
B. lateral, contralateral; medial, ipsilateral
C. lateral, ipsilateral; medial, contralateral
D. Medial, contralateral; lateral, ipsilateral
C
Of the following, what is the best way to functionally manipulate the inferior lateral pterygoid muscle?
A. Ask the patient to clench
B. Ask the patient to open as wide as comfortably possible
C. Ask the patient to retrude their mandible
D. Ask the patient to protrude their mandible against resistance
D
Information about a patient’s TMD history can be obtained in which of the following ways?
A. Conversing directly
B. Written questionnaire
C. Clinical examination
D. Both A and B are possible ways to obtain TMD history.
D
According to the book, with pain disorders, as much as \_\_\_\_\_\_\_% of the information needed to make the diagnosis can come from the history of the disorder. A. 20-30% B. 40-50% C. 70-80% D. 100%
C
Which of the following muscles exhibits pain on clenching, pain on clenching on a separator, AND pain when opening during functional manipulation??
A. Medial Pterygoid
B. Superior Lateral Pterygoid
C. Inferior Lateral Pterygoid
D. Sternocleidomastoid
A
Which functional manipulation test will enable you to tell apart an Inferior lateral pterygoid disorder from an Intracapsular disorder?
A. Have patient open widely and protrude their jaw
B. Have patient simply clench on a separator unilaterally
C. Have patient clench on a separator unilaterally AND protrude against resistance
D. Have patient clench in Maximum ICP
C
When a patient reports previous treatments such as an occlusal appliance, it is not advised to ask the patient to bring the appliance to the evaluation appointment. This is because success of previous treatment is irrelevant, given that the patient is still presenting with symptoms for treatment in your office.
a. The first statement is true. The second statement is false
b. The second statement is true. The first statement is false
c. Both statements are true
d. Both statements are false
C
The normal range of mouth opening when measured interincisally is between:
A. 33-40mm
B. 43-50mm
C. 49-52mm
D. 53-58mm
D
Some of the most common complaints of patients who come to the dental office is tooth sensitivity and pulpitis?
True
False
true
What is the only structure that can retract the disc posteriorly?
A. Superior Retrodiscal Lamina
B. Superior Lateral Pterygoid
C. Inferior Retrodiscal Lamina
D. Inferior Lateral Pterygoid
A
In primary pain the source and the site are in the same location. In heterotopic pain the source is remote from the site.
A. Both statements are true
B. The first statement is true the second statement is false
C. The first statement is false the second statement is true
D. Both statements are false
A
Which are the 3 most commonly administered diagnostic nerve blocks used by dentists to determine the site from the source of pain in TMJ-related conditions?
A. Dental Nerve Blocks, Sternocleidomastoid Injection, Infraorbital Nerve Block
B. Dental Nerve Blocks, Auriculotemporal Nerve Block, Retrodiscal tissue injections
C. Dental Nerve Blocks, Auriculotemporal Nerve Block, Infraorbital Nerve Block
D. Intracapsular injections, Auriculotemporal Nerve Block, Infraorbital Nerve Block
C
According to the book, which nerve is responsible for the primary innervation of the TMJ?
A. Posterior deep temporal nerve
B. Auriculotemporal nerve
C. Glossopharyngeal nerve
D. Vagus nerve
B
Injecting a muscle can be valuable in determining the source of a pain disorder?
True
False
true
According to the book, which of the following injections is used mostly for therapeutic reasons and not for diagnostic reasons?
A. Auriculotemporal nerve block
B. Intracapsular injections
C. Sternocleidomastoid injection
D. Infraorbital block
B
Which of the following correctly describes the difference between disorders with a “hard-end” versus a “soft-end” feel?
A. Hard-end feel is associated with muscular disorders, while Soft-end feel is associated with intracapsular disorders
B. Hard-end feel is associated with intracapsular disorders, while Soft-end feel is associated with muscular disorders
C. Both Hard-end and Soft-end feel are associated with muscular disorders
D. Both Hard-end and Soft-end feel are associated with intracapsular disorders
B
According to the book, which of the following is not a typical clinical characteristic of myofascial pain (trigger point myalgia)?
A. Structural dysfunction
B. Pain at rest
C. Local muscle tenderness
D. Increased pain with function
C
According to the book, which of the following represents a sudden forward movement of the condyle moving beyond the crest of the articular eminence during the latter phase of mouth opening?
A. Disc dislocation without reduction
B. Subluxation (hypermobility) of the TMJ
C. Spontaneous dislocation (open lock)
D. Disc displacement
B
What is the most important factor for successful treatment of TMD?
A. Proper diagnosis
B. Knowing how to polish a splint
C. Nerve injections to relax the muscles
D. Knowing how the lab fabricates the splint.
A
Equilibration is defined as: “The modification of occlusal forms of teeth with the intent of equalizing occlusal stress, producing simultaneous occlusal contacts, or harmonizing cuspal relations.”
True
False
true
Which of the following is the “operational” definition of centric relation?
A. The maxillo-mandibular relationship in which the condyles articulate with the thinnest articular portion of their respective discs in the anterior-superior position against the posterior slope of the articular eminentia.
B. A closed-pack relationship of the condyle, articular disc, and fossae as determined by the mandibular muscles during function. (ie, the compression or functional loading of the articular structures during chewing and swallowing).
C. A border position at the hinge axis of the jaw independent of tooth contact…with the condyles braced in the most anterosuperior direction against the posterior slopes of the eminentia.
C
Prior to comprehensive occlusal adjustment of the occlusion, it is critical to determine if the jaw relationship is stable and if the condyles are seated in the fossae.
True
False
true
Which of the following is the “anatomic” definition of centric relation?
A. The maxillo-mandibular relationship in which the condyles articulate with the thinnest articular portion of their respective discs in the anterior-superior position against the posterior slope of the articular eminentia.
B. A closed-pack relationship of the condyle, articular disc, and fossae as determined by the mandibular muscles during function. (ie, the compression or functional loading of the articular structures during chewing and swallowing).
C. A border position at the hinge axis of the jaw independent of tooth contact…with the condyles braced in the most anterosuperior direction against the posterior slopes of the eminentia.
A
True or False: One of the goals of Equilibration Treatment is to achieve bilateral, simultaneous, and stable CO contacts in CR (BSS).
True
False
true
All of the following statements are true concerning selective tooth grinding and equilibration EXCEPT one. Which is the exception?
A. Maintenance requires very little planning in that only a limited number of teeth and/or restorations are adjusted to an established, acceptable occlusal scheme.
B. Modification suggests that prior to the occlusal adjustment slight to moderate adjunctive therapy is required, such as minor tooth movement or opposing tooth restoration or replacement.
C. It is considered less prudent and biologically more invasive to build up a severely worn or abraded canine to improve guidance before adjusting the posterior teeth in excursive mandibular movements.
D. The jaw relationship must be stabilized and painful or pathologic conditions treated prior to full-mouth equilibration.
E. The pretreatment period may last from weeks to months depending on the amount of instability, dysfunction, and/or pathology within the tissues of the masticatory system.
C
Which could be considered a sign or symptom of occlusal imbalance and masticatory overload.
a. Tooth wear
b. Tooth mobility
c. Muscle pain
d. Ear pain
e. TMJ pain
f. Headache
g. Pulpitis
h. Dry mouth
i. All of the above
j. All except h.
J
The dentist attempting to manage a TMD patient must appreciate the major etiologic factors that may be associated with the condition.
True
False
true
Match the following terms with the correct descriptions.
a. Predisposing factors
b. Initiating factors
c. Perpetuating factors
1. Factors that increase risk of TMD
2. Factors that cause the onset of TMD
3. Factors that interfere with healing or enhance the progression of TMD
Predisposing factors = Factors that increase risk of TMD
Initiating factors = Factors that cause the onset of TMD
Perpetuating factors = Factors that interfere with healing or enhance the progression of TMD
Which is not listed in scientific literature as a major factor associated with TMD?
a. trauma
b. emotional stress
c. deep pain input
d. ethnicity
e. parafunctional activities
f. occlusal condition
D
Whether these factors influence the onset of TMD is determined by the patient’s
a. Economic status
b. Geographic location
c. Individual adaptability
d. Education level
C
The role of occlusion as an etiologic factor in TMD is not the same in all patients.
True
False
true
When occlusal instability at tooth contact level exists, orthopedic instability at TM joint and muscle levels may occur as a result of
a. clenching teeth
b. bruxing of teeth
c. hydration in diet
d. all of the above
e. a. and b. only
E
Which is not a parafunctional habit?
a. chewing
b. clenching
c. bruxing
d. nail biting
e. cheek biting
A
When occlusal instability exists, the possibility of it becoming an initiating factor in the development of a TMD is related to which aspects of clenching?
a. Frequency
b. Duration
c. Sleep quality
d. Intensity
e. all of the above
f. a., b., and d. only
F
Trauma can be an etiologic factor in TMD. Which are common signs and symptoms associated with trauma induced TMD?
a. protective co-contraction of the muscles of mastication
b. pain
c. edema within the joint capsule
d. altered function and avoidance
e. all of the above
f. a,b,and c only
E
According to Okeson, the two major symptoms that can be observed in masticatory muscle disorders are
a. tooth mobility.
b. attrition.
c. pain.
d. dysfunction.
e. all of the above.
f. a and b
g. c and d
G
Pain felt in muscle tissue is called
a. myospasm
b. myalgia
c. myositis
d. myopia
B
Muscle pain is far more complex than simple overuse and fatigue. It is now appreciated that muscle pain can be greatly influenced by central mechanisms.
True
False
true
Dysfunction of the masticatory muscles is usually seen as
a. a decrease in range of mandibular movement.
b. an acute malocclusion.
c. a periodontal access.
d. all of the above.
e. a and b only
f. b and c only
E
According to Okeson, of the five types of masticatory muscle disorders ( protective co-contraction [muscle splinting], local muscle soreness, myofascial (trigger point) pain, myospasm, and chronic centrally mediated myalgia), those most commonly seen in the dental office are
a. all of those listed.
b. the first three listed.
c. the last two listed.
d. all of those listed plus fibromyalgia.
B
Local factors represent any event that acutely alters sensory or proprioceptive input in the masticatory structures. Which are considered local factors?
a. the fracture of a tooth
b. a new restoration in supraocclusion
c. tissue damage from a dental injection
d. chewing unusually hard food
e. chewing for a long time
f. opening the mouth too wide
g. all of the above
G
