Final; Occlusion and TMD

Question 1

This is a common subgroup of orofacial pain and disorders

Answer 1

TMD

Question 2

What are the two types of TMD

Answer 2

myogenous (muscle related)

arthrogenous (joint related)

Question 3

What is the basis of accurate TMD diagnosis

Answer 3

a good history taking

Question 4

What are the six cardinal criteria to be considered when diagnosis TMD

Answer 4

pain
limitation of function
limitation of movement
physical changes
altered jaw relationships
temporomandibular sounds that have been increasing in intensity and frequency

Question 5

What is the etiology of TMD

Answer 5

normal funtion + an event = physiological tolerance = TMD symptoms

Question 6

What are three factors that can cause TMD

Answer 6

predisposing factors; increase risk
initiating factors; cause TMD
prepetuating factors; enhance progression of TMD

Question 7

What are some examples of predisposing factors of TMD

Answer 7

systemic (generalized joint issues), occlusal, loss of posterior teeth

Question 8

What are some examples of initiating factors of TMD

Answer 8

trauma, parafunctional habits

Question 9

What are some examples of perpetuating factors of TMD

Answer 9

behavioral, social or emotional stress

Question 10

What are the five factors associated with TMD

Answer 10

occlusal condition
trauma
emotional stress
deep pain input (referred pain)
parafunctional activities

Question 11

Problems in bringing the teeth together into MI are reflected in what

Answer 11

the muscles

Question 12

Once the teeth are in occlusion, problems in loading the masticatory structures are reflected in what

Answer 12

the joints

Question 13

What two things relate occlusion to TMD

Answer 13

introduction of an acute condition

presence of orthopedic instability

Question 14

This occurs when the stable MI position of teeth is in harmony with the musculoskeletally stable position of the condyles in their fossae

Answer 14

orthopedic stability; mirror definition of CR

Question 15

What are the two components of parafunctional habits

Answer 15

diurnal parafunctional activity (awake and conscious)

nocturnal parafunctional activity

Question 16

Is this diurnal or nocturnal parafunctional activity; bruxism

Answer 16

noctural

Question 17

Is this diurnal or nocturnal parafunctional activity; clenching and grinding, cheek/tongue biting, finger/thumb sucking

Answer 17

durnal

Question 18

If occlusal interferences created muscle symptoms, then dentistry should care of TMD, but if occlusal interferences are not related to symptoms, then what

Answer 18

the dentist must refrain from providing dental therapies

Question 19

This type of treatment to stabilize occlusion may be appropriate for TMD patients with occlusal instability and recurrent symptoms

Answer 19

prosthetic rehabilitation

Question 20

Prosthetic treatment in TMD patients should only be carried out when

Answer 20

after reversible therapy has resulted in the relief of pain and the normalization of function

Question 21

What are the two types of treatment modalities of TMD

Answer 21

conservative (reversible and non-invasive)

non-conservaative (irreversible); like surgery

Question 22

This is intended to directly eliminate or alter the cause or disorder and its consequences

Answer 22

definitive treatment

Question 23

This is directed toward altering the patients symptoms and reducing pain and dysfunction; usually have no effect on the cause of the disorder

Answer 23

supportive therapy

Question 24

What are two examples of supportive therapy

Answer 24

pharmacologic therapy

physical therapy

Question 25

This is a removable device, usually made of hard acrylic that fits over the occlusal and incisal surfaces of the teeth of one arch; creates positive occlusal contact with the teeth in opposing arch

Answer 25

occlusal appliance (splint)

Question 26

What are some examples of occlusal appliances

Answer 26

bite guard night guard interocclusal appliance orthopedic device

Question 27

What are three uses for occlusal appliances

Answer 27

1. temporarily provides a more orthopedically stable joint position 2. to introduce an optimum functional occlusion that reorganizes the neuromuscular reflex activity 3. to protect teeth and supportive structures from abnormal forces that may cause breakdown or occlusal wear

Question 28

Research evidence indicated that occlusal appliance therapy is successful in reducing what percentage of TMD symptoms

Answer 28

70-90%

Question 29

occlusal appliances reduce parafunctional muscle activity, hence reducing what

Answer 29

myogenous pain

Question 30

Occlusal appliances also reduce forces placed on the TMJs and other structures within the masticatory system, therefore causing these structures to become what, and the associated symptoms decrease

Answer 30

unloaded

Question 31

What are the five common features to all occlusal appliances

Answer 31

``` temporary alteration of occlusal condition alteration of condylar position increase in vertical dimension cognitive awareness placebo effect ```

Question 32

What are the six types of occlusal appliances

Answer 32

``` stabilization appliance anterior positioning appliance anterior bite plane posterior bite plane pivoting appliance soft (resilient) appliance ```

Question 33

For which arch is are the occlusal appliances typically fabricated for

Answer 33

the maxillary arch; providing optimum functional occlusion for the patient

Question 34

When the occlusal appliance is in place, what becomes of the condyles

Answer 34

they are in their most musculoskeletally stable position at the time when the teeth are contacting evenly and simultaneously

Question 35

The primary treatment goal of occlusal appliances is to eliminate what

Answer 35

orthopedic instability