Lecture 6_ Inserting the guard

Question 1

Why do we use occlusal devices?

Answer 1

It may be used for occlusal stabilization, for treatment of temporomandibular disorders, or to prevent wear of the dentition

Question 2

T/F
an occlusal device can be used to rule out certain etiologic factors
Helps identify CAUSE-and-EFFECT relationships

Answer 2

TRUE

Question 3

can you treat irreversible TMD with an occlusal guard?

Answer 3

NO, just for reversible

Question 4

can you use an occlusal device to establish and OVD?

Answer 4

yes

Question 5

how effective are occlusal devices in reducing TMD symptoms?

Answer 5

70-90%

Question 6

T/F
Recent studies indicate that a palatal splint, without occlusal coverage is as effective as a full occlusal coverage occlusal device

Answer 6

True

Question 7

T/F

Occlusal splints unload the joint?

Answer 7

FALSE

Question 8

what does increasing the OVD do?

Answer 8

rotates the condyles down while they are STILL LOADED

Question 9

what are the indications for an anterior positioning device?

Answer 9

treat disc displacements and disc dislocations with reduction.

irrgular or chronic locking of the joint

retrodiscicitis

reciprocal click

single click

Question 10

goal of anterior positioning device?

Answer 10

The goal of treatment is not to alter the mandibular position permanently but only to change the position temporarily so as to enhance adaptation of the retrodiscal tissues.

Question 11

is it appropriate to use orthortic device?

Answer 11

no. ..

* *more for bracing a limb

Question 12

what is the most appropriate name for an occlusal device?

Answer 12

orthosis** best**

Question 13

This type of splint allows the muscles to move the condyles into centric relation without interference from any tooth inclines?

Answer 13

permissive splint

Question 14

describe directive splint?

Answer 14

directs the mandible into a predetermined relationship, directing the condyles into pre determined position

Question 15

when can we use splint to describe occlusal device?

Answer 15

if we are splinting mobile maxillary teeth together for instance

Question 16

can you use “appliance”

Answer 16

DON’T…

call it a device or a prosthesis

Question 17

where do yo want the condyles to rest with the occlusal guard?

Answer 17

most superoanterior position against the posterior slopes of the articular eminence

Question 18

Do you want treatment to be reversible or irreversible?

Answer 18

REVERSIBLE!!!! no harm done….

you want to temporarily alter the occlusal condition, but when its removed it returns to the pre-existing condition

Question 19

can you use occlusal device to splint?

Answer 19

yes

Question 20

Can you make the guard to the length of the future OVD??

Answer 20

YES!!! test the fricatives after you do so!

Question 21

benefits of maxillary device vs. mandibular?

Answer 21

-More retentive
-Stronger
-More versatile (can use for class II and III patients)
0-Increased stability

Question 22

benefits of mandibular device?

Answer 22

• easier to speak
• more aesthetic
• cannot use anterior stop to find CR

DON’T DO THIS THOUGH!!!! Cannot use anterior stop to find CR!

-May cause tongue repression..therefore you end up protruding

Question 23

effectiveness of reducing symptoms?

Answer 23

70-90 %

Question 24

is the reduction in muscle activity due to change in OVD?

Answer 24

no

Like when you hold you masters together and put finger in the middle that’s why

Question 25

is it possible to unload the joint with an occlusal device?

Answer 25

no

Question 26

T/F | increasing the OVD takes all the loading forces off the TMJS and puts the load on the teeth?

Answer 26

no the joint rotates in all dimensions whether protruded or retruded...can't take the load off the joints

Question 27

What does increasing OVD do to the condyles?

Answer 27

it simply ROTATES them while still LOADED DOES not distract them down

Question 28

how thick should the guard be on the lingual?

Answer 28

make it only 1 mm thick You should make it 3 mm from the gingival line. You can make it right to the gingival line or just to the occlusal

Question 29

what muscles does the retracted tongue aggrevate?

Answer 29

lateral pterygoids which will push the jaw forward

Question 30

if you make a mandibular guard, can there be resin on the lingual?

Answer 30

NO because can affect the tongue They don't splint the maxillary teeth NOT better for you though because of the force vectors

Question 31

contraindications for mandibular occlusal

Answer 31

-severe retrognathia -tipped lingually mobile max teeth anterior open bite OSAS -endlarged tongue

Question 32

what is the strength of the device dependent upon?

Answer 32

VERTICAL thickness not the palatal width must be able to accurately record the vertical thickness for the record

Question 33

T/F | anterior teeth should occlude on a very small flat shelf and the disocclusion should be immediate and gradual?

Answer 33

true

Question 34

T/F | Anterior teeth should hold, posterior teeth should drag?

Answer 34

false...opposite

Question 35

drawbacks to using a soft material?

Answer 35

precision of the contacts is difficult

Question 36

what can you use soft guards for?

Answer 36

athletic guards clenching or bruxism chronic sinusitis

Question 37

should you use an anterior deprogramming device or pivotal?

Answer 37

no teeth around will super erupt and you can cause malocclusion