occlusion

Question 1

when do we carry out basic occlusal exams

Answer 1

part of every history and exam

Question 2

when do we carry out comprehensive occlusal exams

Answer 2

TMJ disorders, crowns , bridges

Question 3

what type of occlusal exams do we have

Answer 3

basic

or comprehensive

Question 4

what type of skeletal patterns can we have

Answer 4

class 1
class 2 
class 3

Question 5

what are class 1 patterns like

Answer 5

lower jaw in proportion to upper jaw

Question 6

what are class 2 patterns like

Answer 6

lower jaw is retruded

Question 7

what are class 3 patterns like

Answer 7

lower jaw is protruded

Question 8

how do we look for asymmetry

Answer 8

Tell the patient what you are doing and look at the patient straight on
Look for any obvious deviations

Question 9

what do we look for in the TMJ

Answer 9

stand behind pt and listen for clicks crepitus and disc movement

Question 10

how do we check for the range of movement of the TMJ

Answer 10

Willis height gauge & measure in mm

Question 11

what else do we check in terms of the TMJ

Answer 11

size
symmetry
tenderness
tonicity

Question 12

what is the origin of the master

Answer 12

zygomatic arch

Question 13

what is the insertion of the master

Answer 13

lateral wall of the ramps and anglee of the mandible

Question 14

what is the innervation of the masseter

Answer 14

mandibular division of the V3

Question 15

what is the action of the masseter

Answer 15

clenching

Question 16

what is the origin of the temporalis

Answer 16

temporal surface of the skull and temporal fascia

Question 17

what is the insertion of the temporalis

Answer 17

coronoid process and anterior border of the ramps

Question 18

what is the innervation of the temporalis

Answer 18

V3 of the CNV

Question 19

what is the action of the temporalis

Answer 19

action

Question 20

what is the origin of the lateral pterygoid

Answer 20

lateral surface of lateral pterygoid plate and greater wing of sphenoid

Question 21

what is the action of the lateral pterygoid

Answer 21

protrusion and opening

Question 22

what do we look for in the IO

Answer 22

Sharp cusps on the upper arch will cause lines that match with occlusion
Cheek ridging occurs when the patient bites down on buccal mucosa
Tongue scalloping occurs by tongue being squashed against teeth

Question 23

DEFINE ICP

Answer 23

The position of maxilla and mandible when teeth are in maximal intercuspation
Most people have a stable ICP, an unstable ICP occurs when patient bites diff every time

Question 24

What is an overjet

Answer 24

horizontal distance between cusp tips when teeth are in ICP

Question 25

what is an overbite

Answer 25

Vertical distance between cusp tips when teeth are in ICP

Question 26

what is a crossbite

Answer 26

One (or multiple teeth) are out of normal ICP relationship

Question 27

what is RCP

Answer 27

The position of the mandible in the 1st point of contact upon closing when condyle is placed most superiorly and posteriorly in glenoid fossae

Question 28

when do we need to record the RCP this on a patient

Answer 28

on patients who do not have a stable ICP

Question 29

which mandible is consistently reproducibility

Answer 29

the RCP

Question 30

how to record the contacts

Answer 30

articulating paper

Question 31

what are the types of articulating paper

Answer 31

thick 250 microns thin 40 microns ideal 8 microns

Question 32

what is the average perception

Answer 32

10 microns

Question 33

when is thick articulating paper used

Answer 33

prosthetic work

Question 34

what is the thin articulating paper used for

Answer 34

simple cons work

Question 35

what is the ideal articulating paper used for

Answer 35

complex crown work

Question 36

describe cracked cusp syndrome

Answer 36

Pain on releasing on biting and very well localised | Why? Interferences/ weakened cusps/ Bruxism/ Trauma/ Extreme temp change in tooth

Question 37

stages of cracked cusp syndrome

Answer 37

Occlusal loading of a cusp associated with a crack opens the crack (microcracks) Crack fills with fluid Release of occlusal loading causing crack to rapidly close Some fluid is expelled to surface of tooth Some fluid is forced into D tubules leading to pulp stimulation & pain on release

Question 38

tx options for cracked tooth syndrome

Answer 38

Desensitise area with fluoride varnish/ tubule occlusion with bonding agents Remove cracked portion of the tooth and place direct restoration Place indirect restoration (crown/onlay)

Question 39

what is the origin of the anterior belly of the digastric muscle

Answer 39

digastric fossa of the mandible

Question 40

what is the insertion of the anterior belly of the digastric muscle

Answer 40

intermediate tendon

Question 41

what is the innervation of the posterior belly of the digastric muscle

Answer 41

facial nerve

Question 42

what do the digastric muscles do

Answer 42

depresses and draws the mandible back as it opens | The digastric muscle elevates the hyoid bone (used in swallowing & speech)

Question 43

what is the function of the articulator

Answer 43

The job of articulators are to mimic a patients jaw movements Essentially we are trying to replicate jaw movements of plaster models To allow examination of the occlusion (ICP, RCP, Protrusive and lateral movements) To allow fabrication of restorations (Crowns, bridges, dentures, splints) To investigate proposed changes to the occlusion (change from CG to GF)

Question 44

what are the types of articular

Answer 44

Simple hinge Average value Semi adjustable Fully adjustable

Question 45

describe simple hinge articulator

Answer 45

Open and closes the mouth by rotation only | Useful in seeing if what is being made will be high in ICP

Question 46

describe average value articulators

Answer 46

Average value allows for lateral excursion and protrusion as they have moveable joints Values can’t be altered from patient to patient Set up for average distances for average patients

Question 47

describe semi adjustable articulators

Answer 47

Can replicate ICP, RCP, Lateral movements and position of hinge axis (relationship of condyle Must be used with face bows

Question 48

describe fully adjustable

Answer 48

Can replicate Position of hinge axis (which can’t be measure on a patient) (& all of above)

Question 49

what is the working side in the upper

Answer 49

buccal

Question 50

what is the working side on the lower

Answer 50

lingual

Question 51

what do we do if the tooth is high in ICP and lateral excursion

Answer 51

reduce cusp height

Question 52

what do we do if the tooth is high only in ICP

Answer 52

make deeper fossa

Question 53

what are the muscles of mastication

Answer 53

The masseter Temporalis Lateral pterygoid Medial pterygoid