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BDS3 Operative Dentistry - supple > Occlusion > Flashcards

Occlusion Flashcards

(68 cards)

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1
Q

What is the definition of occlusion?

A
  • How the teeth meet together
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2
Q

What joins the TMJ together?

A
  • Condylar head of mandible
  • Glenoid fossa of temporal bone
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3
Q

What muscles involved in mandibular movement?

A
  • Muscles of mastication (masseter, Temporalis, Lateral pterygoid, medial pyerygoid
  • Suprahyoid
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4
Q

What does the temporalis do?

A
  • Elevate and
  • retracts
  • Assists in rotation
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5
Q

What does the lateral pterygoid do?

A

Superior- SLP

  • Positions disc in closing

Inferior - ILP

  • Protrusion
  • Depression
  • Lateral movement
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6
Q

What does the medial pterygoid do?

A
  • Elevates mandible
  • Lateral movement
  • Protrusion
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7
Q

What does masseter do?

A
  • Elevation
  • Protrusion
  • Assists in lateral movement
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8
Q

What are the mandibular movements?

A
  • Rotation (not down and forwards!)
  • Translation
  • Lateral translation
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9
Q

What is rotation movement also known as?

A
  • Hinge movement
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10
Q

How much mouth opening can occur from rotation movement of TMJ?

A
  • Up to 20mm
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11
Q

What happens to the condyle during rotational movement?

A
  • Condyle and disc remain within articular fossa
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12
Q

How do hinge movement occur?

A
  • Rotation of condylar heads around imaginary horizontal line through rotational centres of condylars
  • Line called terminal hinge axis
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13
Q

How can you record the hinge movements measurements?

A
  • Use a facebow
  • Measure distance between condyles on terminal hinge axis
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14
Q

How does translation of the condyle occur?

A
  • Mouth closed
  • lateral pterygoid contracts
  • Articular disc and condyle begin to move
  • Travels downwards and forwards along incline of articular eminence
  • May also travel laterally (laterotrusive movement)
  • Mouth opens
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15
Q

What is Posselts envelope?

A
  • The extremes of mandibular movement
  • Border movements of mandible in sagittal plane
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16
Q

In Posselts envelope what do the abbreviations mean?

A

ICP = Intercuspal position
E = Edge to Edge
Pr = Protrusion
T = Maximum opening
R = Retruded Axis position
RCP = Retruded contact position

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17
Q

What is ICP?

A
  • Intercuspal position
  • Tooth position regardless of condylar position
  • The comfortable bite
  • Best fit of teeth
  • Maximum interdigitation of teeth
  • Can be called centric occlusion (CO)
  • Mandible slides forward from RCP to achieve ICP
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18
Q

What is Edge to Edge?

A
  • Tooth position
  • Teeth slide forward from ICP guiding on palatal surfaces of anterior teeth
  • Incisal edges of upper and lower incisors touch
  • translation movement , not hinge
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19
Q

What is protrusion?

A
  • Condyle moves forwards and downwards on articular eminence
  • Only incisors +/- canines touch
  • No posterior tooth contacts
  • Eventually no tooth contacts
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20
Q

What is Maximum opening?

A
  • No tooth contacts
  • mouth wide open
  • Full translation of condyle over articular eminence
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21
Q

What is retruded axis position?

A
  • No tooth contacts
  • Most superior anterior position of condylar head in fossa
  • Terminal hinge axis
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22
Q

What is retruded contact position?

A
  • First tooth contact when mandible is in retruded axis position
  • ICP is approximately 1mm anterior to RCP in 90% population
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23
Q

What is lateral translation of mandible?

A
  • Has working side and non working side
  • Mandible moves either left or right
  • If mandible moving right then right = working side and left = non working side
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24
Q

What is lateral translation of the mandible also known as?

A
  • Bennet movement
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25
What is the Bennet angle?
- The path of the **nonworking condyle** in the **horizontal** plane during **lateral excursion**
26
How can you mark tooth contacts?
- Use fine articulating paper - Millers forceps
27
When should you mark tooth contacts?
Before - Preparing a tooth - Removing a restoration After - Placement of a crown - Placement of a restoration
28
What do tripodised contacts show?
- Show where the opposing cusps contact (ICP stops)
29
What are functional cusps?
- Cusps that **occlude** with the opposing teeth in the **ICP** - Lingual cusps of upper posterior teeth - Buccal cusps of lower posterior teeth
30
What are non functioning cusps?
- Cusps that do not occlude with the opposing teeth in the ICP - Buccal cusps of upper posterior teeth - Lingual cusps of lower posterior teeth
31
What is a Fossa?
- **Depression** or concavity on tooth surface - **Functional cusp** of a tooth **contacts** the fossa of the opposing tooth
32
What are ICP contacts?
- Lingual cusp of upper molar contacts fossa of lower molar - Buccal cusp of lower molar contacts fossa of upper molar
33
What are some problems that can arise in static occlusion?
- Angles classification of incisor relationship - Overbite - Overjet - Anterior crossbite - Posterior crossbite - Anterior open bite - Posterior/lateral open bite
34
What is Class 1 of Angles classification of incisor relationship?
Class 1 - Incisal edge of mandibular contact cingulum plateau of maxillary
35
What is Class II div 1 of Angles classification of incisors?
- Mandibular incisor edge lie posterior to cingulum plateau of maxillary central incisors - Maxillary central incisors proclined or average inclincation - Increased overjet
36
What is Class II div 2 of Angles classification of incisors?
- Mandibular incisor edge lie posterior to cingulum plateau of maxillary central incisors - Maxillary central incisors retro-clined - Overjet normally minimum but may be increased
37
What is Class III of Angles classification of incisor relationship?
- Mandibular incisor edges lie anterior to cingulum plateau of maxillary central incisors - Overjet reduced or reversed
38
What is overbite?
- Vertical overlap of maxillary central incisors over the mandibular central incisors - Can be decreased, normal or increased
39
What is the normal overbite of teeth?
- 2-4mm
40
What is decreased overbite?
- Can be complete or incomplete - Incisal edge of mandibular lie more anterior than normal - More proclined
41
What is increased overbite?
- Can be complete or incomplete - Complete can be non-traumatic or traumatic (Ackerly classification) - Incisal edge of mandibular posterior to cingulum plateau
42
What is Class 1 of Ackerly classification?
- Lower incisor impinge on palatal mucosa - Signs of trauma inc inflammation of palatal mucosa with imprint of lower incisor
43
What is Class II of Ackerly classification?
- Lower incisors incisal edge occlude into palatal gingival crevices of maxillary teeth - Signs of trauma inc - Labial splaying of maxillary incisors - Palatal pocket
44
What is Class III of Ackerly classification?
- Class II div 2 type of incisor relationship - Sign of trauma inc - Stripping of gingiva in relation to palatal surfaces of upper teeth and labial surfaces of lower anterior teeth
45
What is Class IV of Ackerly classification?
- Lower incisor causing progressive abrasion of palatal surfaces of maxillary teeth - Signs of trauma inc - Abrasion of palatal surfaces of upper anterior teeth - Dentin hypersensitivty
46
What is Overjet?
- Relationship between maxillary and mandibular teeth in a horizontal plane
47
What is an anterior crossbite?
- Condition where one or more anterior teeth may be abnormally malpositioned buccal or lingually or labially with reference to opposing teeth
48
What is a posterior crossbite?
- Condition where one or more posterior teeth may be abnormally malpositioned buccal or lingually with reference to opposing teeth
49
What is an anterior open bite?
- Lack of vertical overlap of anterior teeth **when posterior teeth in full occlusion**
50
What is posterior/ lateral open bite?
- **Failure of contact** between the posterior teeth when teeth are in full occlusion
51
What is canine guidance?
- **Dynamic occlusion** - Mandible moves to one side and there is only contact between the canines - No posterior tooth contacts (creates a space) - Known as **mutually protected occlusion**
52
What is the Gold standard of mutually protected occlusion?
- Canine guidance - Posterior disclusion in lateral excursions - No non-working/ working side contacts - No protrusive interferences
53
What is group function?
- Mandible moves to one side (working side) and multiple teeth contact on that side - **Bilateral group function** frequently seen in **toothwear** - Most favourable guidance alternative to canine guidance
54
What is the desirable group of contacts in a group function latero-trusive movement?
- Canines, premolars and mesio-buccal cusp of first molar - Any contact more posterior not desirable as increased amount of forced placed due to closeness to fulcrum
55
What are some problems of dynamic occlusion?
- Occlusal interferences - Working side - Non working side - Protrusive
56
What occurs during working side occlusal interference?
- **Working side** contact - **Similar cusps contact** e.g. the distal palatal of upper and distal lingual of lower
57
What occurs during non working side occlusal interference?
- **Non working side** contact - **Dissimilar cusps contact** e.g. palatal of uppers and buccal of lowers
58
What is protrusive interference?
- Any posterior contacts during protrusion
59
Why is it important to avoid posterior contacts?
- Teeth are designed to absorb heavy forces in **direction of long axis** of tooth - Most teeth not designed to absorb significant **lateral forces** generated by occlusal interferences - **Musculature gets a rest** as less activity if not undesirable posterior contacts - **Occlusal trauma** and undesirable tooth movement
60
What are the types of Bruxism?
- Eccentric - Centric
61
What is Eccentric Bruxism?
- **Parafunctional grinding** of teeth - Oral habit consisting of **involuntary rhythmic** or spasmodic or functional gnashing, grinding or clenching of teeth in other than chewing movements of mandible - May lead to **occlusal trauma**
62
What is centric Bruxism?
- **Clenching** - Pressing and clamping of jaws and teeth together - Associated with **acute nervous tension** or **physical effort**
63
What are the clinical signs and symptoms of Bruxism?
E/O - **Muscle pain** and fatigue - Headache/ earache - Pain and stiffness in TMJ I/O - tongue scalopping - buccal keratosis (linea alba) - Tooth wear - Fractured restorations/ root - Tooth migration - **Tooth mobility**
64
What are the different types of toothwear?
- Multifactorial - Abrasion - Attrition - Erosion - Abfraction
65
How do you classify toothwear?
- BEWE (basic erosive wear examination) - Smith and Knight
66
What is occlusal trauma?
- Injury resulting in tissue changes within attachment apparatus - Inc PDL, supporting alveolar bone and cementum - As result of occlusal force/s
67
What are the classification of occlusal trauma?
Primary - Intact periodontium Secondary - Reduced periodontium Fremitus - Palpable or visible movement of tooth when subjected to occlusal force
68
What is included in the examination checklist for occlusion?
- Incisor relationship - Guidance - Overjet/overbite - ICP contacts - Working/non working/ protrusive contacts - Pathology

BDS3 Operative Dentistry - supple (5 decks)

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