Optimal Functional Occlusion

Question 1

what we need to know (3)

Answer 1

optimal occlusion in a stationary position (position of teeth, TMJ, muscles)
optimally occlusion during excursive movements of the mandible
occlusal philosophies during excursive movements

Question 2

occlusal philosophies during excursive movements (3)

Answer 2

canine guidance- anterior guidance
group function
balanced occlusion

Question 3

BASELINE FOR EVALUATING PATIENT’S OCCLUSION (4)

Answer 3

teeth
TMJ
musculature
evaluate the entire masticatory system

Question 4

a patient may have an orthodontically ideal angles class 1 occlusion, this does not mean that the patient has (3)

Answer 4

optimal occlusal contants,
optimal condyle/mandibular position and
ideal/optimal contacts in excursive movements

Question 5

conversely someone with a class 2 or 3 occlusion although not orthondontcally idea, may have

Answer 5

an acceptable, function occlusion

Question 6

patients may have a less than ideal occlusion, however, it may still be a (2)

Answer 6

functionally acceptable occlusion or a

physiologically acceptable occlusion

Question 7

is treatment required?

Answer 7

asses the masticatory system for evidence of pathology

-tooth wear, tooth mobility, TMJ dysfunction, muscle dysfunction, etc

Question 8

— capacity of a patient

Answer 8

adaptive

Question 9

if treatment is rendered, what is the optimal position for the (3)

Answer 9

joints
muscles and
teeth

Question 10

the TMJ are in an optimum, orthopedically stable joint position when the mandible is in

Answer 10

centric relation

Question 11

CR

Answer 11

term used to define a position of the condyles in relation to the disc and fossa

Question 12

CR is defined as when the

Answer 12

condyles are in the most anterior-superior position in the glenoid fossa. braced up on the intermediate zone of the disc, and the mandible is free to rotate about the terminal hinge axis (up to but not indulging the point of first tooth contact)

Question 13

CR refers to –, not

Answer 13

joints

teeth

Question 14

mandible can freely arc up and down along the

Answer 14

terminal hinge axis

Question 15

teeth cant contact=

Answer 15

deflection

Question 16

why is CR the ideal position? (2)

Answer 16

musculature in CR

TMJs in CR

Question 17

musculature in CR (4)

the muscles function harmoniously in CR
the joint is stable because the muscles attached to the joint prevent dislocation of the articular surfaces
the muscles that stabilize the TMJs are mainly the (2). contraction of these muscles results in antero-superior vector of force (stability)
the (1) muscles are most relaxed in CR

Answer 17

masseter and the medial pterygoids

lateral pterygoid

Question 18

TMJs in CR

Answer 18

condyles are in the most antero-superior position in the glenoid fossa

condyles rest against the posterior slope of the articular eminence (thickest bone) therefore can tolerate higher stresses

Question 19

CR

condyles are braced gently/rest against the intermediate zone of the disc (non-innervated and avascular zone) therefore

Answer 19

higher stresses can be tolerated

Question 20

there are - other definitions for CR

Answer 20

7

Question 21

in the past: CR was called the most — position of the mandible

Answer 21

retruded

Question 22

in the most retruded position: the retrosical tissues are

Answer 22

innervated and would not tolerate stress

Question 23

in the most retruded position: the posterior wall of the articular fossa is

Answer 23

very thin

Question 24

CR questions (5)

Answer 24

jaw or teeth position?
how are the condyles positioned in the fossa?
how do the condyles move, when the anterior teeth open 20-25mm?
what is the axis of rotation in that position called?
how do the condyles move, when the anterior teeth open further than 20-25mm?

Question 25

the muscles function

Answer 25

harmoniously

Question 26

the TMJS are in an

Answer 26

optimal, orthopedically stable joint position

Question 27

the TMJs are stable even when

Answer 27

heavy loads/forces are applied

Question 28

CR | this is the position to which we restore (3)

Answer 28

completely edentulous patients partially edentulous patients, when there are so few teeth remaining that there is not a stable MIP dentate patients who are going to receive extensive restorations which will alter their occlusion completely

Question 29

Recording the CR position on a patient using an --- --- in order to deprogram the muscles of mastication

Answer 29

anterior deprogrammer

Question 30

optimal functional occlusion (3)

Answer 30

1. the TMJ 2. the teeth 3. the excursive movements

Question 31

teeth relations in optimal function occlusion (2)

Answer 31

in stationary position | during excursive movements

Question 32

THE TEETH (FOR OPTIMAL FUNCTIONAL OCCLUSION) posterior teeth

Answer 32

multiple, even, bilateral and simultaneous occlusal contacts with the mandible in the CR position, are the most desirable

Question 33

the posterior teeth are loaded mainly along the

Answer 33

long axis of the tooth (axial loading)

Question 34

1) multiple

Answer 34

the more teeth that contact the more the stress is distributed throughout the arch

Question 35

2) even

Answer 35

all posterior teeth should contact evenly. this distributes the stress over all the teeth and does not concentrate it on one tooth causing harm

Question 36

3) bilateral

Answer 36

this is for stability. if tooth contacts occur only on the right side and not on the left, then the mandible will pivot around this right side contact and place increased pressure on the left TMJ causing problems

Question 37

4) simultaneous

Answer 37

all the contacts occur at the same time on both sides of the arch and on all the posterior teeth

Question 38

5) the teeth should be axially loaded: ie

Answer 38

through the long axis of the tooth. lateral forces on teeth are not well accepted. on the contrary though axial loading, heavier stresses can be applied

Question 39

anterior teeth should have --- occlusal contacts when the posterior teeth are in occlusion

Answer 39

lighter

Question 40

since the anterior teeth are not loaded axially, they are not able to

Answer 40

withstand high loads

Question 41

why should there be any occlusal contacts on anterior teeth?

Question 42

canine guidance

Answer 42

also called canine discussion or canine rise. when the mandible moves laterally, the canines on the working side guide the movement, causing all other teeth to disclude

Question 43

anterior guidance

Answer 43

in protrusive movement, the anterior teeth should disclude the posterior teeth

Question 44

anterior guidance | the canines, central and lateral incisors disclude the posterior teeth, when the mandible is

Answer 44

protruded

Question 45

anterior guidance contacts between the posterior teeth during excursive movements are considered ---- and can create damaging effects on the teeth and periodontium

Answer 45

interferences

Question 46

WHY IS CANINE GUIDANCE/ANTERIOR | GUIDANCE THE OPTIMAL OCCLUSAL SCHEME? (3)

Answer 46

• MANDIBLE - CLASS III LEVER the more anterior (away from the fulcrum), the resistance (load) occurs, the lesser the impact (magnitude) the canines(s) has the longest root, and best bone support (canine eminence)

Question 47

OPTIMAL FUNCTIONAL OCCLUSION | ALSO REFERRED TO AS

Answer 47

MUTUALLY PROTECTED | OCCLUSION

Question 48

MUTUALLY PROTECTED OCCLUSION

Answer 48

multiple, even, bilateral simultaneous occlusal contacts of the posterior teeth in MIP with the mandible in CR position (MIP and CR are coincident)

Question 49

MUTUALLY PROTECTED OCCLUSION | the anterior teeth exhibit lighter occlusal contacts as compared to posterior teeth in

Answer 49

MIP

Question 50

MUTUALLY PROTECTED OCCLUSION | posterior teeth are axillary loaded in

Answer 50

MIP

Question 51

MUTUALLY PROTECTED OCCLUSION | in excursive movements, what occurs?

Answer 51

canin guidance/anterior guidance

Question 52

MUTUALLY PROTECTED OCCLUSION | the posterior teeth withstand the majority of the load in MIP, protecting the anterior teeth from

Answer 52

high loads

Question 53

MUTUALLY PROTECTED OCCLUSION | the anterior teeth disclude the posterior teeth in excursive movements, thereby

Answer 53

protecting the posterior teeth from off-axis loading

Question 54

MUTUALLY PROTECTED OCCLUSION posterior teeth can. tolerate axial loading well so they protect anterior teeth, which are not axillary loaded, in MIP. anterior teeth can tolerate lateral forces in excursive movements (off axial loading) since they are

Answer 54

further away from the fulcrum and the loads are less

Question 55

GROUP FUNCTION

Answer 55

when the mandible moves laterally, the mandible is guided by the outer inclines of the mandibular buccal cusps sliding along the inner inclines of the buccal cusps of the maxillary posterior teeth

Question 56

GROUP FUNCTION | the most desirable group function consists of the

Answer 56

canine, premolars and MB cusp of the first molar

Question 57

GROUP FUNCTION | the more posterior the contacts, the greater the force-closer to the source of power; the move --- the forces

Answer 57

destructive

Question 58

GROUP FUNCTION on the WS, only the --- cusps of the mandibular teeth guide along the inner inclines of the maxillary teeth, as far posteriorly as the first molar (MB cusp)

Answer 58

buccal

Question 59

GROUP FUNCTION | there are no contacts on the

Answer 59

NWS

Question 60

GROUP FUNCTION is --- but not ---

Answer 60

acceptable | ideal

Question 61

GROUP FUNCTION | is the only option for patients who (4)

Answer 61

``` have no anterior vertical overlap eg anterior open bite a very large anterior horizontal overall eg class 2 div 1 have a reverse overlap eg class 3 you may see group function referred to as unilateral balance (not a term used today) ```

Question 62

BALANCED OCCLUSION (2)

Answer 62

simultaneous contacts on both sides (working and non working) during lateral excursive movements (working side contacts and balancing side contacts) contacts between the posterior and anterior teeth during protrusive movement

Question 63

BALANCED OCCLUSIONif the mandible moves to the right: | on the right side (WS):

Answer 63

outer includes of mandibular buccal cusps contact inner inclines of max buccal cusps and at the same time

Question 64

BALANCED OCCLUSION if the mandible moves to the right on the left side (NWS):

Answer 64

inner inclines of mandibular buccal cusps contact inner inclines of maxillary lingual cusps

Question 65

BALANCED OCCLUSION | in protrusion:

Answer 65

there are contacts between posterior and anterior teeth

Question 66

BALANCED OCCLUSION | on the posterior teeth:

Answer 66

mesial inclines of mandibular cusps occlude with distal inclines of maxillary cusps

Question 67

BALANCED OCCLUSION | not acceptable for

Answer 67

dentate patients

Question 68

BALANCED OCCLUSION | not ideal for

Answer 68

dentate patients

Question 69

BALANCED OCCLUSION | promotes --- on dentate patients

Answer 69

tooth wear

Question 70

BALANCED OCCLUSION | NWS contacts are extremely

Answer 70

destructive and must be avoided

Question 71

BALANCED OCCLUSION is an acceptable form of occlusion for

Answer 71

complete dentures