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Occlusion Lecture > Optimal Functional Occlusion > Flashcards

Optimal Functional Occlusion Flashcards

1
Q

What type of position is the optimal occlusion?

A

stationary position

position of teeth, tmj, muscles

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2
Q

What are the occlusal philosphies during excursive movements?

A
  1. canine guidance (anterior guidance)
  2. group function
  3. balanced occlusion
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3
Q

What three things should you evaluate for the patient’s occlusion?

A
  • teeth
  • TMJ
  • musculature

(the entire masticatory system)

baseline for evaluating pt’s occlusion

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4
Q

True/False: If a patient has orthodontically ideal angles of class I occlusion this means that the patient has optimal occlusal contacts, mandibular position, etc.

A

false

Does not mean this

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5
Q

True/False: Someone with a class II or class III occlusion is not orthodontically ideal but may have an acceptable, functional occlusion.

A

True

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6
Q

If a patient has less than ideal occlusion it may still be a…

A

functionally acceptable occlusion
or
physiologically acceptable occlusion

(no destructive forces/whole system functioning)

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7
Q

How do you know if the patient’s occlusion requires treatment?

A
  • assess the masticatory system for evidence of pathology (tooth wear, tooth mobility, TMJ, dysfunction, muscle dysfunction, etc.)
  • adaptive capacity of pt
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8
Q

The TM joints are in an optimum, orthopedically stable joint position when the mandible is in…

A

centric relation

Goal for restoring a whole arch:

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9
Q

the condyles are in the most anterosuperior 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 including the point of first tooth contact)

A

centric relation

position of condyles in relation to disc and fossa

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10
Q

What term refers to only the joints and does not involve the teeth?

A

CR

–The mandible can freely arc up and down along the
Terminal hinge axis
–Teeth cannot contact = deflection

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11
Q

Why is CR the optimal position to view optimal functional occlusion?

A
  • musculature in CR
  • TMJs in CR

The joint is stable bc the muscles attached to the joint prevent dislocation of the articular surfaces

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12
Q

The muscles that stabilize the TMJs are mainly…

A

masseter and medial pterygoid

The Lateral Pterygoid muscles are most
relaxed in CR

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13
Q

Contraction of the masseter and medial pterygoid result in…

A

antero-superior vector of force (stability)

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14
Q

The lateral pterygoid muscles are msot relaxed in what position?

A

centric relation

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15
Q

The condyles in centric relation rest against the ______ slope of the articular eminence (thickest bone) therefore can tolerate higher stress

A

posterior (tolerate higher stresses since avascular and non-innervated)

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16
Q

TMJs in Centric Relation:

Condyles are braced gently/rest against the
____ zone of the disc (non-innervated and
avascular zone) therefore higher stresses can be
tolerated

A

intermediate zone

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17
Q

CR:

–In the past: CR was called the most ___position of the
mandible.

A

Retruded

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18
Q

CR:

– In the past: CR was called the most retruded position of the
mandible
–In the most retruded position: the retrodiscal tissues are
innervated and would ___
– In the most retruded position: the posterior wall of the
articular fossa is ____

A

not tolerate stresses; very thin.

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19
Q

What are excursive movements?

A

lateral
protrusive

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20
Q

Is CR jaw or teeth position?

A

jaw

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21
Q

How do the condyles move when the anterior teeth open 20-25 mm?

A

rotation

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22
Q

What is the axis of rotation in CR called?

A

terminal hinge axis

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23
Q

What do we restore in CR?

A
  • completely edentulous patients
  • partially edentulous patients (not a stable MIP)
  • dentate patients who are going to receive extensive restorations that will alter their occlusion completely
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24
Q

In what position do we restore:

completely edentulous patients

A

CR

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25
# In what position do we restore: partially edentulous patients, when there are so few teeth remaining that there is not a stable MIP
CR
26
# Why use an anterior deprogramer for a PT?
to deprogram muscles of mastication
27
# In what position do we restore: dentate patients who are going to receive extensive restorations which will alter their occlusion completely
CR
28
Optimal functional occlusion involves?
1. TMJ 2. Teeth 3. excursive movements
29
What is the most desirable position of the *posterior teeth* for optimal funtional occlusion?
- multiple, even, bilateral, and simultaneous occlusal contacts with the mandible in CR position ## Footnote The posterior teeth are loaded mainly along the long axis of the tooth (axial loading)...support occlusion
30
The posterior teeth are loaded mainly along the ______________
long axis of the tooth (axial loading)
31
Why is it important for multiple posterior teeth to contact in occlusion?
more teeth that contact, the more stress is distributed throughout the arch
32
Why is it imporant that the posterior teeth are even in occlusion?
ALL posterior teeth should contact evently. This distributes the stress over all the teeth AND DOES NOT CONCENTRATE IT ON ONE TOOTH CAUSING HARM.
33
Why is it important for posterior teeth to be bilateral in occlusion?
For stability. If not then the mandible can pivot around and place increased pressure on the opposite TMJ ## Footnote 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 problem
34
How should the posterior teeth be loaded?
axially loaded through the long axis of the tooth ## Footnote Lateral forces on teeth are not well accepted. On the contrary through axial loading, heavier stresses can be applied
35
Anterior teeth should have ________ occlusal contact when the posterior teeth are in occlusion
lighter ## Footnote Since the anterior teeth are not loaded axially, they are not able to withstand high loads.
36
Anterior teeth are not loaded axially so they will not be able to withstand...
high loads
37
What is important during excursive movements?
canine guidance (anterior guidance) ## Footnote aka canine disclusion, canine rise
38
mandible moves laterally, the canines on the working side guide the movement, causing all other teeth to disclude
canine guidance (canine disclusion/canine rise)?[
39
What guide is important during protrusive movement?
anterior guidance ## Footnote in Protrusive Movement, the anterior teeth should disclude the posterior teeth
40
Anterior Disclusion
41
Canine Guidance
42
What teeth disclude the posterior teeth when the mandible moves in protrusion?
canines, central, and lateral incisors
43
Contacts between posterior teeth during excursive movements are considered...
interferences (can create damaging effects on teeth and periodontium) | ex: wear, widened pdl, resorption
44
WHY IS CANINE GUIDANCE/ANTERIOR GUIDANCE THE OPTIMAL OCCLUSAL SCHEME?
- canine has the longest root and best bone support (canine eminence) - most anterior and has a lesser impact - -The more anterior (away from the fulcrum), the resistance (load) occurs, the lesser the impact (magnitude) ## Footnote **Mandible - Class III lever**
45
The anterior teeth exhibit lighter occlusal contacts as compared to posterior teeth in...
MIP
46
What teeth are axially loaded in MIP?
posterior teeth
47
What is another name for optimal functional occlusion?
mutually protected occlusion
48
What teeth can tolerate lateral forces in excursive movements (off-axial loading)?
anterior teeth
49
What are the three occlusal schemes/philosophies in excursive movements?
1. canine guidance 2. group function 3. balanced occlusion
50
- 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
Group Function
51
What is the most desirable group function?
canine, premolars, and mesiobuccal (MB) cusp of the first molar ## Footnote The more posterior the contacts, the greater the force - closer to the source of power; the more destructive the forces
52
On the working side during group function only the buccal cusps of the ________ teeth guide along the inner inclines of the _______ teeth
mandibular; maxillary (as far posteriorly as the first molar (MB cusp)) ## Footnote no contacts on the NWS
53
What are the contacts on the non working side during group function?
no contacts
54
Group function is acceptable but...
not ideal
55
Group Function
56
Group function is the only option for patients who... ## Footnote aka "unilateral balance"
- no anterior vertical overlap (anterior open bite) - very large anterior horizontal overlap (class II div 1) - reverse overlap (class III)
57
simultaneous contacts on both sides (working and non-working) during lateral excursive movments
balanced occlusion ## Footnote contacts between posterior and anterior teeth during protrusive movements
58
If the mandible moves to the right during balanced occlusion...
- the right side (working) has outer inclines of mandiblar buccal cusps contact inner inclines of maxillary buccal cusps at the same time - the left side (NWS) has inner inclines of mandibular buccal cusps contact inner inclines of maxillary lingual cusps
59
In protrusion during balance occlusion that contacts are between...
posterior and anterior teeth ## Footnote On the posterior teeth: mesial inclines of mandibular cusps occlude with distal inclines of maxillary cusps.
60
What is bad about balanced occlusion?
- not acceptable for dentate patients - promotes tooth wear on dentate patients - non-working side contacts are extremely destructive and must be avoided
61
Balanced occlusion is an acceptable form of occlusion for...
complete dentures ## Footnote not acceptable or ideal for dentate pts
62
# Group Function: The more posterior the contacts, the greater the force - closer to the source of power; the more ___
destructive the forces
63
Not acceptable for dentate pts * Not ideal for dentate pts * Promotes tooth wear on dentate pts
Balanced Occlusion

Occlusion Lecture (21 decks)

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