Optimal Functional Occlusion Flashcards by Michael McMahan

The dynamic relationship of the lower anterior teeth against the upper anterior teeth through all ranges of function

Anterior guidance

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What teeth should be the only teeth touching ideally in lateral trusive movement?

Canines

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Canines contacting during lateral trusion creates a Class _____ lever

Class III lever

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How much shorter should lateral incisors be than central incisors?

.5-.75 mm

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What are the functions of anterior teeth?

Incise, hold, tear, or puncture

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What are the function of posterior teeth?

Chop, grind, mash, or mince

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Function of ____ teeth: Protect the posterior teeth•Aid in guidance of the mandible•Esthetic representatives•Aid in speech•Incise food

Anterior teeth

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According to Monson, condyles are a ____ not a _____ of mandibular movement

result not a guide

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What are the guiding elements of mandibular movement?

Cusps of teeth

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Without posterior support, the anterior teeth can ____ and become ______

flare and become mobile

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In _____ occlusion: Posterior contacts in centric•Posterior working contacts in lateral•Posterior balancing contacts in lateral•Posterior contacts in protrusive

Balanced

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____ occlusion is not acceptable for dentate pts •not ideal for dentate pts •promotes tooth wear on dentate pts

Balanced occlusion

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_____ side contacts are extremely destructive and must be avoided

non-working side

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______ occlusion is an acceptable form of occlusion for complete dentures but not for dentate patients

Balanced

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_____ occlusion favors wear of the teeth and favors horizontal chewing

Balanced occlusion

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______ occlusion: Several teeth on the working side contact during eccentric movements•Most favorable alternative to canine guidance

Group function

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_____ contacts in group function•Either canine guidance or group function•Needs to provide adequate guidance to discludethe teeth on the opposite side of the arch

Laterotrusive Contacts (Working)

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_____ occlusion: Posterior contacts in centric (maximum intercuspation)•Posterior working contacts in lateral •No posterior balancing contacts in lateral•No posterior contacts in protrusive anterior disclusion

Group function

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____ occlusion is acceptable but not ideal

Group function

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_____ occlusion is the only option for patients who:•have no anterior vertical overlap e.g. anterior open bite, •a very large anterior horizontal overlap e.g. Class II DivI •have a reverse overlap e.g. Class III

Group function

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____ occlusion is ideal

Mutually protected/Cuspid protected

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Physiologic position•A stable musculoskeletal position•Determined by joint anatomy•Determined by muscle forces

Centric Relation•

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In ______ occlusion: Posterior contacts in centric•Cuspid contact only on working side in lateral•No posterior balancing contacts in lateral•No posterior contacts in protrusive anterior disclusion

Mutually protected occlusion

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What tooth has greater proprioceptive sensitivity

Canine

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What tooth contacts prevent periodontal fatigue and restoration failure

Canine

_____ are best suited to accept the horizontal forces that occur during eccentric movements

Canines

_____ Forces•Must be directed to the anterior teeth which are positioned farthest from the fulcrum and the force vectors

Horizontal

Longest and largest roots and therefore the best crown/root ratio

Canines

•Fewer muscles are active when ____ contact during eccentric movements than when posterior teeth contact

Canines

Each tooth should contact in such a manner that the forces of closure are directed through the _____ of the tooth.

long axis

Even and simultaneous contact of all possible teeth should occur when mandibular condyles are in their most ______ position resting on the posterior slopes of articular eminences with the disc properly interposed

superoanterior

stable, orthopedic position is essential to treatment. •Muscles stabilize joints, therefore every mobile joint has a musculoskeletally stable position

Centric relation

____ is achieved by cusp tip to flat surface and tripodization

Axial loading

Elevator muscles pull the mandible in _____ position.

anteriosuperior

If the mandible is not in CR, the _____ must keep some tension on the neck of the condyle to keep it slightly forward.

inferior lateral pterygoids

In _____ occlusion•Good function•Shows the least wear to the teeth•Minimal periotrauma•Minimal TMJ trauma•Comfortable muscle activity

Ideal Occlusion

Which tooth breaks muscle tension in masseter and temporalis?

Canine

We need enough ______ so when the patient goes into a lateral or protrusive movement, the posterior teeth will disclude or separate.

vertical overlap

How much clearance should there be at molars in protrusive?

1 mm

Who started the study of occlusion to make dentures that worked well; developed articulators?

Greene brothers

2 main school of occlusion that are relatively close in theory and philosophy; widely divergent in technique

Pankey-Mann-Schuyler and Gnathology

What type of occlusion do gnathologists use?

Cuspid protected

What type of occlusion do Pankey-Mann-Schuyler use?

Group function

____ concept: Incisal guidance has “the most profound” influence on the occlusion of the posterior teeth •The incisal guidance in the normal occlusion is the lingual contours of the upper anterior teeth •By its proximity to the posterior teeth, it has a predominating influence upon posterior tooth function Harmony of contact on all working inclines •Unilateral balance •Cusp to fossa relationship •Single point contact

Pankey-Mann-Schuyler

``` ____ original concept: Frequently showed excessive wear •Led to occlusal instability •Provided poor usage of the teeth •McCollum died believing the original concept was correct ```

Gnathology

``` ____ concept: •The canine teeth should serve to guide the mandible during eccentric movements •Determines both lateral and protrusive movements of the mandible It is the science and study of: •Mandibular movement •Jaw relationships •Tooth morphology •Functional requirements ```

Gnathology

Baseline for evaluating patients’ occlusion include what 3 things?

•Teeth•TMJ•Musculature

T/F: A patient may have an orthodonticallyideal Angles Class I occlusion, this does not mean that the patient has optimal occlusal contacts, optimal condyle/mandibular position, and ideal/optimal contacts in excursive movements.

True

T/F: Patients may have a less than ideal occlusion, HOWEVER, it may still be a functionally acceptable occlusion or a physiologically acceptable occlusion

True

The TM Joints are in an optimum, orthopedically stable joint position when the mandible is in _____

CENTRIC RELATION

refers only to the joints and does not involve teeth•mandible can freely arc up and down along the Terminal hinge axis •Teeth cannot contact = deflection

CENTRIC RELATION

To determine if treatment is _____: (assess the masticatory system for evidence of pathology -tooth wear, tooth mobility, TMJ dysfunction, muscle dysfunction, etc)

required

____ is a repeatable position where the muscles are relaxed

Centric relation

What are the 2 main muscles that stabilize the TMJ?

Masseter and medial pterygoid

Which muscles are the most relaxed in CR?

Lateral pterygoids

In CR, condyles are is most ____ position of glenoid fossa

Superior-anterior

Condyles rest against ____ slope of articular eminence which can tolerate higher stresses in CR

Posterior slope

In the most retruded position the posterior wall of the articular fossa is very ______

thin

Is CR a jaw or teeth position?

Jaw

______ is the position to which we restore:•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 entirely

Centric relation

____ works to eliminate the habitual closing patterns of the patient

Leaf gauge key

How hard should the patient bite on the leaf gauge?

Half-hard pressure

With the centric relation interocclusal record between the teeth, the patient should be aware of no _____ whatsoever. There should be a feeling of equal pressure throughout the contact.

strain

The ____ relates the maxillary cast to the axis of rotation; accurate and convenient method to get the maxillary cast into the articulator

Facebow

All posterior teeth should ______ . This distributes the stress over all the teeth and does not concentrate it on one tooth causing harm.

contact evenly

Should contacts in CR be unilateral or bilateral?

Bilateral

All the contacts occur ______ on both sides of the arch and on all the posterior teeth

at the same time

The posterior teeth should be ______ i.e. through the long axis of the tooth. Lateral forces on teeth are not well accepted.

axially loaded

Are anterior teeth axially loaded?

______: also called canine disclusion or canine rise. When the mandible moves laterally, the canines on the working side guide the movement, causing all other teeth to disclude.

Canine guidance:

Anterior Guidance: in Protrusive Movement, the anterior teeth should _____ the posterior teeth

disclude

Contacts between the posterior teeth during excursive movements are considered ______ and can create damaging effects on teeth and periodontium.

interferences

What class of levers are created when interferences occur?

Class 1 and 2

The more _____ the resistance (load) occurs, the lesser the impact (magnitude)

anterior (away from the fulcrum),

The _____ has the longest root, and best bone support (canine eminence)

canine(s

_____ occlusion: Multiple, even, bilateral, simultaneous occlusal contacts of the posterior teeth in MIP with the mandible is CR position i.e. MIP and CR are coincident. •The anterior teeth exhibit lighter occlusal contacts as compared to posterior teeth in MIP•Posterior teeth are axially loaded in MIP •In excursive movements canine guidance/anterior guidance occurs

Mutually protected occlusion

The posterior teeth withstand the majority of the load in MIP, protecting the anterior teeth from high loads. •The anterior teeth disclude the posterior teeth in excursive movements, thereby protecting the posterior teeth from off-axis loading.•Posterior teeth can tolerate axial loading well so they protect anterior teeth, which are not axially loaded, in MIP. Anterior teeth can tolerate lateral forces in excursive movements (off-axial loading) since they are further away from the fulcrum and the loads are less.

Mutually protected occlusion