su14_-_occlusion_ii_final_exam_20141210195253 Flashcards
(257 cards)
1
Q
What are the 2 schools of articulator design? Describe each.
A
- the geometric (non-anatomic) school: denied the existence of condylar axes and disregarded the condylar paths as influences on occulsion, instead claiming that the articulation of the teeth guides the mandible during mastication- the condylar (anatomic) school: adjustable condylar guides and average value instruments
2
Q
Describe the Equilateral Triangle Theory. Who created this theory?
A
- the size of the mandible is equal to 10cm (4 inches) from condyle to condyle and from each condyle to the incisor point- William G. A. Bonwill (1838-1899)
3
Q
Describe the Balkwill Angle. Who discovered this?
A
- is formed between the occlusal plane and Bonwill triangle (~26 degrees)- Francis H. Balkwill (1866)
4
Q
What did Ferdinand Graf von Spee discover?
A
in 1890, he discovered “the relationship between the curved arrangements of the occlusal planes of natural teeth and the corresponding curves of the condylar paths”
5
Q
What is the Curve of Spee?
A
the molar masticatory surfaces lie on the same arc of a circle; the posterior continuation of which touches the most anterior point of the condyle
6
Q
Where is the location of the axis of the Curve of Spee?
A
at the level of the horizontal mid-orbital plane
7
Q
True or false: The steeper the path of the condyles, the less pronounced the tooth curve would be, because both have the same radius.
A
FALSE. The steeper the path of the condyles, the MORE pronounced the tooth curve would be, because both have the same radius.
8
Q
What did Carl Christensen discover (“Christensen’s Phenomenon”)?
A
the space that occurs between the maxilla and mandible during protrusion
9
Q
True or false: Christensen was the first to describe an intraoral method fro obtaining a protrusive record to determine the condylar inclination.
A
true
10
Q
What did George S. Monson discover?
A
spherical theory - in 1898, Monson presented for the first time a method for setting denture teeth, using Bonwill’s equilateral triangle conforming to the surface of a sphere
11
Q
Where is the center of rotation in Monson’s Spherical Theory?
A
sella turcica
12
Q
What did George H. Wilson discover?
A
Curve of Wilson - in the theory that occlusion should be spherical, the curvature of the cusps as projected on the frontal plane expressed in both arches; the curve in the lower arch being concave and the one in the upper arch being convex
13
Q
What theory did Rupert E. Hall develop?
A
Conical Theory of Mandibular Movement
14
Q
What is the anatomic rotation center of the mandible, according to the Conical Theory of Mandibular Movement?
A
external occipital protuberance
15
Q
The essence of both anatomic and functional harmony is the “balance” between ______ and ______.
A
elevator and depressor muscles
16
Q
Name the 2 types of mandibular movement.
A
rotational and translational
17
Q
What does THA stand for? (hint: think mandibular movement)
A
terminal hinge axis or transverse horizontal axis (axis around which the mandibular condyles rotate)
18
Q
True or false: In lateral movement, the working side is the side toward which the mandible moves.
A
true
19
Q
In what directions does the non-working condyle move in lateral movement?
A
forward, downward, and medial
20
Q
What is Bennett’s Movement?
A
movement of the working condyle within a cone
21
Q
What is Bennett’s Side Shift?
A
the axis of the working condyle moves laterally? (like a martial artist who turns body from facing front to facing sideways)
22
Q
What is Ulf Posselt’s Envelope of Motion?
A
border movement (maximum movement) of the mandible
23
Q
True or false: Any point found along the arc of rotation is CR.
A
true
24
Q
What are the functions (5) of anterior teeth?
A
- anterior guidance- perform initial acts of masitcation- speech- lip support- esthetics
25
What are the 3 factors that dictate anterior guidance?
- position of the incisal edge of the mandibular anterior teeth relative to the lingual surfaces of the maxillary anterior teeth- changes in morphology of the lingual surfaces of maxillary anterior teeth- length of mandibular incisors or canines
26
What are the 2 types of anterior guidance? What is the third type of guidance (that is not a type of anterior guidance)?
anterior guidance:- incisal guidance- canine guidancegroup function
27
What are the 3 purposes of a custom anterior guidance table?
- when anterior teeth are prepared, the angulation of the custom guide provides anterior guidance in place of the anterior teeth- when only posterior teeth are to be replaced, the angulation of the guide serves to estimate the buccolingual and mesiodistal cusp angles so as to avoid interferences in both protrusive and non-working excursions- reduce the amount of wear of the stone casts during excursive movements made on the articulator
28
When trimming casts, what type of edges (straight or curved) does ortho casts have? Prosthetic casts?
- ortho casts: straight edges- prosthetic casts: curved edges
29
What is the term used for an articulator that has the condyles in the lower part (mandible)?
arcon
30
What is the term used for an articulator that has the condyles in the upper part (maxilla)?
non-arcon
31
What is the purpose of a pantograph?
used to pinpoint movement with tracing papers at the ear and on front (2 in front, 2 vertical in back, 2 horizontal in back)
32
What two angles are measured with a pantograph?
Fischer's angle and Bennett's angle
33
What two lines is Fischer's angle between?
between the protrusive and nonworking lines in vertical dimension
34
What two lines is Bennett's angle between?
between protrusive and non-working lines in horizontal dimension
35
True or false: Bennett's angle deals with the working side and Bennett's shift deals with the non-working side.
FALSE. Bennett's angle deals with the non-working side and Bennett's shift deals with the working side.
36
What does the Ear Bow relate the maxillary cast to?
the terminal hinge axis (mandibular condyles)
37
True or false: The Ear Bow orients the maxillary cast correctly in space using a third point of reference (occlusal plane).
true
38
The Ear Bow is aligned parallel to what?
the interpupillary line (reference)
39
True or false: The Ear Bow permits mounting of the mandibular cast on a semi-adjustable articulator.
FALSE. It permits mounting of a MAXILLARY cast.
40
What is used to mount a mandibular cast after an Ear Bow is used to mount the maxillary?
using a centric relation (CR) record
41
What is the definition of centric relation?
the maxillomandibular relationship in which the condyles articulate with the thinnest avascular portion of their respective disks with the complex in the anterior-superior position against the shapes of the articular eminences; this position is independent of tooth contact
42
True or false: Centric relation is dependent upon tooth contact.
FALSE. Centric relation is INDEPENDENT of tooth contact.
43
What are the 3 ways to record CR?
- bilateral manipulation- chin point guidance- anterior deprogrammer (having a patient bite on something for awhile to have their jaw "forget")
44
In a CR Record, are any of the teeth touching?
no
45
True or false: CR Records are thin, soft, fast setting, dimensionally stable, and easily verifiable.
true
46
What is the average angle of condylar guidance?
40 degrees
47
What is the average angle of anterior guidance?
20 degrees
48
What is the average angle of articular eminence?
30 degrees
49
What is the only time you can ignore CR records?
when the CO = MI
50
True or false: Hand articulation is not necessary when there is slide present between CO and MI.
FALSE. You need to hand articulate because the articulator will not account fro the slide
51
How is an optimal joint relationship achieved?
when the articular discs are properly interposed between the condyles and the articular fossae (CR)
52
What is the purpose of an orthopedically stable joint position?
when the articular surfaces and tissues of the joints are aligned such that forces applied by the musculature do not create any damage
53
True or false: The musculoskeletally stable joint position can only be maintained when it is in harmony with a stable occlusal position.
true
54
What two characteristics of contact between teeth are optimal?
even and simultaneous
55
Is it optimal for CO to coincide with MI?
yes
56
What is the difference between even and simultaneous contact?
- even: all teeth have the same load- simultaneous: all teeth contact at the same time
57
What protects the osseous tissues from pressure forces?
periodontal ligament between the roots and the alveolar bone
58
Which type of occlusion is preferred (cusp-fossa or cusp-marginal ridge)?
cusp-fossa because it is better at receiving force because it takes it along the center of the long axis
59
What is the best method of axial loading?
tripodization (tip of the cusp should not contact, just the sides)
60
Describe a class I lever system. Give an example.
(load v) [fulcrum] (effort v)a dolly moving a box
61
Describe a class II lever system. Give an example.
[fulcrum] (load v) (effort ^)a wheelbarrow
62
Describe a class III lever system. Give an example.
(load v) (effort ^) [fulcrum]a fishing rod
63
What class lever system is represented by the jaw?
class III
64
True or false: The further the load is from the fulcrum, the harder it is to chew.
true
65
Describe the 2 parts of mutually protected occlusion.
- in maximal intercuspal position, posterior teeth come into contact and act as stops to minimize horizontal load on anterior teeth- the anterior teeth guide excursive movements of the mandible so that no posterior teeth contacts occur during lateral or protrusive excursions
66
What are the 2 types of anterior guidance?
incisal and canine guidance
67
What type of guidance is ideal for lateral excursions?
canine guidance (over group function)
68
What are the 7 effects of tooth loss?
- supraeruption- tilting- loss of contact- loss of posterior tooth support- loss of vertical dimension- flaring of anterior teeth- non-working interferences
69
What are the 4 occlusal treatment goals?
- to direct occlusal forces along the long axes of the teeth (stable posterior contacts)- in MI position, all mandibular teeth should contact their maxillary opponents at the same time and with same intensity (CO=MI)- to furnish a smooth protrusive path guided by the anterior teeth without any interference from occlusal contacts between the posterior teeth (posterior disclusion)- working contacts (canine guidance or group function) should not be prevented from contacting by non-working interferences
70
True or false: Mounting accurate diagnostic casts to a semi-adjustable articulator permits static and dynamic relationships of the teeth without interferences from protective neuromuscular reflexes.
true
71
Where is a facebow placed?
13 mm anterior to tragus on tragus-canthus line
72
What is a pantograph used to pinpoint?
used to pinpoint actual hinge axis
73
What is the difference between kinematic and arbitrary hinge axis?
The kinematic is where the actual hinge is and arbitrary is anywhere within the circle around it???
74
What is the formula used to calculate Bennett's angle?
Bennet/lateral angle = (h/8) + 12h = horizontal angle (25, 30, etc.)
75
What term is described by the following definition?the ideal relationship of posterior teeth when the mesiobuccal cusp of the maxillary first molar is centered on the buccal groove of the mandibular first molar
Angle's class I occlusion
76
What term is described by the following definition?malocclusion in which the mandibular dental arch is posterior to the maxillary dental arch in one or both lateral segments; mandibular first molar is distal to maxillary first molar compared to the ideal class I relationship
Angle's class II occlusion
77
What term is described by the following definition?malocclusion in which the mandibular dental arch is anterior to the maxillary dental arch in one or both lateral segments; mandibular first molar is mesial to the maxillary first molar compared to the ideal class I relationship
Angle's class III occlusion
78
What term is described by the following definition?the influence of the contacting surfaces of anterior teeth on tooth-limiting mandibular movements
anterior guidance
79
What term is described by the following definition?a form of mutually-protected articulation in which the vertical and horizontal overlap of the anterior teeth disengage the posterior teeth in all mandibular excursive movements
anterior protected articulation (anterior guidance, cuspid guidance, cuspid rise)
80
What term is described by the following definition?the relative position of teeth to form a curved or "U"-shaped configuration when viewed from the occlusal aspect
arch alignment (tooth alignment)
81
What term is described by the following definition?the orientation of the long axis of a crown (natural or artificial) relative to the sagittal and frontal planes; it may be given generally, in terms of buccal or lingual, and mesial or distal, or specifically in degrees (some portion of 360 degrees)
axial inclination
82
What term is described by the following definition?the angle formed between the sagittal plane and the average path of the non-working condyle, asviewed in the transverse plane during lateral movements
Bennett angle
83
What term is described by the following definition?the bilateral, simultaneous anterior and posterior occlusal contact of teeth in centric and eccentric positions; this occlusion is characteristic of heavily worn natural teeth and complete denture design
balanced articulation (balanced occlusion)
84
What term is described by the following definition?mandibular movement at the limits dictated by anatomic structures, as viewed in a given plane.
border movement
85
What term is described by the following definition?a position of the mandible when it is at the limit of active or passive movement in any direction in space.
border position
86
What term is described by the following definition?a form of mutually-protected articulation in which the vertical and horizontal overlap of the canine teeth disengage the posterior teeth in the excursive movements of the mandible.
canine protected articulation (canine guidance, cuspid guidance, cuspid rise)
87
What term is described by the following definition?the lingual cusps of the maxillary posterior teeth and the buccal cusps of the mandibular posterior teeth. (Assumes proper interarch alignment.) Those cusps or incisal edges of teeth that contact in and support centric occlusion, usually facial cusps of the mandibular posterior teeth, the maxillary palatal cusps, and the incisal edges of the mandibular anterior teeth.
centric cusps (supporting cusps, functional cusps, stamp cusps)
88
What term is described by the following definition?the occlusion of opposing teeth when the mandible is in centric relation. This may or may not coincide with the maximal intercuspation postion(see Maximal Intercuspation).
centric occlusion (CO)*Important Note: CO used to be synonymous with maximal intercuspal position (MI), but this is now improper according to the prosthodontic glossary. Other disciplines and other dental institutions may still consider it synonymous with MI. You must be aware of this significant discrepancy in terminology when taking the Dental National Board Exams. Its intended meaning will require clarification.
89
What term is described by the following definition?the maxillomandibular relationship in which the condyles articulate with thethinnest avascular portion of their respective disks with the complex in the anterior-superior position against the shapes of the articular eminences.This position is independent of tooth contact. This position is clinically discernible when the mandible is directed superiorly and anteriorly. It is restricted to a purely rotary movement about the transverse horizontal axis.
centric relation (CR)(definition 1 of 2)
90
What term is described by the following definition?a clinically determined position of the mandible placing both condyles into their anterior uppermost postion. This can be determined in patients without pain or derangement in the TMJ
centric relation (CR)(definition 2 of 2)
91
What term is described by the following definition?the mechanical form located on the upper-posterior region of an articulator that controls movement of its mobile member. (This movement is intended to simulate that produced by the condyles in the temporomandibular joints.)
condylar guidance (noun)
92
What term is described by the following definition?the path traveled by the mandibular condyle in the temporomandibular joint during any movements of the mandible.
condylar path
93
What term is described by the following definition?the concave (superiorly) line formed by the cusp tip of the mandibular canine and the buccal cusps of the mandibular posterior teeth (usually shown projected onto the median plane).
curve of Spee (anteroposterior curve)
94
What term is described by the following definition?viewed from the frontal plane, it is the concave (superiorly) curve which contacts the buccal and lingual cusps of the mandibular molars bilaterally.
curve of Wilson (mediolateral curve)
95
What term is described by the following definition?the relationship that exists when a centric cusp occludes with an opposing fossa, resulting in three points of contact, with no contact on the cusp tip. Occurs in both cusp-marginal ridge and cusp-fossa occlusal schemes.
cusp-fossa contact
96
What term is described by the following definition?the entire arrangement of posterior teeth in which centric cusps occlude exclusively in specified fossae of the opposing maxillary or mandibular counterpart crown. This articulation is usually associated with gnathologic-based oral rehabilitation (see therapeutic occlusion).
cusp-fossa occlusal scheme (tooth-to-tooth occlusion)
97
What term is described by the following definition?the entire arrangement of posterior teeth in which centric cusps occlude in specified fossae or on adjacent marginal ridges of the opposing maxillary or mandibular crown or crowns. This is the most common type of naturally occurring occlusion.
cusp-marginal ridge occlusal scheme (tooth-to-two tooth occlusion)
98
What term is described by the following definition?the relationship when a centric cusp occludes with opposing adjacent marginal ridges resulting in two contact areas. Occurs in the cusp-marginal ridge scheme of occlusion but not in the cusp-fossa scheme.
cusp-marginal ridge contact
99
What term is described by the following definition?any surface which diverts the mandible from its intended movement.
deflective occlusal contact (occlusal prematurity, occlusal interference, occlusal disharmony)
100
What term is described by the following definition?those anatomic structures that dictate or limit the movements of the mandible when the teeth are in contact. The anterior determinant of mandibular movement is the dental articulation. The posterior determinants of mandibular movement are the temporomandibular articulations and their associated structures.
determinants of mandibular movement (determinants of occlusion)
101
What term is described by the following definition?the spaces formed about the proximal contact areas of adjacent teeth. The embrasures may be divided into four regions: Occlusal (incisal), mesial, distal, and gingival (cervical).
embrasure
102
What term is described by the following definition?movement occurring when the mandible moves away from maximal intercuspation.
excursive movement (excursion)
103
What term is described by the following definition?all normal, proper, or characteristic movements of the mandible made during mastication, swallowing, speech, and other associated movements. (occurs within the range from centric relation to all facial-edge-to-edge-maxillary-to-mandibular-tooth excursive positions)
functional mandibular movments
104
What term is described by the following definition?the influence on mandibular movements by the contacting surfaces of the maxillary and mandibular anterior.
guidance
105
What term is described by the following definition?a line encircling a tooth and designating its greatest circumference at a selected axial position determined by a dental surveyor; a line encircling a body designating its greatest circumference in a specified plane.
height of contour
106
What term is described by the following definition?the amount by which the incisal edges of the maxillary anterior teeth are labial to the incisal edges of the mandibular teeth at maximal intercuspation. The projection of teeth beyond their antagonists in the horizontal plane.
horizontal overlap (overjet)
107
What term is described by the following definition?any tooth contacts that interfere with or hinder harmonious mandibular movement.
interference
108
What term is described by the following definition?the position of the mandibular teeth (or tooth) relative to the maxillary teeth (or tooth) when the teeth are maximally occluded.
interarch tooth alignment
109
What term is described by the following definition?the mediolateral movement of the mandible when viewed in the frontal plane.
mandibular translation (sideshift, Bennett movement)
110
What term is described by the following definition?the translatory portion of lateral movement in which the greatest portion occurs early in the first 4 mm of forward movement of the non-working condyle as it leaves centric relation.
mandibular translation, early
111
What term is described by the following definition?the translatory portion of lateral movement in which the non-working condyle moves essentially straight and medially as it leaves the centric relation position.
mandibular translation, immediate (immediate sideshift)
112
What term is described by the following definition?the translatory portion of mandibular movement viewed in the transverse plane that occurs at a rate or amount that is directly proportional to the forward movement of the non-working condyle (i.e. straight line movement).
mandibular translation, progressive (progressive sideshift, distributed mandibular translation)
113
What term is described by the following definition?the complete intercuspation of the opposing teeth independent of condylar position.
maximal intercuspal position (maximal intercuspation, MI, MIP, intercuspal position, IP, ICP)
114
What term is described by the following definition?tooth contacts (static) in maximal intercuspation.
maximal intercuspal contacts
115
What term is described by the following definition?any contact of opposing teeth which prevents the mandible from achieving the position of maximal intercuspation. This usually results in an increased occlusal vertical dimension which is at a minimum during maximal intercuspation.
maximal intercuspation occlusal prematurity (deflective contact, interference)
116
What term is described by the following definition?An occlusal scheme in which the posterior teeth prevent excessive contact of the anterior teeth in maximal intercuspation, and the anterior teeth disengage the posterior teeth in all mandibular excursive movements.
mutually protected articulation (mutually protected occlusion)
117
What term is described by the following definition?the buccal cusps of the maxillary posterior teeth and the lingual cusps of the mandibular posterior teeth. (assumes proper inter-arch alignment.)
non-centric cusps (non-functional cusps, guiding cusps, shear cusps)
118
What term is described by the following definition?the side of the mandible opposite to the direction of movement or displacement. Assume the direction of movement is away from maximal intercuspation. The side of the mandible that moves toward the median line in lateral excursion.
non-working side (mediotrusive side, non-functional side, balancing side, orbiting side, idling side)
119
What term is described by the following definition?any tooth surface making contact on the side of the mandible opposite to the direction of lateral displacement.
non-working side occlusal contacts (mediotrusive side contacts, non-functional side contacts, orbiting side contacts, idling side contacts)
120
What term is described by the following definition?any tooth surface on the non-working side which hinders the desired occlusal contact or mandibular movement.
non-working side deflective occlusal contacts (mediotrusive interferences, non-working interferences, balancing side interferences, idling side interferences, orbiting side interferences)
121
What term is described by the following definition?any contact of opposing teeth that occurs before the planned intercuspation.
occlusal prematurity
122
What term is described by the following definition?the portion of the occlusal surfaces of posterior teeth that lies within the perimeter of the cusp tips and marginal ridges.
occlusal table
123
What term is described by the following definition?the maximum buccolingual dimension of the occlusal table; the distance from the buccal cusp apex to the lingual cusp apex as viewed from the mesial or distal.
occlusal table width
124
What term is described by the following definition?the distance measured between a maxillary reference point and the mandibular counterpart when the occluding members are in contact. This distance is at a minimum with the mandible in maximal intercuspation.
occlusal vertical dimension (vertical dimension of occlusion, VDO)
125
What term is described by the following definition?an occlusal scheme or design which is thought to satisfy all mechanical and neuromuscular requirements for maximum sustained health of the masticatory system.
optimal occlusion (ideal occlusion)
126
What term is described by the following definition?an occlusion which exists in the absence of signs and symptoms of occlusion-related pathosis. Acceptability of occlusal variation and a sense of psychological and physical patient comfort are implied.
physiologic occlusion
127
What term is described by the following definition?anterior movement of the mandible.
protrusion
128
What term is described by the following definition?any tooth surface making contact when the mandible moves anteriorly.
protrusive contacts
129
What term is described by the following definition?any surface which hinders the desired occlusal contact or mandibular movement during anterior excursions.
protrusive deflective occlusal contact (protrusive interference)
130
What term is described by the following definition?the relation of the mandible to the maxillae at the instant of tooth (or prostheses, or occlusal rim) contact following closure about the transverse horizontal axis.
retruded contact position (RCP, centric relation occlusion)
131
What term is described by the following definition?posterior movement of the mandible.
retrusion
132
What term is described by the following definition?any tooth surface making contact when the mandible moves posteriorly.
retruded contacts (retrusive contact)
133
What term is described by the following definition?any tooth surface which hinders the desired occlusal contact or movement of the mandible during posterior movement. Often applied to the range of movement between maximal intercuspation and the retruded contact position (or centric occlusion).
retrusive deflective occlusal contacts (retrusive interferences)
134
What term is described by the following definition?malocclusion in which the mandibular teeth are located facial to an ideal occlusal relationship with the opposing maxillary teeth when all teeth are maximally occluded. It may involve the entire mouth, specific segments, or individual teeth. The maxillary buccal cusps articulate on the central fossae line of the mandibular teeth.
reverse articulation (reverse occlusion, crossbite)
135
What term is described by the following definition?an occlusal scheme devised and executed by the dentist using comprehensive restorative techniques. It may be used to counteract existing or to minimize future problems.
therapeutic occlusion
136
What term is described by the following definition?a unique imaginary mediolateral line about which the mandible can be made to repeatably undergo pure rotation by clinical manipulation. Both condyles should occupy the most superoanterior position in their mandibular fossa with discs properly interposed (compare this definition with centric relation).
transverse horizontal axis (hinge axis, terminal hinge axis)
137
What term is described by the following definition?arcing motion of the mandible about the transverse horizontal axis. The mandibular cusps move in arcs whose radii are determined by the cusp's distance from the transverse horizontal axis.
transverse horizontal axis movement (arc of closure)
138
What term is described by the following definition?any tooth surface that hinders desired occlusal contact or mandibular movement when the mandible is rotated about the transverse horizontal axis.
transverse horizontal axis deflective occlusion contact (RCP interference, centric relation interference, CR prematurity)
139
What term is described by the following definition?simultaneous contact of most teeth on the working side, but no contact on the non-working side.
unilateral balanced occlusion (group function occlusion)
140
What term is described by the following definition?The degree of separation (distance between) the maxillae and the mandible.
vertical dimension
141
What term is described by the following definition?the amount by which the incisal edges of the maxillary anterior teeth are inferior to the incisal edges of the mandibular teeth at maximal intercuspation.
vertical overlap (overbite)
142
What term is described by the following definition?the side toward which the mandible moves or is displaced. Assume movement or displacement is away from maximal intercuspation.
working side (laterotrusive side, rotating side)
143
What term is described by the following definition?any tooth surface making contact on the side of the mandible toward which it is displaced. Assume displacement occurs laterally from the maximal intercuspal position.
working side contacts (laterotrusive contacts, functional side contacts, rotating side contacts)
144
What term is described by the following definition?any tooth surface on the working side which hinders the desired occlusal contact or mandibular movement.
working side deflective occlusal contacts (laterotrusive interference, working side interference, functional side interference, rotating side interference)
145
What are the 2 components of mandibular movement?
- rotation- translation
146
In the sagittal plane, rotation occurs around the ____.
terminal hinge axis or transverse horizontal axis (THA)
147
The rotational movement is limited to about ____ mm of incisal separation before the mandible begins to translate.
20-25
148
In the horizontal plane, in lateral movement of the mandible, the non-working condyle travels ____. The working condyle travels ____.
- forward and medial- in a slight lateral translation (may be slightly forward or slightly backward)
149
In the frontal plane, in lateral movements, the non-working condyle will move ____. The working condyle will ____.
- downward and medial- rotate and move lateral and upward or lateral and downward
150
Ulf Posselt described the range of mandiblular movement in three planes of orientation using a starting reference point between ____. This range of movement is also referred to as the ____.
- two mandibular central incisors- "envelope of motion"
151
When the mandible is guided to centric relation, the arc traced by the point between the two mandibular central incisors is referred to as the ____.
centric relation arc of closure
152
To find or locate CR, one does not need to have ____.
tooth contact
153
Centric relation is considered a ____ and ____ reference position.
- reliable- reproducible
154
CR is defined as the maxillomandibular relationship in which the condyles articulate with the ____ portion of their respective discs, with the complex in the ____ position against the shapes of the articular eminences. This position is independent of ____. It is restricted to a ____ movement about the ____.
- thinnest avascular- anterior-superior- tooth contact- purely rotary movement- transverse horizontal axis
155
If the mandible is manipulated upward on the centric relation arc of closure until tooth contact occurs, the mandible is now said to be in ____.
centric occlusion (CO)
156
In approximately ____% of the population, centric occlusion occurs between only one or two maxillary and mandibular teeth. These contact points are referred to as ____. These contacting surfaces are located on the ____ inclines of mandibular teeth and the ____ inclines of maxillary teeth.
- 90- initial points of contact- distal inclines- mesial inclines
157
If the mandible continues to close and slide forward or laterally until all the teeth intercuspate together as best as they can, it is called ____.
maximal intercuspal position or maximal intercuspation (MI) of the dental arches
158
MI position is a ____-determined position and ____ (is/is not) susceptible to change throughout life.
- tooth-determined- is susceptible
159
The slide between CO and MI is referred to as ____.
centric slide
160
From MI position, protrusion can occur. During this movement, the mandible has to open as the mandibular anterior teeth ride down along ____ of the maxillary anterior teeth until they reach an ____ position. This tracing on the sagittal plane is dictated by the ____ and ____ of the maxillary anterior teeth (vertical and horizontal overlap).
- lingual concavity- end-to-end (edge-to-edge) position- shape- position
161
As the mandible continues to move forward in protrusive movement and the anterior teeth clear, the contacting ____ dictate its path.
contacting posterior teeth
162
The maximum opening of the mandible may range up to ____ mm measured between the maxillary and mandibular incisors.
50-60 mm
163
If from the maximum open position, the patient is instructed to close, the mandible will trace the path of the ____. This line ____ (is/is not) reproducible.
- habitual arc of closure- is not
164
The ____ position of the mandible lies on the habitual arc of closure. It is the position that the mandible assumes when ____.
- physiologic rest position - all muscles are at a state of equal relaxation
165
Physiologic rest position is characterized by the teeth being separated by the ____
interocclusal rest distance or space
166
The distance between two reference points on each side of the maxillary and mandibular teeth or attached gingiva with teeth in MI is ____. The distance between these two points with the mandible in physiologic rest position is the ____.
- vertical dimension of occlusion (VDO)- verticl dimension at rest (VDR)
167
The interocclusal rest distance = ____.
VDR - VDO
168
____ refers to the resultant protrusive path the lower incisors must follow due to anterior teeth contact. It is determined by ____ as well as ____ of maxillary and mandibular anterior teeth.
- incisal guidance- lingual concavities of maxillary anterior teeth- vertical and horizontal overlap
169
The term ____ is widely used not only to define the resultant protrusive path of the mandibular incisors but also the path they must follow during lateral jaw movements.
incisal guidance
170
If the relationship of the maxillary and mandibular canines determines the lateral jaw movement, the term ____ can be used, but only in reference to the path during lateral movement.
canine (cuspid) guidance
171
The amount the mandible must drop in the anterior region is determined by ____. The amount the mandible must drop in the posterior region is determined by ____.
- incisal guidance- angle of the articular eminence (condylar guidance)
172
The inclination of the inclination of the articular eminence of the TMJ and the morpholgy of the lingual surfaces of the anterior teeth serve to guide ____.
the disclusion of the posterior teeth
173
What are the 3 posterior determinants of mandibular movement?
- inclination of articular eminence- medial wall of glenoid fossa- intercondylar distance
174
What are the 2 anterior determinants of mandibular movement?
- horizontal overlap of anterior teeth- vertical overlap of anterior teeth
175
What are the 3 "other" (not anterior or posterior) determinants of mandibular movement?
- occlusal plane- curve of Spee- neuromuscular response
176
What are the 3 types of articulators?
- small non-adjustable articulator- semi-adjustable articulator- fully-adjustable articulator
177
Small non-adjustable articulators usually lead to restorations with ____ as they ____ (can/cannot) reproduce the full range of mandibular movements.
- occlusal discrepancies- cannot
178
Semi-adjustable articulators ____ (are/are not) the same size as the anatomic structures that they represent. Using a ____, the articulated casts can be positioned with sufficient accuracy that will minimize the need for clinical adjustment during treatment.
- are- face-bow transfer
179
Fully adjustable articulators have a wide range of positions and can be set to follow ____. The ____ is a device that is used in conjunction with these articulators to adjust the condylar elements to follow the tracings obtained intraorally.
- the patient's border movements- pantograph
180
Articulators that have the condyles connected to the lower member are known as ____ whereas those with the condyles connected to their upper member are known as ____.
- arcon- non-arcon
181
The ____ is the means by which you record from the patient the exact anatomical relation of the maxillary dental arch (via imprints of teeth) to the patient's ____. You then use this record to mount the maxillary cast, first, on your articulator.
- ear bow transfer- intercondylar axis
182
The mandibular cast is then related to the maxillary cast and mounted using a ____ obtained from the patient.
centric relation record
183
The significance of the ear bow transfer:1. relates the maxillary cast (occlusal surface) to the ____2. orients the maxillary cast (long axes of teeth) correctly in space using ____; this is particularly important whenever ____.
- terminal hinge axis- third point of reference- extensive anterior restorations are done
184
The significance of the ear bow transfer (continued):3. is aligned parallel to the ____ (horizontal reference)4. permits mounting of the ____ on a semi-adjustable articulator5. allows the mandibular cast to be correctly mounted using ____.
- interpupillary line (horizontal reference)- maxillary cast- centric relation record
185
A natural reflex action of the mandible is to close into a ____ or ____ position when something is introduced in the mouth. Therefore, the relationship of the mandible to the maxilla in the terminal hinge position should be obtained without ____.
- lateral- lateral protruded- tooth contact
186
What are 3 ways to manipulate the mandible into CR?
- chin point guidance- anterior deprogrammer- bilateral (bimanual) manipulation
187
What are the 7 requirements of centric relation record?
- along the arc of rotation of the mandible- no teeth touching- thin- soft- fast setting- dimensionally stable- easily verifiable in the mouth and on the mounted casts
188
Diagnostic casts that are correctly mounted in CR on a semi-adjustable articulator using a face-bow transfer provide valuable information for ____. They are generally used for what 5 things?
- fixed prosthodontic work1. diagnosis2. treatment planning3. diagnostic wax-ups4. fabricate custom trays5. provisional restorations
189
The term ____ refers to the correction of stressful occlusal contacts through selective grinding. It involves the selective reshaping of tooth surfaces that interfere with normal harmonious jaw function.
occlusal equilibration
190
Combining occlusal equilibration with restorative dentistry very often minimizes ____.
restorative needs
191
Doing a poor job of occlusal equilibration is far worse than leaving the mal occlusion. It may produce new ____ that the patient must learn to cope with.
interferences
192
Mutually Protected Occlusion:In maximal intercuspal position, ____ teeth come into contact and act as stops to minimize ____ on ____ teeth.
- posterior- horizontal load- anterior
193
Mutually Protected Occlusion:____ teeth guide excursive movements of the mandible so that no ____ teeth toot contact occurs during ____ or ____ excursions.
- anterior- posterior- lateral- protrusive
194
In natural dentitions, disclusion of ____ during excursive movements is the rule rather than the exception.
posterior teeth
195
Posterior tooth contacts that disclude the anterior teeth during lateral excursive movements are generally considered potentially harmful. Such ____ can alter ____ during lateral movements, as well as create ____, ____, and increase the likelihood of ____ and ____. In addition, this may result in unfavorable ____. Therefore, equilibration of the interfering occlusal surfaces is generally recommended.
Posterior tooth contacts that disclude the anterior teeth during lateral excursive movements are generally considered potentially harmful. Such INTERFERENCES can alter MUSCULAR PATTERNS during lateral movements, as well as create PRIMARY OCCLUSAL TRAUMA, FREMITUS, and increase the likelihood of TOOTH FRACTURE and DEVELOPMENT OF WEAR FACETS. In addition, this may result in unfavorable LOADING OF THE TMJ Therefore, equilibration of the interfering occlusal surfaces is generally recommended.
196
What are the 4 occlusal treatment goals?
1. to direct occlusal forces along the long axes of the teeth (stable posterior contacts)2. in maximal intercuspal position (MI), all mandibular teeth should contact their maxillary opponents at the same time and with the same intensity (centric occlusion (CO) should be coincident with MI)3. to furnish a smooth protrusive path guided by the anterior teeth without any interference from occlusal contacts between the posterior teeth4. working side contacts, whether canine-protected or group function, should not be prevented from contacting by non-working side interferences
197
According to DeVan in 1952, what is the goal of prosthodontic treatment?
to preserve what remains (ex. support remaining teeth and provide a substitute for missing teeth)
198
Esthetic composition is comprised of a relationship between what 3 elements?
- dental composition (teeth)- dentofacial composition (lower third of face - teeth, lips, etc.)- facial composition (whole face)*want everything to match
199
Esthetic harmony depends on equilibrium between ____.
distractive elementsex. teeth may look beautiful but if perio is bad, that is distracting
200
What are the 4 vertical reference lines?
- bridge of the nose- philtrum- face midline- dental midline
201
Which is the "golden proportion"?Pythagoras: 1/1.618 = 0.618Plato: 1/1.733 = 0.577
Pythagoras
202
Regularity in the arrangement of teeth, ____ must be introduced in the dentofacial composition to create a positive psychological response.
symmetry
203
Changing line angles changes the way ____ reflects off the tooth so it changes the way the tooth looks.
light
204
What are the 9 components of a smile?
- lip line- smile line- upper lip curvature- buccal corridor- axial alignment and gradation- dominance- embrasures- dental morphology- gingival morphology
205
What is a smile line?
hypothetical curved line drawn along the edges of maxillary anterior teeth that has to coincide or run parallel to the curvature of the lower lip; it is more pronounced in women
206
Is a smile line more pronounced in men or women?
women
207
What is the buccal corridor?
area between the facials of the posterior teeth and the buccal mucosa; appears as a dark triangle when someone smiles
208
What are the 2 rules for central incisor dominance?
- want central incisors to be the biggest teeth you see in the smile- want central incisors to look lighter in color than the rest of the teeth in the smile
209
What are the 3 components of dental morphology?
- contact areas- embrasures- texture
210
What are the 3 components of gingival morphology?
- gingival tissue and racial factor- gingival health and contour- gingival zenith
211
True or false: The gingival zenith should be a little distal to center.
true
212
What is the definition of diagnostic waxing?
the process of developing intra- and inter-arch relationship to establish crown contours and occlusal schemes for diagnositc purposes
213
What is the purpose of diagnostic waxing?
- enables practitioner to establish the optimum contour and occlusion of eventual prosthesis- helps to explain the intended procedure to the patient- important tooth for construction of provisional restorations (can pour up stone of impression of wax and make vacuform matrix)
214
What is the definition of emergence profile?
imaginary line starting from the depth of the gingival sulcus to the height of contour of the tooth
215
What is the shape of the emergence profile of natural teeth?
straight emergence profile in the gingival third
216
True or false: The fact that an implant fixture integrates in the bone ensures a prosthetic success.
FALSE. It is also necessary that the soft tissue is in harmony with the implant and adjacent teeth.
217
What are the best surfaces for soft tissue to heal on?
glazed porcelain and polished gold
218
What are the 2 goals of occlusal equilibration?
- improve functional and esthetic relationships between maxillary and mandibular teeth- to eliminate TMD
219
When is permanent occlusal therapy indicated?
only when significant evidence exists to support that the occlusal condition is an etiological factor; one should not routinely alter occlusion without such evidence
220
Generally, the best choice for treatment planning for occlusal therapy is to perform the ____ (most/least) amount of dental alterations that will fulfill the treatment goals.
least
221
Rank these treatment plans for occlusal therapy from least to most invasive.fixed prosthodonticsorthodontic therapyselective grindingorthognathic surgery
(least invasive)selective grindingfixed prosthodonticsorthodontic therapyorthognathic surgery(most invasive)
222
What is the rule of thirds for treatment planning for occlusal equilibration?
- if the contact of the cusps is within the 1/3 of the triangular ridge closes to the central groove, selective grinding should be used to improve occlusion- if the contact is in the middle third of the triangular ridge, fixed prosthodontics should be used- if the contact is in the outer third of the triangular ridge, orthodontic treatment should be used
223
What are the 5 factors influencing treatment planning for occlusal equilibration?
- symptoms- condition of the dentition- systemic health- esthetics- finances
224
What is the purpose of selective grinding? When is it appropriate?
- selective grinding is a procedure by which the occlusal surfaces of the teeth are altered to improve the overall contact pattern- appropriate only when alterations of the tooth surfaces are minimal so that all corrections can be made within the enamel structure
225
The shorter the slide, the more likely it is that ____ can be accomplished within the confines of the enamel to correct occlusion.
selective grinding
226
Are vertical or horizontal slides easier to treat?
vertical slides (tall cusps) because they are usually a shorter slide; when the slide has a great horizontal component, it becomes difficult to eliminate within the confines of the enamel
227
True or false: Tooth alignment and the centric relation slide (CO/MI) are more difficult to evaluate on mounted diagnostic casts.
FALSE. they are more easy to evaluate
228
True or false: Selective grinding can be performed on diagnostic casts to visualize the final results.
true
229
If there is a deviation on closing of the mandibular tooth forward, what selective grinding should be done?
MUDLgrind mesial inclines of upper cuspsORdistal inclines of lower cusps
230
If there is a deviation on closing of the mandibular tooth toward the cheek, what selective grinding should be done?
BULLgrind buccal incline of upper cuspORlingual incline of lower cusp
231
If there is a deviation on closing of the mandibular tooth toward the tongue, what selective grinding should be done?
LUBLgrind lingual incline of upper cuspORbuccal incline of lower cusp
232
If there is a deviation on opening of the non-working mandibular tooth from path from centric toward the tongue, what selective grinding should be done?
BULLgrind the buccal incline of upper cuspORlingual incline of lower cusp
233
If there is a deviation on opening of the mandibular tooth of a crossbite with balancing interferences, what selective grinding should be done?
BULLgrind both the buccal incline of the upper and the lingual incline of the lower
234
If there is a deviation on opening of the mandibular tooth on the working-side pathway, what selective grinding should be done?
LUBLgrind lingual incline of upper and buccal incline of lower
235
If there is a deviation on opening of the mandibular tooth during the protrusive pathway, what selective grinding should be done?
DUMLgrind distal of upper most often
236
What are the 2 basic types of TMD?
- myogenous TMD (muscle related)- arthrogenous TMD (joint related)
237
What are the 6 cardinal criteria to be considered when taking a good history for a TMD?
- pain- limitation of function- limitation of movement- physical changes- altered jaw relationships- temporomandibular sounds that have been increasing in intensity and frequency
238
What is the definition of physiologic tolerance?
your body fights back for awhile, like limping after you get a splinter, but you can only limp for so long before your body starts suffering for it
239
What are the 3 groups of etiologic factors for a TMD? Describe each.
- predisposing factors: increase the risk for TMD; ex. systemic, occlusal, loss of posterior teeth- initiating factors: cause TMD; ex. trauma, parafunctional habits- perpetuating factors: enhance progression of TMD; ex. behavioral, social, or emotional stresses
240
What are the 5 factors associated with TMD?
- occlusal condition- trauma- emotional stress- deep pain input ("referred pain")- parafunctional activities
241
____ occurs when the stable MI position of teeth is in harmony with the musculoskeletally stable position of the condyles in their fossae.
orthopedic stability
242
What are the functional activities of the masticatory system?
chewing, eating, swallowing, and speech
243
What are 4 examples of diurnal (daytime) parafunctional activities of the masticatory system?
- clenching and grinding- cheek and tongue biting- finger and thumb sucking- nail biting
244
What is an example of a nocturnal parafunctional activity?
bruxism
245
If ___ create muscle symptoms,, then dentistry should be the main provider of care for many TMDs. However, if ___ are not related to symptoms, the dentist must refrain from providing dental therapies.
occlusal interferences
246
Prosthetic treatment in TMD patients should only be carried out after ____ therapy has resulted in relief of pain and the normalization of function.
reversible therapy
247
What are the 2 types of nonconservative (irreversible) TMD treatments?
- definitive treatment- supportive therapy
248
What is definitive treatment?
intended to directly eliminate or alter the cause of the disorder and its consequences
249
What is supportive therapy? What are the 2 types?
- directed toward altering the patient's symptoms and reducing pain and dysfunction; usually has no effect on the cause of the disorder- pharmocologic therapy- physical therapy
250
What is the definition of an occlusal appliance?
a removable device, usually made of hard acrylic, that fits over the occlusal and incisal surfaces of the teeth of one arch; it creates positive occlusal contact with the teeth in the opposing arch
251
What are the 3 uses of occlusal appliances?
- temporarily provides a more ortho-pedically stable joint position- to introduce an optimum functional occlusion that reorganizes the neruomuscular reflex activity- to protect teeth and supportive structures from abnormal forces that may create breakdown or occlusal wear
252
Research evidence indicates that occlusal appliance therapy is successful in reducing ___-___% of TMD symptoms.
70-90%
253
What are the 2 things occlusal appliance therapy reduces?
- reduce parafunctional muscle activity, hence reduce myogenous pain- reduce the forces placed on the TMJs and other structures within the masticatory system; when these structures are unloaded, the associated symptoms decrease
254
What are the 5 common features to all occlusal appliances?
- temporary alteration of occlusal condition- alteration of the condylar position- increase in the vertical dimension- cognitive awareness- placebo effect
255
What are the 6 types of occlusal appliances?
- stabilization appliance- anterior positioning appliance- anterior bite plane- posterior bite plane- pivoting appliance- soft (resilient) appliance
256
A stabilization appliance is fabricated for the ____ arch and provides an optimum functional occlusion for the patient. When the appliance is in place, the condyles are in the ____ position at the time when the teeth are contacting evenly and simultaneously.
- maxillary- their most musculoskeletally stable position
257
The primary treatment goal of a stabilization appliance is ____.
to eliminate any orthopedic instability
