the potential space between the lips and cheeks on one side and the tongue on the other forces come together - where we put the teeth to remain in equilibrium no equilibrium if push too far buccal/lingual

VDO Flashcards by Abigail Cook

intermaxillary records are what number visit?

Third patient visit

5th overall step
lab portions between visits

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what do we have at the intermaxillary record phase - sequence of this step

occlusion rims – adjusted in mouth THEN facebow registration and centric relation record and then mounted on articulator

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inter-ridge space

when natural teeth are in occlusion, ridge crests are approximately a minimum of 12 mm apart in the anterior

posterior? 1-2mm

or height of tongue blade in anterior and width of it in posterior

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Freeway space

Inter-occlusal distance

between the teeth when the mandible is at rest (VDR)

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when does VDR and VDO occur?

VDR- after swallow – like saying EMMA - after saying the word emma - after say this word the space is the freeway space

VDO - during /end of swallow

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movement from VDR to VDO

2-3 mm change when mandible moves up to go to VDO traveling 2-3 mm

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freeway space?

increases with age?

average is approx 2-3 mm

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closest speaking space

smaller than freeway space

.5-1mm at max

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neutral zone

the potential space between the lips and cheeks on one side and the tongue on the other

forces come together

where we put the teeth to remain in equilibrium

no equilibrium if push too far buccal/lingual

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space of donders

space between palate and tongue in VDR - during rest

can be altered with VDO (increase VDO - increase this) and vise versa

can be altered independent of VDO if palate is too thick - can decrease this space

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what do occlusal rims mimic?

temporarily the placement of teeth in the oral cavity for the purpose of making maxilla-mandibular relation records and arranging teeth

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most clinically dense informational visit we have?

Intermaxillary Records

- adjust occlusion rim -VDO

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sequence of intermaxillary records

occlusal plane
vertical dimension of occlusion
facebow registration
centric relation registration
tooth selection

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beginnings of occlusal plane - what do you know

2/3 height of retro pad we have marked so know the height of this in that area

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where do we start

maxillary centrals

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where do we begin when adjusting for VDO

start with the upper rim

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flare in occlusal rims is there for what?

there is a concavity in the lips and accounts for this

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if set rim too far forward?

lips out too far forward

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Fricative sounds? what contacts at these sounds? what does it indicate?

Vermillion border contact @ F
F or V sound “55” which determine teh position of incisal edges of central incisors
where lip makes sound against teeth – hits at or near the wet-dry line

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how much tooth visible at rest?

about 1-2 mm of teeth visible @ rest

lips slightly parted

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full smile? what is revealed? where does lip end up?

maximum visibility and tooth length (CEJ)

free gingival margin - little above CEJ or the gingival zenith

have to record high smile line on rim

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acute naso-labial angle?

can see that the pt. is now wearing denture vs. when not - it is more 90 degrees or less acute because the teeth support the lips

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what do the teeth do?

support the lip – there is an acute naso-labial angle
thicker vermillion border (w/out teeth this flattens and rolls inward)
esthetics

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high smile line is where?

at the CEJ of the centrals

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adjust area A with patient to when at rest?

so can see 1-2 mm of the rim

midline comes from?

face

two occlusal planes

lateral - horizontal | and anterio-posterior

lateral plane is parallel?

ALWAYS parallel to the inter-pupillary line

antero-posterior plane is initially parallel to? then modified?

parallel to the ala-tragus line first | then modified upward as needed during rim try in -- adjustments made to area D

area on rims that gets most adjustment?

fox occlusal plane

permits viewing of both planes on Maxilla simultaneously

what determines if you need to make adjustments to area A?

Phonetics with the fricative sounds - F and V indicates the position of incisal edges of the central incisors if too long - interferences if too short-- patient will just be blowing air - will not find their teeth

Area A adjusted for?

1. phonetics 2. esthetics once complete DON NOT TOUCH

after area A adjusted?

Go to the lower (leave area D alone for now)

what if lip has too much support?

if teeth too far forward - more support and see more tooth than want

adjustments to area B?

should be to lip length so B is AT HEIGHT OF LIP and approx. parallel to the dorsum of tongue

Area C measurment?

1/2 or 2/3 height of retromolar pad

flate plane tooth?

dont have to worry about curves - so starts and ends at 2/3 height retromolar pad

what is area D based upon after adjustments to other areas have been made?

initially - siblant sounds siblant sounds -- so adjustments made last

how to change area D?

1. lubricate lower rim 2. remove upper and warm area 3. reset and close until A contacts B

distance between U/L arches

VDO

vertical dimension of occlusion | - during occlusal contact

VDR

vertical dimension of rest | -during muscular rest

what hold VDO?

Posterior teeth

how to measure distance from VDR to VDO?

using tongue blade and dots placed on nose and chin, the distance traveled from VDR and VDO can be measured because mandible moves upward from VDR to VDO

freeway space anterior posterior ratio? | what happens with age?

3:1 increases with age - but averages 2-3 mm

therapeutic VDO?

we establish this for the patient with almost 2-3 mm of inter-occlusal rest distance

minimum distance for freeway space of interocclusal distance

2-3 mm

do teeth touch in closest speaking space?

Closest speaking space

is the small space between the occlusal surfaces during sibilant sounds *about .5-1 mm tiny space left after saying words like "66" mississippi church judge

is clicking of teeth ever normal?

NO - no clicking is not normal when VDO is correct - even if patient has porcelain teeth

examples of silibant sounds

``` 66 mississippi church massachusettes sandwhich "j" jelly judge ```

S sounds determine

Incisor position premolar position - lateral border of tongue hits here VDO

sibilant sound on pre-molar area?

S sounds if too constricted - whistle too wide - like sh

space of dondors implication which is independent of VDO

if palate is TOO THICK - it will decrease this space and the patient will have difficulty swallowing

effect on space of dondors if increase or decrease VDO

increase VDO - increase space decrease VDO - decrease space

commercial guidelines on max and mandibular

``` max = 22mm mand = 18 mm ```

anterior-posterior guidelines for anterior teeth position

1. lip support 2. naso-labial fold 3. vermillion border of the lip 4. Fricatives

inciso-gingival guidelines for anterior teeth position

1. rest position (reveal) 2. high smile line 3. fricatives 4. sibilants

incisal-occlusal plane orientation guidelines for determining teeth position

1. 1/2-2/3 RMP | 2. Inter-pupillary line

Areas (A,B,C,D) | which are adjusted for VDO which are not?

A- not adjusted for VDO C- not adjusted for VDO B and D can adjust for the right VDO - both contributing to "S" sound

occlusal plane is determined by?

A and C | need an anterior and posterior component

area A =

esthetics and phonetics

area C=

anatomy of retromolar pad

VDO is altered by? | determined by?

altering areas B and D B sibilants with A D sibilants with C determined by 'A' + B' and 'C+D'

VDR - VDO is about what?

3mm

what to do if rims are not flush? what results? | getting VDO by changing plane

D is changed by taking just a WEDGE AWAY | - this raises the plane from the ala-tragus line

Changing plane but NOT VDO | want to go from 2/3 to 1/2

changing C so you move from monoplane to curved | curved = 1/2 pad

changing VDO and Occlusal Plane describe what is done to A, B, C, D how?

``` A= NOT adjusted anteriorly B= totally adjustable C= NOT adjustable posteriorly D totally adjustable ``` VDO AND PLANE ARE CHANGED BY TAPERING THE RIMS (adding or removing a WEDGE of wax)

does changing the VDO always change the plane?

YES

does changing the plane always change the VDO?

NO | - may just need to change plane to go from 2/3 to 1/2 for monoplane vs curved dentition

plane of occlusion =

A + C

Vertical Dimension of Occlusion =

A+B and C+D

To change VDO, change

B+D

VDR-FWS =

VDO

which is posturial position?

VDR

when are ridges parallel to each other?

when in VDO

which is better or worse? insufficient? Excessive?

Excessive = INCREASE RIDGE RESORPTION Insufficient may not be pretty - results in angular chelitis, possible muscle tone loss and hearing problems, esthetic problmes but excessive causes BONE LOSS and painful problems

how do you change the occlusal plane without changing VDO?

make adjustments to area C to either 1/2 or 2/3 2/3 = flat plane 1/2 = curved plane

can you change VDO without changing the occlusal plane?

NO changing the VDO will always change the plane see this with situations where D needs to be trimmed so we get flush also see this with making adjustments to area B and D bringing B up or D down by wedges of wax

after rims are flush sequence of events to get flush AND VDO?

1. adjust B and D for VDR and FWS 2. adjust B and D for VDO 3. Adjust B and D for Sibilants now flush and at VDO