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Articulators and Splints Flashcards

0
Q

What are the four types?

A

Simple hinge
Average value
Semi adjustable
Fully adjustable

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1
Q

What is an articulator?

A

A mechanical hinge like device which stimulates movements of the mandible
Replication of the paths of movements of the TMJ

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2
Q

What is the simple hinge type of articulator?

A

Most basic type
Arbitrary arc of closure
Produces an even occlusal contact in a static position only
Cannot simulate excursions

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3
Q

What is the simple hinge articulator based upon?

A

Bonwills 4” equilateral triangle

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4
Q

What is an example of the average value articulator a?

A

Ash free plane 75 and dentatus ARS

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5
Q

What are the values for the average value?

A

Incisor : 10: horizontal plane
Condylance angle: 30: horizontal plane
Bennetts angle: 15: Sagittaal

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6
Q

What are the semi adjustable articulators?

A

Dentatus ARH non archon and Denark Mark 2 arcon

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7
Q

What are the angles measures in the semi adjustable?

A

Incisor: adjustable : horizontal
Condyla: set to patients protrusion wafer: Frankfort plane
Bennett: set to oateint later : Sagittaal

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8
Q

What is the fully adjustable type of articulator?

A

Denark D5A

Incisor: adjustable
Condylar: set to pantographs 
Bennett: pantographs 
Inter condylar distance: adjustable width
Pantographs: recordings transferable
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9
Q

What is the condylar guidance angle?

A

The angle created when the condylar path is compared to the Frankfort plane which is usually set at 30dgrees

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10
Q

What is the incisal guidance angle?

A

The angle formed with the horizontal plane by the line between the incisal edges of the maxillary and mandibular central incisors when the teeth are ICP set at 10 degrees

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11
Q

What is the Bennett angle?

A

This is the angle between the Sagittal plane and the path of the advancing condyle during lateral mandibular event as viewed along the horizontal plane

15degreees

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12
Q

What is arcon?

A

The condylar element on the lower member

Better for crown and bridge

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13
Q

What is non arcon?

A

The condylar element is on the upper member

More beneficial for denture construction

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14
Q

What are the advantages of Articulators?

A

Occlusal movements can be reproduced outside the mouth
Occlusal surfaces can be constructed out the mouth
Occlusion can be viewed from lingual aspects
Time saving
Convenient for patient

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15
Q

What are the uses of articulators?

A 
Diagnosis
Treatment planning
Multiple crowns and bridge 
Reorganising the occlusion 
Occlusal splints eg Michigan
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16
Q

What can hand held casts do?

A

They can reproduce ICP
All excursions are governed by the teeth with no include of TMJ
But not accurate enough for multiple restorations

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17
Q

When are simple hinges useful?

A

For single crown but not popular

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18
Q

When are average values used?

A

In denture construction

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19
Q

T/F the semi adjustable articulators provide a better approximation to the retruded position

A

T

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20
Q

What articulator is used for fixed prosthesis ?

A

Semi adjustable articulators

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21
Q

When would you use ICP?

A

When only restoring a small segment of the arch and enough inter occlusal stops

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22
Q

When would you use RCP?

A

When having to restore larger parts of the occlusion

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23
Q

What is a Facebow? And when is it indicated?

A

An instrument used to record the relation of the maxilla to the hinge axis of the rotation of the mandible

Multiple crowns
Bridgework
Occasionally dentures
Reorganising occlusion

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24
What do you use to set the condylar guidance angle on a semi adjustable articulator?
Inter occlusal Wafers
25
How thick are the wafers used to record the condylar guidance angle?
3-5mm thick
26
What happens with the wafers for the arcon vs non arcon?
When the wafer is removed and articulator is closed, the arcon articulator condylar guidance angle remains the same but non arcon the angle changes
27
T/F the fult adjustable articulators can reproduce a full range of movements?
T
28
What are used to record the mandibular borders in fully adjustable?
Pantographs paper or digital
29
What are thr two types of facebows?
Kinematic/hinge axis | Average
30
What are kinematic hinge axis facebows?
Facebow is attached to the mandible which is moved through the translational retruded arc Ends of the bow have stylinwhich sit over the condylar head areas Need a second now to record this transfer to the articulator
31
T/F the average axis Facebow is more commonly used?
T | Too time consuming for kinematic
32
What do the average facebows use for landmarks?
3 points | Anterior and posterior landmarks
33
How do you use the denar face bow?
1. Mark 43mm dot from the incisal edge of upper right lateral 2. Place hydro bite on to bite fork 3. Centre bite fork in mouth and pt then bites 4. Place the ear plugs into EAM and slide the the reference pin to number 2 5. Then tighten screw 5.
34
What are Occlusal splints ?
Rigid or flexible appliances that overlay the occlusal surfaces of the teeth
35
When are splints used?
Tooth surface loss - diagnosis - prevention - mangement Bruxism -control the noise but not a treatment TMD -not to be used for long term c
36
What are the functions of splints?
``` Alter occlusal forces Prevent wear and mobility of teeth Reduce bruxism and Parafunction Treat masticatory muscle pain and dysfunction Alter thr structural relationship of TMJ ```
37
What are the theories to how a splint works?
``` Clarke 1984 OMRTC -occlusal disengagement -maxilliomandibular realignment -restore vertical dimension -TMJ repositions -cognitive awareness ```
38
WHat is the occlusal disengagement theory?
Provide an ideal occlusion to reduce abnormal muscle activity
39
What is the maxilliomandibular realignments theory?
Assumes that ore existing mandibular positions were incorrect
40
What is the aim of the maxilla mandibular relaignemnt ?
Produce Neuronmuscular balance
41
What is the restored vertical dimension theory?
-Assumes patient has lost vertical height leading to abnormal muscle activity
42
What happens to the muscles in the restored vertical dimension theory?
Restored to correct length
43
What is the TMJ repositions theory?
Assumes condylar had needs to be repositioned in glenoid fossa
44
What adjunct is needed for the TMJ repositioning theory?
Need Radiograph to diagnose it
45
What is the cognitive awareness theory?
Having something in you mouth alters behaviour PLACEBO
46
Which type of splint mechanism can be applied to all?
Cognitive awareness
47
What are the three groups of splints?
Relaxation Repositions Stabilisation
48
What are the types of relaxation splints?
Soft splint/POC Localised interference splint Anterior bite plane
49
Which type of splint is rarely used now?
Repositioning
50
What are Types of the stabilisation splint?
Michigan/stabilisation | Thermoform
51
What is the soft splint/POC made from?
Polyethene Polyvinyl VAccum formed
52
T/F there is no attempt to balance occlusion in the soft splint/POC ?
T
53
What can the soft splint/POC be used for and why?
First line splint and diagnostic aid in bruxism Cheap and quick and easy Simple alginate impression and no jaw reg needed
54
When are soft splint/POC usually worn?
At night
55
Which arch are soft splint/POC usually made?
Lower | But can be for either
56
What can happen in some peopl with soft splint/POC ?
May increase Parafunction so monitor
57
T/F soft splint/POC can be used over ful denture to increase face height?
T
58
What are LOIsplints used for?
Deliberately over load the proprioception fibres of four teeth and this provide neuromuscular feedback May also remove posterior interferences as anterior teeth are separated
59
How do you make a LOIS?
Upper and lower alginate Centric occlusion wax Upper heat cured acyclic plate retained with Adams clasp or ball end clasp and then to occlusal ball end clasps on canine or premolar to interfere with Occluding
60
When would you use a LOIS?
Patient who bruxism or clench Habit breakers Short periods only
61
What is another name for ther anterior bite plane?
Lucia Jig | De programmer
62
What type of splint is the anterior bite plane, full or patprtial coverage?
Partial | Occlusal disengagement
63
T/F can make an anterior bite plane at chair side?
T can use autopolymersising acrylic
64
When are anterior bite planes used?
Acute muscle spasms SHORT TERM
65
When shoud the anterior bite plane be used?
Not at night!!!!
66
How does the anterior reposition splint work?
Provides mandible
67
How do you make an anterior repositions splint?
Upper and lower alginate Patient open wide until click heard and then into protrusion no click heard When In this protuding position no opening or closing clicks should be heard, at this point, record wax
68
When are anterior repositions splints used?
Patients that have internal dereangemtn
69
When should you not use an anterior reposition splint?
If the click does not disappear on protrusion
70
When shoud anterior repositions splints be worn?
Everyday All day Including eating
71
What should you advise with ant reporting splint?
Soft diet and review monthly
72
How long does it take for patient to become symptom free with anterior reposition splint?
6-12 weeks Weaned off slowly
73
What is another name for a stabilisation splint?
Tanner Michigan Fox appliance Centric relation appliance
74
What does the stabilisation splint provide?
Ideal occlusion Anterior guidance which is free from posterior interference RCP equals ICP
75
Which arch is the stabilisation splint made on?
The one with the most missing teeth RECORD RJR/CR
76
How does the stabilisation splint retain itself?
Friction fit but can also be ball ended clasp
77
What should the stabilisation splint allow in centric occlusion?
Even contact with oppsing teeth | posterior balanced occlusion
78
What is the stabilisation splint useful for?
Determine the positi of centric relation in those that have deranged occluso
79
When should the stabilisation splint be made?
Night time Review monthly Weaned off
80
What are thermoformed splints?
Half way version between soft and hard splint Made in hard polymer or laminate version
81
What are the determinant of occlusion?
Teeth Left and right TMJ Neuromuscular system
82
What is occlusion?
Any contact between opposing arches | It is static
83
What is another term for ICp?
Centric occlusion | Maximim intercuspation
84
What is ICP?
Position of the mandible when there is maximum intercuspation of oppsing teeth and fossa Purely tooth related Held on average for 17mins per day
85
What is another term for RCP?
Centric relation | Ligamentous position
86
What is RCP?
Position of the mandibl when tooth contact first occurs on retruded arc of closure
87
Where are the heads of the condyle in RCP?
Medically braced Upper most Unstrained
88
Where does RCP lie relative to ICP?
RCP is 1-1.5mm posterior to ICP
89
What is the working side?
Side to which mandibular movement is directed
90
What is non working side?
Side away from a mandible movement
91
The working side is also the ?
Bennett movement
92
What is anterior guidance ?
Path of guidance provided by the Palatal surfaces of the most anterior functional upper teeth during protrusion of mandible
93
What is canine guidance?
Path of guidance provided by Palatal surface of thr maxillary canoe teeth during lateral movement of mandible
94
What is disclusion?
Separation of anterior and posterior teeth during canine guidance Separation of posterior teeth during anterior guidance
95
What is group function?
Articulation between posterior teeth On working side during lateral movement of the mandible
96
What is long centric?
Is a patient lacks anterior tooth contact in ICP they must protrude or move laterally before guidance teeth touch If front teeth hit together as hard or harder than posterior teeth then there is no freedom in centric
97
Which patient have long centric?
Class 2/2 and crowns that are toot thick on plagal surfaces
98
What is an occlusal interference ?
Undesirable occlusal contact that May produce deviation of the mandible to and from ICP
99
What are centric interferences?
Premature contact that occurs when the mandible closes with the condyles in their optimum position in the glenoid fossa
100
What are working interferences?
Premature contact between the maxillary and mandibular posterior teeth on the same side of the arch as the direction of movement in lateral excursion
101
What are non working interferences?
Premature contact between the maxillary posterior teeth on the opposite side of the arches as the direction in which the mandible moves in lateral excursion
102
What are protrusive interferences?
Premature contact between the mesial aspects of mandibular pst teeth and distal aspect of maxillary teeth during protrusion
103
What is the optimum occlusion?
Condyles in Unstrained position in ICP Molars in heavy contact in ICP Anterior teeth in lighter contact in ICP Occlusal forces dericted along long axis of teeth In lateral movement working side guidance and no non working side interferences In protrude movements anterior guidance and posterior disclusio
104
WHat is the confimratife approach?
Accepts ICP
105
What is the reorganised approach?
Makes ICP and RCP co incident
106
What are the features of a Michigan splint?
RCP equals ICP Posterior disclusion Canine protection No non working side contacts

Restorative (45 decks)

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