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Prosthesis > Chapter 7: Optimal functional occlusion > Flashcards

Chapter 7: Optimal functional occlusion Flashcards

1
Q

Stomatognathic system dysfunction can be caused by alterations in dental occlusion. True or False

A

True

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2
Q

Maintaining oral health depends on:

A
  • Optimal joint positions
  • Optimal tooth contacts
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3
Q

Posterior teeth contacts:

A
  • Simultaneous and uniform contacts
  • It should lead to axial (vertical loads)
  • Tripod contact: cusp to fossa (pit)
  • There should never be contacts between cusp slopes
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4
Q

What happens when we have contact between cusp slopes

A

We have prematurities

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5
Q

What happens when we have oblique loads for posterior teeth?

A

It becomes harmful for the periodontium

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6
Q

Anterior teeth contacts:

A
  • Soft contacts
  • Non-axial contacts
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7
Q

What happens to the anterior teeth when we do not have our posterior teeth?

A

We will not have soft contacts in the anterior teeth, so they tend to collapse

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8
Q

Optimal functional contacts in positions and eccentric movements aka anterior guidance:

A
  • Christensen’s phenomenon
  • Protrusion: 4 incisors
    Adequate overbite: incisors 2-3 mm, canines 3-4 mm
    Slight overjet
  • Laterality: canine guidance
  • No axial loads
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9
Q

Why do canines support non-axial loads better?

A
  • Because they are far from the TMJ
  • They have a bigger capacity of proprioception
  • They have longer roots
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10
Q

Functions of the anterior guidance

A
  • They allow posterior disocclusion
  • They direct the mandibular dynamics
  • Masticatory, phonetics, aesthetics
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11
Q

Optimal anterior guidance in laterality and protrusion:

A

Canine guidance:
- Conditioned by the overbite
- Posterior: NWS: 1mm, WS: 0.5mm

Incisal guidance:
- Conditioned by the overjet and the overbite
- 1mm in posterior

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12
Q

The types of undesirable contacts:

A
  • Prematurities in opening and closing
  • Interferences in eccentric movements like protrusion and laterality
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13
Q

What are prematurities?

A

They are contacts between cusp slopes (shift): between the mesial of the upper cusp and the distal of the lower cusp

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14
Q

Prematurities cause a delay of CR and MI coinciding. True or False

A

True

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15
Q

What do prematurities lead to?

A
  • Wear facets
  • Bone resorption
  • External pterygoid pain on palpation
  • TMJ click
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16
Q

Protrusion desirable contacts:

A
  • Incisal guidance: mandibular movement forward from MI to edge to edge
  • Contacts in anterior teeth:
    a. Upper incisors: palatal surface
    b. Lower incisors: vestibular surface
  • No posterior contacts
17
Q

Absence of incisal guidance in protrusion causes:

A
  • Excessive overjet and a slight overbite
  • Anterior open bite
  • Class III of angle
  • Extruded upper posterior teeth
  • Posterior teeth mal position
18
Q

Where do undesirable contacts (interferences) in protrusion occur?

A

Between the upper distal ridges against the lower mesial ridges

19
Q

What do interferences in protrusion cause?

A
  • Wear facets
  • Bone resorption
  • Temporal or pterygoid pain
20
Q

Desirable contacts in laterlity:

A
  • Canine guidance
  • Canine overbite of 3-4 mm
  • Minimal overjet
  • No posterior contacts –> escape grooves
21
Q

Interferences in Laterality:

A
  1. On the working side:
    - Contacts between homonyms cusps (same side cusps)
    - Group function: they are not considered real interferences unless they generate a pathology (if it is the lingual cusp of premolar that is in contact, we have an interference)
  2. On the non-working side:
    - Mandibular posterior teeth on NWS move mesially on the maxillary teeth
    - They appear between internal slopes of active cusps
22
Q

When do we have interferences in laterality?

A

When the canine does not work properly and therefore we do not have a good canine guidance

23
Q

Consequences of interferences in laterality on WS:

A
  • Wear facets
  • Cervical erosion
  • Gingival recession
  • Myalgia of the elevator muscles
24
Q

Is it okay if a molar promotes posterior disocclusion?

A

No, if we let molars promote posterior disocclusion, we are promoting oblique forces

25
Q

What is the most pathogenic interference?

A

The contact with the internal slopes of active cusps

26
Q

Consequences of interferences in laterality on NWS:

A
  • Wear facets in cusp slopes
  • Cervical erosions in the lower buccal area
  • Gingival recession in the lower buccal area
  • Gingival recession in the upper palatal area
  • External pterygoid myalgia
  • TMJ pain and click
  • Deviation of the mandible in the opening towards the affected side
27
Q

Prematurities during retrusion:

A
  • Prematurities occur in MIOP or LIOP patients from MI to CR with a retrusion motion
  • They occur between the upper mesial ridge and the lower distal ridge
28
Q

What do prematurities in retrusion lead to?

A

Vertical bone loss

29
Q

What are the 3 types of occlusion?

A
  • Balanced occlusion
  • Mutually protected occlusion
  • Group function
30
Q

What is a balanced occlusion?

A
  • When we have contacts in all teeth in MI during all eccentric movements
  • Lateral forces are shared by all teeth and the TMJ
  • Maximum contact of cusps in all movements
31
Q

When is balanced occlusion desirable?

A

In full dentures, we need as much contact as possible to be able to stabilise the denture

32
Q

What is the mutually protected occlusion?

A
  • When the posterior teeth protect the anterior teeth and vice versa
  • THIOP
  • Mollar support occlusal loads
  • Protrusion: incisors
  • Laterality: canines
  • Fixed prosthesis
  • Organic occlusion:
    a. CR = MI
    b. Posterior contact is cusp to fossa
    c. Tripod contacts
    d. Protrusion: 4 maxillary incisors
    e. Laterality: upper palatal to lower distal slope
33
Q

Mutually protected occlusion is the _______ of balanced occlusion

A

Opposite

34
Q

What is group function occlusion?

A
  • When in laterality the rest of the teeth help the canines (on WS)
  • Internal slopes of the upper buccal cusp with external slopes of lower buccal cusps
  • If there is a single contact on the back molars –> interference
  • Lower lingual cusp with upper palatal cusp (same side cusps) –> interference
35
Q

We can sometimes find the mutually protected occlusion in removable partial dentures. True or False

A

False. We can find the group function in the removable partial dentures

36
Q

What is the difference between the mutually protected occlusion and the group function?

A

In the group function occlusion, the premolars are helping the canines

Prosthesis (9 decks)

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