Denture Napoleon Dynamite Part II Flashcards
Premature, deflective contacts between artificial teeth cause what?
Movement of the teeth
What 2 types of guidance are definitely NOT part of a denture?
Anterior
Canine
Instead of Anterior or Canine guidance, what are we looking for in a denture?
Balanced Occlusion
Balance Occlusion is both _______ (side to side) and ________
Excursive
Protrusive
T/F
A goal of complete denture occlusion is to limit trauma to the supporting structures
True
Bilateral Balanced Denture Occlusion: simultaneous contact of upper/lower teeth in _____
*smooth bilateral gliding to ANY eccentric position w/in…
developed to lessen/limit tipping or ______ or denture bases in relation to supporting structures
Centric Relation
normal range Mn function
rotation
3 functions of Record Bases:
Support Wax Rim
Facilitate Mx/Mn relation records
Provide a BASE for Try-In
Mx occlusal Wax Rim ___mm
Mn occlusal Wax Rim ___mm
22mm
15-18mm
How much tooth should be showing on the Maxillary try-in?
1-2 mm
*protruding below lip
2 Planes that must be lined up to the Occlusal Plane:
Inter-Pupillary Line
Camper’s Line
The Camper’s Line, aka…
Ala-Tragus line
Once the Wax Rims are in, what 3 markings need to be made on it?
Smile Line
Midline
Canine Line
Measure the distance between the canines to determine what?
The size of the teeth
In order to establish a balanced occlusion we must transfer Mx/Mn relationship to the _____
Do this using a…
Articulator
Facebow
The facebow orients what 2 features?
Maxilla
Terminal Hinge Axis
T/F
The facebow provides the same relative opening axis on the articulator as the mandible has to the TMJ
True
Blind orientation, Without a Facebow, on articulator may result in what type of error?
Lateral Jaw Movement
Facebow record gives us Mx to Terminal Hinge Axis, and what else?
Mn to TMJ opening axis on articulator
Mn rotates in the Saggital Plane via?
Transverse Horizontal Axis
T/F
The true Hinge Axis is easy to determine
False
*esp in edentulous
Estimated Hinge Axis location:
Must be how close to the actual hinge axis?
What serves as the Arbitrary Location?
Arbitrary hinge axis
6 mm
Ear-bows (Ext. Auditory Meatus)
4 Reasons to Use a Facebow:
Cusped teeth
Balanced Occlusion in eccentric positions
VOD might change
Cusp to Fossa/Cusp to Marginal Ridge
If cusp to fossa or cusp to marginal ridge is required, what to do?
Use Facebow
2 Examples of Arbitrary Facebows:
Denar
Whip Mix
The Denar Slidematic Facebow needs a 3rd point of reference ____mm from the Incisal Edge using a Reference Plane Locator
43 mm
Denar Slidematic Facebow - slide shaft of bitefork through the ___ Clamp
Position the Anterior Pointer to the ___ Point of Reference
2
3rd
Whip Mix Facebow measurements: ___ mm higher/lower than Ext. Auditory Meatus
Naison rest ____mm above main bow
___ in the anterior
2 mm
22 mm
24 mm
Prior to mounting the Cast on the Articulator, the centric latch must be ______ and the Bennet side-shift set at ______
locked
zero
VDR
Vertical Dimension of Rest
*aka Physiologic rest position
How do we get patients in VDR?
m m m
emma emma emma
VDO
Vertical Dimension of Occlusion
VDR VDO difference =
Freeway Space
The Freeway space, aka…
Interocclusal Rest Space
The distance between the occluding surfaces of the Mx and Mn teeth when the Mn is in its physiologic rest position
Interocclusal Rest Space (Freeway Space)
VDR and VDO points of reference are usually where?
Chin and Nose
Facial measurements, Tactile Sense, Phonetics (emma), and facial expression are all ways to determine Physiologic Rest Position
True
The Free Way Space (interocclusal rest space) is usually what dimension?
2-3mm
VDR - Free Way Space =
VDO
What defines the Closest Speaking Space?
How much space is between the Incisal Edges?
when ‘ss’ words can be pronounced
*incisal edges 1-2 mm apart
Inadequate Interocclusal Rest Space:
excessive matl on Mn
*you need more rest space, take matl off Mn
Clicking teeth, facial distortion (tense/strained), difficulty closing lips, difficulty Swallowing, soreness under denture, increased ridge resorption
Inadequate Interocclusal Rest Space
*Excessive VDO
Reduced interarch distance, Potential damage to TMJ, Tongue space limited, Facial Distortion, Muscles lose tonicity, Angular Chelitis:
Excessive Interocclusal Rest Space
*Inadequate VDO
If Excessive Interocclusal Rest Space,
add more to the Mn
VDR is a ______
CR is a _____
measurement
relationship
Centric Relation is Mx/Mn relationship in which condyles articulate with the ________ portion of disks in the most _______ position against the slopes of the Articular Eminences
avascular
anterior-superior
Centric Relation is ______ of tooth contact and is a __________ position
Independent
Repeatable
The occlusion of opposing teeth when the mandible is in CR
Centric Occlusion
In a Complete Denture ___ = ____ = _____
CR = CO = MIP
T/F
Centric Relation is a dental/occlusal relationship
False
*position of the Mn only
How do you record CR with proper VDO?
mark wax rims and do a bit reg
Facebow mounts the ___
CR mounts the ____
Mx
Mn
Mx incisors contact the wet-dry line to make what sounds?
F and V
Why is it important to have the front of the Incisors 5-7 mm in Ant to the Incisive Papilla?
Phonetics
*at wet-dry line for F and V sounds
If lips aren’t supported by the teeth, what sounds suffer?
Sound produced by Mx CI interface with wet/dry line:
Sound made by contact btwn tip of tongue and palate at Rugae:
P and B
F and V
S and SH
When mounting teeth in wax, the cervical portion should incline what direction?
Slightly Lingual
When mounting Mx LI in Wax Rim, the long axis is tilted what direction?
The cervical portion is inclined…
Incisal Edge raised ___mm from occlusal rim
Distally
Lingually
1mm
Wax Rim: the cervical 1/3 of the Labial portion of the Canine should incline what direction?
Buccally (for prominence)
Mn Anterior tooth overlap:
*if using anatomic posteriors
1 mm vertical
1 mm horizontal
Use 1 mm vertical and 1 mm horizontal overlap for Mn anteriors only if…
using Anatomic Posteriors
Mn - perpendicular to occlusal plane
slightly inclined distally
slightly distal
Mn centrals
Mn laterals
Mn canines
T/F
Mn centrals, laterals, and canines should all line up with the occlusal plane
True
Anterior teeth Primary selected for…
Posterior teeth Primarily selected for…
Esthetics
Masticatory requirements
T/F
Manufacturers Square, Tapering, and Ovoid molds for teeth are considered antiquated
True
What is the more valid approach for tooth shape (than square, tapering, or ovoid)?
Dentogenics
*esthetics gauged by sex, age, personality
Dentogenics, Young teeth are tapered and _____
Old are _____
Ovoid
Square
The Anterior teeth should be set where?
The Posterior teeth should be set where?
Used to Be
Over the Bone
3 Factors affecting the Size of Ant teeth:
Size of Face
High lip line
Distance between Canines
Distance between the Canines gives us what?
Smile Line gives us what?
Width of 6 anteriors
Height of 6 anteriors
If you don’t have old records, etc, what should be used to determine size of Anterior teeth?
Canine line (width)
Smile Line (height)
3 Factors affecting the Form of the Anterior Teeth:
Contour of Face
Sex
Age
What 4 Factors affect the Arrangement of the Teeth:
Age
Sex
Personality
Artistic considerations
In the Female, the Incisal Edges of the Mx Anteriors follow what?
Distal Mx CI rotated ______
Mesial LI _____ to CI
Distal Canine rotated ______
Lower Lip Curvature
Posterior
Anterior
Posteriorly
Female Canines - can see ____ of the mesial view Labial surface
Male Canines - can see ____ of the mesial view Labial surface
1/3
2/3
Male teeth - Mesial surface of the LI has what relationship to the CI?
Female teeth - Mesial surface of the LI what relationship to the CI?
hidden behind
Anterior
T/F
Tooth color should blend with skin tone, hair color, and Sclera/Eye color
True
What pattern does Alveolar Ridge resorption follow on the Anterior Mx?
Therefore…
Labial to Lingual
Anterior teeth should NOT be placed over the ridge
Lips not supported by teeth, can’t make what sound?
contact btwn Mx incisors and Posterior 1/3 lower lip:
tip tongue to palate/rugae
P and B
F and V
S and Sh
S space too small makes a ______
too large makes a _____
whistle
Sh
If the Mx Tuberosity is large and hanging down, it could create a _______
*requires OS
Reverse Curve
2 things that might cause a Reverse Curve:
Mx tuberosity
Improper Ala-Tragus line
A smile line follows the contour of what?
Lower Lip
3 Tooth materials for Dentures:
Porcelain
Plastic (resin, acrylic resin)
Plastic facing (butted acrylic resin teeth )
3 Advantages for Anterior Porcelains Teeth:
3 Disadvantages:
Wear resistant, Stain resistant, Esthetic
Space, recontour scratch, Breakage
Anterior Porcelain teeth must never oppose ______ teeth
Natural
3 Advantages Anterior Plastic teeth:
2 disadvantages:
Polish/contour, Bond physico-mechanically, easily stained
Excess wear, stains
5 types of Posterior Teeth:
Porcelain
Plastic
Plastic facing
Metal
Metal (cast gold)
3 Advantages for Porcelain Posterior teeth:
3 Disadvantages:
Wear, Stain, Esthetics, Vertical Dimension
Space, Breakage, Opposing Wear
3 Advantages for Plastic Posterior teeth:
2 Disadvantages:
Phyisico-mechanically bonded, stain, esthetics
Wear, staining
Posterior metal denture teeth should be used when opposing ______ to overcome losing vertical dimension
They are ______
Gold
Expensive
T/F
A well developed ridge will be able to Tolerate Anatomical Teeth
True
T/F
A Flat Ridge (not well developed) will do better with Flat/non-anatomical teeth
True
Pts with poor neuromuscular control should have what type of Occlusal Scheme?
Monoplane
*non-anatomical teeth
Chronic bruxers/grinders should have what type of Occlusal Scheme?
Monoplane
*non-anatomical
Skeletal Class II and III relationship requires what Posterior teeth?
Crossbite requires what Posterior Teeth?
Non-anatomic
Non-anatomic
If teeth are Cusp to Fossa and have and Incline, they are…
Anatomic
T/F
It is easier to get a contact with a non-anatomic tooth
True
Non-anatomic (monoplane) reduces _____ forces
CR can be developed as ______
Horizontal
Area (not point)
Anatomic teeth: cusp inclinations cause ______ force
Horizontal
2 Criteria for setting Posterior Teeth:
Esthetic
Functional
If teeth are too wide posteriorly they will give the appearance of what?
too many teeth
T/F
Height of the occlusal plane is determined by: esthetic placement, corners of mouth, dorsum of tongue, retromolar pad (2/3 way up)
True
Central Fossa of Mn denture teeth should be where?
This prevents…
Center of Mn ridge
unfavorable leverages
T/F
Centric relation is equal to Max intercuspation in complete dentures
True
Mx teeth overlap the Mn teeth _____
Long axis of each Mx tooth is ____ to corresponding Mn tooth
Each tooth in both arch are opposed by 2 teeth, with what 2 exceptions?
horizontally
distal
Mn CI, Mx 2M
T/F
Horizontal overlap prevents pts from biting tongue/cheeks
True
Mx Posteriors: MB/ML 1M touch _______
DB cusp raised _____mm
DL cusp raised _____ to ____ mm
MB cusp 2M ____ mm from occlusal Plane
occlusal plane
1/2 mm
1/2 to 3/4
1 mm
Occlusion in which lateral excursions don’t have to be bilaterally occlusive (will cause sore spots and excessive forces on the ridge)
Neutrocentric
What type of Occlusion limits tipping of the dentures during para-functional movements?
Bilateral Balance
T/F
a goal of complete denture occlusion is to reduce lateral forces to the residual ridges
True
The main determinant of denture tooth position:
Anatomy
Stable simultaneous contact of opposing upper/lower teeth in CR with smooth bilateral gliding contact to ANY eccentric position w/ in normal Mn function
*limits tipping/rotation of denture bases
Bilateral Balanced Denture Occlusion
Traditionally bilateral balance could only be achieved with _____ posterior teeth
It can be achieved with Non-Anatomic teeth using ________ or by manipulating the ______ curve
Anatomic
Balancing Ramps, compensating
Bilateral blalanced occlusion with Monoplane can be achieved by using what?
Balancing Ramps
Neutrocentric concept used to be applied to Non-anatomical teeth. Balancing Ramps allow us to have Balanced Occlusion with Non-anatomical teeth
True
All lateral excursions need at least _____ points of contact bilaterally if bilateral balance is to be achieved.
3
T/F
The resistance to forces should be at a right angle to the occlusal surface of a denture
True
The quality of the Support depends on what?
thickness soft tissue over bone
Mx arch Support areas are Crest of Ridge, Hard Palate and for the Mn what are the 2 Primary Support Areas?
Buccal Shelf
Retromolar Pads
*slope of Ridge - not primary
What determines Max Support is attained in the Denture? ?
Proper Final Impression
*to attain Max tissue coverage
Stability is the resitance to ____ forces
Horizontal
4 Factors Affecting the Stability of the Denture:
RR anatomy
Flanges
Post Teeth (teeth set on Center)
Occlusion (balanced)
T/F
Instruct pts not to chew on the Front (premaxilla resorption) and the Chew on Both Sides
True
Denture Retention: Adhesion between _____ molecules
Cohesion between _____ molecules
unlike
like
Hydrostatic pressure due to the weight of the atmosphere on surfaces
Atmospheric Pressure
In order to use Atmospheric Pressure as a retentive force, what must the denture base have?
Peripheral Seal
*prevents air from getting underneath
How do you make Neutrocentric Occlusion balanced?
Balancing Ramps
Anatomic, Semi-anatomic, Lingualized, Non-Anatomics, can all be balanced
True
It is very difficult to create Spee/Wilson with _______
Flat Teeth
Monoplane, aka…
Balanced has…
Neutrocentric
Balancing Ramp
Immediate Denture has what type of teeth
Flat
When using the Neutrocentric Concept, the patient is instructed not to…
Incise the Bolus
How much Vertical Overlap is there with a Neutrocentric concept?
None
Class II (underbite) needs what to compensate for more functional movement?
More overlap
Class III (overbite) needs a lot of horizontal overlap
False
*little movement forward for function
When setting the Posterior Teeth the horizontal and lateral Condylar Guidance should be set at…
The Mn Occlusal Table should end ____ to the Ascending Ramus
Zero
Prior
Which tooth most Posterior (Mx or Mn)?
How far?
Mx 1-2mm distal
*to most Post Mn denture tooth
The Horizontal Overlap of the posterior teeth should be sufficient to prevent what?
Biting cheek/corner of mouth
Steeper the Condylar Inclination the Greater the ______ in excursion
Known as…
Counteracted by…
Posterior discrepancy
Christiansen’s phenomenon
Balancing Ramps
Bilateral balanced occlusion when using Zero Degree cusped teeth is obtained by using…
Balancing Ramps
Inclined plane contact comes from Cuspal Inclines on the Posterior and ______ on the Anterior
Vertical Overlap
2 Benefits of Anatomic Uppers:
Chewing efficiency
Esthetics
Lingual Cusps longer (hanging down more) and the only touching:
Lingualized
Lingualized with Anatomical Teeth can have ______
Lingualized with Flat Lowers needs______
Spee/Wilson
Balancing Ramps
Mx Lingual Cusp to Mn ______
central fossa
Mx Posterior teeth should have Lingual Inclines of Buccal Cusps ___mm away from Mn cusp
1 mm
In Lingualized Balanced occlusion the Mx teeth are ______
There should be no____ cusp contacts of posterior teeth in centric/lateral excursion
Flared out
buccal
Hanau Quint: 5 Factors Affecting Articulation of denture teeth, which are…
(5 factors affecting occlusal balance)
Condylar inclination/guidance
Incisal guidance
Compensating curve (Spee/Wilson)
Cusp angle/height
Plane of occlusion and its orientation
In the Hanau Quint, what is the only factor that can’t be controlled? `
Condylar Inclination
How can you get an Accurate Condylar Inclination?
What is the Avg inclination we use in dentures?
Protrusive check bite-record
30 degrees
Angle formed by drawing a line in the Sagittal Plane between the Incisal Edge of the Mx/Mn teeth when teeth are in CO and the Horizontal Plane
Incisal Guide Angle
Condylar Inclination x Incisal Guidance / Occlusal Plane x Cuspal Inclination x CompCurve
Theilman’s Formula
= C (balance occlusion)
Theilman’s Formula
= C (balanced Occlusion)
Condylar Inclination x Incisal Guidance /
Occlusal Plane x Cuspal Inclination x CompCurve
An increased incisal guidance can be compensated by increasing one of what 3 things?
***or??
OccPlane
Cuspal Inclination
Comp Curve
***or a Balancing Ramp
In Theilman’s Formula, the Occlusal Plane can be altered
False
- *not substantially
- **functional requirements dictate position
Theilman’s Formula (Hanau Quint), what is very helpful in obtaining balanced occlusion (depending on the posterior tooth forms it can easily be corrected to facilitate posterior tooth contacts in eccentric positions)
Compensating Curve
CompCurve
Setting Posterior Teeth - where does Curve of Spee begin?
** 33 degree
DB cusp Mx 1M - 1/2 mm
DL cusp 1/2 to 3/4 mm