Final Exam 1-17 (Anna)

Question 1

SLIDE 1: MAXIMUM INTERCUSPATION (Facial Perspective)

From a FORCE perspective, what is considered ideal?

• • There must be an _________________ (adequate or maximum protrusive) overlap of the maxillary over the mandibular teeth
• • Occlusal forces should be exerted down the long axis of the ______________ (posterior or anterior) teeth
• • There must be ___________ (simultaneous or nonsimultaneous) contact of all the maxillary and mandibular teeth.

Answer 1

From a FORCE perspective, what is considered ideal?

• • There must be an ADEQUATE overlap of the maxillary over the mandibular teeth
• • Occlusal forces should be exerted down the long axis of the POSTERIOR teeth
• • There must be SIMULTANEOUS contact of all the maxillary and mandibular teeth.

Question 2

SLIDE 1: MAXIMUM INTERCUSPATION (Facial Perspective)

There must be SIMULTANEOUS contact of all the maxillary and mandibular teeth:

• • _________ (Posterior or anterior) tooth occlusal contacts should DOMINATE over the __________ ( posterior or anterior) teeth.
• • Anterior teeth should display ______________ (“ passive” or “active”) occlusal contact, or __________ (minimal or multiple) occlusal contact with each other.
• • There should be __________ (multiple or minimal) occlusal contacts on all teeth that ADEQUATELY DISTRIBUTES FORCES.

Answer 2

There must be SIMULTANEOUS contact of all the maxillary and mandibular teeth:
– POSTERIOR tooth occlusal contacts should DOMINATE over the ANTERIOR teeth. (passive and heavier posterior tooth contact)

• • Anterior teeth should display PASSIVE occlusal contact, or MINIMAL occlusal contact with each other.
• • There should be MULTIPLE occlusal contacts on all teeth that ADEQUATELY DISTRIBUTES FORCES.

Question 3

SLIDE 2: TERMS DESCRIBING MANDIBULAR POSITION

CENTRIC RELATION:
Why is a superior and anterior position of the condyle important?
1) It is the MOST kind of what position?
2) Which muscles drive the process (centric relation)?
3) A proper ANATOMICAL position of the condyle is required to maintain _________________ (minimal contracture or maximal relaxation) of all muscles attached to the craniomandibular apparatus.

Answer 3

1. It is the MOST OPTIMUM MECHANICAL position.
2. The MUSCLES of MASTICATION drives the process.
3. A proper ANATOMICAL position of the condyle is required to maintain MINIMAL CONTRACTURE of all muscles attached to the CRANIOMANDIBULAR apparactus.

NOTE: Can’t get centric relation via force –> must be released.

Question 4

SLIDE 2: MAXIMUM INTERCUSPATION (Facial Perspective)

There must be SIMULTANEOUS contact of all the maxillary and mandibular teeth:

• • _________ (Posterior or anterior) tooth occlusal contacts should DOMINATE over the __________ ( posterior or anterior) teeth.
• • Anterior teeth should display ______________ (“ passive” or “active”) occlusal contact, or __________ (minimal or multiple) occlusal contact with each other.
• • There should be __________ (multiple or minimal) occlusal contacts on all teeth that ADEQUATELY DISTRIBUTES FORCES.

Answer 4

There must be SIMULTANEOUS contact of all the maxillary and mandibular teeth:
– POSTERIOR tooth occlusal contacts should DOMINATE over the ANTERIOR teeth. (passive and heavier posterior tooth contact)

• • Anterior teeth should display PASSIVE occlusal contact, or MINIMAL occlusal contact with each other.
• • There should be MULTIPLE occlusal contacts on all teeth that ADEQUATELY DISTRIBUTES FORCES.

Question 5

SLIDE 4: TERMS OF DESCRIBING MOVEMENTS OF THE MANDIBLE
(Question will be: Which of the following is essentially the correct term describing various movements of the mandible)

1) What is ECCENTRIC movement?

Answer 5

1) Movement AWAY from a CENTRALLY LOCATED position (centric relation or maximum intercuspation)

Question 6

SLIDE 4: TERMS OF DESCRIBING MOVEMENTS OF THE MANDIBLE
(Question will be: Which of the following is essentially the correct term describing various movements of the mandible)

2) What is protrusive movement
3) What is retrusive movement?
4) What is lateral movement?

Answer 6

2) Protrusive: ANTERIOR movement of the mandible
3) Retrusive: POSTERIOR movement of the mandible (moving back into the fossa)
4) Lateral: Movement to the RIGHT or to the LEFT

Question 7

SLIDE 5: TERMS FOR DESCRIBING ECCENTRIC MOVEMENTS OF THE MANDIBLE

Lateral mandibular movements are guided by one of two guidance schemes: Name these two types of guidance scheme?

Answer 7

1) Canine Protected Articulation

2) Group Function Occlusion

Question 8

SLIDE 5: TERMS FOR DESCRIBING ECCENTRIC MOVEMENTS OF THE MANDIBLE

• • Canine Protected Articulation:
    1) Canine protected articulation implies that only the ___________ (canines, incisors or molars) are touching during the complete extent of __________ (lateral or vertical movement)
    2) Canine protected articulation is considered the _____________ (ideal or non-ideal) occusal scheme

Answer 8

• • Canine Protected Articulation:
    1) Canine protected articulation implies that only the CANINES are touching during the complete extent of LATERAL movement.
    2) Canine protected articulation is considered the IDEAL occusal scheme

Question 9

SLIDE 5: TERMS FOR DESCRIBING ECCENTRIC MOVEMENTS OF THE MANDIBLE

Lateral mandibular movements are guided by one of two guidance schemes: Name these two types of guidance scheme?

Answer 9

1) Canine Protected Articulation

2) Group Function Occlusion

Question 10

SLIDE 5: TERMS FOR DESCRIBING ECCENTRIC MOVEMENTS OF THE MANDIBLE

• • Canine Protected Articulation:
    1) Canine protected articulation implies that only the ___________ (canines, incisors or molars) are touching during the complete extent of __________ (lateral or vertical movement)
    2) Canine protected articulation is considered the _____________ (ideal or non-ideal) occusal scheme

Answer 10

• • Canine Protected Articulation:
    1) Canine protected articulation implies that only the CANINES are touching during the complete extent of LATERAL movement.
    2) Canine protected articulation is considered the IDEAL occusal scheme

Question 11

SLIDE 5: TERMS FOR DESCRIBING ECCENTRIC MOVEMENTS OF THE MANDIBLE

• • Group Function Occlusion:
    1) Group function occlusion entails that one or more of the POSTERIOR teeth, in combination with some of the ANTERIOR teeth, are in some degree of contact during the complete extent of ____________ (lateral or protrusive movement)
    2) Group function occlusion is considered the __________ (primary or secondary) occlusal scheme or the ________________ (most or least) practical approach.
    3) ___________ (Younger or older) patients commonly exhibit group function occlusion more commonly than canine protected articulation.

Answer 11

– Group Function Occlusion:

1) Group function occlusion entails that one or more of the POSTERIOR teeth, in combination with some of the ANTERIOR teeth, are in some degree of contact during the complete extent of LATERAL MOVEMENT.
2) Group function occlusion is considered the SECONDARY occlusal scheme or the MOST practical approach.
3) OLDER patients commonly exhibit group function occlusion more commonly than canine protected articulation.

Question 12

SLIDE 7: NORMAL CLOSURE OF THE MANDIBLE

The following actions occur when the mandible closes against the maxilla, from an extended opening position:

1) The condyle will be located primarily within what fossa?
2) The __________ (anterior or posterior) fibers of the TEMPORALIS muscle will contract
3) The _________ (medial or lateral pterygoid) muscle will contract
4) (T/F): The ENTIRE masseter muscle will relax
5) (T/F): The suprahyoids and infrahyoids relax
6) The POSTERIOR NECK musculature will _______ (minimally or completely contract) to hold the cranium in place.

Answer 12

The following actions occur when the mandible CLOSES against the maxilla, from an extended opening position:

1) The condyle will be located primarily within the GLENOID FOSSA
2) The ANTERIOR fibers of the TEMPORALIS muscle will contract
3) The MEDIAL PTERYGOID muscle will contract
4) FALSE: The ENTIRE masseter muscle will CONTRACT
5) TRUE: The suprahyoids and infrahyoids relax
6) The POSTERIOR NECK musculature will MINIMALLY CONTRACT to hold the cranium in place.

• *** NOTE: (This will be on exam)
• • The INFERIOR HEAD of the LATERAL pterygoid SHOULD NOT contract. SHOULD BE AT REST. It’s involved in only OPENING movement of the mandible, not closing.

Question 13

SLIDE 6: TERMS FOR DESCRIBING ECCENTRIC MOVEMENTS OF THE MANDIBLE CROSSOVER OF THE MAXILLARY AND MANDIBULAR TEETH.

Crossover:

3) Is critical to the SUCCESS of _________ (anterior or posterior) restorations
4) Displays extended _______________ (lateral or protrusive movement) that _________ (smoothly or roughly) transfer OCCLUSAL contact from the ___________ (canines or premolars) to the __________ ( incisors or molars).
5) Should NOT display any occlusal contact on __________ (anterior or posterior) teeth.

Answer 13

Crossover:

3) Is critical to the SUCCESS of ANTERIOR restorations
4) Displays extended LATERAL MOVEMENTS that SMOOTHYLU transfer OCCLUSAL contact from the CANINES to the INCISORS. (ANTERIOR TEETH)
5) Should NOT display any occlusal contact on POSTERIOR teeth.

Question 14

SLIDE 7: NORMAL CLOSURE OF THE MANDIBLE

The following actions occur when the mandible closes against the maxilla, from an extended opening position:

1) The condyle will be located primarily within what fossa?
2) The __________ (anterior or posterior) fibers of the TEMPORALIS muscle will contract
3) The _________ (medial or lateral pterygoid) muscle will contract
4) (T/F): The ENTIRE masseter muscle will relax
5) (T/F): The suprahyoids and infrahyoids relax
6) The POSTERIOR NECK musculature will _______ (minimally or completely contract) to hold the cranium in place.

Answer 14

The following actions occur when the mandible closes against the maxilla, from an extended opening position:

1) The condyle will be located primarily within the GLENOID FOSSA
2) The ANTERIOR fibers of the TEMPORALIS muscle will contract
3) The MEDIAL PTERYGOID muscle will contract
4) FALSE: The ENTIRE masseter muscle will CONTRACT
5) TRUE: The suprahyoids and infrahyoids relax
6) The POSTERIOR NECK musculature will MINIMALLY CONTRACT to hold the cranium in place.

• *** NOTE: (This will be on exam)
• • The INFERIOR HEAD of the LATERAL pterygoid SHOULD NOT contract. SHOULD BE AT REST.

Question 15

SLIDE 9: MUSCLE VECTORS IN FRONTAL PLANE

1) Anterior, middle and posterior temporalis have what kind of (direction) force vector location:
2) The Masseter has what kind of (direction) force vector location:
3) The medial pterygoid has what kind of (direction) force vector location:
4) The inferior head of the later pterygoid has what kind of (direction) force vector location:

Answer 15

1) Anterior, middle and posterior temporalis force vector: SUPERIOR
2) The Masseter force vector: SUPERIOR
3) The medial pterygoid muscle force vector: SUPERIOR and SLIGHTLY MEDIAL (mediotrusive)

4) The inferior head of the LATERAL pterygoid muscle force vector: ANTERIOR and MEDIAL (slightly mediotrusive)
* * This is the unique one in terms of the muscles of mastication.

Question 16

SLIDE 8: NORMAL JAW OPENING MOVEMENT –LATE

The following actions occur during late mandibular opening movement:

3) The articular disc has rotated slightly ___________ (anteriorly or posteriorly) over the POSTERIOR portion of the head of the condyle.
- – the __________ (superior or inferior) head of the LATERAL pterygoid is in ________ (minimal or maximum contracture), attempting to hold the articular disc over the head of the condyle

4) The SUPERIOR RETRODISCAL TISSUES are in _______________ (maximum or minimal tautness) and cannot further hold the articular disc in position over the head of the condyle without either stretching or tearing.
- – The ________ (posterior or anterior) portion of the collateral ligament is LACKING in tautness
- – the __________ (posterior or anterior) portion of the collateral ligament is TAUT.

Answer 16

The following actions occur during late mandibular opening movement:

3) The articular disc has rotated slightly POSTERIORLY over the POSTERIOR portion of the head of the condyle.
- – the SUPERIOR head of the LATERAL pterygoid is in MAXIMUM CONTRACTURE, attempting to hold the articular disc over the head of the condyle

4) The SUPERIOR RETRODISCAL TISSUES are in MAXIMUM TAUTNESS and cannot further hold the articular disc in position over the head of the condyle without either stretching or tearing.
- – The POSTERIOR portion of the collateral ligament is LACKING in tautness
- – the ANTERIOR portion of the collateral ligament is TAUT.

Question 17

SLIDE 9: MUCLE VECTORS IN FRONTAL PLANE

1) Anterior, middle and posterior temporalis have what kind of (direction) force vector location:
2) The Masseter has what kind of (direction) force vector location:
3) The medial pterygoid has what kind of (direction) force vector location:
4) The inferior head of the later pterygoid has what kind of (direction) force vector location:

Answer 17

1) Anterior, middle and posterior temporalis force vector: SUPERIOR
2) The Masseter force vector: SUPERIOR
3) The medial pterygoid muscle force vector: SUPERIOR and SLIGHTLY MEDIAL (mediotrusive)
4) The inferior head of the LATERAL pterygoid muscle force vector: ANTERIOR and MEDIAL (slightly mediotrusive)

Question 18

SLIDE 10: ACCESSORY MUSCLES of MASTICATION

ACCESSORY MUSCLES of MASTICATION:
1) (T/F): In the craniofacial apparatus, these muscles serve as ADJUNCTS or SUPPORTIVE ENTITIES to the four main muscles of mastication.

2) By themselves, the accessory muscles of mastication ____________(can or cannot) effectively drive the process of NORMAL mandibular movement
3) List the three neck musculature that are known as the accessory muscles of mastication
4) The accessory muscles of mastication are known primarily for the EXPRESSION of DYSFUNCTION and PAIN that occurs as a result of what kind of oral cavity problem?

Answer 18

ACCESSORY MUSCLES of MASTICATION:
1) TRUE: In the craniofacial apparatus, these muscles serve as ADJUNCTS or SUPPORTIVE ENTITIES to the four main muscles of mastication.

2) By themselves, the accessory muscles of mastication CANNOT effectively drive the process of NORMAL mandibular movement
3) The SUPRAHYOIDS, INFRAHYOIDS, and POSTERIOR neck musculature are collectively known as the accessory muscles of mastication
4) The accessory muscles of mastication are known primarily for the EXPRESSION of DYSFUNCTION and PAIN that occurs as a result of temporomandibular or occlusal problem

Question 19

SLIDE 11: CLASS 3 LEVER SYSTEM:

Features of a class 3 lever system:

1) The ___________ (load “teeth” or effort “musculature”) are OPPOSITE to the fulcrum “condyle”, with the _____________ (load “teeth” or effort “musculature”) in the middle.
2) The amount of EFFORT is _______ (greater or less) than the forces exerted on the LOAD.
3) An ____________ (optimum or minimal) amount of work will be done.
4) This system can last for a __________ (long or moderate) period of time (i.e. ______ (#) years.

Answer 19

Features of a class 3 lever system:
1)  The TEETH or LOAD are OPPOSITE to the FULCRUM (condyle-fossa apparatus), with the \_\_\_\_\_\_\_\_\_\_\_\_\_ EFFORT (musculature) in the middle.

2) The amount of EFFORT is GREATER THAN the forces exerted on the LOAD.
3) An OPTIMUM amount of work will be done.
4) This system can last for a MODERATE period of time (i.e. 80 years.

Question 20

SLIDE 12: CUSP-FOSSA RELATIONSHIP of POSTERIOR TEETH

CUSP SCHEMA: 
MAXILLARY LINGUAL CUSPS AND MANDIBULAR FACIAL CUSPS
1) Preferred name:
2) Secondary name:
3) Acceptable name:
4) Obsolete (old) name:

Answer 20

CUSP SCHEMA: 
MAXILLARY LINGUAL CUSPS AND MANDIBULAR FACIAL CUSPS
1) Preferred name: CENTRIC cusp
2) Secondary name: FUNCTIONAL cusp
3) Acceptable name: SUPPORTING cusp
4) Obsolete (old) name: STAMP cusp

Question 21

SLIDE 12: CUSP-FOSSA RELATIONSHIP of POSTERIOR TEETH

CUSP SCHEMA: 
MAXILLARY FACIAL CUSPS AND MANDIBULAR LINGUAL CUSPS
1) Preferred name:
2) Secondary name:
3) Acceptable name:
4) Obsolete (old) name:

Answer 21

CUSP SCHEMA: 
MAXILLARY FACIAL CUSPS AND MANDIBULAR LINGUAL CUSPS
1) Preferred name: NON-CENTRIC cusp
2) Secondary name: NON-FUNCTIONAL cusp
3) Acceptable name: GUIDING cusp
4) Obsolete (old) name: SHEARING cusp

Question 22

SLIDE 13: RELATIONSHIP of TEMPOROMANDIBULAR ANATOMICAL LANDMARKS TO FUNCTION:

The articular disc and synovial cavities possess the following attributes:

1) What type of lubrication?
2) The SUPERIOR synovial cavity displays __________ (rotation or translation) movement of the mandible
3) The INFERIOR synovial cavity displays ____________ (rotation or translation) movement of the mandible.

Answer 22

The articular disc and synovial cavities possess the following attributes:

1) BOUNDARY and WEEPING lubrication
2) The SUPERIOR synovial cavity displays TRANSLATION movement of the mandible
3) The INFERIOR synovial cavity displays ROTATION movement of the mandible.

NOTE:
Most of the time it is translation with a little or rotation

Question 23

SLIDE 14: CUSP-FOSSA/MARGINAL RIDGE LOCATIONS for CENTRIC HOLDING CUSPS on MAXILLARY POSTERIOR TEETH

Q: In an ideal innercuspal postion:
The LINGUAL cusp of the maxillary second premolar = what ridge/fossa of the mandibular end.

Answer 23

Q: In an ideal innercuspal postion:
The LINGUAL cusp of the maxillary first premolar = DISTAL MARGINAL RIDGE or DISTAL FOSSA of the mandibular second premolar.

Question 24

SLIDE 13: RELATIONSHIP of TEMPOROMANDIBULAR ANATOMICAL LANDMARKS TO FUNCTION:

The articular disc and synovial cavities possess the following attributes:

1) What type of lubrication?
2) The SUPERIOR synovial cavity displays __________ (rotation or translation) movement of the mandible
3) The INFERIOR synovial cavity displays ____________ (rotation or translation) movement of the mandible.

Answer 24

The articular disc and synovial cavities possess the following attributes:

1) BOUNDARY and WEEPING lubrication
2) The SUPERIOR synovial cavity displays TRANSLATION movement of the mandible
3) The INFERIOR synovial cavity displays ROTATION movement of the mandible.

Question 25

SLIDE 14: CUSP-FOSSA/MARGINAL RIDGE RELATIONSHIPS for CENTRIC HOLDING CUSPS on MAXILLARY POSTERIOR TEETH

Q: In an ideal innercuspal postion:
The LINGUAL cusp of the maxillary second premolar = what ridge/fossa of the mandibular end.

Answer 25

Q: In an ideal innercuspal postion:
The LINGUAL cusp of the maxillary second premolar = DISTAL MARGINAL RIDGE or DISTAL FOSSA of the mandibular second premolar.

Question 26

SLIDE 15: CUSP-FOSSA/MARGINAL RIDGE LOCATIONS for NON-CENTRIC HOLDING CUSPS on MAXILLARY POSTERIOR TEETH

Q: In an ideal innercuspal postion:
The MESIOFACIAL cusp of the maxillary second molar = what groove of the mandibular end?

Answer 26

Q: In an ideal innercuspal postion:

The MESIOFACIAL cusp of the maxillary second molar = MESIOFACIAL GROOVE of the mandibular second molar.

Question 27

SLIDE 16: NON-WORKING CUSPS and PATHWAYS (mesial occlusion)

LEFT WORKING MOVEMENT (laterotrusive)
Q: The facial cusp of a maxillary left 2nd premolar, during left lateral working movement, will escape through what?

Answer 27

– escape through the OCCLUSAL EMBRASURE between the mandibular 2nd premolar and mandibular 1st molar.

Question 28

SLIDE 17: NON-FUNCTIONAL DIAGRAM –MANDIBLE

Look at diagram on slide Question #17 and answer the following questions:

Legend:
MOVEMENT: Protrusive, Left Lateral, Right lateral, lateral protrusive or non-functional
SLIDE: The side that the pictured arch is located on
CUSP: The cusp that is position or occluding at the base of the arrow.

Answer 28

MOVEMENT: non-functional
SIDE: LEFT
CUSP: D CUSP of mandibular 1st molar (#19)

– non-functional implies that the mandibular movement is NOT possible.