Final Exam Flashcards

1
Q

2 Types of TMD

A

Myogenous TMD

Arthrogenous TMD

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2
Q

Mygoenous TMD

A

Muscle and ligament related

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3
Q

Arthrogenous TMD

A

Joint and bone related

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4
Q

TMD are

A

A common subgroup of orofacial pain disorders

There are 2 basic types of TMD

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5
Q

Joint Disc

A

The disc is vascular innervated and elastic

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6
Q

Lateral ptergyogid muscle is

A

Located in front of the disk and attached to the front of the disc

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7
Q

Reasons you cant open your mouth

A

If you cannot open your mouth might be because the disc is locked in front and then you’re hitting on the retrodiscal tissues causing pain

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8
Q

Retrodiscal tissue

A

Are innervated so if there is a load in the back it will be painful

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9
Q

Can apply loads to front because

A

Cartilage at the front of the disc is a vascular so there wont be any pain

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10
Q

Disc reduction

A

Bring the disc back into place

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11
Q

A good history taking is the

A

Basis of accurate diagnosis

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12
Q

Cardinal criteria to diangose TMD

A
Pain
Limitation of function
Limitation of movement 
Physical change 
Alternated jaw relationship 
Tempromandibular sounds that have increased in intensity and frequency
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13
Q

TMD: Limitation of function

A

Cannot bite

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14
Q

TMD: Limitation of movemnt

A

Cannot open or close mouth

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15
Q

TMD: Altered jaw relationship

A

Deviation instead of biting in a straight line

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16
Q

TMD: Sounds

A

CLicking can be normal what is very important is that the sounds are increasing in intensity and frequency

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17
Q

Articulator eminence angle defines

A

Condylar Guidance

Around 30-40 degrees

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18
Q

When trying to replicated TMD

A

You cannot Control Articulator eminence angles can only simulate in articulator

Cannot replicate joint only the teeth

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19
Q

Mandible works in what plane

A

Circular plane so it drops more in the back than in the front

Articulator is only one plane so anterior teeth must be set a lower angle (20 degrees) Posterior teeth (30 degrees)

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20
Q

Articulator is only one plane so anterior teeth vs posterior

A

Anterior teethmust be set a lower angle (20 degrees) Posterior teeth (30 degrees)

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21
Q

Etiology TMD

A
Issues with
Pulp
Occlusal
Perio
Muscles of mastication
Joint
Ear infections
Neck muscles
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22
Q

Tolerance

A

The body will tolerate the problem for a narrow period of time. If you keep ignoring it then you end up with a problem

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23
Q

TMJ innervated

A

CN V
CN VII

Can cause referred pain

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24
Q

TMD is a disease that has

A

A multifactorial etiology

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25
Q

TMD etiologic factors may be classified into

A

Predisposing factors

Initiating factors

Perpetuating factors

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26
Q

TMD: Predisposing factors

A

Increase the risk of TMD

Systemic, occlusal, loss of posterior teeth

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27
Q

TMD: Initiating Factors

A

Cause TMD

Trauma, parafunctional habits

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28
Q

TMD: Perpetuating factors

A

Enhance progression of TMD

Behavioral, social, or emotional stress

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29
Q

Factors associated with TMD

A
Occlusal condition
Trauma
Emotional stress
Deep Pain input
Parafunctional activities
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30
Q

Problems in bringing teeth together into MI are reflected in the

A

Muscles

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31
Q

Once the teeth are in occlusion problems in loading the mastication structures are reflected in

A

The joints

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32
Q

Introduction of an acute condition——>

A

Presence of orthopedic instability

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33
Q

Orthopedic stability occurs when

A

The stable MI position of teeth is in harmony with the musculoskelatlyl stable position of the condyles in their fossa

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34
Q

Activities of the mastication system

A

Functional

Parafunctional

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35
Q

Functional activities of masticatory system

A

Chewing eating and swallowing

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36
Q

Parafunctional activities of masticatory

A

Diurnal parafunctilal activity

Nocturnal parafunctional

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37
Q

Diurnal Parafunctional activity

A

Clenching eating swallowing
Cheek and tongue biting
Finger and thumb sucking

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38
Q

Nocturnal Parafunctional activity

A

Bruxing-clenching and grinding result in the same consequence as clenching and grinding

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39
Q

Prosthetic treatment in TMD should only be carried out

A

After reversible therapy (night guard) has resulted in relief of pain and function

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40
Q

Dentist must refrain from providing dental therapies if

A

Occlusal interferences are not related to symptoms

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41
Q

TMD Treatment Modalities

A

Conservative

No conservative

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42
Q

Conservative modalities

A

Reversible non invasive

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43
Q

Nonconservative modalities

A

Irreviesrible

Surgery

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44
Q

Definitive treatment

A

Intended to directly eliminate or alter the cause o the disorder and its consequences

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45
Q

Supportive therapy

A

Not treating the problem but helping ease the pain/discomfort

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46
Q

Supportive therapy is directed toward

A

Altering the patients symptoms and reducing pain and dysfunction

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47
Q

Supportive therapy has _____ on the cause of disorder

A

No effect

Pharmacological
Physical therapy

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48
Q

Analgesics

A

Aspirin

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49
Q

Anti-inflammatory

A

Ibuprofen

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50
Q

Muscle relaxants

A

Soma

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51
Q

Anxiolytics agents

A

Valium

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52
Q

Antidepressant

A

Prozac

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53
Q

Anticonvulsant

A

Lyrics

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54
Q

Occlusal appliance material

A

Hard acrylic

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55
Q

Positive Occlusal contact

A

With teeth in opposing arch

Teeth do not touch anymore

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56
Q

Uses of occlusal appliances

A

Temporarily provides a more ortho-pedically stable joint position

To introduce an optimum functional occlusion that reorganizes the neuromuscular reflex activity

To protect teeth and supportive structures from abnormal forces that may create breakdown or occlusal wear

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57
Q

Occlusal appliances reduce what activity

A

They reduce parafunctional muscle activity, hence reduce myogenous pain

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58
Q

Occlusal appliances also reduce forced placed on

A

The TMJs and other structures within the masticatory system

When these structures are unloaded the associated symptoms decrease

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59
Q

Common features to all occlusal appliances

A

Temporary alteration of occlusal condition

Alteration of the condylar position

Increase in vertical dimension

Cognitive awareness

Placebo effect

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60
Q

Types of occlusal appliances

A

Stabilization appliance

Anterior positioning appliance

Anterior bite plane

Posterior bite plane

Pivoting appliance

Soft appliance

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61
Q

Most common appliance

A

Stabilization appliance

Easiest

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62
Q

Soft appliances are not

A

Therapeutic but might relieve pain

Not manufactured by dentist

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63
Q

Stabilization appliance is generally fabricated for

A

The maxillary arch and provides optimum functional occlusion

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64
Q

When stabilization appliance is in place the condyles are

A

In there most musculoskelatly stable position at the time when the teeth are contacting evenly

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65
Q

Primary goal of stabilization appliance

A

Elimante any orthopedic instability

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66
Q

Static

A

Don’t move

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67
Q

Dynamic

A

Do move

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68
Q

Goal of prosthodontic treatment

A

PRESERVE what remain

Support reaming teeth and provide a substitute for missing teeth

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69
Q

Relationship between elements

A

Dental compositions (micro)

Dentofacial composition (mini)

Facial composition (macro)

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70
Q

Esthetic harmony

A

Harmony depends on equilibrium between distractive elements

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71
Q

Frame of Reference

A

Bridge of nose
Philtrum
Face midline
Dental midline

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72
Q

Philtrum

A

BEST reference to find midline of the face

Not nose

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73
Q

Face midline

A

Should match the midline of the maxillary and mandibular teeth midline

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74
Q

Dental Midline

A

Studies have shown that the mean threshold for acceptable dental midline deviations is 2.2+/-1.5 mm

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75
Q

Esthetics depends largely on

A

Proportion

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76
Q

Unattractive if

A

Top heavy
Squat
Out of proportion

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77
Q

Golden proportion

A

How much smaller each tooth is compared to the one adjacent to it

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78
Q

Pythagoras

A

1/1/618

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79
Q

Plato

A

1/1.733

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80
Q

Increased embrasure is seen in

A

Young dentition and a restoration with unnaturally reduced embrasures

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81
Q

Incisor angulation slight______ is acceptable but ______ should be avoided

A

Mesial

Distal

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82
Q

Lip Line

A

Upper Lip

High: Enitre length of the tooth

Moderate

Low: hides margins and defects

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83
Q

Smile Line

A

Has to do with the teeth

Imaginary line that curves with the lower lip

More pronounced in women

Hypoethical curved line drawn along the edges of maxillary anterior teeth that has to coincide or run parallel to the curve a true of the lower lip

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84
Q

Buccal Corridor

A

Dark triangle on the side of the lips-are a singe of beauty

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85
Q

No corridor —>

A

Mouth full of teeth

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86
Q

Dominance

A

Primarily refers to the two central incisors

largest tooth that shows the highest in value

Brightest and stands out more

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87
Q

Embrasures

A

Form
Symmetry
Progression

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88
Q

Dental morphology

A

Contact areas
Embrasures
Texture

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89
Q

Gingival Morphology

A

Gingival tissue and racial factor
Gingival health and contour
Gingival zenith

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90
Q

Diagnostic waxing is the process of

A

Developing intra and inter arch relationships to establish crown contours and occlusal schemes for diagnostic purposes

91
Q

Diagnostic waxes allow

A

The practioner to establish the optimum contour and occlusion fo the eventual prosthesis

92
Q

Natural teeth have a _____ emergence profile in the ______ _______

A

Straight

Gingival third

93
Q

Emergence Profile

A

Zone around the tooth below the crest of curvature

94
Q

Emergence Profile

A

Zone around the tooth below the crest of curvature

95
Q

All teeth have an emergence profile that is

A

A straight line

Not concave or convex

96
Q

Most important feature of anterior teeth

A

Mesiobuccal line angle

97
Q

Macroesthetics

A

The face in all 3 planes

Excessive buccal corridor
Inappropriate gingival height
Excessive or inadequeate gingival display

98
Q

Microesthetics

A

The teeth
Tooth proportion in height and width
Gingival shape and contour

99
Q

Is the golden proportions always best option

A

No too strong for dental esthetics

100
Q

Dentist perception of anterior esthetics

A
Embrasure size
Central angulation
Lateral angulation
Lateral length
Central width to heigh ration
101
Q

Central incisors width height ration

A

.75-.78

102
Q

Lateral is ___ of central

A

66%

103
Q

Canine is ____ width of lateral

A

84%

104
Q

3 elements of prosthetic rehabilitation

A

Occlusion
Esthetics
Phonetics

105
Q

Harmony depends on equilibrium between

A

Distractive elements

106
Q

Goals of Occlusal Equilibration

A

To improve functional and esthetic relationships between auxiliary and mandibular teeth

Eliminate TMD

107
Q

Treatment planning for Occlusal therapy

A

Selective Grinding
Fixed prosthodontics
Orthodontic therapy
Orthographic Surgery

108
Q

Selective Grinding

A

Select Sponts on occlusal surface and grind them away

Most conservative method

109
Q

Fixed prosthodontics for TMD

A

Grind whole tooth away and make a crown

Can creat new contacts and delete the slide to make CO=MI

110
Q

Orthographic surgery

A

Combination between orthodontic therapy and surgery can cut The jaw and move it around

111
Q

Anterior contact is usually coronal to the ______ and _____ to the _____

A

Cingulum

Apical
Fossa

112
Q

Tripod contact

A

Is best

If its only the cusp tip it may slide

113
Q

Rule of thirds: Selective Grinding

A

Contact occurring at center of tooth

114
Q

Rul Rule of thirds: Fixed

A

Cusp angles (middle third) hitting

115
Q

Rule of thirds: Orthodontic

A

Cusp tips hitting

116
Q

Factors influencing treatment planning

A
Symptoms
Condition of the dentition
Systemic Health
Esthetics
Finances
117
Q

The shorter the slide the

A

More likely it is that selective grinding can be accomplished within the confines of enamel

118
Q

When the slide has a great horizontal component (flat cusps)

A

It becomes difficult to elimante within the confines of the enamel

119
Q

Never grind the

A

Functional cusp

You grind the fossa

120
Q

Mandibular excursions

A

Locate tooth in. The arch

Determine if it moves (mandibular only teeth that move)

Identify movement (working non working protrusive etc.)

121
Q

MUDL

A

Mesial upper

Distal lower

122
Q

BULL

A

Buccal upper

Lingual lower

123
Q

Deviation forward on closing

A

Grind MUDL

124
Q

Deviation toward the cheek on closing

A

Grind BULL

125
Q

Deviation toward tongue on closing

A

LUBL

126
Q

LUBL

A

Lingual upper

Buccal lower

127
Q

Non working interferences (opening)

A

BULL

128
Q

Working interferences (opening)

A

LUBL

129
Q

Protrusive Interferecesn

A

DUML

Only anterior teeth should touch

130
Q

Horizontal slide

A

That’s a problem if there is a slide is should go upward

131
Q

Optimal joint relationships is achieved only when

A

The Articulator disks are properly interposed between the condyles and the Articulator fossae (CR)

132
Q

When in optimal joint relationships the Articulator surfaces and tissues of the joints are aligned so

A

So that forces are applied by the masculine do not create any damage

Loaded evenly

133
Q

Musculoskeltally stable joint position can only be maintained when

A

It is in harmony with a stable occlusal position

134
Q

More teeth =

A

Better
More distribution of forces

More stabilization of the mandible

135
Q

_____ and ______ contact of all teeth during mandible closure

A

Even and simultaneous

136
Q

Osseous tissues do not

A

Tolerate pressure forces

137
Q

The PDL is present between the roots and bone to

A

Controls pressure forecasts

138
Q

When trauma occurs the PDL

A

Prevents tooth to bone contact

Acts like a net that supports tooth not really elastic

139
Q

Class I lever

A

Fulcrum is in the middle

140
Q

Class 2 lever

A

Load is in the middle

Wheelbarrow

141
Q

Class 3 lever

A

Effort is in the middle

Fishing

142
Q

In MI posterior teeth come into contact and act

A

As a stop to minimzal horizontal load on anterior teeth

143
Q

Anterior teeth take ______ forces

A

Lateral

144
Q

Posterior teeth take ______ forces

A

Vertical

145
Q

Anterior guidance

A

Protects posterior teeth during protrusion

146
Q

Effects of tooth loss

A
Supraeruption 
Tilting
Loss of contact
Loss of posterior tooth support
Loss of vertical dimension
Flaring of anterior teeth
Non-working interferences
147
Q

Occlusal forces treatment goals

A

Furnish a smooth protrusive path guided by anterior teeth without any interferences from occlusal contacts between posterior teeth

148
Q

In MI positions all mandibular teeth should

A

Contact their maxillary opponents at the same time with same intensity

149
Q

To direct occlusal forces along the

A

Long axes of teeth

150
Q

Working contacts

A

Should not be prevented from cotanting by non. Working interferences

151
Q

Ear bow should be parallel to

A

The eyes

152
Q

Earbow transfer related maxillary cast to

A

Terminal hinge axis (mandibular condyles)

153
Q

Ear bow transfer orients the maxillary cast correctly in space using

A

A third point of reference (occlusal plane)

154
Q

Ear bow transfer is aligned parallel to

A

Interpupillay line

155
Q

Ear bow transfer permits mounting of the maxillary cast

A

On a semi adjustable Articulator

156
Q

The mandibular cast is mounted using ______ record

A

Centric relation

157
Q

Centric Relation

A

Relationship in which the condyles articulate with the thinnest avasular portion of their respective disk with the complex in the anterior superior position against the shaped of the Articulator eminences

This position in independent of tooth contact

158
Q

Centric Relation is of _______ of tooth contact

A

Independent

159
Q

Methods of recording CR

A

Bilateral manipulation

Chin point guidance

Anterior deprogrammed

160
Q

When doing excurvisve movements you don’t want teeth

A

In black to touch

discussion

161
Q

Increased VO

A

Allows longer cusps

162
Q

Decreased VO

A

Required shorter cusps

163
Q

Increased HO

A

Requires shorter cusps

164
Q

Decreased HO a

A

Allows longer cusps

165
Q

On the horizontal path the angle known as _________ is the angle between the protrusive and mesial or non working path

A

Bennetts angle

166
Q

On the Sagittal plane the angle between the protrusive and mesial or non working path is I known as

A

Fischer’s angle

167
Q

The essence of both an atomic and curtail harmony is the balance between

A

Elevator muscles and depressor muscles

168
Q

In order for the jaw to protrude it must go

A

Down and then forward

169
Q

Translation and rotation can happen

A

Simultaneously

170
Q

THA

A

An imaginary line that joins the condyles

The mandible rotates along this line and the mandible can move downwards and forward

171
Q

Protrusive movement

A

Forward and downward

Cannot go straight forward or straight downward

172
Q

Right lateral movement

A

Working side non working side

The opposite condyle moves forward and downward mesially

173
Q

Bennett’s movement

A

The non working ALWAYS only goes down and forward

The working condyle anywhere inside the cone of Bennett sticking out laterally

174
Q

Bennett’s side shift

A

Mandibular lateral translation = The center moves

The mesial pole is a little backwards from the distal pole

The distal pole is more forward

175
Q

Chewing movement

A

You close in a circle bite

176
Q

The centric relation curve

A

Line or curve our rotational

When you open your moth only slightly

177
Q

Curve of translation

A

the whole jaw translated

This is the maximum opening because the tendons and uncles will prevent you from opening more

178
Q

Maximum protrusive limit

A

Can bite down in a protrusive fashion; a straight line

179
Q

Centric occlusion

A

Initial point of contact

180
Q

Usually the direction of the shift is

A

A little forward but can be sidweways or a little backward

181
Q

Ulf posselts motion

A

It wil hit the initial point of contact then slide into the maximum intercupstaion

182
Q

Anterior guidance

A

Slide the mandibular teeth forward until you reach end to end position

183
Q

CO=

A

MI

Is ideal only 10%

184
Q

Any point at the CR curve is termed centric relation=

A

Only rotation

185
Q

Functions of anterior teeth

A
Anterior guidance
Initial acts of mastication 
Speech
Lip Support
Esthetics
186
Q

VO

A

Vertical overlap

187
Q

HO

A

Horizontal overlap

188
Q

Posterior teeth are not designed to take

A

Lateral surfaces they will chip off gum recession perio

189
Q

Anterior guidance is dictated by

A

Position of the incisal edge of the mandibular anterior teeth relative to the lingual surfaces of the maxillary teeth

Changes in morphology of the lingual surfaces of maxillary anterior teeth

Length of mandibular incisors or canines

190
Q

The incisal guide on an Articulator has 3 functions

A

When anterior teeth are prepped the angulation of the custom guide provides anterior guidance In place of the anterior teeth

When only posterior teeth are to be replaced the angulation of the guide serves to estimate the buccolingula and mesiodistal cusp angles so as to avoid interferceesn in both protrusive and non working excursions

Reduce the amount of wear of the stone casts during excursive Muenster made not he articulator

191
Q

The geomtetric school

A

Denied the existence of condylar axes and disregarded the condylar paths as influences on occlusion instead claiming that the articulation of teeth guides the mandible during mastication

192
Q

The condylar school

A

Adjustable condylar guides

Average value instruments

193
Q

Bonwill Triangle

A

The size of the mandible is equal to 10cm(4in) from condyle to condyle and from each condyle to the incisor point

194
Q

Balkwill Angle

A

Is formed between the occlusal plane and the bonwill triangle

26 degrees

195
Q

Curve of Spee

A

The molar masticatory surfaces lie on the same arc of a circle the posterior continuation of which touches the most anterior point of the condyle

196
Q

The steeper the path of the condyle the more

A

Pronounced the tooth curve would be because both have the same radius

(Theory)

197
Q

Christensen

A

The space that occurs between he maxilla and mandible during protrusion because of the curve of Spee

198
Q

Monsons spherical theory

A

Center located in sella trucica

Formed a pyramid using bonwill equilateral triangle (D)

199
Q

Curve of Wilson

A

Upper convex
Lower concave

Curvature of cusps projected on the frontal plane expressed in both arches

200
Q

Hall’s Conical Theory

A

The external occipital protuberance was considered as the anatomical rotation center of mandible

201
Q

Horizontal Plane: Lateral Movement

A

Working Condyle: Slight lateral translation (forward or backwards)

Non-Working Condyle: Forward and Medial

202
Q

Frontal Plane: Lateral Movements

A

Working: Rotate and move lateral and upward or lateral and downwards

Non-working: Downward and medial

203
Q

Centric Relation Arc of Closure

A

When the mandible is guided to centric relation the arc traced between the two mandibular central incisors. At any point along this arc the mandible is in centric relation

204
Q

Incisal guidance is measured in degrees from the horizontal plane. The amount the mandible must drop in the anterior region is determined by the

A

Incisal guidance

205
Q

Incisal guidance is measured in degrees from the horizontal plane. The amount the mandible must drop in the posterior region is determined by

A

The angle of the Articular eminence

206
Q

what serve to guid the disclusion of posterior teeth

A

Inclination of the articular eminence of the TMJ

The morphology of the lingual surfaces of anterior teeth

207
Q

Determinants of Mandibular Movements: Posterior Determinants

A

Inclination of articular eminence
Medial wall of glenoid fossa
Intercondylar distance

208
Q

Determinants of Mandibular Movements: Anterior determinants

A

Horizontal overlap of anterior teeth

Vertical overlap of anterior teeth

209
Q

Determinants of Mandibular Movements: Other

A

Occlusal plane
Curve of spee
Neuromuscular response

210
Q

Eliminating protrusive interferences

A

DUML

211
Q

Working Side interferences on opening

A

(Anterior guidance) LUBL

212
Q

Non-working interferences on opening

A

BULL

213
Q

Interferences to line of Closure toward cheek

A

BULL

214
Q

Interferences on line of Closure toward tongue

A

LUBL

215
Q

Interference to the arc of Closure (CR) (Anterior slide)

A

MUDL

216
Q

Medial Pterygoid

A

Ptergoid plate—-medial angle of mandible

V3

Elevates
Lateral movements

217
Q

Lateral Pterygoid

A

Superior head- infratemporal fossa—anterior side of condyle

Inferior head- lateral ptergoid plate——Pterygoid fovea

V3

Depresses mandible
Lateral movements

218
Q

Temporalis

A

Temporal bone——coronoid process

V3
Elevation
Retraction

219
Q

Masseter

A

Zygomatic arch—-coronoid procees lateral ramps

V3

Close mouth
Protrusion of mandible

220
Q

Appliance mainly used to reduce muscle pain

A

Stabilization appliance

221
Q

Anterior Positioning Appliance goal is to

A

change positioning of the mandible in relation to the cranium

Interocclusal that has the mandible more anterior

Patients with joint sounds and to treat disc displacement

222
Q

Anterior bite plane is suggested for treatment of

A

Muscle disorders related to orthopedic instability or an acute change in occlusal condition

223
Q

Indications for posterior bite plane

A

Cases of severe loss of vertical dimension or when major changes need to be done to the anterior positioning of the mandible