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occlusion > handbook > Flashcards

handbook Flashcards

1
Q

define prosthodontics

A

dental specialty that deals with restoring missing oral and para-oral structures.

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2
Q

what knowledge is needed for prosthodontics

A

development, anatomy, and fuction of the stomatognathic system

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3
Q

what are the two types of movements of the mandible

A

rotation

translation

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4
Q

3 planes of mandibular movement

A

frontal/coronal
midsagittal
transverse

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5
Q

Where does rotation of the mandible occure

A

terminal hinge axis/transverse horizontal axis (THA)

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6
Q

where is the terminal hinge axis/transverse horizontal axis(THA)

A

the imaginary line connecting the two condyls

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7
Q

how long does the mandible rotate

A

20-25 mm of incisal separation

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8
Q

when doing lateral protrusion, what side is working and non-working

A

working: slight lateral translation (the side on the direction movement)
non-working: travels forward and medial

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9
Q

travel of the condyls in strait protrusive movement

A

both condyles move dowards along their eminenceies

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10
Q

travel of condyles along the eminence in lateral movement

A

non-working (downward and medial)

working (rotate, lateral and up or lateral and down)

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11
Q

who described the movement of the mandible in the 3 planes of movement

A

ulf posselt

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12
Q

the range of movement of the mandible envelope of rotation

A

envelope of motion

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13
Q

the starting reference point for he envelop of rotation

A

between the mandibular 2 central incisors

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14
Q

When the mandible is guided to centric relation, the arc traced by the point between 2 mandibular central incisors

A

centric relation arc of closure

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15
Q

at any point along the centric relation arc of closure, the mandible is at

A

centric relation

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16
Q

a spacial relation of one bone to another

A

Centric relation

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17
Q

define centric relation

A

the maxillomandibular relation in which the condyles articulate with the thinnest avascular portion of their respective disks, with the complex in the anterior-superior position against the shapes of the articular eminences. this position is independent of tooth contact. it is restricted to a purely rotary movement about the transverse horizontal axis

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18
Q

when the mandible is manipulated upward on the centric relation arc of closure until tooth contact occurs

A

centric occlusion

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19
Q

where does centric occlusion occur in 90% of the population

A

one or 2 maxillary or mandibular teeth

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20
Q

what are the first contacts to contact in centric occlusion

A

initial points of contact

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21
Q

what parts of mandibular and maxillary teeth contact at the initial points of contact

A

max: mesial
mand: distal

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22
Q

to go beyond initial contact, is the mandible still in centric relation

A

no, slides out of it due to shape of posterior inclines

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23
Q

when all teeth touch

A

maximal intercuspal position/ maximal intercuspation( MI)

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24
Q

the slide between centric occlusion and maximal intercuspal position

A

centric slide

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25
Q

is restorations easy if Centric occlusion is the same as maximal intercuspal position

A

easy (slide makes it hard)

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26
Q

what dictates protrusion from the maximum intercuspal position

A

mandibular anterior teeth ride along the lingual concavity of the maxillary teeth until tip to tip.
after, contacting posterior teeth determine movement until maximum protrusion is reached

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27
Q

maximum opening range

A

50-60mm between incisors.

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28
Q

after maximum opening, what does the mandible do to reach Centric relation

A

translation and rotation back to Centric relation arc of closure

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29
Q

what represents the border movement of the mandible

A

sagital plane tracing

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30
Q

size of the functional boarder movements

A

small area

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31
Q

the normal closing of the mandible

A

habitual arc of closure

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32
Q

problem with the habitual arc of closure

A

not as reproducible since it is not a boarder possition

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33
Q

where is the physiological rest position of the mandible

A

lies on the habitual arc of closure, where all the muscles are at the state of equal relation

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34
Q

the separation of the teeth at the physiological rest position

A

interocclusal rest distance

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35
Q

the distance between 2 points in the mouth during maximal intercuspation

A

vertical dimension of occlusion

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36
Q

the distance between 2 points in the mouth during physiological rest

A

vertical dimension at rest

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37
Q

determining the interocclusal rest distance

A

Vertical dimension at rest- vertical dimension of occlusion

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38
Q

the protrusive path the lower incisors must follow due to anterior teeth contact

A

incisal guidance

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39
Q

what does incisal guidance determine

A

protrusive path of mandibular incisors and during lateral movement

40
Q

when canine guidance is used

A

only during lateral movement

41
Q

why called anterior guidance

A

inclination of the articular eminence of the TMJ and the morphology of the lingual surface of anterior teeth guide the disclusion of the posterior teeth

42
Q

posterior determinants of mandibular movements

A

inclinatinoof articular eminence
medial wall of glenoid fossa
intercondylar distance

43
Q

anterior determinants of mandibular movements

A

horizontal overlap of anterior teeth

Vertical overlap of anterior teeth

44
Q

other detrminants of mandibular movements

A

occlusal plane
curve of spee
neuromuscular response

45
Q

problems with small non-adjustable articulators

A

lead to restorations with occlusal discrepancies, as they cannot reproduce the full range of mandibular movements

46
Q

what is used with semiadjustable articulators

A

face-bow to minimize the need for clinical adjustment

47
Q

what articulator can follow the patients border movements

A

fully adjustable articulators

48
Q

what is used with a fully adjustable articulator

A

pantograph (adjust the condylar elements to follow tracing obtained intraorally

49
Q

articulators that have the condyles connected to the lower member

A

arcon

50
Q

articulators with condyles connected to upper members

A

non-arcon

51
Q

roll of the ear bow transfer

A

record the patients exact anatomical relation of the maxillary dental arch to the patients intercondylar axis

52
Q

what is related to one another via the ear bow transfer

A

maxillary cost occlusal surface to the terminal hinge axis
orrients maxillary cast correctly in space using 3 points of reference
parallel to interpupillary line
mandible to be correctly mounted using the centric relation record

53
Q

ways in which you can move the mandible into Centric relation

A

chin point guidance
anterior deprogramer
bilateral bimanual manipulation

54
Q

what does the mouth normally do

A

used proprioceptive impulses to follow a natural reflex to close into a lateral or a lateral protruded possion when something is in the mouth

55
Q

requirements of the centric relation record

A 
along the arc of rotation of the manible
no teeth touching
thin
soft
fast setting
dimenstionally stable
easily verifiable in the mouth and mounted casts
56
Q

the correction of stressful occlusal contacts through selective grinding, to correct to normal harmonious jaw function

A

occlusal equilibration

57
Q

benifit of combining occlusal equilibration with restorative dentistry

A

minimize the restorative needs

58
Q

whats worse, mal-occlusion of bad equilibration

A

poor equilibration (may produce new interferences that patient must learn to cope with, creating occlusal awareness and discomfort in teeth, TMJ, and muscles

59
Q

parts of mutually protected occlusion

A

MI: posterior teeth come into contact to minimize horizontal load on anterior teeth
excursive movements of the mandible: anterior teeth guide so posterior dont have lateral or protrusive excursions

60
Q

does disclusion of posterior teeth happen in natural dentistions

A

yes, it is the norm

61
Q

posterior contacts that disclude anterior teeth during lateral excursive movements can cause

A

alter muscular patterns during lateral movements
create primary occlusal trauma, fremitus,
increase likelihood of tooth fracture
development of wear facets
unfavorable loading of the TMHs

62
Q

goals of occlusal treatment

A
  1. direct occlusal forces along the long axes of teeth (stable posterior contacts)
  2. in MI, all mandibular teeth should contact maxillary opponents at same tie with
    same intenisve (CO=MI)
  3. furnish a smooth protrusive path guided by the anterior teeth without any interference from occlusal contacts between posterior teeth
  4. working side contacts, whether canine-protected or group function, should not be prevented from contacting by non-working side interferences.
63
Q

4 parts of equilibration procedures can be divided into 4 parts

A
  1. reduction of all contacting tooth surfaces that interfere with the terminal hinge axis closure (CR)
  2. selective reduction of tooth structure that interferes with lateral excursions
  3. elimination of all posterior tooth structure that interferes with protrusive excursions
  4. harmonization of the anterior guidance
64
Q

the reason for most failures in equilibration

A

improper manipulation of the mandible

65
Q

what is necessary for equilibration to be successful

A

the condyle-disk assemblies must be free to seat in thier most anterior superior positions without any forced displacement when the teeth intercuspate

66
Q

finding Centric Relation

A

no contact of teeth
freely arc mandible without muscle interference with force bilaterally
slowly close mandible by moving it up and down to fist teeth touch (first interference)

67
Q

how to determine the slide for locating occlusal interferences

A

allow for first touch, then squeeze to feel the mandible slide from CR

68
Q

how should a slide be removed

A

such that either conyl is not displaced when CO=MI

69
Q

what produces the anterior slide

A

primary interferences that deviate the condyl forward

70
Q

the basic grinding rule to correct an anterior slide

A

Always MUDL

71
Q

MUDL

A

grind mesial inclines of uppers

grind distal inclines of lowers

72
Q

what to do about interference to the arc of closure

A

MUDL

73
Q

primary interferences that cause the mandile to deviate right or left from the initial contact point to MI

A

Line of closure interferences

74
Q

What to grind if the interfereing inclide causes the mandible to deviate toward the cheek

A

BULL

75
Q

BULL

A

grind bucccal incline of the upper

grind the lingual incline of the lower

76
Q

what to grind if the interfering incline causes the mandible to deviate toward the tongue

A

LUBL

77
Q

LUBL

A

Grind Lingual incline of upper

Grind Buccal incline of lower

78
Q

does the vertical dimension of occlusion change after equilibration

A

should be the same

79
Q

what can lateral interferences be divided into

A

working and non-working

80
Q

the goal of eleminating non-wrking lateral interferences

A

eliminate all contacts on inclines as soon as the lower teeth move out of MI and start toward the tongue

81
Q

Grinding for Non-working interferences

A

BULL

82
Q

what may happen when elimating non-working lateral interferences

A

working side inclines may appear, and when they are corrected, non-working may re-appear.must do non-working and working together

83
Q

what must you determine for adjusting working side interferences

A

weather group function or anterior guidance

84
Q

what is group function

A

working side inclines are precisely adjusted to harmonize with both condylar movements and anterior guidance

85
Q

why anterior guidance is the occlusion of choice in most patients

A

b/c of its effect on the elevator muscles ( at the momemnt of posterior disclusion, most of the elevator muscles contraction is shut off, reducing the load on both anterior teeth and joints

86
Q

what type of patients will beneift more from a group function in working side excusions

A

patients with large horizontal overlap

87
Q

the basic rule for equilibrating working side contacts

A

LUBL

88
Q

rule from eliminating protrusive interferences

A

DUML

89
Q

DUML

A

grind the disnding of the distal inclines of upper
grind the mesial inclines of the lower
also some hollow grinding of the offending inclines

90
Q

what provides posterior disclusion during protrusion

A

anterior guidance and downward movements of the protruding condyles

91
Q

what type of anterior guidance relies more on condyles for disclusion

A

flat anterior guidance (needs more corrections for protrusive interferences

92
Q

the 3 requisites of contour

A

Mechanical, biological, and esthetics

93
Q

Mechanical requisite for contour is dictated

A

by precise mechanics of intercuspation and mandibular movements

94
Q

biological requisite for contour is because

A

protect the gingivia from the over contouring of the teeth

95
Q

how the universal occlusal stand is angled

A

has a 10 degree inclination

96
Q

normal articular condylar guides

A

30 degrees

occlusion (8 decks)

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