Lectur 8- Tx of trauma from occlusion: occlusal adj./splinting

Question 1

working hypothesis 1 is that occlusal trauma MAY under certain circumstances accelerate…

Answer 1

att. loss

Question 2

working hypothesis 2 is that tooth immobilization is essential for

Answer 2

periodontal regeneration

Question 3

4 reversible occlusal therapies

Answer 3

night guard

extracoronal splints

muscle relaxants (medications)

muscle exercises

Question 4

4 irreversible occlusal therapies

Answer 4

intracoronal splints (require tooth prep)

occlusal adjustment by selective grinding

orthodontics

orthognathic surgery

Question 5

1st principle of occlusal adjustment?

Answer 5

occ. adj. by selective grinding is one of the MOST IRREVERSIBLE dental procedures you will ever do (know limitations!)

Question 6

2nd principle of occlusal adjustment?

Answer 6

knowing the contraindications to occlusal adjustment is more important than knowing the indications to adjust

Question 7

indications for selective grinding

Answer 7

periodontal occlusal trauma

post-ortho

prior to extensive restos

certain types of TMD

certain wear patterns

Question 8

contraindications for selective grinding

Answer 8

severe malocclusion

non-ideal but well tolerated occlusion

severe wear or if adjustment would expose dentin

patient in pain

if no suitable endpoint can be reached

Question 9

goals in occ. adj.

Answer 9

occlusal stability over time

axial loading of forces

anterior guidance in excursions that are smoothing and unrestrained

Question 10

occ. adj. by selective grinding can either be … or …

Answer 10

comprehensive (CR/excursions)

limited (elim. lateral jiggling-type forces)

Question 11

what are the 6 steps in comprehensive occlusal adjustment by selective grinding

Answer 11

1. reduce CR-CO hit and slide
2. non-working side interferences (elim)
3. working contacts (canine guided and smooth)
4. protrusive contacts
5. sharp or irregular incisal edges
6. polish teeth that were ajdusted

Question 12

4 methods of jaw manipulation in centric relation

Answer 12

chin grasp
bilateral mandibular manip.
leaf gauge
patient determined

Question 13

6 possible contact relations from best to worst

Answer 13

1. cusp to fossa (ideal)
2. cusp to flat area (acceptable)
3. cusp to incline
4. cusp to embrassure
5. incline to incline
6. cusp to cusp (worst)

Question 14

CR interferences:

1. mesial inclines …
2. distal inclines ….

Answer 14

maxillary

mandibular

Question 15

as a general rule, do NOT reduce a …., adjust on ….

Answer 15

holding cusp tip

inclines

Question 16

flatten the cusp tip only when

Answer 16

there is a cusp to embrassure relationship then place the contact on flat areas