Lecture 6_ Inserting the guard Flashcards
Why do we use occlusal devices?
It may be used for occlusal stabilization, for treatment of temporomandibular disorders, or to prevent wear of the dentition
T/F
an occlusal device can be used to rule out certain etiologic factors
Helps identify CAUSE-and-EFFECT relationships
TRUE
can you treat irreversible TMD with an occlusal guard?
NO, just for reversible
can you use an occlusal device to establish and OVD?
yes
how effective are occlusal devices in reducing TMD symptoms?
70-90%
T/F
Recent studies indicate that a palatal splint, without occlusal coverage is as effective as a full occlusal coverage occlusal device
True
T/F
Occlusal splints unload the joint?
FALSE
what does increasing the OVD do?
rotates the condyles down while they are STILL LOADED
what are the indications for an anterior positioning device?
treat disc displacements and disc dislocations with reduction.
irrgular or chronic locking of the joint
retrodiscicitis
reciprocal click
single click
goal of anterior positioning device?
The goal of treatment is not to alter the mandibular position permanently but only to change the position temporarily so as to enhance adaptation of the retrodiscal tissues.
is it appropriate to use orthortic device?
no. ..
* *more for bracing a limb
what is the most appropriate name for an occlusal device?
orthosis** best**
This type of splint allows the muscles to move the condyles into centric relation without interference from any tooth inclines?
permissive splint
describe directive splint?
directs the mandible into a predetermined relationship, directing the condyles into pre determined position
when can we use splint to describe occlusal device?
if we are splinting mobile maxillary teeth together for instance
can you use “appliance”
DON’T…
call it a device or a prosthesis
where do yo want the condyles to rest with the occlusal guard?
most superoanterior position against the posterior slopes of the articular eminence
Do you want treatment to be reversible or irreversible?
REVERSIBLE!!!! no harm done….
you want to temporarily alter the occlusal condition, but when its removed it returns to the pre-existing condition
can you use occlusal device to splint?
yes
Can you make the guard to the length of the future OVD??
YES!!! test the fricatives after you do so!
benefits of maxillary device vs. mandibular?
-More retentive
-Stronger
-More versatile (can use for class II and III patients)
0-Increased stability
benefits of mandibular device?
- easier to speak
- more aesthetic
- cannot use anterior stop to find CR
DON’T DO THIS THOUGH!!!! Cannot use anterior stop to find CR!
-May cause tongue repression..therefore you end up protruding
effectiveness of reducing symptoms?
70-90 %
is the reduction in muscle activity due to change in OVD?
no
Like when you hold you masters together and put finger in the middle that’s why
is it possible to unload the joint with an occlusal device?
no
T/F
increasing the OVD takes all the loading forces off the TMJS and puts the load on the teeth?
no
the joint rotates in all dimensions whether protruded or retruded…can’t take the load off the joints
What does increasing OVD do to the condyles?
it simply ROTATES them while still LOADED
DOES not distract them down
how thick should the guard be on the lingual?
make it only 1 mm thick
You should make it 3 mm from the gingival line. You can make it right to the gingival line or just to the occlusal
what muscles does the retracted tongue aggrevate?
lateral pterygoids which will push the jaw forward
if you make a mandibular guard, can there be resin on the lingual?
NO because can affect the tongue
They don’t splint the maxillary teeth
NOT better for you though because of the force vectors
contraindications for mandibular occlusal
-severe retrognathia
-tipped lingually
mobile max teeth
anterior open bite
OSAS
-endlarged tongue
what is the strength of the device dependent upon?
VERTICAL thickness not the palatal width
must be able to accurately record the vertical thickness for the record
T/F
anterior teeth should occlude on a very small flat shelf and the disocclusion should be immediate and gradual?
true
T/F
Anterior teeth should hold, posterior teeth should drag?
false…opposite
drawbacks to using a soft material?
precision of the contacts is difficult
what can you use soft guards for?
athletic guards
clenching or bruxism
chronic sinusitis
should you use an anterior deprogramming device or pivotal?
no
teeth around will super erupt and you can cause malocclusion
