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Occlusion and Fixed > Lecture 9- Optimal Functional Occlusion > Flashcards

Lecture 9- Optimal Functional Occlusion Flashcards

1
Q

what do we need to know for optimal function occlusion

A
  • optimal occlusion in a stationary position: position of teeth, TMJ, muscles
  • optimal occlusion during excursive movements of the mandible
  • occlusal philosophies during excursive movements such as canine guidance, group function, balanced occlusion
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2
Q

what is the baseline for evaluating the patients occlusion

A

-teeth
-TMJ
- musculature

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3
Q

even though a patient may have an othodontically ideal angles class I occlusion what does this not mean

A

the patient has optimal occlusal contacts, optimal condyle/mandibular position, and ideal/optimal contacts in excursive movements

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4
Q

patients may have a less than ideal occlusion however it may still be a ____ or _____

A

functionally acceptable occlusion or a physiologically acceptable occlusion

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5
Q

to determine if occlusal treatment is required what should you assess

A

-the masticatory system for evidence of pathology - tooth wear, tooth mobility, TMJ dysfunction, muscle dysfunction
-adaptive capacity of the patient
- if treatment is rendered what is the optimal position for the joints, muscles and teeth

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6
Q

when are the TM joints in an optimum orthopedically stable joint position_____

A

when the mandible is in CR

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7
Q

what is centric relation used to define

A

a position in the condyles in relation to the disc and fossa

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8
Q

what is CR

A

when the condyles are in the most anteriorsuperior position in the glenoid fossa braced up on the intermediate zone of the disc and the mandible is free to rotate about the terminal hinge axis (up to but not including the point of first tooth contact

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9
Q

what does CR refer to

A

the joints not the teeth

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10
Q

how does the mandible move in CR

A

freely arc up and down along the terminal hinge axis

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11
Q

what is it called when the teeth cannot contact in CR

A

deflection

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12
Q

what is CR the ideal position

A
  • musculature in CR
    -TMJs in CR
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13
Q

the muscles ____ in CR

A

function harmoniously

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14
Q

why is the joint stable in CR

A

because the muscles attached to the joint prevent dislocation of the articular surfaces

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15
Q

what are the muscles that stabilize the TMJs and what does their contraction result in

A

-the masseters and the medial pterygoids
- contraction results in antero superior vector of force (stability)

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16
Q

what muscles are the most relaxed in CR

A

lateral pterygoids

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17
Q

describe the condyles in relation to the articular eminence in CR

A

condyles rest against the posterior slope of the articular eminence therefore can tolerate higher stresses

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18
Q

in the most retruded position:

A

-the retrodiscal tissues are innervated and would not tolerate stress
- the posterior wall of the articular fossa is very thin

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19
Q

in CR TMJs are stable even when

A

heavy loads/forces are applied

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20
Q

CR is the position to which we restore

A
  • completely edentulous patients
  • partially edentulous patients, when there are so few teeth remaining that there is not a stable MIP
  • dentate patients who are going to receive extensive restorations which will alter their occlusion completely
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21
Q

what should the posterior teeth be described as in CR for optimal functional occlusion

A

multiple, even, bilateral and simultaneous occlusal contacts with the mandible

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22
Q

how are the posterior teeth loaded for optimal functional occlusion

A

loaded along the long axis of the tooth called axial loading

23
Q

why are mutliple posterior teeth contacts importatn

A

the more teeth that contact the more stress is distributed throughout the arch

24
Q

why are even posterior teeth contacts important

A

ALL posterior teeth should contact evenly because it distributes the stress over all the teeth

25
Q

why are bilateral posterior teeth contacts important

A

for stability. if tooth contacts occur only on one side the mandible will pivot towards that side of contact and put increased pressure on the other side’s TMJ

26
Q

what type of forces on the teeth are not well accepted

A

lateral forces

27
Q

through axial loading _____ can be applied

A

heavier stresses

28
Q

anterior teeth should have ____ occlusal contacts when the posterior teeth are in occlusion

A

lighter

29
Q

why are anterior teeth not able to withstand higher loads

A

they are not loaded axially

30
Q

what is canine guidance

A

when the mandible moves laterally, the canines on the working side guide the. movement causing all other teeth to disclude

31
Q

what is anterior guidance

A

in protrusive movement the anterior teeth should disclude the posterior teeth

32
Q

what are contacts between the posterior teeth during excursive movements called and what can they cause

A

interferences and can cause damage to teeth and periodontium

33
Q

why is canine guidance/anterior guidance the optimal occusal scheme

A
  • the more anterior the resistance (load) occurs, the lesser the impact
  • the canine has the longest root and best bone support
34
Q

what is the mandible classified as

A

a class III lever

35
Q

what is optimal functional occlusion also referred to as

A

mutually protected occlusion

36
Q

what is optimal functional occlsuion

A

multiple, even, bilateral, simultaneous occlusal contacts of the posterior teeth in MIP while the mandible is in CR position
- MIP = CR

37
Q

how are posterior teeth loaded in MIP

A

axially

38
Q

what is mutually protected occlusion

A

the posterior teeth withstand the majority of the load in MIP, protecting the teeth from high loads
- the anterior teeth disclude the posterior teeth in excursive movements thereby protecting the posterior teeth from off axis loading
-posterior teeth can tolerate axial loading well and protect anterior teeth which are not axially loaded in MIP

39
Q

why can anterior teeth can tolerate lateral forces in excursive movements

A

because they are further away from the fulcrum and the loads are less

40
Q

what is group function

A

when the mandible moves laterally the mandible is guided by the outer inclines of the mandibular buccal cusps sliding along the inner inclines of the buccal cusps of the maxillary posterior teeth

41
Q

what is the most desirable group function

A

the canine, premolars and MB cusp of the first molar

42
Q

the more ____ the contacts, the greater the force- ____to the source of power; the more destructive the forces

A

posterior; closer

43
Q

on the working side, what guides along the inner inclines of the maxillary teeth as far posteriorly as the MB cusp of the first molar

A

only the buccal cusps of the mandibular teeth

44
Q

are there contacts on the non working side in group function

A

no

45
Q

is group function ideal

A

no but it is acceptable

46
Q

group function is the only option for patients who:

A
  • have no anterior vertical overlap
  • a very large anterior horizontal overlap (Class II)
  • have a reverse overlap (class III)
47
Q

what is group function also known as

A

unilateral balance

48
Q

what is balanced occlusion

A

-simultaneous contacts on both sides (working and non working) during lateral excursive movements (working side contacts and balancing side contacts)
- contacts between the posterior and anterior teeth during protrusive movement

49
Q

what happens in balanced occlusion on the WS and NWS if the mandible moves to the right

A
  • on the right side (WS) outer inclines of mandibular buccal cusps contact inner inclines of maxillary buccal cusps
  • on the left side (NWS) inner inclines of mandibular buccal cusps contact inner inclines of maxillary lingual cusps
50
Q

describe balanced occlusion during protrusion

A

there are contacts between posterior and anterior teeth

51
Q

describe balanced occlusion on posterior teeth

A

mesial inclines of mandibular cusps occlude with distal inclines of maxillary cusps

52
Q

describe balanced occlusion for dentate patients

A
  • not acceptable or ideal for dentate patients
  • promotes tooth wear on dentate patients
53
Q

when is balanced occlusion acceptable

A

for complete dentures

54
Q

describe non working side contacts in balanced occlusion

A

non working side contacts are extremely destructive and must be avoided

Occlusion and Fixed (14 decks)

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