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Sp15-Occlusion Final > Mandibular Movement > Flashcards

Mandibular Movement Flashcards

0
Q

When does translation occur?

A

When the incisors surpass 20-25mm of separation.

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1
Q

What is rotation?

A

Mandibular movement about the terminal hinge axis or transverse horizontal axis (imaginary line between two condyles). Rotational movement is limited to 20-25mm of incisal separation.

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2
Q

In a straight protrusive movement, both condyles will move ____________ as they slide along the eminences.

A

downward

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3
Q

In lateral movements, the non-working condyle will move _________ and ___________. Whereas, the working condyle will rotate and move _______and______ OR ________and__________.

A

Non-working: downward and medial

Working: lateral and upward, or lateral and downward

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4
Q

What did Ulf Posselt describe about the limits of mandibular movements?

A

Limits occur within a certain range that can be described in three planes of orientation. The starting reference point is between the two mandibular central incisors.

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5
Q

Ulf Posselt’s range of movement can be referred to as what phrase?

A

Envelope of Motion

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6
Q

What is centric relation?

A

The maxillomandibular relationship 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.

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7
Q

True or False: Centric relation is independent of tooth contact.

A

True

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8
Q

True or False: Centric relation is considered a reliable and reproducible reference position.

A

True

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9
Q

What is centric occlusion?

A

When the mandible is manipulated upward on the centric relation arc until tooth contact occurs.

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10
Q

Initial Points of Contact (first contacts in centric occlusion) occur on _____inclines of mandibular teeth and _______inclines of maxillary teeth.

A

Distal (mandibular)

Mesial (maxillary)

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11
Q

What is maximal intercuspation?

A

The position in which all teeth intercuspate together as best as they can.

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12
Q

What is centric slide?

A

The slide between centric occlusion (CO) and Maximum Intercuspation (MI). Susceptible to change throughout life.

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13
Q

True or False: If there is a slide between CO and MI, it is not necessary to determine whether corrective therapy is needed before restorative treatment.

A

False: If there is a centric slide, it is important to determine whether corrective treatment is needed.

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14
Q

What is the vertical dimension of occlusion?

A

The distance between two reference points (arbitrary points on the mandible and maxilla) when the teeth are in MI.

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15
Q

Incisal Guidance is measured in ______ from the ______ plane.

A

Degrees

Horizontal

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16
Q

The amount the mandible must drop in the anterior region is determined by the _______ guidance. The amount the mandible must drop in the posterior region is determined by the ________guidance.

A

anterior: incisal guidance
posterior: condylar guidance (angle of articular eminence)

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17
Q

Articulators can be classified as one of three types. What are the three?

A
  1. Small, non-adjustable
  2. Semi-adjustable
  3. Fully adjustable
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18
Q

Which type of articulator often leads to restorations with occlusal discrepancies because they cannot reproduce the full range of mandibular movement?

A

Small, non-adjustable articulator

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19
Q

Which type of articulator uses a face-bow transfer to position the casts with sufficient accuracy to minimize the need for adjustment?

A

Semi-adjustable articulator

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20
Q

Which type of articulator uses a pantograph to adjust the condylar elements?

A

Full adjustable articulator

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21
Q

Articulators with the condyles connected to the lower member are known as_________ articulators.

A

Arcon (articulating condyle)

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23
Q

The ear bow transfer relates the maxillary cast to the ______ _______ _______.

A

Terminal hinge Axis

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24
Q

What is incisal guidance determined by?

A
  1. Lingual Concavities of maxillary anterior teeth
  2. Vertical overlap of maxillary and mandibular anteriors
  3. Horizontal overlap of maxillary and mandibular anteriors
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25
Q

True or False: The Habitual Arc of Closure is reproducible.

A

False

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26
Q

Centric Relation is _____ and ______.

A

Reliable

Reproducible

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27
Q

What is the approximate range for Interocclusal Rest Distance? How is it found?

A

2-4mm

VDR (rest) - VDO (occlusion)

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28
Q

Incisal guidance is used to define the protrusive path of the mandible and the path the incisors must follow during ______ jaw movements.

A

Lateral

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29
Q

In order for the condyles to articulate with the thinnest avascular portion of their disks, the complex must be in the _________ position.

A

Anterior-Superior

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30
Q

In the horizontal plane, the working condyle moves _______.

A

Forward and Lateral
or
Backward and Lateral
(within Cone of Bennet)

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31
Q

In the horizontal plane, the non-working condyle moves_______.

A

Forward and Medial

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32
Q

In the frontal plane, both condyles will move ______ during protrusive movement.

A

Downward

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33
Q

In the frontal plane, the non-working condyle will move ________ during lateral movements.

A

Down and medial

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34
Q

In the frontal plane, the working condyle will move _____during lateral movements.

A

Down and Lateral
or
Up and Lateral

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35
Q

Ulf Posselt’s __________ describes the range of mandibular movements and its limits. Is this reproducible?

A

Envelope of Motion

No, only border movements are reproducible through operator manipulation

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36
Q

During protrusive movement, which teeth will most likely be in contact?

A

Incisors or Canines

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37
Q

What does the angle of the articular eminence determine?

A

Condylar Guidance

-the amount the mandible must drop in the posterior region

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38
Q

What are the posterior determinants of mandibular movement (x3)?

A
  1. Inclination of articular eminence
  2. Medial Wall of glenoid fossa
  3. Intercondylar distance
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39
Q

What are the anterior determinants of mandibular movement (x2)?

A
  1. Horizontal overlap of anterior teeth

2. Vertical overlap of anterior teeth

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40
Q

What are three additional determinants of mandibular movement (beyond anterior/posterior)?

A
  1. Occlusal Plane
  2. Curve of Spee
  3. Neuromuscular Response
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41
Q

True or False: Bonwill and Balkwill triangles are important determinants of mandibular movement.

A

False. They show relationships that are important for placing dentures. Nothing beyond that

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42
Q

Which type of articulator will often lead to occlusal discrepancies? Why?

A

Small, Non-adjustable

They cannot reproduce the full range of mandibular movements

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43
Q

Which type of articulator is about the same size as anatomic structures and uses an ear-bow transfer to position casts with accuracy?

A

Semi-Adjustable

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44
Q

Which type of articulator is capable of capturing border movements?

A

Full-Adjustable

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45
Q

The ______ cast is mounted by using the ear bow transfer.

A

Maxillary

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46
Q

The _______ cast is mounted by using the centric relation record.

A

Mandibular

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47
Q

The ear bow transfer allows the operator to relate the maxillary cast to the _______.

A

Terminal Hinge Axis

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48
Q

True or False: The Ear Bow Transfer allows correct orientation of the long axes of teeth in space and allows for extensive anterior restoration.

A

True

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49
Q

What is the horizontal reference in an ear bow transfer?

A

Interpupillary Line

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50
Q

In order to record centric relation, the patient’s _______ that guide the mandible in habitual movement have to be blocked out.

A

Proprioceptive Impulses

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51
Q

A natural reflex action of the mandible is to close into a _______ or a _____ ______ position when something is introduced in the mouth (wax, bite registration material) and the patient is instructed to bite.

A

Lateral

Lateral-protruded

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52
Q

True or False: The CR record should be obtained without tooth contact.

A

True

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53
Q

What are the three discussed methods for recording CR?

A
  1. Chin-Point Guidance
  2. Anterior Deprogrammer
  3. Bilateral (Bimanual) Manipulation (Dr. Dawson)
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54
Q

True or False: Doing a poor job of occlusal equilibration is far worse than leaving the malocclusion.

A

True
*New interferences can create an awareness that will trigger extreme discomfort of the teeth, TMJs, and masticatory muscles

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55
Q

In MI position, posterior teeth come into contact and act as stops to minimize ________ load on anterior teeth.

A

Horizontal

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56
Q

Anterior teeth guide ____ movements of the mandible and prevent posterior contact.

A

Excursive (lateral or protrussive)

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57
Q

True or False: Disclusion of posterior teeth during excursive movements is the rule, not the exception.

A

True

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58
Q

Occlusal forces should be direct along ______.

A

The long axes of teeth

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59
Q

In MI, all mandibular teeth should contact opposing maxillary teeth _______ and with _________.

A

At the same time

the same intensity

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60
Q

Working side contacts (canine or group function) should not be prevented from contacting due to _______.

A

Non-working interferences

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61
Q

Canine guidance creates posterior disclusion during _____ movement; incisal guidance creates disclusion during _____.

A

lateral

protrusion

62
Q

What is “group function?”

A

Mandibular (Buccal) working cusps contact lingual inclines of maxillary buccal cusps AND canines

63
Q

What are the four parts of the equilibration procedure?

A
  1. Reduction of contact that interferes with CR
  2. Reduction of lateral interference
  3. Elimination of posterior interference on protrusion
  4. Harmonization
64
Q

The rule for correcting anterior slide during closure is:

A

MUDL
mesial incline of upper
distal incline of lower

65
Q

The rule for correcting deviation toward the cheek during closure is:

A

BULL
Buccal Upper
Lingual Lower

66
Q

The rule for correcting deviation toward the tongue during closure is:

A

LUBL
Lingual Upper
Buccal Lower

67
Q

If there is a lateral interference during opening that involves the non-working side, correct using:

A

BULL

i think its “bull” that some people are not-working

68
Q

If there is a lateral interference during opening that involves the working side, correct using:

A

LUBL

69
Q

True or False: Canine guidance is the occlusion of choice because at the moment of posterior disclusion, the elevator muscle contraction is shut off and reduces the load on joints and anterior teeth.

A

False. ANTERIOR guidance does this

70
Q

In order to eliminate protrussive interferences, the grinding rule is:

A

DUML
Distal Upper
Mesial Lower

71
Q

What are the two uses of “incisal guide tables?”

A
  1. Record existing guidance prior to preparing teeth

2. Protect wax patterns

72
Q

The curve of spee utilizes a _______theory in which the axis lies along the mid-orbital plane.

A

Cylindrical

73
Q

What is Carl Christensen known for?

A

Christensen’s Phenomenon: During protrusion, there is posterior disclusion

74
Q

Monson’s Spherical theory used the ______ as a center of rotation for setting denture teeth.

A

Sella Turcica

75
Q

The curve of Wilson is seen in the ______ plane.

A

Frontal (MedioLateral Curve)

76
Q

The curve of Spee is seen in the ______ plane.

A

Sagital (AnteroPosterior Curve)

77
Q

The Conical Theory used the _______ as the anatomic rotation center of the mandible.

A

External Occipital Protuberance

78
Q

Increased Vertical Overlap allows for ______cusps during wax-up.

A

Longer

79
Q

Decreased Vertical Overlap requires _______ cusps during wax-up.

A

Shorter

80
Q

The superior head of the lateral pterygoid originates on the ______ and inserts on the ______.

A

O: sphenoid
I: medial side of condyle

81
Q

The inferior head of the lateral pterygoid originates on the ____ and inserts on the ______.

A

O: outer pterygoid plate
I: neck of condyle

82
Q

What is the action of the lateral pterygoid?

A

Open the mouth (digastric helps)

83
Q

The Medial Pterygoid originates on the pterygoid plate and inserts on the ______.

A

Mandible

84
Q

Which muscle is penetrated during anesthesia?

A

Meidal Pterygoid

85
Q

Which muscles close the mouth?

A

Temporalis, Medial Pterygoid, Masseter

86
Q

What type of joint is the TMJ?

A

Synovial

87
Q

A protrusive movement is ____ in the horizontal plane and _____ in the frontal plane.

A

Forward

Downward

88
Q

The chewing movement is in the shape of a _____.

A

Teardrop

89
Q

Which head of the lateral pterygoid works closely with the digastric to open the mouth?

A

Inferior head

90
Q

Which teeth are embedded in compact bone?

A

Canines only

91
Q

What technique is used to determine mandibular movements for use on a Fully Adjustable Articulator?

A

Pantograph (6 images with horizontal and sagittal angles)

92
Q

For Pantograph sketches, which angle is horizontal and which angle is sagittal?

A

Bennetts: Horizontal
Fischers: Sagittal

93
Q

Where should the ruler be placed in order to find the 3rd point of reference for the ear bow?

A

Between incisor and canine

94
Q

There are arbitrary and kinematic measures for finding the hinge axis location, but percent error is negligible if within a range of _____mm of the actual point.

A

6mm

95
Q

The ______ ____ ______ is located along the habitual arc of closure.

A

Physiological Rest Position

96
Q

The _______ is a built-in anatomical defense mechanism for controlling occlusal pressure forces.

A

Periodontal Ligament

97
Q

______-_____ occlusion is ideal.

A

Cusp-Fossa (tooth-to-tooth)

98
Q

____-_____ occlusion is not as stable.

A

Cusp-Marginal Ridge (tooth-to-two teeth)

99
Q

What is axial loading?

A

Cusp tip to flat surface (one point of contact). We AIM for “tripodization” during occlusion

100
Q

Our jaw is a Class ____ lever which is less efficient and therefore requires that most force be applied toward the fulcrum (posterior teeth)

A

THREE

101
Q

Posterior teeth contact will prevent _____ load on anterior teeth.

A

Horizontal

102
Q

What are the effects of tooth loss?

A
  1. Supraeruption of opposing arch
  2. Tilting of adjacent teeth
  3. Loss of contact
  4. Loss of posterior support
  5. Loss of vertical dimension
  6. Flaring of anterior teeth
  7. Non-working interference
103
Q

What is the preferred order of occlusal therapy?

A
  1. Selective Grinding
  2. Fixed Prosthodontics
  3. Orthodontic Therapy
  4. Orthognathic Surgery
104
Q

For the rule of thirds: Contact at the inner third would dictate______.

A

Selective Grinding within the enamel

105
Q

For the rule of thirds: Contact at the middle third would dictate ______.

A

Fixed Prosthodontics

106
Q

For the rule of thirds: Contact at the outer third would dictate _______.

A

Orthodontic Treatment

107
Q

The _____ the slide, the more likely it is to selectively grind within the confines of enamel.

A

shorter (taller cusps allow shorter slide than flat teeth)

108
Q

What is “gingival zenith?”

A

A slightly distal curve of the gingival margin

109
Q

What is the difference between macro-, mini-, and micro-esthetics?

A
  1. Macro = the face in three planes
  2. Mini = the framework from lips and buccal corridors
  3. Micro = teeth proportions, gingival shape, and color
110
Q

What is the difference between “smile line” and “lip line”?

A

Smile: Lower lip compared to maxillary teeth
Lip: Upper lip height

111
Q

_______ are a common subgroup of Orofacial pain disorders.

A

Temperomandibular Disorders (TMD)

112
Q

What are the two basic types of TMD?

A
  1. Myogenous (muscles related)

2. Arthrogenous (joint related)

113
Q

The _____ muscle lies in front of the joint disc and the ______ lie behind the disc.

A 
Lateral Pterygoid
Blood vessels (retrodiscal tissue + nerves)
114
Q

True or False: The history of pain does not particularly matter when diagnosing a TMD issue.

A

False: Good history taking is the BASIS for accurate diagnosis (when? how?)

115
Q

What are the cardinal criteria to consider when diagnosing TMD issues?

A
  1. Pain
  2. Limitation of Function
  3. Limitation of Movement
  4. Physical Changes (swelling)
  5. Altered jaw relationship
  6. Sounds that have been INCREASING in intensity and frequency
116
Q

What must you consider when evaluating sounds of the TMJ?

A

Has the INTENSITY or frequency increased recently

is it “normal”

117
Q

The etiology of TMD involves [Normal Function] + {event} which results in a period of _________ before TMD symptoms arise.

A

Physiologic Tolerance

118
Q

What is the importance of Physiologic Tolerance?

A

It is a narrow period of time during which the problem can be reversed before causing joint issues

119
Q

TMD is multifactorial and may involve what kind of factors or structures?

A
  1. pulp
  2. occlusion
  3. Perio (gingiva)
  4. Muscles of mastication
  5. Joint
  6. Ear
  7. Neck Muscles
  8. Sinuses
120
Q

Etiological Factors of TMD may be classified into what three categories?

A
  1. Predisposing
  2. Initiating
  3. Perpetuating
    {P.I.P. pop, make the pain stop!}
121
Q

_____ factors increase the risk for TMD but do not cause it.

A

Predisposing (loss of teeth)

122
Q

_____ factors CAUSE TMD

A

Initiating (Trauma, parafunctional habits)

123
Q

______ factors enhance the progression of TMD.

A

Perpetuating (behavioral, social, emotional)

124
Q

What are the five factors associated with TMD?

A
  1. Occlusal Condition
  2. Trauma
  3. Emotional Stress
  4. Deep Pain Input
  5. Parafunctional Habits (nail biting, thumb sucking)
125
Q

_______ occurs when the MI position of teeth is in harmony with the musculoskeletally stable position of the condyles in their fossae.

A

Orthopedic Stability

126
Q

What are some examples of Diurnal parafunctional activity?

A

Clenching/Grinding (only “bruxism” if at night)
Thumb Sucking
Cheek Biting
Nail Biting

127
Q

True or False: If occlusal interferences are found not to be related to TMJ pain, the dentist should use various therapies to find the cause.

A

False: Dentist should only provide care if occlusal interferences are the CAUSE of muscle symptoms

128
Q

Prosthetic treatment in TMD patients should only be carried out after ___________ has resulted in relief of pain and the normalization of function.

A

Reversible Therapy (i.e. Night Guard)

129
Q

_______ treatment of TMD is intended to directly eliminate or alter the cause of the disorder and its consequences.

A

Definitive

130
Q

________ is directed toward altering the patient’s symptoms, and reducing pain or dysfunction. No effect on the cause.

A

Supportive Therapy (pharmacological)

131
Q

What is an occlusal appliance?

A

ANY removable device that fits over the occlusal and incisal surfaces of the teeth on one arch. Creates a POSTIVE OCCLUSAL CONTACT with the teeth of the opposing arch

132
Q

Occlusal appliances may provide a temporary ______ join position, introduce an optimum functional _______, or protect teeth from abnormal forces.

A

Orthopedically Stable

Occlusion

133
Q

True or False: Occlusal appliances may reduce parafunctional muscle activity and reduce myogenous pain.

A

True

134
Q

Stabilization appliances, Anterior positioning appliances, Anterior bite plane, Posterior bite plane, Pivoting appliances, and Soft appliances are all examples of ______.

A

Occlusal appliances

135
Q

True or False: Inclined planes within the mouth are stable.

A

False, when contacting an incline plane the force will keep going until hitting a “stop”

136
Q

What is the most common type of occlusal appliance?

A

Stabilization

137
Q

How is an “Anterior Positioning Device” used to provide relief?

A

It provides mutually protected occlusion and allows retrodiscal tissue to heal when at rest

  • ***Should not be used over a large span on time. Posterior teeth are designed to bear most of the load and should be allowed to do so.
  • **Wearing for a long time= posterior teeth supraeruption.
138
Q

What is “Optimum Functional Occlusion?”

A

The condyles are in their most musculoskeletally stable position and teeth are able to contact EVENLY and SIMULTANEOUSLY to eliminate orthopedic instability

139
Q

What is the most common arch for placement of occlusal appliances?

A

Maxillary

140
Q

When are mandibular appliances used?

A

When patient grinds/clenches throughout the day

141
Q

What are the two methods for fabricating occlusal appliances?

A

Indirect

Direct

142
Q

Anterior positioning appliances may be used to force the condyle ____ to reduce the disc.

A

forward

143
Q

When making a single crown, in what position should the casts be related?

A

MI

not at CO

144
Q

BOARDS: Name the two condyles/sides for describing a right movement.

A

Right Working
Right Non-working (do not call it “left”)
Focus on the direction of movement, not the side of the jaw

145
Q

BOARDS: Name the two sides during a left movement of the mandible.

A

Left Working
Left Non-working (do not call it “right”)
Focus on the direction of movement, not the side of the jaw

146
Q

BOARDS: When the joint complex is in the _____ position, there is no pain because the force is taken by the avascular disc.

A

Anterior Superior

147
Q

The working condyle moves in any direction within ______; the non-working condyle may move medially and protrude along ______ angle or it may move downward and forward along ______angle.

A

The Cone of Bennett
Medial/Protrudes: horizontal plane = Bennett’s Angle
Downward/forward: Sagittal = Fischer’s Angle

148
Q

The mandibular buccal cusp will occlude with the _____ of the maxillary counterpart.

A

Mesial Fossa

149
Q

Endentulous patients will still have _____ movements even if you cannot trace occlusion.

A

Border (CR record)

150
Q

True or False: The arch of rotation is used to create wax-ups.

A

False: only use CR record because border movements are reliable and reproducible.
**The arch of rotation is nearly impossible to replicate

Sp15-Occlusion Final (1 decks)

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