Module 6 Flashcards
Describe “Reorganized Occlusion”
eg. Making the patient’s CR with MI
Tx steps then include occlusal adjustment of existing dentition by selective reshaping and reorganization of the anterior (incisal) guidance before tooth prep for the definitive cast restorations`
Describe “Conformative Occlusion”
A cast restoration that conforms to the pt’s existing occlusion, even if there is a discrepancy between CR and MI
The goal is to maintain rather than reorganize a healthy masticatory apparatus
Done when the pt has symptom-free occlusion and requires relatively few cast restorations
What are the goals of selective grinding?
All posterior teeth contact evenly and simultaneously in CR
When mandible is moved laterally, laterotrusive contacts on the anterior teeth disocclude the posteriors
When mandible is protruded, posterior don’t contact
Redistribute forces parallel to the long axis of the tooth, and create cusp-fossa relationship
Eliminate occlusal interferences
Improve worn occlusal anatomy
Create optimal occlusion
Improve mandibular movement, chewing efficiency, and tooth stability
Describe optimal occlusion
Proper relationship of disc-condyle assembly when the mandible is in CR
Uniform simultaneous contact of all teeth when mandible is in CR
During any lateral movement, there is immediate disclusion of posterior, guided by ipsilateral canines
During protrusive movement, there is disclusion of posteriors, guided by anteriors
Anterior guidance that is compatible with functional mandibular movement and patient comfort
What are the two phases of a diagnostic occlusal adjustment?
Phase I - Eliminate CR prematurity
Phase II - Eliminate lateral and protrusive interferences
If MI does not equal Cr, what is the issue?
Premature contacts will occur
Protrusive Interferences
Cause condylar processes to be displaced anteriorly
Found between mesial inclines of max teeth and distal inclines of mandibular teeth (MUDL)
Adjust ll contacts evenly
Fossae should be deepened before funcitonal cusp is shortened
Lateral Displacing Prematurity
Results in lateral (toward cheek) or medial (toward tongue) slide
Buccal inclines of max teeth and lingual inclines of man teeth should be adjusted (BULL)
What should be ground to eliminate lateral and protrusive interferences?
DUML
What are the indications of an occlusal adjustment?
Prior to restorative dentistry involving occlusion of an entire sextant with opposing natural teeth
TMD patients whose occlusal discrepancies have been diagnosed as the cause
Pts whose occlusal relationships contribute to perio destruction
Following ortho treatment
(TFO, post ortho/surgery, TMD pts with strong occlusal etiology)
What are the contraindicatiosn of occlusal adjustment
Pts w/ severe skeletal deformities or malocclusions
Pts w/ painful symptoms with man movement
Pts whose man movement is limited by splints or inflammation
Pts unwilling to accept restoratie procedures resulting form the exposure of dentin
Incomplete development
Anticipated ortho or maxillofacial surgery
Pts taking meds with Parkinsons-like side effects
(Severe malocclusion, adolescents, pain, restricted movement, lack of consent)
What are the limitations of occlusal adjustment
Subtractive process
Dentin exposure (causes sensitivity)
Reduction of occlusal vertical dimension)
Can affect facial esthetics
