Objectives Module 1 + 2

Question 1

What are the 5 patient treatment descriptions that would require “complex” diagnosis + treatment planning procedure?

Answer 1

• 4 or more fixed restorations
• RPD
• FPD
• immediate denture opposed by natural teeth
• implant restoration

Question 2

What are the importances of accurate diagnostic casts?

Answer 2

• static + dynamic relationships of the teeth to be examined w/out interferences from neuromuscular reflexes
• unencumbered views from all directs reveal aspects of the occlusion not always seen intraorally
• occlusocervical dimension of edentulous spaces
• relative alignment + angulation of proposed abutment teeeth
• detailed analysis of occlusal plane
• tooth preps rehearsed + diagnostic waxing can evaluate CR + MI

Question 3

What is the pertinent info considered when formulating a tx plan?

Answer 3

• making correct diagnosis is prereq
• comprehensive assessment of pts general + dental health
• ind needs
• ind preferences
• personal circumstances

Question 4

What is diagnosis?

Answer 4

conditions which requires tx

Question 5

what is prognosis?

Answer 5

long-term outlook of the probable tx

Question 6

What are the general factors that influence the prognosis of tx?

Answer 6

overall caries rate
pt comprehensive + physical ability for plaque control
systemic problems (diabetes)
high occlusal force
history + success of previous dental tx

Question 7

What are the local factors that influence the prognosis of tx?

Answer 7

observed vertical overlap of anterior teeth (local dist)
impactions next to planned crown in younger person
ind tooth mobility
root angulation
root structure
crown/root ratio

Question 8

Describe the facebow procedure in relation to the transverse horizontal axis

Answer 8

facebow procedure establishes the rel of the maxillary dentition to horizontal reference plane so that the cast can be mounted in the correct anatomical position

Question 9

The facebow uses the _______ _______ _____ to determine arbitrary hinge axis

Answer 9

external auditory meatus

Question 10

What type of facebow do we use here at the OSU clinics?

Answer 10

Arbitrary hinge axis (AHA) facebow

Question 11

Describe the arbitrary hinge axis facebow + the purpose of an anterior reference point

Answer 11

approximates the horizontal axis + relies on anatomic average values
uses ext auditory meatus
minimum error of 5mm from axis expected
The anterior reference pt allows clinicians to duplicate the recorded position at future appointments w/out repeating procedure

Question 12

The anterior reference point is _____ mm above the right lateral or central incisor

Answer 12

43

Question 13

What is the difference btw nonadjustable + semidadjustable articulator?

Answer 13

nonadjustable- difference btw hinge + tooth being restored is sig less than in pt, results in premature contacts btw distal mand inclines + mesial max inclines of posterior teeth (usually nonworking side)
semiadjustable- requires less chairside adjusting, permits adjustment of condyalar inclination + immediate side shift

Question 14

What is the difference btw arcon + nonarcon articulators?

Answer 14

Arcon- anatomically correct- fossae attached to maxilla

Nonarcon- fossae attached to mandible

Question 15

When should nonadjustable or semiadjustable articulator be used?

Answer 15

selection depends on tx needs, demands for procdural accuracy + general expediency
when dental prosthesis is waxed, its advantageous to be able to separate the instrument
many cast restorations are made on small nonadjustable articulators

Question 16

Why is it essential that teeth do not perforate the CR record?

Answer 16

any tooth contact can cause mandibular translation bc of neuromuscular protective reflexes governed by mechanoreceptors in periodontium
reders the resulting articulation useless

Question 17

Describe the bimanual manipulation technique for making a CR record

Answer 17

dental chair reclined
both thumbs on chin
fingers resting firmly on inferior border of mandible
gentle downward pressure on thumbs + upward pressure on fingers

Question 18

Why is it recommended that CR records be trimmed before articulating the casts?

Answer 18

an untrimmed record makes assessment of proper cast seating much more difficult than a properly trimmed recrod
improperly seated record will result in a restoration w/ supraoccluson

Question 19

What is an example of anterior programming device

Answer 19

cotton rolls, leaf gauge, or small anterior programming device made of autopolymerizing resin

Question 20

When is an anterior programming device utilized?

Answer 20

when CR does not coincide w/ MI
resistance from well established protective reflexes can prevent mandibular manipulation (anterior device used to make pt forget the reflex)

Question 21

An anterior programming device is designed to hold the posterior teeth about ____ mm apart in CR in order to maintain a thin CR record

Answer 21

1mm

Question 22

What is the purpose of mounting 2 sets of casts in the diagnosis + tx planning of complex prost pts

Answer 22

generally pts dont enjoy having impressions made + complex tx often requires having more than 1 set of casts
- we duplicate the casts + reserve the master casts while perfomring tx plans on duplicates

Question 23

_______ _______ _______ is the complete intercuspation of the opposing teeth independent of condylar position, sometimes referred to as the best fit of the teeth regardless of the condylar position

Answer 23

maximal intercuspal position

Question 24

Maximal intercupsal position is also referred to what?

Answer 24

maximal intercuspation

Question 25

_____ ______ is the maxillomandibular relationship in which the condyles articuate w/ the thinnest avascular portion of their respective disks w/ the complex in the A-S position against the shapes of the articular eminences. This position is independent of tooth contact. Restricted purely to rotary movement about the THA

Answer 25

centric relation

Question 26

______ ______ is the occusion of the opposing teeth when the mandible is in centric relation. may or may not coincide w/ maximal intercuspal position

Answer 26

centric occlusion

Question 27

What is the significance of examining the amount of horizontal overlap of the maxillary and mandibular incisors before making the CR record?

Answer 27

amount of horizontal overlap will remain the same or slightly increase dep on amount of discrpancy btw CR and MIP

Question 28

What is the significance of a reduction in the amount of horizontal overlap ?

Answer 28

indication that pt is biting in protrusive (most common error when making a CR record)

Question 29

When is CR record recommended (as opposed to mounting in MIP?

Answer 29

restoring all posterior teeth in 1 or both arches
restoring all teeth in 1 arch
complete denture
occlusal equilibrium

Question 30

What are the advantages of a leaf gauge for making a CR record?

Answer 30

eliminates operator error ( dont need to manipulate the pt into CR bc flexible polyester material of leaves does this)
does not require fabrication of acrylic resin jig
ease of use

Question 31

What are the disadvantages of a leaf gauge for making a CR record?

Answer 31

pt may bite to hard + actually be in a “strained” position

leaf gauge not transferable to the cast to aid in the mounting procedure

Question 32

What are the advantages of using an anterior acrylic resin jig for making a CR record?

Answer 32

smallest variations
provide more security to operator at time of seating the casts on the registrations
fit accurately + not easily distorted
any type of occlusal rims can be mounted on it

Question 33

What are the disadvantages of using an anterior acrylic resin jig for making a CR record?

Answer 33

may take up space needed for setting the teeth, necessitating some grinding of the resin base in required areas
may be loose bc of necessary block out of undercuts in the cast