Occlusal Examination

Question 1

Angle’s Class I

Answer 1

MB cusp of max 1st molar bisects/occludes w/ buccal groove of mand 1st molar
- Can have severe crowding & labially erupted canines

Question 2

Angle’s Class II

Answer 2

MB cusp of max 1st molar is M/forward to mand 1st molar’s buccal groove – “overbite”

Question 3

Angle’s Class III

Answer 3

MB cusp of max 1st molar is D to buccal groove of mand 1st molar – “underbite”

Question 4

Anterior crossbite

Answer 4

lateral & canine, bang causing it to turn lingually

Mand teeth in front of max (opposite is right)

Question 5

Posterior cross bite causes

Answer 5

friction, wear and tear

Question 6

Overbite

Answer 6

Extent of vertical (superior-inferior) overlap of max central incisors over mand central incisors

• Measured relative to incisal ridges/edges – how much does max cover mand?
• Not a form of malocclusion, instead an absence or excessiveness = malocclusion
• Can’t see mand anteriors very well, find incisal edge of lower anteriors & estimate where they are and how much max central incisors cover them
• Class I malocclusion

Question 7

Overjet

Answer 7

Extent of horizontal (anterior posterior) overlap of max central incisors over mand central incisors

• How much space btw mand incisors & max? – Close & measure w/ perioprobe on mand anteriors (measurement first seen pointing out after central incisor)
• Class II malocclusion

Question 8

Retrognathic

Answer 8

Abnormal posterior positioning of mandible, relative to facial skeleton & soft tissues – more common in mand, not seen straight on but from profile – looks like a severe
overbite
- underdeveloped mandible

Question 9

Prognathic

Answer 9

Marked protrusion of either mandible, not extremely severe can be treated in growing pt w/ orthodontic appliances – in severe (most) cases & adult pt, correction requires
surgical AND orthodontic treatment
- lower jaw juts out – bolus of food becomes difficult to eat – ortho & go in surgically to
resect & move jaw

Question 10

Lateral excursions (way teeth move on one another) border

Answer 10

Start @ max intercuspation

• “move lower jaw R (or L) while keeping your teeth in light contact (touch shoulder)” – See which teeth guide – contact while sliding
• Articulating paper marks where teeth are hitting each other

Question 11

Protrusion

Answer 11

Start @ max intercuspation

• “move mand straight forward while keeping teeth in light contact”
• See which teeth guide – contact will sliding & usually anteriors

Question 12

Occlusal trauma

Answer 12

Wear facets, broken restorations, chipped teeth

Question 13

Bruxism

Answer 13

Rubbing, gritting, or grinding (usually during sleep)

Question 14

Exostosis

Answer 14

Benign growth of new bone on top of existing bone, recession, periodontal

Question 15

Abfraction

Answer 15

Form of non-carious tooth loss occurring along gingival margin (cervical),
mechanical loss of tooth structure usually from flexural forces. Ex: bruxism or excessive brushing/attrition

Question 16

TMJ problems cause

Answer 16

headaches, sore m., cheek irritation (bilateral linea alba), scalloped tongue

Question 17

Attrition

Answer 17

loss of normal tooth structure & functional/parafunctional tooth to tooth contact (caused by bruxism)

Question 18

Ways to treat Abfraction

Answer 18

Night guard/splint to take on occlusal forces/load

Question 19

Abrasion-originating from friction or mechanical forces-foreign object

Answer 19

• Abnormal mechanical
• Interproximal (mechanical): toothpicks
• Incisal notching: nails, pipe, fishing line, sewers (used to tear)
• Cervical: tooth brushing (diff from abfraction not as deep)

Question 20

Erosion

Answer 20

Wearing away of the tooth surface by acid, dietary (carbonated drinks, fruit juice, and
fruits like lemons), regurgitation (GERG, bulimia)

Question 21

Erosion is caused by/signs

Answer 21

• Abnormal chemical – chemical wearing a way of tooth surfaces
• Facial: lemons, chlorine
• Lingual: bulimia – wouldn’t know until you looked in lingually
• Slick & outline of enamel is intact & see raised amalgam, thermal sensitivity
• Thinning, chipping of incisal edges - Anterior open bite (due to bulimia and thumb suckers)
• Loss of vertical dimension

Question 22

Attrition is caused by

Answer 22

Normal mastication, diet & age related, occlusal/incisal, bruxism accelerates (glassy, slick, hard to get composite to stick, deepen to restore?? b/c loss of vertical height)