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BDS3 Operative Dentistry > Occlusion > Flashcards

Occlusion Flashcards

1
Q

What is the definition of occlusion?

A
  • How the teeth meet together
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2
Q

What joins the TMJ together?

A
  • Condylar head of mandible
  • Mandibular fossa of temporal bone
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3
Q

What muscles involved in mandibular movement?

A
  • Muscles of mastication (masseter, Temporalis, Lateral pterygoid, medial pyerygoid
  • Suprahyoid
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4
Q

What does the temporalis do?

A
  • Elevate and retracts mandible
  • Assists in rotation
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5
Q

What does the lateral pterygoid do?

A
  • Positions disc in closing (Superior - SLP)
  • Protrudes and depresses mandible and causes lateral movement (inferior - ILP)
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6
Q

What does the medial pterygoid do?

A
  • Elevates mandible
  • Lateral movement and protrusion
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7
Q

What does masseter do?

A
  • Elevates and protracts mandible
  • Assists in lateral movement
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8
Q

What are the mandibular movements?

A
  • Rotation (not down and forwards!)
  • Translation
  • Lateral translation
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9
Q

What is rotation movement also known as?

A
  • Hinge movement
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10
Q

How much mouth opening can occur from rotation movement of TMJ?

A
  • Up to 20mm
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11
Q

What happens to the condyle during rotational movement?

A
  • Condyle and disc remain within articular fossa
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12
Q

How do hinge movement occur?

A
  • Rotation of condylar heads around imaginary horizontal line through rotational centres of condylars
  • Line called terminal hinge axis
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13
Q

How can you record the hinge movements measurements?

A
  • Use a facebow
  • Measure distance between condyles on terminal hinge axis
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14
Q

How does translation of the condyle occur?

A
  • Mouth closed
  • lateral pterygoid contracts
  • Articular disc and condyle begin to move
  • Travels downwards and forwards along incline of articular eminence
  • May also travel laterally (laterotrusive movement)
  • Mouth opens
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15
Q

What is Posselts envelope?

A
  • The extremes of mandibular movement
  • Border movements of mandible in sagittal plane
  • See word doc for diagram
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16
Q

In Posselts envelope what do the abbreviations mean?

A

ICP = Intercuspal position
E = Edge to Edge
Pr = Protrusion
T = Maximum opening
R = Retruded Axis position
RCP = Retruded contact position

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17
Q

What is ICP?

A
  • Intercuspal position
  • Tooth position regardless of condylar position
  • The comfortable bite
  • Best fit of teeth
  • Maximum interdigitation of teeth
  • Can be called centric occlusion (CO)
  • Mandible slides forward from RCP to achieve ICP
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18
Q

What is Edge to Edge?

A
  • Tooth position
  • Teeth slide forward from ICP guiding on palatal surfaces of anterior teeth
  • Incisal edges of upper and lower incisors touch
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19
Q

What is protrusion?

A
  • Condyle moves forwards and downwards on articular eminence
  • Only incisors +/- canines touch
  • No posterior tooth contacts
  • Eventually no tooth contacts
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20
Q

What is Maximum opening?

A
  • No tooth contacts
  • mouth wide open
  • Full translation of condyle over articular eminence
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21
Q

What is retruded axis position?

A
  • No tooth contacts
  • Most superior anterior position of condylar head in fossa
  • Terminal hinge axis
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22
Q

What is retruded contact position?

A
  • First tooth contact when mandible is in retruded axis position
  • ICP is approximately 1mm anterior to RCP in 90% population
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23
Q

What is lateral translation of mandible?

A
  • Has working side and non working side
  • Mandible moves either left or right
  • If mandible moving right then right = working side and left = non working side
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24
Q

What is lateral translation of the mandible also known as?

A
  • Bennet movement
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25
Q

What is the Bennet angle?

A
  • The path of the nonworking condyle in the horizontal plane during lateral excursion
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26
Q

How can you mark tooth contacts?

A
  • Use fine articulating paper
  • Millers forceps
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27
Q

When should you mark tooth contacts?

A

Before
- Preparing a tooth
- Removing a restoration

After
- Placement of a crown
- Placement of a restoration

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28
Q

What do tripodised contacts show?

A
  • Show where the opposing cusps contact (ICP stops)
29
Q

What are functional cusps?

A
  • Cusps that occlude with the opposing teeth in the ICP
  • Lingual cusps of upper posterior teeth
  • Buccal cusps of lower posterior teeth
30
Q

What are non functioning cusps?

A
  • Cusps that do not occlude with the opposing teeth in the ICP
  • Buccal cusps of upper posterior teeth
  • Lingual cusps of lower posterior teeth
31
Q

What is a Fossa?

A
  • Depression or concavity on tooth surface
  • Functional cusp of a tooth contacts the fossa of the opposing tooth
32
Q

What are ICP contacts?

A
  • Lingual cusp of upper molar contacts fossa of lower molar
  • Buccal cusp of lower molar contacts fossa of upper molar
33
Q

What are some problems that can arise in static occlusion?

A
  • Angles classification of incisor relationship
  • Overbite
  • Overjet
  • Anterior crossbite
  • Posterior crossbite
  • Anterior open bite
  • Posterior/lateral open bite
34
Q

What is Class 1 of Angles classification of incisor relationship?

A

Class 1 - Incisal edge of mandibular contact cingulum plateau of maxillary

35
Q

What is Class II div 1 of Angles classification of incisors?

A
  • Mandibular incisor edge lie posterior to cingulum plateau of maxillary central incisors
  • Maxillary central incisors proclined or average inclincation
  • Increased overjet
36
Q

What is Class II div 2 of Angles classification of incisors?

A
  • Mandibular incisor edge lie posterior to cingulum plateau of maxillary central incisors
  • Maxillary central incisors retro-clined
  • Overjet normally minimum but may be increased
37
Q

What is Class III of Angles classification of incisor relationship?

A
  • Mandibular incisor edges lie anterior to cingulum plateau of maxillary central incisors
  • Overjet reduced or reversed
38
Q

What is overbite?

A
  • Vertical overlap of maxillary central incisors over the mandibular central incisors
  • Can be decreased, normal or increased
39
Q

What is the normal overbite of teeth?

A
  • 2-4mm
40
Q

What is decreased overbite?

A
  • Can be complete or incomplete
  • Incisal edge of mandibular lie more anterior than normal
  • More proclined
41
Q

What is increased overbite?

A
  • Can be complete or incomplete
  • Complete can be non-traumatic or traumatic (Ackerly classification)
  • Incisal edge of mandibular posterior to cingulum plateau
42
Q

What is Class 1 of Ackerly classification?

A
  • Lower incisor impinge on palatal mucosa
  • Signs of trauma inc inflammation of palatal mucosa with imprint of lower incisor
43
Q

What is Class II of Ackerly classification?

A
  • Lower incisors incisal edge occlude into palatal gingival crevices of maxillary teeth
  • Signs of trauma inc
  • Labial splaying of maxillary incisors
  • Palatal pocket
44
Q

What is Class III of Ackerly classification?

A
  • Class II div 2 type of incisor relationship
  • Sign of trauma inc
  • Stripping of gingiva in relation to palatal surfaces of upper teeth and labial surfaces of lower anterior teeth
45
Q

What is Class IV of Ackerly classification?

A
  • Lower incisor causing progressive abrasion of palatal surfaces of maxillary teeth
  • Signs of trauma inc
  • Abrasion of palatal surfaces of upper anterior teeth
  • Dentin hypersensitivty
46
Q

What is Overjet?

A
  • Relationship between maxillary and mandibular teeth in a horizontal plane
47
Q

What is an anterior crossbite?

A
  • Condition where one or more anterior teeth may be abnormally malpositioned buccal or lingually or labially with reference to opposing teeth
48
Q

What is a posterior crossbite?

A
  • Condition where one or more posterior teeth may be abnormally malpositioned buccal or lingually or labially with reference to opposing teeth
49
Q

What is an anterior open bite?

A
  • Lack of vertical overlap of anterior teeth when posterior teeth in full occlusion
50
Q

What is posterior/ lateral open bite?

A
  • Failure of contact between the posterior teeth when teeth are in full occlusion
51
Q

What is canine guidance?

A
  • Dynamic occlusion
  • Mandible moves to one side and there is only contact between the canines
  • No posterior tooth contacts (creates a space)
  • Known as mutually protected occlusion
52
Q

What is the Gold standard of mutually protected occlusion?

A
  • Canine guidance
  • Posterior disclusion in lateral excursions
  • No non-working/ working side contacts
  • No protrusive interferences
53
Q

What is group function?

A
  • Mandible moves to one side (working side) and multiple teeth contact on that side
  • Bilateral group function frequently seen in toothwear
  • Most favourable guidance alternative to canine guidance
54
Q

What is the desirable group of contacts in a group function latero-trusive movement?

A
  • Canines, premolars and mesio-buccal cusp of first molar
  • Any contact more posterior not desirable as increased amount of forced placed due to closeness to fulcrum
55
Q

What is protrusion?

A
  • Condyle moves forwards and downwards on articular eminence
  • Only incisors +/- canines touch
  • No posterior tooth contacts
56
Q

What are some problems of dynamic occlusion?

A
  • Occlusal interferences
    - Working side
    - Non working side
    - Protrusive
57
Q

What occurs during working side occlusal interference?

A
  • Working side contact
  • Similar cusps contact e.g. the distal palatal of upper and distal lingual of lower
58
Q

What occurs during non working side occlusal interference?

A
  • Non working side contact
  • Dissimilar cusps contact e.g. palatal of uppers and buccal of lowers
59
Q

What is protrusive interference?

A
  • Any posterior contacts during protrusion
60
Q

Why is it important to avoid posterior contacts?

A
  • Teeth are designed to absorb heavy forces in direction of long axis of tooth
  • Most teeth not designed to absorb significant lateral forces generated by occlusal interferences
  • Musculature gets a rest as less activity if not undesirable posterior contacts
  • Occlusal trauma and undesirable tooth movement
61
Q

What are the types of Bruxism?

A
  • Eccentric
  • Centric
62
Q

What is Eccentric Bruxism?

A
  • Parafunctional grinding of teeth
  • Oral habit consisting of involuntary rhythmic or spasmodic or functional gnashing, grinding or clenching of teeth in other than chewing movements of mandible
  • May lead to occlusal trauma
63
Q

What is centric Bruxism?

A
  • Clenching
  • Pressing and clamping of jaws and teeth together
  • Associated with acute nervous tension or physical effort
64
Q

What are the clinical signs and symptoms of Bruxism?

A
  • Tooth wear
  • Fractured restorations
  • Tooth migration
  • Tooth mobility
  • Muscle pain and fatigue
  • Headache
  • Earache
  • Pain and stiffness in TMJ and surrounding muscles
65
Q

What are the different types of toothwear?

A
  • Multifactorial
  • Abrasion
  • Attrition
  • Erosion
  • Abfraction
66
Q

How do you classify toothwear?

A
  • Mild
    -Moderate
  • Severe
67
Q

What is occlusal trauma?

A
  • Injury resulting in tissue changes within attachment apparatus
  • Inc PDL, supporting alveolar bone and cementum
  • As result of occlusal force/s
68
Q

What are the classification of occlusal trauma?

A

Primary - Intact periodontium

Secondary - Reduced periodontium

Fremitus - Palpable or visible movement of tooth when subjected to occlusal force

69
Q

What is included in the examination checklist for occlusion?

A
  • Incisor relationship
  • Guidance
  • Overjet/overbite
  • ICP contacts
  • Working/non working/ protrusive contacts
  • Pathology

BDS3 Operative Dentistry (5 decks)

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