Occlusion

Question 1

Occlusion

• The____ ___ ____
• More technically, it is the relationship between the ___ and ___ ____ when they ____ each other, as occurs during ____ or at ___.

Answer 1

Occlusion • The contact between teeth • More technically, it is the relationship between the maxillary and mandibular teeth when they approach each other, as occurs during chewing or at rest.

Question 2

Intercuspation

• The ___-to-___ relationship of the upper and lower posterior teeth to one another.
• The ____ or ___ ___ of the ___ of opposing teeth.
• Also called _____

Answer 2

Intercuspation • The cusp-to-fossa relationship of the upper and lower posterior teeth to one another. • The interlocking or fitting together of the cusps of opposing teeth. • Also called interdigitation

Question 3

• As a general rule, each tooth interdigitates with ____ opposing teeth.

o This helps provide ____ to the dental arches.

• Interdigitation is most distinct in the________ regions. It is less distinct in the _____ region.

Answer 3

• As a general rule, each tooth interdigitates with two opposing teeth. o This helps provide stability to the dental arches. • Interdigitation is most distinct in the anterior and premolar regions. It is less distinct in the molar region.

Question 4

• A mandibular tooth interdigitates with the same tooth in the maxillary arch and the tooth _____ to it.
• A maxillary tooth interdigitates with the same tooth in the mandibular arch and the tooth ___ to it.
• Exceptions - _______ and ______ interdigitate with only ___ opposing tooth.

Answer 4

• A mandibular tooth interdigitates with the same tooth in the maxillary arch and the tooth mesial to it. • A maxillary tooth interdigitates with the same tooth in the mandibular arch and the tooth distal to it. • Exceptions - mandibular central incisors and maxillary third molars interdigitate with only one opposing tooth. •

Question 5

Centric Occlusion

Centric occlusion - the occlusion of opposing teeth when the mandible is in ___ ___.

This may or may not coincide with____ ____

Answer 5

Centric Occlusion Centric occlusion - the occlusion of opposing teeth when the mandible is in centric relation. This may or may not coincide with maximum intercuspation.

Question 6

Centric Occlusion - Buccal View Note - ____ buccal ____ are in line with opposing buccal ____ and ___ ____

Answer 6

Centric Occlusion - Buccal View Note - maxillary buccal cusps are in line with opposing buccal embrasures and developmental grooves.

Question 7

Centric Occlusion - Lingual View Note - _____ lingual ___ are in line with opposing lingual ____ and___ ____

Answer 7

Centric Occlusion - Lingual View Note - mandibular lingual cusps are in line with opposing lingual embrasures and developmental grooves.

Question 8

Maximum Intercuspation

The occlusal position of the mandible in which the___ of the teeth of both arches ___ _____ themselves with the cusps of the teeth of the opposing arch.

“___ __ __ __ ____ ___ ___ __ ____”

Answer 8

Maximum Intercuspation The occlusal position of the mandible in which the cusps of the teeth of both arches fully interpose themselves with the cusps of the teeth of the opposing arch. Most stuff on top touching most stuff on bottom

Question 9

Centric Relation

• The _____ relationship in which the ____ articulate with the ____ ____ portion of their respective____ with the complex in the ____-___ position against the shapes of the ___ _____.
• This position is independent of __ ___.
• This position is clinically discernible when the mandible is directed ____ and _____
• It is restricted to a purely ____ movement about the transverse ____axis.
• Mandible has body (___ ____ portion), ramus (____portion)
• At top of ramus is the____ which is the joint ball
• The condyle as ____ up as it can get, it fits into an upside down “U” (the ___ ____)

o When its as high up as it can get and as far forward as it can get

o It must be ____ on the disk

• Disk is ____ shaped from front to back

o Fat on front and back and thin in the middle

o Condyle is supposed to be centered in the middle of that

• Important for when you are doing restorative dentistry on people who don’t have teeth because _____ function as a landmark
• For people with joint problems, Use ____ as an occlusal relationship to get these people back where they should be

Answer 9

Centric Relation • 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 eminencies. • This position is independent of tooth contact. • This position is clinically discernible when the mandible is directed superior and anteriorly. • It is restricted to a purely rotary movement about the transverse horizontal axis. •

Mandible has body (lower horizontal portion), ramus (vertical portion) • At top of ramus is the condyle which is the joint ball • The condyle as high up as it can get, it fits into an upside down “U” (the glenoid fossae) o When its as high up as it can get and as far forward as it can get o It must be centered on the disk • Disk is dumbbell shaped from front to back o Fat on front and back and thin in the middle o Condyle is supposed to be centered in the middle of that • Important for when you are doing restorative dentistry on people who don’t have teeth because teeth function as a landmark • For people with joint problems, Use CR as an occlusal relationship to get these people back where they should be

Question 10

Centric relation - when the condyles are in their most _______ position, resting on the ____ slopes of the ___ ____ with the___ properly____

Answer 10

Centric relation - when the condyles are in their most superoanterior position, resting on the posterior slopes of the articular eminences with the disks properly interposed.

Question 11

Centric occlusion has been described as a ___ to ____ relationship.

Most people have teeth.

This takes ____ in most cases.

Use them as a guide for where teeth are supposed to be

Answer 11

Centric occlusion has been described as a tooth-to-tooth relationship. Most people have teeth. This takes precedent in most cases. Use them as a guide for where teeth are supposed to be

Question 12

Centric relation has been described as a ___ to ___ relationship.

More accurately, it is a ___-to-___-to-____ relationship.

Answer 12

Centric relation has been described as a bone-to-bone relationship. More accurately, it is a bone-to-disk-to-bone relationship.

Question 13

Centric Stop

Opposing ___/____ _____ that maintain the ___ _____ dimension between the opposing arches.

Answer 13

Centric Stop Opposing cuspal/fossae contacts that maintain the occlusal vertical dimension between the opposing arches.

Question 14

Examples:

• Cusp -_______
• Cusp - ______
• Cusp - _______

Answer 14

Examples: • Cusp -Marginal Ridge • Cusp - Fossa • Cusp - Occlusal Embrasure

Question 15

Line of the Central Groove

This ___ ___ of the ____ inclines of the_____ cusps places them under/over the line of the ___ groove of the ____ arch.

Answer 15

Line of the Central Groove This rolling in of the outer inclines of the supporting cusps places them under/over the line of the central groove of the opposing arch.

Question 16

Posterior Occlusion – Passive

• The posterior teeth should act as “___ ____.”
• They are the ___ of ____
• You can’t bite down any more bc you are in ____ ____
• Ideally, the only ____ contacts should be on the ____ teeth.
• In the drawing to the right, a traditional cusp-marginal ridge type occlusion is depicted.

o Dots: ___ ___, ___ ___

o Skid marks: ____, fwd and lateral movements on the incisors and canines

o That is ____

Answer 16

Posterior Occlusion – Passive • The posterior teeth should act as “closure stoppers.” • They are the limit of closing • You can’t bite down any more bc you are in maximum intercuspation • Ideally, the only excursive contacts should be on the anterior teeth. • In the drawing to the right, a traditional cusp-marginal ridge type occlusion is depicted. o Dots: centric contacts, closure stoppers o Skid marks: protrusion, fwd and lateral movements on the incisors and canines o That is IDEAL

Question 17

Mutually Protected Occlusion

• The ____ teeth protect the ____ teeth in ___ and help prevent ___ ____ to the _____.

o They are contributors of ___and they limit ___ ____

• In protrusive movement the ____ protect the ____ and ____ teeth.

o When you move jaw fwd, ___ ___ fcn on the ___ ____and it should ____ (disclude) the rest of your teeth

• During lateral excursions the ____protect the____ and ____ teeth.

o During lateral movements, the _____ will disclude the rest of your teeth

Those are ____ they don’t always occur

Answer 17

Mutually Protected Occlusion • The posterior teeth protect the anterior teeth in CO and help prevent excess loading to the TMJ’s. o They are contributors of stability and they limit stop closure • In protrusive movement the incisors protect the canines and posterior teeth. o When you move jaw fwd, lower incisors fcn on the maxillary incisors and it should separate (disclude) the rest of your teeth • During lateral excursions the canines protect the incisors and posterior teeth. o During lateral movements, the canines will disclude the rest of your teeth Those are ideal, they don’t always occur

Question 18

Supporting Cusps

• In the maxillary arch, the supporting cusps are the ___ cusps.
• In the mandibular arch, the supporting cusps are the ____ cusps.
• The supporting cusps contact opposing ___ ____ and do most of the ____during mastication.

Answer 18

Supporting Cusps • In the maxillary arch, the supporting cusps are the lingual cusps. • In the mandibular arch, the supporting cusps are the buccal cusps. • The supporting cusps contact opposing centric stops and do most of the grinding during mastication.

Question 19

Non-supporting Cusps

• In the maxillary arch, the non-supporting cusps are the ___cusps.
• In the mandibular arch, the non-supporting cusps are the ___ cusps.
• These cusps ____ the supporting cusps.

In centric occlusion there is a ______. space between the ____ and ___ ____;.

Answer 19

Non-supporting Cusps • In the maxillary arch, the non-supporting cusps are the buccal cusps. • In the mandibular arch, the non-supporting cusps are the lingual cusps. • These cusps overlap the supporting cusps. In centric occlusion there is a .5-1.0 mm. space between the supporting and non-supporting cusps.

Question 20

Non-supporting Cusps -Protection of the Soft Tissues

• The maxillary buccal cusps overlap the opposing mandibular ____ cusps.
• The mandibular lingual cusps overlap the opposing maxillary ____ cusps.

Answer 20

Non-supporting Cusps -Protection of the Soft Tissues • The maxillary buccal cusps overlap the opposing mandibular buccal cusps. • The mandibular lingual cusps overlap the opposing maxillary lingual cusps.

Question 21

• The maxillary ____ cusps help keep the____ out of the way during mastication.
• The mandibular____ cusps help keep the ____ out of the way during mastication.

Answer 21

• The maxillary buccal cusps help keep the cheeks out of the way during mastication. • The mandibular lingual cusps help keep the tongue out of the way during mastication.

Question 22

Anterior Guidance

• Anterior guidance refers to the ____ relationships of the maxillary and mandibular ____ teeth during ____ movements. 

Excursive movements: movements ___ from ___

• Anterior guidance protects the____ teeth through posterior ____.

 If you push your chin___ and you ride on your anterior teeth, your back teet ___ ___.

Doesn’t always occur, but this is ideal

• The effects of anterior guidance are greater in the ____ region. The effects of condylar guidance are greater in the ____region.
• Anterior guidance helps prevent an excessive __ __ ____. This protects the ____ by limiting excursive movements.

Answer 22

Anterior Guidance • Anterior guidance refers to the functional relationships of the maxillary and mandibular anterior teeth during excursive movements.  Excursive movements: movements away from CO • Anterior guidance protects the posterior teeth through posterior disclusion.  If you push your chin fwd and you ride on your anterior teeth, your back teeth come apart  Doesn’t always occur, but this is ideal • The effects of anterior guidance are greater in the premolar region. The effects of condylar guidance are greater in the molar region. • Anterior guidance helps prevent an excessive range of motion. This protects the TMJ’s by limiting excursive movements.

Question 23

The anterior teeth are protected during excursive movements by their ____ from the ______. Note - the forces close to the joints are much ____.

Answer 23

The anterior teeth are protected during excursive movements by their distance from the temporomandibular joints. Note - the forces close to the joints are much greater.

Question 24

Cuspid Rise

___ ____ (Cuspid Rise): AKA ___ ___ ____

A form of ___ ___ articulation in which the vertical and horizontal_____ of the canine teeth ______ the ____ teeth in the _____ movements of the mandible.

If you move chin to___ or ____ you should ride the lingual of your _____canines and it will separate the rest of your teeth

Again, this is ideal

Answer 24

Cuspid Rise Canine Guidance (Cuspid Rise): AKA CANINE PROTECTED ARTICULATION Canine Protected Articulation – A form of mutually protected articulation in which the vertical and horizontal overlap of the canine teeth disengage the posterior teeth in the excursive movements of the mandible. If you move chin to left or right you should ride the lingual of your max canines and it will separate the rest of your teeth Again, this is ideal

Question 25

• Cuspid rise is a true friend to the ____ dentist.

o It helps prevent ___ and ____ interferences.

• The canine eminences are ___ ___ ___ of ___ that provide additional ____ from the forces on the____. Over the___ of the canines
• The canines also receive additional protection from the fact that they have the ___ ___in the mouth.

Mechanical devices can manage ____ forces more easily than ____or ____ forces.

Molars work mostly in ____ movements, compression

Canines: whole arch pushing against lingual of canines.

That’s a straight ____ force

If you want to break something like tear down a fence.

Reach up high and start pulling ____

You can overwhelm the forces

Answer 25

• Cuspid rise is a true friend to the restorative dentist. o It helps prevent working and balancing interferences. • The canine eminences are thick facial plates of bone that provide additional protection from the forces on the canines. Over the roots of the canines • The canines also receive additional protection from the fact that they have the longest roots in the mouth. Mechanical devices can manage linear forces more easily than oblique or lateral forces. Molars work mostly in vertical movements, compression Canines: whole arch pushing against lingual of canines. That’s a straight horizontal force If you want to break something like tear down a fence. Reach up high and start pulling laterally. You can overwhelm the forces

Question 26

Cuspid rise - during a lateral excursion, the ____ are the only teeth to touch on the___ ___.

We are on R side of patients mouth, top of tongue

Told patient to move chin to the right.

Cusp tip of mandibular canine is sliding down lingual incline of maxillary canine. This person has canine guidance and they are ____ the rest of their teeth when they do that .

Answer 26

Cuspid rise - during a lateral excursion, the canines are the only teeth to touch on the working side. We are on R side of patients mouth, top of tongue Told patient to move chin to the right. Cusp tip of mandibular canine is sliding down lingual incline of maxillary canine. This person has canine guidance and they are discluding the rest of their teeth when they do that .

Question 27

Group Function: Another possible scenario

____contact relations between the maxillary and mandibular teeth in ____movements on the ____ side whereby simultaneous contact of several teeth acts as a group to _____ occlusal ____

Answer 27

Group Function: Another possible scenario Multiple contact relations between the maxillary and mandibular teeth in lateral movements on the working side whereby simultaneous contact of several teeth acts as a group to distribute occlusal forces.

Question 28

Group function - during a lateral excursion, the ____ cusps contact along with the____ on the ____ side. Same scenario.

Patient move chin to the right

Answer 28

Group function - during a lateral excursion, the buccal cusps contact along with the canines on the working side. Same scenario. Patient move chin to the right

Question 29

In group function the ____ inclines of mandibular ____ cusps contact the ____ inclines of maxillary ___cusps.

Answer 29

In group function the outer inclines of mandibular buccal cusps contact the inner inclines of maxillary buccal cusps.

Question 30

When a patient has group function, the restorative dentist may need to give special consideration to the ___ ____.

The use of ___ and ___records to set the ____ walls may not be ____ for setting the condylar guidance on the articulator. We will talk about this another time.

Answer 30

When a patient has group function, the restorative dentist may need to give special consideration to the condylar guidance. The use of protrusive and lateral records to set the superior walls may not be adequate for setting the condylar guidance on the articulator. We will talk about this another time.

Question 31

Group Function - Occlusal Scheme

On ____ restorative cases with group function, some clinicians want ___ working contacts on the _____ cusps of the____ molars and the ____ cusps of the____molars.

That is to keep loads and forces more ____.

Stops it from breaking restorative work

Answer 31

Group Function - Occlusal Scheme On large restorative cases with group function, some clinicians want no working contacts on the distobuccal cusps of the first molars and the buccal cusps of the second molars. That is to keep loads and forces more manageable Stops it from breaking restorative work

Question 32

Group Function/Cuspid Rise

The ____ teeth can be described as the___ ____ of the occlusion. This is the same person!!

Answer 32

Group Function/Cuspid Rise The anterior teeth can be described as the steering wheel of the occlusion. This is the same person!!