Occlusion

Question 1

Occlusion Considerations: When considering a restoration for your patients, when should we check the occlusion?

Answer 1

Before and after a procedure. (probably during too, vaguely remember her saying that.) It is important to check the patient’s occlusion before placing a restoration so we can compare. We also need to diagnose and evaluate any occlusion interferences prior to any treatment.

Question 2

Occlusion Considerations: What if your patient’s pre-existing condition is not an ideal occlusion or even if your patient has a temporomandibular disorder (TMD)?

Answer 2

Make sure that whatever adjustment you make, it does not exacerbate the patient’s pre-existing condition.

Question 3

Teeth are designed to absorb force in which direction?

Answer 3

Teeth are designed to absorb heavy forces in the direction of the long axis of the tooth. (vertical)

Question 4

Teeth are NOT designed to absorb what kind of force? What are the consequences of kind of force?

Answer 4

Lateral forces. These can come from an incline contact.

Lateral forces can cause tooth fracture, tooth jiggling, and mandibular deflection.

Question 5

Definition of OCCLUSION

Answer 5

Occlusion means the contacts between teeth.

Question 6

Describe Class 1 Occlusion (Angle’s Classification)

Answer 6

Basically this is normal occlusion, i.e. the maxilla and mandible are in a normal position.

Question 7

Describe Class 2 Occlusion (Angle’s Classification)

Answer 7

The maxilla is too far forward. (Or jaw is too far back.)

Question 8

Describe Class 3 Occlusion (Angle’s Classification)

Answer 8

The mandible is too far forward. (Like an underbite)

Question 9

Describe Centric Relation (CR)

Answer 9

• It has NOTHING to do with teeth.

- Relationship between maxilla and mandible.

Question 10

What is the most ideal position in Centric Relation (CR)?

Answer 10

Centric Relation (CR) is the mandibular position in which the head of the condyle is situated at the most posterior and superior position within the mandibular fossa.

Question 11

Why is the ideal centric relation (CR) important?

Answer 11

This position is used when restoring edentulous patients with removable or either implant-supported hybrid or fixed prostheses. Because the dentist wants to be able to reproducibly relate the patient’s maxilla and mandible, but the patient does not have teeth with which to establish his or her own vertical dimension of occlusion, another method has been devised to achieve this goal. The condyle can only be in the same place as it was the last time it was positioned by the dentist if it is consistently moved to the most superior and posterior position within the fossa.

Question 12

Define CENTRIC OCCLUSION (CO)

Answer 12

the occlusion position in which the patient fits all the teeth together in maximum intercuspation (ICP)

This is a type of static occlusion.

it has 100% to do with teeth!!!

Basically its the typodont.

This isn’t that difficult of a concept to understand, dangit.

Question 13

What are types of Dynamic Occlusion?

Answer 13

• Working and non-working balancing sides
• anterior guidance
• posterior guidance
  - canine guidance
  - group function

Question 14

describe Working side vs. Non-working side (balancing side)

Answer 14

Working side is the side your mandible is in, the non working side is the opposite side of that.

working side moves towards your cheek.

balancing side moves toward your tongue.

WC-BT

Question 15

Define Canine Guidance

Answer 15

when you slide your teeth to your right, and only your right canines contact during this lateral excursion, then you have canine guidance.

Question 16

Define Group Function

Answer 16

If however when you slide laterally a number of teeth on your working side are in contact at the same time, all sharing the load, this is called group function.

Question 17

What population has a high prevalence of loss of canine guidance?

Answer 17

Med and dent students.

70% of bruxism is due to anxiety and stress

Question 18

What is bruxism?

Answer 18

the involuntary or habitual grinding of the teeth, typically during sleep

bruxism causes abfraction, gum recession, and attrition

Question 19

Define Working Side Interference

Answer 19

When you move your jaw laterally, if the first contact is just on a single tooth near the back (on the working side), this is called a working side interference. For example, perhaps there is an upper molar which has tilted into an adjacent extraction space.

Question 20

Define Balancing Side Interference

Answer 20

A balancing side interference is when any tooth on the opposite side makes the first contact.

Question 21

Protrusion

Answer 21

In the protrusion (protrusive movement), all posterior teeth should separate (discclusion), which is known as Anterior Guidance
Ideally 6-4 the anterior teeth touching only
Very important to protect the posterior teeth during the protrusion

Question 22

define CENTRIC STOPS/contact points

what should you do if you have them already?

Answer 22

the stable points of contact between occluded maxillary and mandibular teeth, located in the central pits, marginal ridges, and buccal and lingual cusps of posterior teeth and the incisals and linguals of anterior teeth.

You should try to keep them when adjusting occlusion.

Question 23

What are SEALANTS?

Answer 23

You will learn more about them in DENT 519.- Dr. Karl

lol jk

“Dental sealants are plastic coatings that are usually placed on the chewing (occlusal) surface of the permanent back teeth — the molars and premolars — to help protect them from decay.”

Question 24

What is occlusal adjustment?

Answer 24

Attempt to distribute the occlusal contacts in an uniform way.
to achieve maximum intercuspation

Types:
Orthodontic
Prosthetic
Selective grinding

Question 25

BULL Rule

Answer 25

Buccal “Upper”, Lingual “Lower”

describes the non-supporting cusps
these are the cusps where interference will happen
don’t remove centric stops on these ones

Question 26

Which should you adjust if given a choice between:

Cusp tip OR Incline

Answer 26

INCLINE

Question 27

Which should you adjust if given a choice between:

Cusp tip or Bottom fossa

Answer 27

CUSP TIP

Question 28

Which should you adjust if given a choice between:

Incline or Incline

Answer 28

BOTH

Question 29

Which should you adjust if given a choice between:

Maxillary Incisal edge or Mandibular Incisal edge

Answer 29

Mandibular incisal edge

Question 30

Which should you adjust if given a choice between:

Maxillary Lingual incline or Mandibular incisal edge

Answer 30

Mandibular incisal edge (To avoid increasing vertical overlap)

Question 31

Which should you adjust if given a choice between:

Maxillary Lingual cusp or Mandibular lingual cusp tip

Answer 31

Mandibular lingual cusp tip (non-supporting cusp)

note: better to have wide shallow fossa and short bulky cusps to avoid deep bites

Question 32

How should you treat CENTRIC STOPS?

Answer 32

Do not remove centric stops- those are stable contacts established by Maximum Intercuspation

Question 33

How should you utilize the BULL rule?

Answer 33

Protrusive and working excursions use the BULL rule, which means grind the buccal cusps on maxillary teeth and lingual inclines of the buccal cusps.

Question 34

How to achieve acceptable occlusion?

Answer 34

Occlusal contact on all teeth
Protrusive: All posterior teeth are in disclusion (clearance between them) – Incisal Guidance
Bilateral protrusive contact on anterior teeth when the mandible is in protrusive
Disclusion of posterior teeth on the non-working side in lateral excursions
Canine guided or group function in lateral excursions

Question 35

Goal is to achieve a mutually protected occlusion. What does that mean?

Answer 35

Anterior teeth protect posterior teeth

Posterior teeth protect anterior teeth