Occlusion Flashcards
Occlusion Considerations: When considering a restoration for your patients, when should we check the occlusion?
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.
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)?
Make sure that whatever adjustment you make, it does not exacerbate the patient’s pre-existing condition.
Teeth are designed to absorb force in which direction?
Teeth are designed to absorb heavy forces in the direction of the long axis of the tooth. (vertical)
Teeth are NOT designed to absorb what kind of force? What are the consequences of kind of force?
Lateral forces. These can come from an incline contact.
Lateral forces can cause tooth fracture, tooth jiggling, and mandibular deflection.
Definition of OCCLUSION
Occlusion means the contacts between teeth.
Describe Class 1 Occlusion (Angle’s Classification)
Basically this is normal occlusion, i.e. the maxilla and mandible are in a normal position.
Describe Class 2 Occlusion (Angle’s Classification)
The maxilla is too far forward. (Or jaw is too far back.)
Describe Class 3 Occlusion (Angle’s Classification)
The mandible is too far forward. (Like an underbite)
Describe Centric Relation (CR)
- It has NOTHING to do with teeth.
- Relationship between maxilla and mandible.
What is the most ideal position in Centric Relation (CR)?
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.
Why is the ideal centric relation (CR) important?
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.
Define CENTRIC OCCLUSION (CO)
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.
What are types of Dynamic Occlusion?
- Working and non-working balancing sides
- anterior guidance
- posterior guidance
- canine guidance
- group function
describe Working side vs. Non-working side (balancing side)
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
Define Canine Guidance
when you slide your teeth to your right, and only your right canines contact during this lateral excursion, then you have canine guidance.
Define Group Function
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.
What population has a high prevalence of loss of canine guidance?
Med and dent students.
70% of bruxism is due to anxiety and stress
What is bruxism?
the involuntary or habitual grinding of the teeth, typically during sleep
bruxism causes abfraction, gum recession, and attrition
Define Working Side Interference
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.
Define Balancing Side Interference
A balancing side interference is when any tooth on the opposite side makes the first contact.
Protrusion
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
define CENTRIC STOPS/contact points
what should you do if you have them already?
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.
What are SEALANTS?
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.”
What is occlusal adjustment?
Attempt to distribute the occlusal contacts in an uniform way.
to achieve maximum intercuspation
Types:
Orthodontic
Prosthetic
Selective grinding
BULL Rule
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
Which should you adjust if given a choice between:
Cusp tip OR Incline
INCLINE
Which should you adjust if given a choice between:
Cusp tip or Bottom fossa
CUSP TIP
Which should you adjust if given a choice between:
Incline or Incline
BOTH
Which should you adjust if given a choice between:
Maxillary Incisal edge or Mandibular Incisal edge
Mandibular incisal edge
Which should you adjust if given a choice between:
Maxillary Lingual incline or Mandibular incisal edge
Mandibular incisal edge (To avoid increasing vertical overlap)
Which should you adjust if given a choice between:
Maxillary Lingual cusp or Mandibular lingual cusp tip
Mandibular lingual cusp tip (non-supporting cusp)
note: better to have wide shallow fossa and short bulky cusps to avoid deep bites
How should you treat CENTRIC STOPS?
Do not remove centric stops- those are stable contacts established by Maximum Intercuspation
How should you utilize the BULL rule?
Protrusive and working excursions use the BULL rule, which means grind the buccal cusps on maxillary teeth and lingual inclines of the buccal cusps.
How to achieve acceptable occlusion?
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
Goal is to achieve a mutually protected occlusion. What does that mean?
Anterior teeth protect posterior teeth
Posterior teeth protect anterior teeth
