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Removable Pros > Occlusion and Equilibration > Flashcards

Occlusion and Equilibration Flashcards

1
Q

if occlusal plane is curved and mandibular path is curved, posterior teeth will ____ in excursions?

A

OCCLUDE

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2
Q

if occlusal plane is flat and mandibular path is curved, posterior teeth will ____ in excursions?

A

DISCLUDE IN excursion

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3
Q

what tooth set up when H and V are efficient but ridge is not?

A

use monoplane with flat cusp and flat plane – will go up t0 2/3 height of RM pad because we want mosr retention

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4
Q

what tooth / plane set up when H and V are insufficient and ridge is insufficient

A

flat cusp with CURVED PLANE
- we need to use a curved plane because we need to provide protection in the anterior – so build in a curve but use flat plane because the ridge is insufficient

using 2/ 3 or 1/2 RMP

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5
Q

when do use anatomical set up

A

when H and V are sufficient
curve is sufficient
ridge is sufficient
- so we can add cusps – to provide further disclusion when the patient goes into protrusion or lateral movements

2/3 or 1/2

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6
Q

christensen’s phenomena

A

if occlusal plane is FLAT but the mandibular path is curved posterior teeth will DISCLUDE in excursions

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7
Q

H and V refer to?

A

anterior teeth – so we do not get anterior guidance

can build in curve to limit incisal guidance

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8
Q

curve of spee is what?

A

compensating curve

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9
Q

what do curves do?

A

curves create balance – whatever the cusp is

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10
Q

balancing ramp?

A

either TIPPING LAST TOOTH or ADD- addition of more wax/ material distal to the last tooth that can act as a compensating curve and create the same effect of curving the mandibular path – creating balance

so if occlusal plane is flat but there is a CURVE with this balancing ramp – posterior teeth with DISCLUDE in excursions

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11
Q

what do cusps create - general

A

further disclusion

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12
Q

can you have balance with a flat plane?

A

yes

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13
Q

what is compensating curve compensating for?

A

the slope of the articular eminence –

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14
Q

if really big overlap?

A

create a curve that is more severe and add cusps
- protecting the overbite

(little overlap– can create little curve)

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15
Q

relationship between vertical walls and retromylohyoid space

A

this space is afforded to us by the retromylohyoid space – better vertical walls = better resistance

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16
Q

vertical walls of good ridge give us?

implications on tooth selection?

A

RESISTANCE to lateral movements – “walls” afforded to us by the retromylohyoid ridge

we use this to determine which cusp to use – as better walls = better resistance in lateral movements

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17
Q

Vertical walls of resorbing ridges?

A

offer less resistance to lateral movement s

and vertical walls of resorbed ridges offer NO RESISTANCE to lateral movement

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18
Q

implication of cusped teeth in terms of force?

A

they deliver a greater lateral force than flat teeth

so if patient with no ridge is locked in with cusps – mandible moves and denture wont so pt. cannot retain and resoprtion occurs

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19
Q

cusp teeth stay in what for longer?

A

CONTACT – we want this only if ridges can support it

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20
Q

bad contact when going into protrusive movements can cuase?

A

sore spot against the anterior ridge

same thing can happen if bad contact when going into lateral excursions as the denture will push against the ridge

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21
Q

relationship of LOWER teeth to lower crest of ridge in monoplane?
in anatomical?

A

monoplane = centered to the ridge

anatomical = lingual to the ridge

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22
Q

lingualizing the lower teeth is beneficial how?

A

lingualizing the teeth will help resist the lateral forces

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23
Q

what is the relationship between the maxillary and mandibular molars in an anatomical set up?

A

3mm buccal to center of ridge – so buccal cusp of max sits here – so the buccal cusp of the mandibular molars

MANDIBULAR BUCCAL CUSP CENTERED OVER CREST OF RIDGE – aligning with the maxillary central fossa

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24
Q

maxillary central fossa is over what?

A

centered to the mandibular crest of ridge

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25
Q

long axis of the bicuspids are what to the plan in anatomical set up?

A

PERPENDICULAR to the plane

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26
Q

what cusps of bicuspids contact the plane in anatomical set up?

A

except the buccal cusp of the second pre-molar

- creating the curve

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27
Q

contact of maxillary first molar in anatomical set up?

A

only the ML cusp touches - so it is tilted

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28
Q

explain ‘two curves of spee”

A

buccal and lingual curves of spee and the difference in them is the curve of wilson

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29
Q

curve of spee starts where?

A

1/2 height of RMP - so if place second molar the height / tilt of this cannot be placed any higher than 2/3 the height of the pad

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30
Q

key relationship in anatomical set up?

A

MAX FIRST MOLAR
MB cusp must align in the buccal groove of the mandibular first molar — this is the most important tooth relationship besides the maxillary centrals

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31
Q

if max centrals too far facial? too far lingual?

A

too far facial – mandibular anteriors are forced to be too facial

to far lingual – mandibualr anteriors will also be too far lingual – so whole set up is too distal and arc is not big enough and wont have enough room

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32
Q

diastemas in anatomical set up?

A

NO – percise alignemnt in centric will facilitate alignement in excursions

  • means no diastemas and no wax on occlusions
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33
Q

how is vertical overlap created?

A

by raising the lowers

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34
Q

when can you never have a vertical overjet?

A

with a flat tooth and a flat plane

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35
Q

flat tooth curved plane in relationship to H and V? - deciding to raise plane?

A

can lift up the lower anteriors

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36
Q

cusped teeth with curved plane H and V relationship if need to adjust?

A

can have vertical overlap and can get more close horizontally as well – because the cusps afford dislcuson in anterior

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37
Q

cusp affords what?

A

ability to disclude in protrusion

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38
Q

rotational and lapping in anterior teeth?

A

may need to occur in the anatomical set up of mandibular anterios if there is not enough room and need to fit the teeth in the arch

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39
Q

working contact?

A

THE TEETH ARE EDGE TO EDGE ON WORKING – the mesial and distal inclines are aligned

all cusps contacting buccal-buccal
lingual- lingual

we get it to look like this by eliminating canine guidance

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40
Q

balancing contacts where?

A

contact between SUPPORTING CUSP INCLINES — incline of max lingual and incline of mandibulr buccal

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41
Q

centric occlusion contact in anatomical

A

NO ANTERIOR CONTACT
- there is contact between the supporting cusps

cusps in fossas

*the inner inclines of the upper cusps should be visible

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42
Q

what should be visible in centric in anatomical- what inclines? if cannot see what are you in?

A

INNER INLCINES of the upper cusps– teeth are NOT edge to edge

need to have the inner inclines visible as this is the ‘reveal’ area – if not = EDGE TO EDGE

43
Q

REVEAL

A

in centric occlusion – the reveal of the inner inclines of the max buccal – so we are ofset a bit and this should be UNIFORM

44
Q

what can you manipulate in upper or lower teeth to provide the reveal?

A

upper teeth can be rotated

lower teeth can be labialized

45
Q

anterior contact / relationship in centric in anatomical? posterior?

A

anterior =NO CONTACT - but we can have overlap

posterior = SUPPORTING / functional cusp contact – cusps in their fossas

46
Q

cusp relationship in left working?
incline relationship?
how do we achieve this?

A

cusps are EDGE TO EDGE – all are touching

mesial and distal inclines are aligned – they slide through eachother

we get it to look like this by ELIMINATING canine guidance

same if this was for right working too

47
Q

right balancing contact?

A

in SUPPORTING CUSP INCLINES – maxillary LINGUAL
– mandibular buccal

as mandible moves left – this is what contacts

48
Q

what can go wrong in terms of lab remound with exothermic reaction or wax on teeth?
if dough too rubbery?

A

teeth can move – if not enough wax on record base part – cannot separate as well

dough too rubbery = excessive VDO

49
Q

proccessing error in terms of occlusion? how does this happen?

A

IF WAX LEFT ON TEETH — the space between tooth and investement from wax remaianing on occlusal

so results in space b/w the tooth and investment – allows tooth to MOVE and there WILL BE AN OCCLUSAL ERROR

50
Q

tooth movement during processing causes?

A

occlusal errors

51
Q

what can go wrong before processing?

A

poor tooth position

wax shrinkage

52
Q

during processing errors

A 
wax on teeth 
poor luting
exothermic reaction
overpacking
packing too slowlt 
insufficient pressure
heating/cooling too fast

ALOT can go wrong and can all effect the occlusoin when back on the patient

53
Q

after processing errors?

A

heat from polishing

dessication (if dentures not kpet in water until the insertion)

54
Q

sequence of corrections

A
  1. lab remount

2. clinical remoount

55
Q

Lab remount
when
check what

A

IMMEDIATELY AFTER processing and BEFORE decasting and polishing

checks VDO and re-establishes VDO

number one reason is to RESTORE THE VDO

56
Q

clinical remound
when
check what

A

DONE AT INSERTION

checks centric and eccentric

maintains the VDO

EQUALIBRATE THE OCCLUSION

57
Q

describe lab remount

A

processed dentures on their final casts

plaster mountings on articulator and pin at VDO

final casts remounted via notches with pin up

dentures ground down to re-establish the VD) - pin down

58
Q

when does de-casting occur?

A

after the lab remount

59
Q

what could go wrong in the clinical remount?

A
  1. facebow preservation BEFORE THE final occlusion check
  2. CR registration incorrect - or perforation of aluwax
  3. mount without luting or lack of stablizatoin
  4. pt. remount not in CR
60
Q

6 main goals of equilibration

A
  1. to have CO=CR
  2. to maintain VDO
  3. to distribute stress
  4. to retain cusp shape
  5. to smooth contacting surfaces
  6. to achieve balanced occlusion
61
Q

polymerization shrinkage occurs towards what?

A

the greatest bulk of the denture – so towards the posterior – so where we may have an interference — like

62
Q

adjusting monoplane occlusion where do you start?

A

look at the height of the RMP – make sure we are at 2/3 if this is correct (area C and B) – we go to area D - maxillary

63
Q

with monoplane if need to reduce VDO?

A

need to adjust both up and bottom

but can only adjust C to 1/2 if need to

64
Q

what type of adjustemnts are we doing in monoplane?- general

what to do with bulls eyes?

A

flat adjustments – this is a flat occlusion

do not aim at the bullseye – adjust into it - remove them

65
Q

if incisal or canine guidance exists what do you do?

A

create WEAR FACETS

– CONSIDER BEVEL

66
Q

desired contact in CR for monoplane

A

no anterior contact no canine contact - contact in posterior

67
Q

any tooth that has gone beyond occlusal plane in monoplant posterior is considered?

A

a posterior INTERFERENCE - need to adjsut this
adjust D
adjusr pad

68
Q

what do you adjust first plane or pad

A

PLANE – so perfect lower plan to 2/3 RMP then adjust maxillary D area

69
Q

anterior interference in CR for monoplane? incisal guidance?

A

increase the horizontal and decrease the vertical

bevel it - to try and keep the height if we can so adjust the facial aspect

70
Q

monoplane posterior interference in lateral?

A

want group function – but if not cannot just remove single tooth interference — have to adjust ENTIRE OCCLUSAL PLANE – and create a curve of wilson

71
Q

what type of occlusal shceme are we aiming for in monoplane?

A

group function -

72
Q

T/F with all flat mandibular you use same rules for adjusting occlusion if have flat upper OR lingualized

A

TRUE – true for all flat mandibular monoplane

73
Q

equilibration sequence for anatomical set up

A
  1. centric interferences
  2. lateral interferences
  3. protrusive interferences
74
Q

interference

A

any contact that interferes with desired outcome

75
Q

what will grinding supporting cusps do

A

results in LOSS of CR and VDO

76
Q

primary and secondary cusps are move vs non -movable in working movement/ balancing on other side

A

primary = upper lingual – do NOT MOVE

secondary = lower buccal = move

aka mandible is moving

77
Q

centric prematurity AKA…

implication?

A

interference and will OPEN OCCLUSION ON OPPOSITE SIDE

78
Q

vertical centric interference in centric occlusion do you grind cusp (mandibular buccal) or fossa (maxillary){

A

DEPENDS

79
Q

before grinding you have to check?

A

excursions - so check right lateral/ left lateral and protrusion

80
Q

when to grind fossa if centric interference

A

if all excursions are okay because cusps contact in these

81
Q

grind cusp when? for adjusting vertical interference in centric for anatomical?

A

only adjust cusp if there is interference in eccentric and centric

82
Q

what are our contacting inclines in centric for anatomical?

A

MUDL = mesial of upper and distal of lower BUCCAL

DUML = distal of upper and mesial of lower BUCCAL cusps

83
Q

horizontal contacts will exist between? which will you grind to get rid of

A

MUDL

mesial of upper and distal of the lower

BUCCAL cusps

grind the mesial of the upper because these are not the functional ones like the lower buccal

84
Q

left working = what for right

A

left working = right balancing

85
Q

if you touch a supporting cusp what will you lose?

A

VERTICAL

86
Q

what contacts in working? non-working/balancing?

A

pairs of cusps = working so each working cusp opposes a non - supporting cusp

example – upper and lower buccal

upper and lower lingual

one pair = non -working ; the supporting functional ones (upper lingual, lower buccal

87
Q

how to restore bilateral balance if interferences in working movements?

A

BULL rule

buccal of upper

lower of lingual

88
Q

grinding ‘centric stops’

A

this is okay - no loss of CR or VDO

89
Q

T/F contact of supporting cusps on balancing side

A

TRUE – so grinding these WILL change CR or VDO

90
Q

how to adjust for balancing side interference?

A

in order to maintain CR and VDO grind ONLY the INNER INCLINE of the secondary supporting cusp – so the lower buccal inner incline

*INCLINE OF BL

91
Q

what do you use for articulating paper to remove lateral interferences?

A

use 2 COLORS of paper

92
Q

what if there is posterior disclusion in lateral?

A

there is CANINE GUIDANCE

93
Q

Rules for adjusting occlusion with canine guidance?

A

GRIND LOWERS FIRST
lower canine
lower premolar
then upper canine as last resort

94
Q

what contacts in protrusion for anatomical dentures

A

ONLY BUCCAL CUSP INCLINES

so contact between supporting and non supporting cusp inclines

DUML
- distal upper mesial of lower buccal

no lingual cusp contact in protrusion

95
Q

which inclines do you adjust if have interfernce in protrusion?

A

DISTAL OF UPPER – because these are the non- supporting/functional cusps

96
Q

when is the only time you can have anterior contac??

A

IN PROTRUSION but only with POSTERIOR CONTACT AT SAME TIME — BALANCE IN PROTRUSION

97
Q

what is the desired balance in anatomical set up

A

simultaneous anterior and posterior contact in protrusion

98
Q

reason for posterior disclusion in protrusion?

A

INCISAL GUIDANCE

99
Q

Iif in wax vs if in processed denture and we have incisal guidance?

A

wax = move or TRANSPOSE DO NOT TIP

cut– create wear facets if in the processed denture

100
Q

how to create a wear facet? what does it do?

A
  1. look at overlap you have – look at the shadow you have this is A - this is the furthest gingival point
  2. go half way up on your overlap and this is B
  3. then bevel – which is C — C = 1/2 bevel

This is first bevel – if need more – bevel until A

decreases vertical and gives you more horizontal

101
Q

what to do if full bevel is NOT sufficient enough to eliminate incisal guidance in protrusion?

A

upper LINGUAL may be ground but only as a last resort

102
Q

marking on the lower lingual and upper buccal.. what type of interference is this?

A

WORKING INTERFERENCE – USE BULL RULE

103
Q

marking on maxillary lingual and mandibular buccal?- what type of interference?

A

Balancing interference so grinf the BL - INCLINES ONLY

104
Q

grind only what?

A

THE BULLS EYES

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