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restorative > occlusion and Rx dentistry (3rd year) > Flashcards

occlusion and Rx dentistry (3rd year) Flashcards

1
Q

muscles involved in mandibular movement

A

MofM

suprahyoids

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2
Q

muscles involved in mandibular movement - MofM

A

temporalis - elevates and retracts
LP - protrudes, depresses, lat movement
MP - elevates, lat movement
masseter - elevates and protracts

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3
Q

muscles involved in mandibular movement - suprahyoids

A

elevate hyoid bone/depress mandible

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4
Q

mandibular movements

A

rotation

translocation

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5
Q

rotation

A

small amount of mouth opening (up to 20mm)
condyle and disc remains within the articular fossa
no downwards or forwards movement
“hinge movement”

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6
Q

hinge movements and terminal hinge axis

A

rotation of condylar heads around the imaginary horizontal line through rotational centres of the condyles
imaginary line - terminal hinge axis

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7
Q

facebow

A

records relationship of maxilla to the hinge axis of rotation of the mandible

  • terminal hinge axis
  • inter-condylar distance
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8
Q

translocation

A

LP contracts
articular disc and condyle begin to move
travel downwards and forwards along incline of the articular eminence
may also travel laterally (laterotrusive movement)

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9
Q

condylar guidance angle

A 
condyle sliding down the articular eminence
anatomy varies (av value)
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10
Q

ICP-RCP slide

A

ICP about 1mm anterior to RCP in 90% of the pop

RCP and ICP not coincident so mandible slides forward to achieve ICP - anterior slide

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11
Q

ICP-RCP slide and restoring last tooth in arch

A

if pt has a large bite and you don’t take a facebow before crowns then you may prop open

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12
Q

describe the working and non-working sides if the mandible moves to the right

A

RS - working side

LS - non-working side

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13
Q

Posselt’s envelope

A

extremes of mandibular movement

border movements of the mandible in the sagittal plane

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14
Q

border movements of the mandible - positions

A 
ICP
E (edge to edge)
Pr
T (max opening)
R (retruded axis position)
RCP
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15
Q

ICP

A

tooth position regardless of the condylar position

max interdigitation

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16
Q

edge to edge

A

tooth position
teeth slide forward from ICP guiding on palatal surfaces of anterior teeth
incisal edges of U and L incisors touch

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17
Q

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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18
Q

max opening

A

no tooth contacts
mouth wide open
full translocation of the condyle over the articular eminence

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19
Q

retruded axis position

A

reproducible - used in dentures and toothwear
no tooth contacts
most superior anterior position of the condylar head in the fossa
terminal hinge axis

20
Q

RCP

A

1st tooth contact when the mandible is in R

ICP is about 1mm anterior to RCP in 90% of population - in 10% RCP and ICP are the same

21
Q

marking tooth contacts

A

dry teeth
Millers forceps and fine articulating paper
for ICP contacts just get them to tap
if want guidance get ICP in blue then get them to grind using red

22
Q

when to mark tooth contacts

A 
before
 - preparing a tooth
 - removing a restoration
after
 - placement of a crown
 - placement of a restoration
23
Q

what to look at in the static occlusion

A 
incisor relationship
molar relationship
OJ/OB
cross bites
open bites
individual tooth contacts
RCP-ICP slide (freedom in static)
24
Q

functional (working) cusps

A

cusps that occlude with the opposing teeth in ICP

lingual cusps of U posteriors and buccal cusps of L posteriors

25
Q

non-functional (balancing) cusps

A

cusps that do not occlude with the opposing teeth in ICP

buccal cusps of U posteriors and lingual cusps of L posteriors

26
Q

fossa

A

depression/concavity

fct cusp of a tooth contacts fossa of opposing tooth

27
Q

ICP contacts

A

lingual cusp of U molar contacts fossa of L molar

buccal cusp of L molar contacts fossa of U molar

28
Q

normal overbite

A

2-4mm

29
Q

Ackerly classification of complete traumatic overbites

A

1 - palatal mucosa
2 - gingival crevice
3 - stripping
4 - palatal abrasion

30
Q

crossbite

A

where one or more teeth may be abnormally malpositioned bucally/lingually/labially with reference to opposing teeth

31
Q

mutually protected dynamic occlusion - gold standard

A

canine guidance
posterior disocclusion in lateral excursions
no non-working/working side contacts
no protrusive interferences

32
Q

canine guidance

A

when mandible moves to one side, contact only between canines
no posterior tooth contacts (a space)

33
Q

why are canines chosen as guidance for lateral excursions?

A

longest and largest roots (C:R)
dense compact bone surrounding them
fewer muscles are active when canines contact during eccentric movements than when posterior teeth contact
dissipate horizontal forces while disoccluding posterior teeth

34
Q

what is it important that canine/group function provide enough guidance for?

A

to disocclude teeth on the NW side which are not desirable contacts

35
Q

group function

A

mandible moves to left (WS), multiple teeth in contact on left
several teeth on WS contact during laterotrusive movement

36
Q

when is bilateral group function seen often?

A

toothwear

37
Q

what is the most favourable alternative to canine guidance?

A

group function

38
Q

best teeth for group function

A

3,4,5,MB cusp 6
any contact more posterior not desirable as increased force due to closeness of fulcrum
buccal cusp to buccal cusp is more desirable contact during movement than lingual to lingual cusp

39
Q

occlusal interferences

A

undesirable tooth contacts that may produce mandibular deviation during closure to ICP or may hinder smooth passage to and from ICP

40
Q

types of occlusal interferences

A

working side - similar cusps contact
non-working side - dissimilar cusps contact
protrusive - any posterior contact during protrusion

41
Q

why avoid posterior contacts?

A

teeth 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 movements

42
Q

eccentric bruxism

A

moving away from CO, dynamic
parafunctional grinding
involuntary rhythmic/spasmoidic/fct gnashing/grinding/clenching in other than chewing movements

43
Q

centric bruxism

A

clenching

freq associated with acute nervous tension or physical effort

44
Q

S and S of bruxism

A 
toothwear
fractured restorations
tooth mobility - often absence of PDD
tooth migration
muscle pain and fatigue
headache - worse at end of day
earache
pain and stiffness in TMJ and surrounding muscles
45
Q

occlusal trauma

A

injury resulting in tissue changes within the attachment apparatus, inc PDL, supporting alv bone and cementum, as a result of occlusal force(s)
primary - intact periodontium
secondary - reduced periodontium

46
Q

fremitus

A

presence/absence
palpable/visible movement of a tooth when subjected to occlusal forces
finger on cervical 1/3 and ask pt to close together

47
Q

examining the occlusion

A 
incisor relationship
guidance 
OJ/OB
ICP contacts
W/NW/P contacts
pathology

restorative (12 decks)

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