Occlusion & Articulation Compendium Flashcards
What are some anatomical characteristics of the TM joint?
- Temporal bone (Mandibular fossa)
- Mandible (condyle)
- Dentition
- Synovial cavities
- Articular disc
- Articular eminence
- Retrodiscal tissues
Synovial cavities include superior (_____________) and inferior (______________)
- translation
- rotation
Describe the Articular Disc
- Fibrous connective tissue
- Interface between bones
- Somewhat pliable
- Biconcave shape
- Collateral ligaments
- No innervation
- No vascularization
Describe the Retrodiscal tissues
- Elasticity
- Highly innervated and vascular
- Loading is painful
- Trauma can cause inflammation
Maximum intercuspation (MI) is also known as
- Centric occlusion (CO)
- Habitual occlusion
- Habitual centric
Maximum intercuspation describes ______________
an occlusal relationship
In MI teeth are contacting in a position that the patient finds the most ___________
comfortable
MI is easily ___________ but not always ___________ by the patient?
- Achievable
- Reproducible
Centric Relation (CR) is ______
A condylar position
CR is the _______ portion of the disc
Thin
CR describes the most _______ position of the ________
- Stable
- condyle
CR describes the ___________ and __________ position of the mandible with the _____ properly interposed
- Superior
- Anterior
- disc
What is Ideal Occlusion?
When all teeth contact simultaneously
In Ideal Occlusion ________ and ________ occur simultaneously
- CR
- MI
In Ideal Occlusion, All occlusal forces are ____________
-longitudinal
In Ideal Occlusion, during crossover, how is guidance transferred to the incisors?
Smoothly transferred
In Ideal Occlusion, which tooth contacts dominate?
Posterior tooth contacts
In Ideal Occlusion, Eccentric movements are what?
Anterior-guided
In Ideal Occlusion, there are no cross-over contact on what teeth?
Posterior
What are the muscles of mastication?
- Temproalis
- Massester
- Medial Pterygoid
- Lateral Pterygoid
Which muscle is least likely of the 4 muscles of mastication to be palpated by the clinician?
The lateral pterygoid
If the left lateral pterygoid is severely damaged and the patient is instructed to open their mouth the mandible will devastate or move to the ____ side as the damaged lateral pterygoid muscle is located on.
-Same
During a normal closure of the mandible contracture of the
- Temporalis anterior fibers
- Medial pterygoid
- Masseter
Normal closure of the mandible will ______ the mandible from open position
-Elevate
In the normal closure of the mandible which muscles play no part?
- Suprahyoids (relaxs)
- Inferior belly of Lateral Pterygoid
During the maximum opening position which muscle contracts ?
Lateral pterygoid–>Inferior belly pulls the condyle completely out of the fossa to the anterior
During the maximum opening position the condyle moves __________.
-Stops at the ________ of the articular eminence
- Anteriorly
- Terminus
During the maximum opening position, the Articular Disc moves with the __________.
-Superior belly is in significant _____________ at maximum opening.
- Condyle
- contraction
Regarding Angle’s Class I Occlusion:
ML cusp of Maxillary 1st molar occludes in the what?
The CENTRAL FOSSA of the Mandibular 1st molar
Regarding Angle’s Class I Occlusion:
MF cusp of Maxillary 1st molar occludes in the what?
in the MF GROOVES of Mandibular 1st molar
Regarding Angle’s Class I Occlusion:
Cusp tip of Maxillary canine articulates with the what?
Facial embrasure between the mandibular CANINE & first premolar
Regarding border movements in the sagittal plane, which involve tooth contact?
- CR= centric relation
- MI= maximum intercuspation
- E-T-E= Edge to Edge incisal
- MP= maximum protrusion point
Regarding border movements in the sagittal plane, which DO NOT involve tooth contact?
- MOA= Maximum opening arc
- MO= Maximum opening point
- HA-MO= Hinge axis to maximum opening
- HAT= Hinge Axis Terminating point
- HA= Hinge Axis Arc
- RP= Rest position or postural or position of the mandible
- CL= Chewing Loop
What is Immediate Side-shift?
When the lateral translation movement occurs before the condyle translates from the fossa
What is Progressive Side-shift?
The progressive Lateral Translation moment of the condyle in a downward, forward, and inward (medial) direction.
The more severe the immediate side shift, the ____________ the posterior cusps and the _________ are the fossae & grooves.
- shorter
- wider
Immediate Side-shift + Progressive Side-shift = ?
Bennett Movement : Lateral movement of the mandible toward the working side as the non-working condyle moves forward.
What are the border movements in the frontal plane (6) ?
- MI= Maximum Intercuspation
- ELL= Extreme Left Lateral
- MO= Maximum opening
- CL= Chewing loop
- RP= Rest positon
- ERL= Extreme Right Lateral
What are the vertical determinants of occlusion (7) ?
-Which ones are fixed vs variable?
- Condylar guidance angle (FIXED)
- Anterior Guidance (VARIABLE)
- Nearness of cusp to the Controlling Factors (VARIABLE)
- Plane of occlusion (VARIABLE)
- Curve of Spee (VARIABLE)
- Mandibular Lateral Translation aka Bennett Movement (FIXED)
- Timing of MLT: (a) Immediate Sideshift aka Bennett Shift & (b) Progressive Sideshift (FIXED)
- The medial wall of the non-working condyle can affect the ___________of the maxillary lingual cusps and the mandibular _________ cusp on the ___________ side.
- The working side cusps are more _________ by the _________ rise on that working side.
- Nonworking
- Facial
- Nonworking
- affected
- canine
Anterior Guidance Influence:
An INCREASE in Vertical Overlap results in more of a _________ component to mandibular movement and __________ posterior cusps.
- vertical
- steeper
Anterior Guidance Influence:
An INCREASE in Horizontal Overlap (diminished anterior guidance angle) results in __________ vertical displacement of the mandible and _________ posterior cusps.
- Less
- flatter
Anterior Guidance Influence:
Variations in the anatomy of the TMJ’s and/or the anterior teeth will lead to ________ in the __________ pattern of the ____________.
- changes
- movement
- mandible
Anterior Guidance Influence:
The occlusal morphology of posterior teeth must be in ________ with their _________ teeth during __________ mandibular movements.
- harmony
- opposing
- eccentric
Anterior Guidance Influence:
The exact _________ of the posterior teeth is influenced by the __________ it travels across its ________ tooth or teeth.
- morphology
- pathway
- opposing
Anterior Guidance Influence _________ of restorations
wax-ups
Occlusal Determinant Factors:
The nearer the tooth to the TMJ, the more the joint anatomy influences what?
-Eccentric movement
Occlusal Determinant Factors:
The nearer a specific tooth is to the anterior teeth, the more the anatomy of the anterior teeth what?
-Influence its eccentric movement
Occlusal Determinant Factors:
What are horizontal considerations of occlusal morphology?
The width of fossae and the direction of grooves
Occlusal Determinant Factors:
What are vertical considerations of occlusal morphology?
The depth of fossae and the height of cusps
Occlusal Determinant Factors:
How are the occlusal forces placed on posterior teeth best distributed?
In maximum intercuspation
Occlusal Determinant Factors:
As the plane of occlusion approaches parallelism with the articular eminence, the ____________ the posterior cusps will need to be in order to avoid _________
- Shorter
- Collision
Tall vs. Short Cusps Height Allowances:
A steep condylar guidance will allow for what?
-Taller cusps
Tall vs. Short Cusps Height Allowances:
The more acute the Curve of Spee, the __________ the cusps will need to be to avoid _________
- shorter
- collision
Tall vs. Short Cusps Height Allowances:
The ___________ the distance between the orbiting condyle and the medial wall, the greater the amount immediate ___________
- greater
- sideshift
Tall vs. Short Cusps Height Allowances:
The greater the amount of immediate side shift, the ________ the cusps will need to be
-shorter
Tall vs. Short Cusps Height Allowances:
The greater the amount of the immediate side shift, the _________ the grooves will need to be
-wider
What are the 4 Location of Non-working Side Interferences?
- Facial inclines of _______
- Lingual inclines of_________
- Parallel to distal oblique groove of _________
- Parallel to the distofacial development groove of ____
1) Facial inclines of the maxillary posterior lingual cusps
2) Lingual inclines of mandibular posterior facial cusps
3) Parallel to the distal oblique groove- Max 1st Molar
4) Parallel to the distofacial development groove- Mand 1st Molars
Note: B contacts
FL, LF, DOGMAX, DFMAND
What are the 4 locations of Working Side Interferences?
1) Lingual inclines of the maxillary posterior facial cusps
2) Lingual inclines of the maxillary posterior lingual cusps
3) Facial inclines of the mandibular posterior facial cusps
4) Facial inclines of the mandibular posterior lingual cusps
Note: LF, LL, FF, FL
A or C contants
Where are the 2 locations of Protrusive Interferences?
1) Distal marginal ridges of the mandibular posterior teeth
2) Mesial marginal ridges of the maxillary posterior teeth
- A & C contacts will display Medial and Lateral __________ contracture on the _______ side.
- The ________ and Posterior/Middle _________ are contracting on the ________ side of the interference
- Pterygoid
- Opposite
- Masseter
- Temporalis
- Same
“B” contacts will display Medial & Lateral ____________ contracture on the _______ side.
-The _________ and Posterior/Middle ___________ are contracting on the _________ side of the interference
- Pterygoid
- same
- Masseter
- Temporalis
- opposite
What is Internal Derangement?
A deviation in position of form of the tissues within the capsular apparatus of TMJ essentially giving rise to an abnormal relation of the articular disc to the condyle, mandibular fossa and/or articular eminence.
What is Intracapsular TMD?
Problems and clinical conditions associated with the TMJ tat hare contained within capsular apparatus (i.e.., the immediate joint tissues)
What is Extracapsular TMD?
Problems and clinical conditions associated with the TMJ that are outside the joint (i.e., the muscles of mastication and many ligaments)
What is Myofascial Pain Dysfunction Syndrome?
- Describes a # of different common painful states characterized by the presence of trigger points within the affected muscle(s).
- Common source of low-back pain, neck pain, shoulder pain, chest pain, and rib pain.
What is Articular Disc Displacement?
Physical dislocation or displacement of the articular disc, either anterior to or posterior to the head of the condyle.
What is Reciprocal Clicking?
Popping sound from the articular disc, exhibited as a forceful “jumping” back or “snapping” over the head of the condyle, usually occurring during early opening or later closing condylar movement.
What is Closed Lock?
An internal derangement of the TMJ in which the articular disc is dislocated anteriorly and usually medially to condyle.
-The articular disc is physically incapable of reducing or receding posteriorly into position on head of condyle.
What is Differential Diagnosis?
The determination of 1 or 2 or more conditions a patient is suffering from by systemically comparing and contrasting their historical & clinical findings.
What is the etiology of Tempromandibular dysfunction (TMD) include?
1) Predisposing factors: that will INCREASE risk
2) Initiating factors L responsible for the onset
3) Perpetuating factors: interfere w/ handing or enhabce progression
What are the 5 major factors regarding the etiology of TMD?
1) Occlusal
2) Trauma
3) Emotional Stress
4) Deep pain
5) Parafunction
What are the trigger points ?
1) Masseter of the maxillary & mandibular posterior teeth
2) Anterior Temporalis to the Maxillary incisors
3) Middle Temporalis to the Maxillary Premolars and Molars
4) Posterior Temporalis to the posterior cranium
5) Medial Pterygoid to the TMJ
6) Lateral Pterygoid to the zygomatic arch and TMJ
What are the symptoms of intracapsular TMD?
Joint sounds, limited opening w/ a hard end feel, pain during loading of the TMJ, & sudden change in patients occlusion
What is Disc Displacement w/ a reciprocal click?
Opening click (regaining poison), closing click (articular disc pops out of position to anterior, very near closed, & reciprocal click (2 clicks, one on opening and one closing)
What is Para-functional Activities
1) Clenching
2) Bruxism
What is Para-functional Features?
1) Occur at a “subconscious level”
2) Occlusal prematurities
- DOESNT directly cause bruxing events,
- Emotional stress DIRECTLY relates to parafunction
