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Fixed Pros I > Occlusion for Fixed Prosthodontics > Flashcards

Occlusion for Fixed Prosthodontics Flashcards

1
Q

occlusion is a critical factor for:

A

all dental restorations and for the health and longevity of teeth and intraoral structures

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2
Q

if a patient has orthodontically ideal angles class I occlusion this does not mean that:

A

the patient has optimal occlusal contacts, optimal condyle/mandibular position, and ideal/optimal contacts in excursive movements

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3
Q

patients may have a less than ideal occlusion however it may still be:

A
  • a functionally acceptable occlusion
  • a physiologically acceptable occlusion
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4
Q

what do you need to assess to see if treatment is required

A
  • the masticatory system for evidence of pathology - tooth wear, tooth mobility, TMJ dysfunction, muscle dysfunction
  • adaptive capacity of a patient
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5
Q

what is the optimal functional occlusion

A

mutually protected occlusion

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6
Q

what is mutually protected occlusion

A
  • multiple, even, bilateral, simultaneous occlusal contacts of the posterior teeth in MIP with the mandible is CR position
  • MIP and CR are coincident
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7
Q

describe the anterior teeth in mutually protected occlusion

A

anterior teeth exhibit lighter occlusal contacts as compared to posterior teeth in MIP

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8
Q

describe posterior teeth in mutually protected occlusion

A

posterior teeth are loaded axially in MIP

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9
Q

describe excursive movements in mutually protected occlusion

A
  • canine guidance/anterior guidance occurs
  • the anterior teeth disclude the posterior teeth in excursive movements to protect the posterior teeth from off-axis loading
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10
Q

the TM joints are in optimum, orthopedically stable joint position when the mandible is in:

A

centric relation

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11
Q

which teeth withstand the majority of the load in MIP in mutually protected occlusion

A

the posterior teeth

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12
Q

which teeth can tolerate axial loading and why

A

posterior teeth to protect the anterior teeth in MIP

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13
Q

which teeth can tolerate lateral forces and why

A

anterior teeth because they are further away from the fulcrum and the loads are less

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14
Q

evaluation of occlusion:

A
  • is required at all phases of the fixed pros treatment
  • better results if the evaluation of occlusion has been done at all stages
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15
Q

when is evaluation of occlusion done

A

in conjunction to clinical examination and articulated casts

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16
Q

what cast is articulated using a facebow record

A

maxillary

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17
Q

what are the 2 positions to articular mandibular casts

A
  • CR
  • MIP
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18
Q

what is the purpose of a facebow

A

orient the maxillary cast to the rotational axis in three planes

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19
Q

describe the kinematic facebow

A
  • the most accurate
  • locates the true hinge axis
  • requires training, elaborate instruments and more time
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20
Q

describe the arbitrary facebow

A
  • locates an arbitrary hinge axis by using anatomical landmarks
  • less accurate
  • requires less complicated instruments and less time
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21
Q

what are the benefits of using a facebow

A

results in the path of opening and closure being the same on articulator as intraorally

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22
Q

describe CR

A

the position of the mandible in which the condyles are in the most superior and anterior position in the articular fossae resting against the posterior slopes of the articular eminences with the articular discs interposed

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23
Q

recording CR on a dentate pt requires:

A

an anterior deprogrammer

24
Q

describe the articulation of casts in CR

A
  • interocclusal records
  • the record is made at increased OVD
  • avoid deflective tooth contacts
25
Q

if an accurate CR record is made, then the ________ can be achieved on the articulator

A

MIP position

26
Q

describe MIP

A
  • a position in which the maxillary and mandibular teeth make maximum surface contact with each other
  • the mandible is elevated as superiorly as possible in the sagittal place
  • habitual closing position
27
Q

for most patients: are MIP and CR coincident

A

no

28
Q

should an interocclusal record be used to articulate the dx casts in MIP

A

no

29
Q

what is the importance of accurate articulation

A

the casts that are mounted on the articulator need to exhibit the same occlusal relation as the teeth do intraorally

30
Q

when do you articulate casts using CR record

A
  • diagnose occlusal disease
  • completely edentulous patients
  • partially edentulous patients
  • dentate patients to receive extensive fixed prosthodontics restorations
31
Q

what occlusal disease constitutes using CR record when articulating casts

A
  • TMD
  • occlusal equilibration
  • splint
  • orthodontic
  • orthognathic surgery
32
Q

what partially edentulous patients use articulates casts in CR record

A

when there are few teeth remaining
- a stable MIP is not present

33
Q

what dentate patients receiving fixed pros restoration require articulating casts in CR

A
  • occlusion will be altered completely
  • the restorations will be made at an increased OVD
  • kinematic facebow recording necessary
34
Q

describe full size articulators

A
  • anatomic hinge axis close to that of patient
  • slight different in arc of closure between patient and articulator
35
Q

describe the hinge articulator

A
  • large difference in arc of closure between patient and articulator
  • centric premature contacts in restorations
36
Q

condylar elements are set with:

A

eccentric records

37
Q

opposing cusps will travel through:

A

groove pathways without tooth contact in excursions
- posterior teeth disclude during excursive movements

38
Q

discrepancies in occlusal morphology ->

A

interferences on the restoration - especially on NW side

39
Q

when is a full arch impression/articulation recommended:

A

more posterior teeth occlusal surfaces being restored
- FPDs and multiple crowns

40
Q

what does a custom incisal guide table provide

A

a record of the lingual concavity and incisal edge length/position and therefore anterior guidance for replication when fabrication anterior indirect restorations

41
Q

what happens during the occlusion treatment phase

A

articulate working casts

42
Q

what is the purpose of articulation of the master cast/working cast

A
  • ensure accurate tooth to tooth occlusal contacts
  • verify contact of incisal pin to the anterior guide table
  • accuracy of mounting is critical to create accurate occlusion on restorations
43
Q

describe the material of the mounting casts

A
  • no resistance to closure
  • rigid when set
  • dimensional stability/accuracy
44
Q

when and how should you mount casts for patients in MIP

A
  • for patients that have a stable MIP position
  • mount casts with MIP record at OVD
45
Q

what are the occlusal schemes

A
  • mutually protected occlusion
  • group function/ unilaterally balanced occlusion
  • balanced occlusion/ bilateral balanced occlusion
46
Q

describe group function

A
  • as mandible moves laterally, it is guided by a group of teeth (canine, premolars and MB cusp of 1st molar) on the WS
47
Q

describe balanced occlusion and what patients use this

A
  • simulataneous contacts on both sides during lateral movements - WS and NWS - and between posterior/anterior during protrusive
  • not acceptable for dentate patients
  • acceptable form of occlusion for CD and RPD
48
Q

why is balanced occlusion not acceptable for dentate patients

A

promotes tooth wear, NW side contacts are destructive

49
Q

why is balanced occlusion an acceptable form of occlusion for CD and RPD

A
  • contact on NW side can help stabilization of the removable prosthesis
50
Q

how should you create the occlusal surface to ensure proper loading of the teeth

A
  • cusps and ridges should allow even occlusal contacts with opposing teeth with forces along long axis
  • non centric cusps should overlap horizontally and vertically
51
Q

describe the curve of spee

A
  • A-P curve
  • cusps follow an anteroposterior curve
  • steepness of curve influences the cusp heights
52
Q

describe the curve of wilson

A
  • M-L curve
  • mediolateral curve
  • non functional cusps shorter than functional cusps
  • helps prevent interferences in lateral excursions
53
Q

what are the two types of contact relationships

A
  • cusp- fossa
  • cusp- marginal ridge
54
Q

where should the occlusal contacts be on the occlusal surfaces

A
  • tripodized point contacts on cusps, fossa/marginal ridges
  • buccal and lingual cusps lie along a-p lines
55
Q

describe the waxing technique of proximal contact areas

A
  • size and location are established first
  • proper size: convex oval area, not pinpoint or deficient
  • location: occlusal 1/3, distal: more cervically located, slightly towards facial
  • should reflect the emergence profile and contour gingival to the contact area
  • flat to slightly concave from contact area to CEJ
    -proper space for interdental papilla
56
Q

describe the waxing technique of axial surfaces

A
  • shape buccal and lingual surfaces to follow contours of adjacent and contralateral teeth
  • height of contour: buccal: cervical 1/3, lingual: middle 1/3
  • emergence profile: surface apical to height of contour adjacent to gingival soft tissues. flat or straight, avoid bulky convexity in cervical region
57
Q
A

Fixed Pros I (13 decks)

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