Occlusion in Fixed Prosth Pt. I

Question 1

Variable Factorsof Occlusion
—PLANE OF OCCLUSION:
—Imaginary plane containing the incisal edges of the ____ and the distobuccal cusps of the ____
—The teeth are never straight along the line; there is always a curve to follow (thecurve of Spee)
—Generally the plane isatdifferent ____ relative to the floor

Answer 1

mandibular canines
mandibular second molars
angles

Question 2

Variable Factorsof Occlusion
—CURVE OF SPEE:
—Describes how great or little the curve actually is
—It goes from the cusp tip of the ____ through the cusp tips of all the ____h on the sameside
—Acompilation ofindividual planes of occlusion of individual teeth

Answer 2

mandibular canine

mandinular posterior teeth

Question 3

Variable Factorsof Occlusion
—CURVE OF WILSON: —Connects the cusp tips of the
molars ina ____plane
—This changes from the first to the ____ molars
—There is change in the curve of Wilson with ____r of the dentition. In unworn dentition it is ____ from above. It becomes ____ with wear of the dentition or it can be ____ when the buccal cusps are longer than the palatal cusps.

Answer 3

frontal
third
wear
concave
flatter
convex

Question 4

Variable Factors of Occlusion
— INCISALGUIDANCE
a)OVERBITE: Measured from ____ of maxillary incisors to ____ of mandibular incisors

Answer 4

incisal edge

incisal edge

Question 5

Variable Factors of Occlusion
— INCISAL GUIDANCE
b) OVERJET: Measured from ____ of maxillary incisors along the horizontal plane to ____ of mandibular incisors.

Answer 5

incisal edge

facial surface

Question 6

Variable Factors of Occlusion
—INCISAL GUIDANCE
c) FUNCTIONAL OVERJET: Measured from ____sof mandibular incisors to ____ of maxillary incisors.

Answer 6

FOA’s

guiding inclines

Question 7

Variable Factors of Occlusion
—EFFECTIVE ANTERIOR GUIDANCE:
—Defined as immediate disarticulation of ____ teeth by anterior teeth on movement into mandibular ____
—Generally for this to be able to occur, the functional overjet for the anterior teeth must be at or near ____

Answer 7

posterior
excursions
zero

Question 8

Role of Anterior Teeth

—In a normal occlusal relationship the maxillary and mandibular ____ contact during ____ movements.

Answer 8

canines

lateral

Question 9

Static Occlusal Contacts
—Tooth to tooth vs. tooth to two teeth —
Helps to distribute ____ evenly —Helps to maintain ____
—Angle classifications

Answer 9

force

arch integrity

Question 10

Angle Classifications

• We are looking at both anterior and posterior rela5ve to classifica5ons

• Class 1 in anterior (right) but not class 1 on the lec side
• Class 2 division 1 – ____
• Class 2 division 2 – maxillary central is ____ in a lingual version
• Class 3 – ____ or class 3 in cross bite. No ____ in either of these
• Finally, you can have pa5ent with Anterior open bite – caused by late ____

Answer 10

deep bite
tipped
edge to edge
incisal guidance
thumb sucking

Question 11

• Z – centric holding. This is important to hold the ____. If the pa5ent has too light of an
occlusion/centric holding, then we change their ____.

Answer 11

occlusion
occlusion
posterior support

Question 12

Class II Div I

• Mandible is retronas5c, or the maxilla is ____
• This can be corrected with ortho or orthonac5c surgery
• The rela5onship is off by 1⁄4 - 1⁄2 a tooth
• Here we don’t have effec5ve ____ guidance

Answer 12

prognathic

incisal

Question 13

Class III

• We see a ____ mandible & a ____ maxilla
• The MB cusp of first maxillary molar is behind the buccal groove of the
first mandibular molar

Answer 13

protrusive

retrognathic

Question 14

Dynamic Occlusal Contacts
—Any movement of the mandible from the centric occlusion position that results in tooth contact is termed ____.
—There are three basic eccentric movements
____
____
____

Answer 14

eccentric
protrusive
laterotrusive
retrusive

Question 15

patient doing a canine guided occlusion. looking posteriorly, we see the posterior teeth ____

Answer 15

disarticulate

Question 16

pa5ent guiding in protrusive movement. All ____ teeth disar5culate. This is a protected occlusion. They are not picking up occlusion on posterior teeth. This is what we want in ____ pa5ents. Not the case in dentures cases. We will learn more in later courses

Answer 16

posterior

dentate

Question 17

Contacts vs. Interferences

—Contacts: The patient has no ____ associated with the occlusion. The occlusion is either ____ or ____.
—Interferences: The patient has ____ associated with the occlusion.

Answer 17

pathology
ideal
physiologic
pathology

Question 18

Protrusive
—The mandible moves ____ from the ____ position.
—The predominant protrusive contact occurs between the ____ teeth.

Answer 18

forward
centric occlusion
maxillary and mandibular anterior

Question 19

Protrusive
• What contacts is the ____ of maxillary against ____ of mandibular teeth
• We don’t want ____ teeth to touch. We want them to disar5culate!

Answer 19

distal inclines

mesial inclines

Question 20

Laterotrusive (Working)

—Most function occurs on the ____ (lateral movement) the side to which the mandible is shifted.

—Working contacts and cross-tooth contacts occur on the ____.

—Working contacts occur between the ____ of maxillary buccal (guiding) cusps and the ____ of the mandibular buccal (supporting) cusps.

—Cross-tooth contacts occur between the outer inclines of the maxillary supporting cusps____ and the ____ of the mandibular lingual cusps (non- supporting).

Answer 20

working side
working side
inner inclines
outer inlcines (FOA's)
FOA's
inner inclines

Question 21

Laterotrusive

We look from ____ plane
• Working movement on one side (points to right side)
• On opposite side we have a non-working side (points to lec side)
• We have ____ contact on non working side and
____ on working side

Answer 21

mediotrusive

laterotrusive

Question 22

Working Interference

Happens when we have a posterior tooth that is contac5ng when we guide on the working side, but not the ____

When do you think we will have issues with working interferences? – a pa5ent with normal maximum intercuspa5on might get working interference when we give a new ____, and when we check the bite the pa5ent says feels comfortable
But when pa5ent ____ they complain that it feels weird. When you put the paper in, you may find that the provisional was too bulky on inner incline so now when it guides you created a working interference
The working interference has to be adjusted for because it adds lateral forces, discomfort, and pain to pa5en

Answer 22

canine
crown
chews

Question 23

CrossTooth Contact/
Interference

• We are guiding on working side. If its possible, the ____ cusps contact.
• Contact between ____ of mandible lingual non suppor5ng cusps (points to
green dots)against maxillary ____ area (points to green dots)
• Many 5mes ini5ally you have cross tooth interferences when you do ____ for a provisional. This is because the cusps are too bulky. It is something you will check for.

Answer 23

lingual
inclines
FOAs
block carving

Question 24

Mediotrusive (Non-working)
—Formerly balancing contacts, but now the teeth disclude.
—Potential sites of contact on the ____ of maxillary lingual and mandibular buccal cusps.
—Mediotrusive contacts are ____.

Answer 24

inner inclines

interferences

Question 25

Non-working Interference • Common on ____ in pa5ents. Pa5ents will complain of pain. • What is another situa5on where you can have non working interference in the mouth? – When suppor5ng cusps are out of alignment like if the pa5ent had an ____ tooth. So you end up with loss of a tooth & loss of ideal occlusion. • Is this easy to fix? – simply grinding away at the marks is not a long term solu5on. The teeth will shic back together and non working interference will return. So you leave the cusps in contact but you leave a ____ so that it slides through. But you don’t loose the ____ by grinding down the suppor5ng cusps

Answer 25

third molars extruded channel VDO

Question 26

Working, Cross tooth, Non-working Take a look at all

Answer 26

yay!

Question 27

Retrusive * Have the pa5ent move ____ * Maxillary ____ and mandibular ____ contactv

Answer 27

back medial inclines distal inclines

Question 28

History —Bilateral Balanced Occlusion —Based on theories related to ____ —Became apparent these principles did not apply to ____ —Resulted in ____, mobile teeth and gingival clefting

Answer 28

dentures fixed prosthodontics premature wear

Question 29

Unilateral Balanced Occlusion —Group Function —Earlier rehabs were modified by eliminating ____ —Led to the functionally generated path or ____ technique —Importance of ____ guidance discovered and incorporated into the occlusal scheme

Answer 29

balancing contacts "wax chew-in" incisal guidance

Question 30

Group Function —Based on the philosophy that the more teeth to share the load the better ____ guidance established first —Spreads working side contact over ____ or more teeth in each arch —These teeth should be adjacent to each other —Involves ____ cusps only

Answer 30

canine/incisal 3 buccal

Question 31

Cuspid Rise Occlusion —Cuspids on the ____ disclude all other teeth during working movement. —This does not happen ____ ____ inch of space between opposing cuspids —Posterior occlusion involves ____ —All posterior teeth disclude in protrusive movements —CR = ____

Answer 31

``` working side immediately 0.001 tripodization CO ```

Question 32

Cuspid Rise Occlusion/Canine Guidance —Most ____ occlusal scheme in fixed prosthodontics —Most clinicians combine the concept of organic occlusion and ____

Answer 32

common | cuspid rise occlusion

Question 33

Optimum FunctionalOcclusion —CR---for purposes of this lecture it is the most ____ position. —CR=CO with even and ____ contact of ____ teeth —Anterior teeth contact, but more ____ than the posterior

Answer 33

anterior superior simultaneous posterior lightly

Question 34

Optimum FunctionalOcclusion —All tooth contacts provide ____ loading of occlusal forces. ____ (laterotrusive) movements have adequate tooth guided contacts to disclude the ____ (mediotrusive) sideimmediately. —Guidance is provided by the ____.

Answer 34

axial working nonworking canines

Question 35

Optimum FunctionalOcclusion ____ movements have adequate tooth guided contacts on the ____ teeth to disclude all posterior teeth immediately. —Basically this is the definition of ____ protected occlusion.

Answer 35

protrusive anterior mutually

Question 36

Optimum FunctionalOcclusion —Ideal — Physiologic — Pathologic Lec photo: ____ occlusion Right photo: This pa5ent might be caries free and periodontally healthy. This occlusion is ____. The pa5ent could get treatment for aesthe5cs. If they are having TMJ issues they would seek out ortho treatment

Answer 36

ideal physiologic | physiologic

Question 37

Pathologic Occlusion —Occlusal relationship capable of producing pathogenic changes —Signs and symptoms —Teeth – ____, fractures, fremitus —Periodontium – ____, widened PDL —Musculature – ____ or chronic pain —TMJ – pain...

Answer 37

wear mobility acute

Question 38

Goals of Occlusal Therapy —Direct occlusal forces along long axes of teeth —Simultaneous contact for ____ —Eliminate ____ contacts/interferences —Provide ____

Answer 38

CR-CO eccentric canine guidance/group function

Question 39

Occlusal Treatment ____ —Grind —____ —Splint

Answer 39

move | restore

Question 40

Occlusal Therapy —Splint/appliance —Types —Hard splint —Soft splint —May be diagnostic or ____ * Splint therapy involves ____ (like a retainer so the posterior teeth can't contact and pa5ent can't grind teeth, thus breaking the grinding cycle). * (Poin5ng to boNom lec photo). This cannot be work all day, 24/7. If you wore it all day, you would get ____ erup5on. * For pa5ents with posterior bite collapse, you put the pa5ent in a splint to open up their ____

Answer 40

definitive guards posterior occlusal vertical dimension

Question 41

Occlusal Therapy | —Reposition ____—Decrease ____ activity —Modify ____ —Change ____

Answer 41

condyle/disk muscular behavior occlusion

Question 42

CASES!

Answer 42

Take a look!