Occlusion Part 2

Question 1

Rotation

• In the initial phase of ____from ___ ____, the condyles hinge or ____ about a ____ axis.
• This axis runs through each condyle and is called the ____ _____.
• The hinge axis can be ______ and recorded for _____ and____ purposes.

Answer 1

Rotation • In the initial phase of opening from centric relation, the condyles hinge or rotate about a fixed axis. • This axis runs through each condyle and is called the hinge axis. • The hinge axis can determined and recorded for diagnostic and restorative purposes.

Question 2

Posselt’s Diagram – Rotation

___ _____ is represented by the line ____ on Posselt’s diagram.

CR: Centric Relation

CO: Centric Occlusion

CO and CR can be switched

CR to B: Centric Relation to end of rotational opening

If you wear a denture CR and CO should be coincident or you screwed up denture

In indivs with all their teeth CR and CO may not be the same

Answer 2

Posselt’s Diagram – Rotation • Hinge opening is represented by the line B-CR on Posselt’s diagram. CR: Centric Relation CO: Centric Occlusion CO and CR can be switched CR to B Centric Relation to end of rotational opening If you wear a denture CR and CO should be coincident or you screwed up denture In indivs with all their teeth CR and CO may not be the same

Question 3

Hinge or rotary opening occurs for the ___ ___or ______ _____ from ____ ____

Answer 3

Hinge or rotary opening occurs for the first inch or 20-25 mm from centric relation.

Question 4

Translation

• During translatory opening, the condyles translate or ___ ____ and ___ on the ___ ____.

The condyles slide down and fwd on the ____ slope of the articular eminence

____ is riding along

• At maximum opening the condyles may slide ___ the ___ of the ___ ____

Not in this picture

In people that happens to, it can ___ ___

 Muscles tense up  Try to relax the patient

Answer 4

Translation • During translatory opening, the condyles translate or slide down and forward on the articular eminences.  The condyles slide down and fwd on the distal slope of the articular eminence  Disk is riding along • At maximum opening the condyles may slide over the crests of the articular eminences.  Not in this picture  In people that happens to, it can get stuck  Muscles tense up  Try to relax the patient

Question 5

Posselt’s Diagram - Translation

• Translatory opening is represented by the line____ on Posselt’s diagram.
• Translation of the condyles normally continues until there has been ____ of total opening.

Answer 5

Posselt’s Diagram - Translation • Translatory opening is represented by the line B-E on Posselt’s diagram. • Translation of the condyles normally continues until there has been 40-60 mm. of total opening.

Question 6

Working and Non-working Sides

During a right lateral excursion, the ___ side is the working side and the___ side is the non-working or ____ side.

Side you moving to is the working side

Side you moving away from is the nonworking side

Answer 6

Working and Non-working Sides During a right lateral excursion, the right side is the working side and the left side is the non-working or balancing side. Side you moving to is the working side Side you moving away from is the nonworking side

Question 7

Molar Relationships - Working Side

• On the working side, ______ cusps of maxillary molars track out the ____ grooves of mandibular molars.
• On the working side, the _______ cusps of mandibular molars track out the____ grooves of maxillary molars.

Answer 7

Molar Relationships - Working Side • On the working side, mesiolingual cusps of maxillary molars track out the lingual grooves of mandibular molars. • On the working side, the disto-buccal cusps of mandibular molars track out the buccal grooves of maxillary molars.

Question 8

Molar Relationships - Non-working Side

On the non-working or balancing side, the ______ cusp of the _____ ____ molar tracks over the ______ groove of the ______ ____ molar.

The cusp tracks in a ______ direction.

Answer 8

Molar Relationships - Non-working Side On the non-working or balancing side, the mesio-lingual cusp of the maxillary first molar tracks over the disto-buccal groove of the mandibular first molar. The cusp tracks in a disto-buccal direction.

Question 9

Working Position

• The_____ position of the _____________ accommodates working movements.
• These cusps are _____ with opposing _____ and____ _____in the working position.
• Move chin to R or L and stop when you get out there

Answer 9

Working Position • The mesiodistal position of the non-supporting cusps accommodates working movements. • These cusps are aligned with opposing embrasures and developmental grooves in the working position. • Move chin to R or L and stop when you get out there

Question 10

Orbiting and Rotating Condyles

• When the mandible goes into a left lateral excursion, the ____ condyle is the orbiting condyle. • The _____ condyle is the rotating condyle.

Answer 10

Orbiting and Rotating Condyles • When the mandible goes into a left lateral excursion, the right condyle is the orbiting condyle. • The left condyle is the rotating condyle.

Question 11

Orbiting Condyle

• The orbiting condyle moves ______________.
• The orbiting condyle is the condyle on the ______ side.
• Moves fwd, contacts articular eminence and it will ________.

Fwd and down the hill

• Why medially? Twd the ____. Bc its_____________. It can’t move move fwd if other side doesn’t move

Answer 11

Orbiting Condyle • The orbiting condyle moves downward, forward and medially. • The orbiting condyle is the condyle on the non-working or balancing side. • Moves fwd, contacts articular eminence and it will roll down the hill. Fwd and down the hill • Why medially? Twd the middle. Bc its hooked to the other side . It can’t move move fwd if other side doesn’t move

Question 12

Rotating Condyle

• As the rotating condyle moves ______, it may move (1) _________ and (2) _______. (not a lot) • The rotating condyle is the condyle on the _______ side.

Answer 12

Rotating Condyle • As the rotating condyle moves laterally, it may move (1) forward or backward and (2) upward or downward. (not a lot) • The rotating condyle is the condyle on the working side.

Question 13

Protrusive Movement

• Protrusive movement - the condyles slide____ and ____ on the articular eminences.
• _____ incisal edges are sliding down the lingual surfaces of the ____incisors.
• Push chin fwd.

Condyles contact eminence and begin to slide down it.

• In the ideal occlusion where there is incisal guidance meaning that the patient can contact their incisors and slide down them. Look how stable that is o They have __contacts.
• _ at each condyle
• __ large one at incisors

o Triangle. If they maintain contact at all of those areas at once its very____

Answer 13

Protrusive Movement • Protrusive movement - the condyles slide forward and downward on the articular eminences. • Mandibular incisal edges are sliding down the lingual surfaces of the maxillary incisors. • Push chin fwd. Condyles contact eminence and begin to slide down it. • In the ideal occlusion where there is incisal guidance meaning that the patient can contact their incisors and slide down them. Look how stable that is o They have 3 contacts. • 1 at each condyle • 1 large one at incisors o Triangle. If they maintain contact at all of those areas at once its very stable

Question 14

Condylar Guidance

• Condylar guidance - the ____ relation of the___ and__ ___of the __________ which controls _____ movements.

Answer 14

Condylar Guidance • Condylar guidance - the functional relation of the hard and soft tissues of the temporomandibular joints which controls mandibular movements.

Question 15

• The flatter the articular eminence, the ____ the cusps must be.
• The steeper the articular eminence, the ____ the cusps may be.

If you have a steep articular eminence and you go into protrusive movement, what happens to your posterior teeth? If you slide down steeper hill, they get apart ____ and ___.

If you have shallow articular eminence→ They get apart ___ and ___.

If we doing a bunch of posterior crowns. Need to think about cusp height.

Answer 15

• The flatter the articular eminence, the shorter the cusps must be. • The steeper the articular eminence, the taller the cusps may be. Normal Shallow Steep If you have a steep articular eminence and you go into protrusive movement, what happens to your posterior teeth? If you slide down steeper hill, they get apart quicker and more. If you have shallow articular eminence→ They get apart later and less. If we doing a bunch of posterior crowns. Need to think about cusp height.

Question 16

Anterior Guidance - Condylar Guidance

• The anterior guidance should be__ ___ or _____ than the condylar guidance.
• This helps keep the condyles working ____ the___ ___of the articular eminences during excursive movements.
• Distraction of the condyles due to ___ or ___ ____ can be ___ to the temporomandibular joints.

o All the pictures we’ve seen, the condyle is on the disk/on the bone.

o If we distract the condyles: we put ____ in there

o Eat something chewy and then hear a loud pop in a joint and a quick sharp pain→ Distraction

o You pull condyle and ____ apart

o Distraction is a problem. This can harm the joint

Answer 16

Anterior Guidance - Condylar Guidance • The anterior guidance should be equal to or greater than the condylar guidance. • This helps keep the condyles working against the posterior slopes of the articular eminences during excursive movements. • Distraction of the condyles due to CR or excursive interferences can be harmful to the temporomandibular joints. o All the pictures we’ve seen, the condyle is on the disk/on the bone. o If we distract the condyles: we put space in there o Eat something chewy and then hear a loud pop in a joint and a quick sharp pain→ Distraction o You pull condyle and fossae apart o Distraction is a problem. This can harm the joint

Question 17

Determinants of Occlusion

The determinants of occlusion are the __________, the _________and the _______.

Answer 17

Determinants of Occlusion The determinants of occlusion are the right and left temporomandibular joints, the occlusion of the permanent dentition and the neuromusculature. (nerves and muscles)

Question 18

For the occlusion determinant, we may want to consider the anterior teeth as ____ determinants and the posterior teeth as ____ determinants.

Posterior teeth function as ___ ___→Passive

Anterior teeth begin to work as we move around→ Active

Answer 18

For the occlusion determinant, we may want to consider the anterior teeth as active determinants and the posterior teeth as passive determinants. Posterior teeth function as closure stoppers→Passive Anterior teeth begin to work as we move around→ Active

Question 19

Physiologic Rest Position

• Physiologic rest position - the _____ position of the____ when the head is in an _____ position and the associated muscles are in a state of ___ ____.
• The physiologic rest position is also known as the ___ ____position or ___ ___position.

VDR: ____ ____ of ____

Answer 19

Physiologic Rest Position • Physiologic rest position - the postural position of the mandible when the head is in an upright position and the associated muscles are in a state of minimal contraction. • The physiologic rest position is also known as the postural rest position or clinical rest position. VDR: vertical dimension of rest

Question 20

Freeway Space

• Freeway space - the ___ between the___ ____of the maxillary and mandibular teeth when the mandible is in the ___ ___ ___.
• The normal amount of freeway space in a dentulous dentition is _____.

Answer 20

Freeway Space • Freeway space - the distance between the occluding surfaces of the maxillary and mandibular teeth when the mandible is in the physiologic rest position. • The normal amount of freeway space in a dentulous dentition is 2-4 millimeters.

Question 21

Malocclusion

• Any deviation from a physiologically ___ ___ between the opposing dental arches.
• Any deviation from a ___ __—see ____ ____ of ____

Answer 21

Malocclusion • Any deviation from a physiologically acceptable contact between the opposing dental arches. • Any deviation from a normal occlusion—see ANGLE’SCLASSIFICATION OF OCCLUSION

Question 22

Occlusal Prematurity

Any contact of ___ ____ that occurs before the ___ ___.

Sometimes we do restorations and we ___ __

Answer 22

Occlusal Prematurity Any contact of opposing teeth that occurs before the planned intercuspation. Sometimes we do restorations and we create it

Question 23

Premature Contact

• A premature contact is signaled to the ____
• The brain instructs the ___ of mastication to bring the teeth into a “___” ___ ____.

Answer 23

Premature Contact • A premature contact is signaled to the brain. • The brain instructs the muscles of mastication to bring the teeth into a “new” maximum intercuspation.

Question 24

Primary Occlusal Traumatism

• The ___ ___ ____of occlusal _____is ____.
• Fremitus – ___ ____

You can put finger on their tooth and feel it banging and moving when they bite down

• Primary occlusal traumatism is defined as ___ ___on normal _____structures.
• When the prematurities and interferences are removed, the tooth can ____ in several days.

Answer 24

Primary Occlusal Traumatism • The number one sign of occlusal traumatism is mobility. • Fremitus – functional mobility You can put finger on their tooth and feel it banging and moving when they bite down • Primary occlusal traumatism is defined as abnormal forces on normal supporting structures. • When the prematurities and interferences are removed, the tooth can stabilize in several days.

Question 25

Occlusal Interference

• Any tooth contact that ____ the remaining _____ surfaces from achieving ___ and____ contacts.
• An occlusal contact that disrupts the ___ ___ ____of teeth against each other.

Presence of occlusal interferences can result in_____ of the ___ ___

Answer 25

Occlusal Interference • Any tooth contact that inhibits the remaining occluding surfaces from achieving stable and harmonious contacts. • An occlusal contact that disrupts the smooth excursive movements of teeth against each other. Presence of occlusal interferences can result in disclusion of the anterior guidance.

Question 26

Occlusal Adjustment

• 1:Any change in the____ intended to alter the ___ ___.
• 2:Any alteration of the ____ ____ of the teeth or restorations—see also ___ ____

Answer 26

Occlusal Adjustment • 1:Any change in the occlusion intended to alter the occluding relation. • 2:Any alteration of the occluding surfaces of the teeth or restorations—see also OCCLUSAL RESHAPING.

Question 27

Diagnostic Casts

Critical so we can study cases Y

ou need models like you need x rays

They contribute to ____ picture

Answer 27

Diagnostic Casts Critical so we can study cases You need models like you need x rays They contribute to diagnostic picture

Question 28

Articulator

A ____ instrument that represents the ___ ___ and____, to which maxillary and mandibular____ may be attached to simulate some ________ _____. – THE JOURNAL OF PROSTHETIC DENTISTRY THE ACADEMY OF PROSTHODONTICS

Answer 28

Articulator A mechanical instrument that represents the temporomandibular joints and jaws, to which maxillary and mandibular casts may be attached to simulate some oralmandibularmovements. – THE JOURNAL OF PROSTHETIC DENTISTRY THE ACADEMY OF PROSTHODONTICS

Question 29

Facebows

Most facebows relate the____ to an arbitrary ___ ___.

If the dentist is going to alter the ____ dimension, it may be necessary to use a _____ facebow to record the ____ hinge axis.

Helps mount the _____ model in your articulator in as close ____ compared to patient as possible. Point of reference is ___ ___ ___, which is not in the same place as the condyle. Some averaging work done.

Answer 29

Facebows Most facebows relate the maxilla to an arbitrary hinge axis. If the dentist is going to alter the vertical dimension, it may be necessary to use a kinematic facebow to record the true hinge axis. Helps mount the maxillary model in your articulator in as close orientation comparted to patient as possible. Point of reference is external auditory meatus, which is not in the same place as the condyle. Some averaging work done.