Occlusion Q&A

Question 1

how to reorganise occlusion

Answer 1

retruded contact position

take registration

wax up

Question 2

retruded contact position

Answer 2

tooth position somewhere along retruded axis

Question 3

registration done in

Answer 3

wax
silicone

mandible aspect of facebow

Question 4

purpose of wax up

Answer 4

see what restorations will look like in new position and try in pt mouth

Question 5

when can you not mark occlusion before restorative procedures

Answer 5

If changing occlusal contact in the area – check occlusion before (check how teeth meet ICP and then can check replaced it in the same way) esp if many posterior

May not be possible – widely spread caries – multiple teeth and surfaces

Question 6

non working side

Answer 6

no posterior tooth contacts as slide to working side

Question 7

working side

Answer 7

tooth contacts

Question 8

how do teeth stay in reorganised occlusion

Answer 8

occlusal stop - stable position - tooth contact in retruded

Question 9

what tooth is key to holding position

Answer 9

canines

Question 10

what tooth is key to get waxed up first

Answer 10

Canines key to holding position – get them waxed up first on mandible

Add material to canine first – stable occlusal stop contact
- Guidance desired
Protect the other restorations if cannot all be completed in one app

Will hold your mandibular positions

Question 11

reason why to wax canine first and get canine guidance

Answer 11

stable occlusal stop contact

desired guidance - protect other restorations if cannot all be completed in one app

will hold your mandibular positions

Question 12

most anatomical and easy to achieve occlusal scheme

Answer 12

cusp tip to fossa

force transmitted down long axis of tooth (centric loading)

Good function and stability and easy to equilibrate/match

Question 13

RCP

Answer 13

first point of tooth contact on retruded arc of closure of mandible

may be able to slide it forward and maintain contact (help reduce open bite)

Question 14

how to spot premature contact

Answer 14

broad dots or dark in colour are higher/premature contacts

additionally other dots may be missing

Question 15

what to do is RCP uncomfortable for pt but that is there only occlusal contact

Answer 15

can train them into the position

Can be hard to get registration

• Lucia jig – allow mandible to slide on it
• Get acrylic splint (Michigan splint) made to help deprogramme them into the new position

Question 16

most imp occlusal position in primary care

Answer 16

ICP
pt comfortable bite
try to get back to this

Question 17

pt management of premature contacts

Answer 17

grinding to remove as uncomfy –> periodontal issue

Question 18

how to deal with flat grinding masticatory ares generated over years of parafunction

Answer 18

Need to make space for restorations

first RCP contact (centric relation) but slide forward of retruded arc of closure – more anterior on same tooth contact so anterior open bite decrease to be acceptable (2mm for strength of composite)

Build up canine and then rest of teeth