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Occlusion: Anna and Diewitt > Occlusion Quiz 2: SLIDES 1-20 > Flashcards

Occlusion Quiz 2: SLIDES 1-20 Flashcards

1
Q

SLIDE 1: DENTAL ARTICULATOR DEFINITION

Dental Articulator:
A mechanical instrument used to:
1) Orient what kind of relationship?
2) Duplicate what kind of movements?

A

1) Orient the RELATIVE relationship of the maxillary and madibular casts of a patient
2) Duplicate the FUNCTIONAL and BORDER movements of the mandible.

Side note: Has nothing to do with any other entity. Such as CORONOID process, tuberosity…..
Does not relate to the craniomandibular apparatus.

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2
Q

SLIDE 1: DENTAL ARTICULATOR DEFINITION

Dental Articulator:
A mechanical instrument used to:
1) Orient the RELATIVE relationship of the maxillary and mandibular casts of a patient to what two things?

A
  1. To one another

2. To the posterior determinants of occlusion (TMJ)

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3
Q

SLIDE 2: NONADJUSTABLE ARTICULATOR

Various Features:

1) ___________ (No adjustments or adjustments) are possible
2) Allow for ____________ (centric or eccentric movements) within limitations of the instrument
3) _____________ ( Can or cannot duplicate) a patient’s specific movements.
4) Sometimes referred to as what kind of “hinge”
5) ___________ (open or closed) occlusal contact position only one that is ______________ (reproducible or nonreproducile)
- - What two occlusal contacts are associated with nonadjustable articulator.

A

Various Features:

1) NO ADJUSTMENTS are possible
2) Allow for ECCENTRIC MOVEMENTS within limitations of the instrument
3) CANNOT DUPLICATE a patient’s specific movements.
4) Sometimes referred to as a “BARN DOOR HINGE”
5) CLOSED occlusal contact position only one that is REPRODUCIBLE.
- - Associated with MI or ICP

*1, 3-5: ONLY associated with NONADJUSTABLE ARTICULATOR.

-------
NOTE: 
Articulator is fixed. 
Cheap..... around $50.
NOT ASSOCIATED with CR
Can only duplicate with GENERAL types of movement
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4
Q

SLIDE 3: ADVANTAGES vs. DISADVANTAGES of the SEMIADJUSTABLE ARTICULATOR

1) Provides a ______________ (minor or significant) advantage over the non-adjustable articulator in REPLICATING the patient’s ___________ (condylar or articular eminence movement)
2) _____________ (Excellent or not practical) for ROUTINE dental treatment
3) __________ (Less or more) time consuming as in order to be EFFECTIVE, __________ (information or no information) must be transferred from the patient to the articulator.
4) ___________ (More or less expensive) instrument than the nonadjustable articulator.

A

1) Provides a SIGNIFICANT advantage over the non-adjustable articulator in REPLICATING the patient’s CONDYLAR movement.
2) EXCELLENT for ROUTINE dental treatment
3) MORE time consuming as in order to be EFFECTIVE, INFORMATION must be transferred from the patient to the articulator.
4) MORE EXPENSIVE instrument than the nonadjustable articulator.

Semiadjustable articulator is designed for 1,2,3 crowns… NOT 15 crowns.
Most expensive than nonadjustable articulator
Greater advantage over nonadjustable articulator.

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5
Q

SLIDE 4: NATURE of OCCLUSAL PREMATURITIES

1) These are recorded and recognized as a _______________ (“high” or “low”) contact, before the patient ____________( opens or closes) all the way into ____________________ ( maximum occlusion or maximum intercuspation).
2) FIRST tooth contact in _______________ ( centric relation or maximum occlusion) is a good example of an occlusal prematurity.

A

SLIDE 4: NATURE of OCCLUSAL PREMATURITIES

1) These are recorded and recognized as a “HIGH” contact, before the patient CLOSES all the way into MAXIMUM INTERCUSPATION.
2) FIRST tooth contact in CENTRIC RELATION is a good example of an occlusal prematurity.

NOTE:
Occlusal prematurities: type of occlusion that patient has prior to having their ideal occlusion
– NOT stable: not in that position for a long period of time.

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6
Q

SLIDE 4: NATURE of OCCLUSAL PREMATURITIES

3) The term prematurity implies that the contact is either on an _______________ (incline or decline) or is in an area that is _____________ (considered or not considered) STABLE (for the teeth and/or the condyles)
4) NONE of these contacts are proper ____________ (centric relation or maximum intercuspation) occlusal contacts.
5) The mandible can be displaced __________ (posteriorly or anteriorly) and/or ___________ (vertically or laterally)

A

SLIDE 4: NATURE of OCCLUSAL PREMATURITIES

3) The term prematurity implies that the contact is either on an INCLINE or is in an area that is NOT CONSIDERED STABLE (for the teeth and/or the condyles)
4) NONE of these contacts are proper MAXIMUM INSTERCUSPATION occlusal contacts.
5) The mandible can be displaced (sliding) ANTERIORLY and/or LATERALLY.

NOTE:
The mandible can be displaced anteriorly and/or laterally if we get an occlusal prematurity.

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7
Q

SLIDE 5: LOCATION OF WORKING INTERFERENCES- MANDIBLE (prematurities)

Q: Triangular ridge (facial inclines) of a DISTOLINGUAL cusp of a mandibular first molar. What is the name of this type of interference.

A

Triangular ridge (facial inclines) of a DISTOLINGUAL cusp of a mandibular first molar. This is called a:

WORKING INTERFERENCE.

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8
Q

SLIDE 6: NORMAL CLOSURE – MUSCLES INVOLVED.

What two muscles are involved in NORMAL mandibular closure ( CLOSE TO MAXIMUM INTERCUSPATION):

Extra:
— The lateral pterygoid is involved in what in what?

A

MUSCLE OF MASTICATION WILL CONTRACT:
– POSTERIOR AND MIDDLE TEMPORALIS: predominantly contract. (certain

Extra:
RELAXATION:
– LATERAL PTERYGOID: RELAXATION of INFERIOR AND SUPERIOR BELLY OF THE LATERAL PTERYGOIDS.

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9
Q

SLIDE 7: DIFFERENTIAL DIAGNOSIS OF CLICKING (of articular disc):

  1. Early opening click = Occurs when?
  2. Late opening click = Occurs when?
  3. Deviation in form = What kind of structure of the articular disc
  4. Partial disc displacement = What happens to the articular disc here?
A
  1. Early opening click = occurs at initiation of the translation of the condyle (s).
  2. Late opening click = occurs just PRIOR to termination of opening in patients with ANTERIORLY displaced discs.
  3. Deviation in form ABERRANT structure of the articular disc
  4. Partial disc displacement = PORTION of the articular disc that is displaced to the ANTERIOR
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10
Q

SLIDE 7: DIFFERENTIAL DIAGNOSIS OF CLICKING (of articular disc):

  1. Disc Displacement WITH REDUCTION: generic displacement of the articular disc at rest, which _____________ (resolves or does not resolve) upon mandibular opening.
  2. Disc Displacement WITHOUT REDUCTION: generic displacement of the articular disc at rest, which _____________ (resolves or does not resolve) upon mandibular opening.
A
  1. Disc Displacement WITH REDUCTION: generic displacement of the articular disc at rest, which RESOLVES upon mandibular opening.
    (you’ll hear a click, and disc will pop back into place)
  2. Disc Displacement WITHOUT REDUCTION: generic displacement of the articular disc at rest, which DOES NOT RESOLVE upon mandibular opening.
    ( you will NOT hear a click)
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11
Q

SLIDE 8: PROCEDURES UTILIZING a NONADJUSTABLE ARTICULATOR:

  1. _____________ (arbitrary or nonarbitrary mounting) procedures used to LOCATE and FIX the casts.
  2. Cast are located ____________ (equidistant or more lateral) between the maxillary and mandibular components of the articulator.
  3. Casts are held together with the ____________ (teeth or articulator) in ________________ (maximum occlusion or maximum intercuspation)
  4. Any bite registration material that allows the teeth to SEPARATE will result in an ____________( accurate or inaccurate replication) of the ____________________ (intercuspal position “ICP” or interproximal position “IPP”).
A
  1. ARBITRARY MOUNTING procedures used to LOCATE and FIX the casts.
  2. Cast are located EQUIDISTANT between the maxillary and mandibular components of the articulator.
  3. Casts are held together with the TEETH in MAXIMUM INTERCUSPATION
  4. Any bite registration material that allows the teeth to SEPARATE will result in an INACCURATE REPLICATION of the INTERCUSPAL POSITION (ICP)
-------
#4: bite registration... such as wax.... so we don't use any bite registration cause it'll get in the way.
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12
Q

SLIDE 9: BENNETT ANGLE PATHWAY ( aka: progressive slide shift)

NOTE: In the skull, the pathway the CONDYLE descends during ____________ (protrusive or retrusive) and ___________ (laterotrusive or mediotrusive) movements is generally __________ (straight or curved). SEMIADJUSTABLE articulators are limited to providing only a ___________ (straight or curve pathway).

A

NOTE: In the skull, the pathway the CONDYLE descends during PROTRUSIVE and LATEROTRUSIVE MOVEMENTS is generally CURVE. SEMIADJUSTABLE articulators are limited to providing only a STRAIGHT pathway.

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13
Q

SLIDE 10: 3 PROCEDURES ARE NECESSARY TO USE THE FULLY ADJUSTABLE ARTICULATOR PROPERLY AND EFFECTIVELY:

Three procedures are necessary to use the fully adjustable articulator properly and effectively:

  1. What kind of axis location of the condyles is used for the FACEBOW?
  2. What type of recording
  3. What type of occlusal record
A
  1. An EXACT HINGE AXIS LOCATION of the condyles for the facebow
  2. A PANTOGRAPHIC recording
  3. A CR occlusal record. (a very accurate centric relation occlusal record).

Note:
#3: NOT MI occlusal record.

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14
Q

SLIDE 11: SELECTION OF AN ARTICULATOR
(deciding when is it appropriate to use a certain type of articulator)

  1. CHARACTERISTICS of the Patient’s Occlusion:
    _____ (#) Factors determine mandibular movement:
    What are they?

– When a patient has ___________ & ____________ (list the two characteristics) ANTERIOR guidance, these tooth contacts DOMINATE and CONTROL mandibular movement.

A

2 factors determine mandibular movement:

a. POSTERIOR CONTROLLING FACTORS –> (TMJ’s)
b. ANTERIOR CONTROLLING FACTORS –> (anterior teeth)

– When a patient has ADEQUATE & IMMEDIATE ANTERIOR GUIDANCE, these tooth contacts dominate and control mandibular movement.

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15
Q

SLIDE 12: OBJECTIVES and GOALS of this LECTURE: (of occlusal prematurities)

  1. Understand the location of occlusal prematurities during _______ (open or normal closure)
  2. Recognize the locations of ______________ ( working or non-working side) premature occlusal contacts.
  3. Recognize the locations of ________ (protrusive or retrusive) premature occlusal contacts.
  4. Recognize the ______________ (condular or articular eminence) positions as a result of EITHER WORKING OR NON-WORKING premature occlusal contact.
  5. (T/F): Identify which muscles of mastication are affected by working, non-working and protrusive premature occlusal contacts.
  6. (T/F): Know which side that the mandible deviates or moves towards whenever a working, non-working, or retrusive prematurity is present.
A
  1. Understand the location of occlusal prematurities during NORMAL closure.
  2. Recognize the locations of BOTH, WORKING and NON-WORKING premature occlusal contacts.
  3. Recognize the locations of PROTRUSIVE premature occlusal contacts.
  4. Recognize the CONDULAR positions as a result of EITHER WORKING OR NON-WORKING premature occlusal contact.
  5. TRUE: Identify which muscles of mastication are affected by working, non-working and protrusive premature occlusal contacts.
  6. FALSE: Know which side that the mandible deviates or moves towards whenever a working, non-working, or PROTRUSIVE prematurity is present.
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16
Q

SLIDE 13: LOCATION OF WORKING/NON-WORKING INTERFERENCES – MANDIBLE

Q: If a patient has an occlusal prematurity that’s located on the TRIANGULAR RIDGE of the FACIAL CUSP of the mandibular 2nd premolar, it is most likely what kind of interference?

A

– IT is a NON-WORKING INTERFERENCE:

since it’s associated with the triangular ridge/LINGUAL INCLINES of the FACIAL CUSP

17
Q

SLIDE 13: LOCATION OF NON-WORKING INTERFERENCES – MANDIBLE

NON-WORKING INTERFERENCES:
1) _____________ (Facial or lingual) inclines of the mandibular _________ (anterior facial or posterior facial) cusps.

  1. Parallel to the ___________ (distofacial or mesiofacial) developmental groove – Mand 1st molars.
A

NON-WORKING INTERFERENCES:
1) LINGUAL inclines of the mandibular POSTERIOR FACIAL cusps.

  1. Parallel to the DISTOFACIAL developmental groove – Mand 1st molars.
18
Q

SLIDE 14: LOCATION OF __________ INTERFERENCES – MAXILLA (prematurity)

Q: If a patient has an occlusal prematurity that’s located on the MESIAL MARGINAL RIDGE of the maxillary 1st PREMOLAR, it is most likely what type of interference?

A

– PROTRUSIVE INTERFERENCE: MESIAL MARGINAL RIDGES of the maxillary posterior teeth.

19
Q

SLIDE 15: CLOSURE INTERFERENCE – TOOTH/JAW POSITIONS

Q: If a patient has a premature contact or a closure interference, that involves direct contact with the triangular ridge of the mesial facial cusp of the maxillary 1st molar, and facial ridge of the mesiofacial cusp of the mandibular 1st molar, which of the following clinical condition is going to be noted:
Q1) Is it going to be an A, B, or C contact?
Q2) This contact will display mandibular deviation to which side?

A

A1: an A contact
A2: Will display mandibular deviation to the OPPOSITE side.

20
Q

SLIDE 15: CLOSURE INTERFERENCE – TOOTH/JAW POSITIONS

Mandibular deviation to the ________ (opposite or same) side will occur with maxillary _______ (facial or lingual cusp) to mandibular ________ (facial or lingual cusp contact).

A

Mandibular deviation to the OPPOSITE side will occur with maxillary FACIAL CUSP to mandibular FACIAL CUSP contact.

21
Q

SLIDE 16: LATERAL DISPLACEMENT OF THE MANDIBLE:

Q: If a patient has a premature contact or closure interference that involves direct contact with the triangular ridge of the mesiolingual cusp of the maxillary 1st molar, and the triangular ridge of the mesiofacial cusp of the mandibular 1st molar, what conditions are clinically noted:
Q1) Is it going to be an A, B, or C contact?
Q2: This contact will display mandibular deviation to which side?

A

A1: a B contact
A2: Will display the condyle on the SAME side deviating laterally.

22
Q

SLIDE 16: LATERAL DISPLACEMENT OF THE MANDIBLE:

Summation: “B” contacts will display the condyle on the ___________ (same or opposite) side deviating LATERALLY. The condyle on the opposite side of the interference is __________ (anterior or posterior) to the ________ (CR or MI) position.

– Premature B contacts are: Maxillary _____ (lingual or facial) to mandibular __________ (lingual to facial) cusp contact.

A

Summation: “B” contacts will display the condyle on the SAME side deviating LATERALLY. The condyle on the opposite side of the interference is ANTERIOR to the CR position.

– Summation B contacts are: Maxillary LINGUAL to mandibular FACIAL CUSP contact.

23
Q

SLIDE 17: BASIC TERMINOLOGY OF TMD FUNCTION and DYSFUNCTION.

– ANTERIOR DISC DISPLACEMENT: Physical dislocation or displacement of the ________ (articular disc or articular eminence), either anterior to or posterior to the ___________ (head or neck) of the condyle.

A

– ANTERIOR DISC DISPLACEMENT: Physical dislocation or displacement of the ARTICULAR DISC, either anterior to or posterior to the HEAD of the condyle.

24
Q

SLIDE 18: BASIC TERMINOLOGY OF TMD FUNCTION and DYSFUNCTION.

  1. INTRACAPSULAR TMD: Problems and clinical conditions associated with the _____________ (name joint) joint that are contained WITHIN the ______________ (capsular or craniomandibular apparatus). (i.e., the immediate joint tissues)
  2. MYOFASCIAL PAIN DYSFUNCTION SYNDROME: is used to describe a number of different common painful states characterized by the presence of ________ (list the point) within the affected muscle (s). This syndrome is a common source of low-back, neck pain, shoulder pain, chest pain, and rib pain.
A
  1. INTRACAPSULAR TMD: Problems and clinical conditions associated with the TEMPOROMANDIBULAR joint that are contained WITHIN the CAPSULAR APPARATUS. (i.e., the immediate joint tissues)
  2. MYOFASCIAL PAIN DYSFUNCTION SYNDROME: is used to describe a number of different common painful states characterized by the presence of TRIGGER POINTS within the affected muscle (s). This syndrome is a common source of low-back, neck pain, shoulder pain, chest pain, and rib pain.
25
Q

SLIDE 18: BASIC TERMINOLOGY OF TMD FUNCTION and DYSFUNCTION.

RECIPROCAL CLICKING: A popping sound from the _____________ (articular disc or eminence), exhibited as a forceful “jumping” back or “snapping” ___________ (over or behind) the condyle, usually occurring during the early opening or late closing condylar movement

CLOSED LOCK: An ____________ (internal or external) derangement of the temporomandibular joint in which the articular disc is dislocated __________ (anteriorly or posteriorly) and usually __________ (medially or distally) to the condyle. The articular disc is physically incapable of reducing or receding posteriorly into position on the head of the condyle.

A

RECIPROCAL CLICKING: A popping sound from the ARTICULAR DISC, exhibited as a forceful “jumping” back or “snapping” OVER the condyle, usually occurring during the early opening or late closing condylar movement

CLOSED LOCK: An INTERNAL derangement of the temporomandibular joint in which the articular disc is dislocated ANTERIORLY and usually MEDIALLY to the condyle. The articular disc is physically incapable of reducing or receding posteriorly into position on the head of the condyle.

26
Q

SLIDE 19: TERMINOLOGY for INTERNAL DERANGEMENTS:

  • KNOW THE PICTURES FOR THIS SLIDE. WILL BE ON EXAM

Which one is NORMAL, DISPLACEMENT, or DISLOCATION:

1) Articular disc is located completely over the head of the condyle
2) Has a portion of the articulator disc that is occluding or articulating on posterior segment.
3) Articular disc is ompletely anteriorly positioned.

A

Which one is NORMAL, DISPLACEMENT, or DISLOCATION:

1) Articular disc is located completely over the head of the condyle: NORMAL
2) Has a portion of the articulator disc that is occluding or articulating on posterior segment: DISPLACEMENT
3) Articular disc is ompletely anteriorly positioned: DISLOCATION

— KNOW PICTURES!!!!

27
Q

SLIDE 20: DISC DISLOCATION

    • WITHOUT REDUCTION (not hearing the proper clicking sound):
      1. This type of dislocation is also known as?
      2. The Disc is positioned _____________ (anteriorly or posteriorly).
      3. Realignment ____________ ( does not or does occur)
      4. __________ (Yes or No) joint noises
      5. _________ (Limited or maximum) opening
A

– WITHOUT REDUCTION (not hearing the proper clicking sound):

  1. This type of dislocation is also known as “CLOSED LOCK”
  2. The Disc is positioned ANTERIORLY (entire time.)
  3. Realignment DOES NOT OCCUR
  4. NO joint noises
  5. LIMITED opening

Occlusion: Anna and Diewitt (6 decks)

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