Occlusion: teeth selection and type of occlusal schemes Flashcards

1
Q

In edentulous pt, how to you decide ideal face height (OVD)?

A

RECORD REST FACE HEIGHT

measure lower third

dduct 2-3 mm from face height = OVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do you use to measure face height for OVD?

A

willis guage

bottom bar press onto bone not just soft tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the only fixed position for a n edentulous pt?

A

rest face height

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 points on a willis gauge?

A

the position of the fixed arm under the nose

the position of the sliding arm under the chin

the vertical orientation of the gauge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

free way space?

A

you want this

difference between teeth at rest and in RCP (closed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how to record bite?

A

record blocks

record rims should be placed in well-fitting rigid bases

  • heat cured acrylic bases –> permanent denture base
  • cold-curing acrylic resin
  • shellac (cold cured)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

try in mandibular or maxillary first?

A

maxillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens if the wax try-in the denture is unretentive?

A

pt might do altered movements to try keep it in place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

can you just add on to the flanges to extend them?

A

no - need new impression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

where can you add or remove wax from?

A

lip support

incisal level

incisal tooth position

buccal

palatal surfaces

(latter changes to arch width)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Can you remove wax to change occlusal plane orientation?

A

yes on upper block

fox’s plane guide - should be parallel to ala-tragus line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when you are happy with the maxillary wax block, what do you do?

A

mark:

either side of nose

smile line

filtrum - midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do you adjust the lower block in relation to?

A

upper block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what to think about when trimming the lower wax block?

A

lip support, buccal and lingual surfaces

care with position of occlusal surfaces in relation to tongue

correct OVD - 2-4 mm between biting and rest position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how much free way space is needed?

A

2-4 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how to record the jaw relationship after both bite blocks are fitting well?

A

cut 2 notches is posterior occlusal surface of upper block –> one on each side

place upper record block in opts mouth

apply appropriate adhesive to lower block for bite recording paste being used

apply sufficient bite recording paste to occlusal surfaces of lower block - NOT ONTO ANTERIORS

insert block and guide pt into correct jaw relationship

allow sufficient time for material to set before removing from mouth - NOT A SNAP SET - hold for around 30 seconds

remove blocks carefully - may be sealed together

separate blocks carefully so that dental technician can cast impressions in upper and lower blocks where required

select appropriate anterior and posterior teeth

prescribe for correct articulator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how to know the bite blocks are fitting well?

A

pt needs to be in supine position

check relationship with blocks in pts mouth

ensure that is is as reproducible as possible

record ligamentous (or retruded contact position) if pt has moved to habitual path of closure

ligamentous position is considered the most reproducible

recheck that there is an identified FWS

ensure centre line is appropriate and marked if removed during modifications

18
Q

what is the shade guide used?

A

DELPHIC V or VITA

19
Q

what type of occlusal schemes are we going to prescribe? (most common)

A

most common: conventional bilateral balanced occlusion :

  • inter-cuspal position = retruded contact position
  • ICP on posterior teeth
  • working side and balancing side contacts in lateral excursions
  • anterior and posterior contact in protrusive excursions
20
Q

why do we have the conventional bilateral balanced occlusion scheme?

A

mutually protecting

  • denture will not be displaced if something is eaten on one side

contacts when pt has lateral and protrusive movement

21
Q

What is lingualized bilaterally balanced occlusion?

A
  • maxillary palatal cusps contacting mandibular central fossae
  • different from conventional bilateral balanced occlusion by eliminating the contact between the mandibular buccal cusps and maxillary central fossae
22
Q

How to achieve lingualized bilaterally balanced occlusion?

A

1 - modify anatomical mandibular posterior teeth or

2 - by applying anatomical maxillary posterior teeth against flat mandibular posterior teeth

23
Q

What is the monoplane occlusion occlusal scheme?

A

can be establish balanced or nonbalanced occlusion

occlusal contact comprise surfaces rather than points

24
Q

3 types of occlusal scheme you can prescribe?

A

conventional bilateral balanced occlusion

lingualized bilaterally balanced occlusion

monoplane occlusion occlusal scheme

25
when to prescribe LBBO?
severely resorbed ridge on mandibular arch ALLOWS - masticatory efficiency and preservation of ICP)
26
factors influencing teeth selection?
previous dentures (if any) age of pt size and shape of facial skeleton colour of complexion pt choice pt friend OK or Hello magazine old photos - usually school or wedding
27
materials of teeth?
acrylic composite porcelain combination
28
acrylic teeth pros and cons?
highly cross-linked acrylic (improves wear resistance and colour stability) good appearance and adhesion to denture base wears quickly
29
composite teeth pros and cons?
harder and longer lasting than acrylic good aesthetic properties reduced bond strength to underlying acrylic can be modified/added
30
porcelain teeth pros and cons?
retention to denture base through mechanical features celled diatoric holes (pins) designed into teeth (can be dislodged) good appearance but can be noisy, chip with high occlusal forces, extra weight
31
How to decide central incisor width?
using philtrum width the height of the central incisor should be equal to or greater than the height if the smile line above the incisal edge high smile should be marked on the wax rim
32
when to use larger central incisor?
high lip line larger stature larger face
33
how to find canine position?
using a straight edge aligned with the inner canthus of the eye and the ala of the nose to find the position of the canine
34
how to select teeth shape?
using pt old denture inverted shape of pts shape shape of pt upper plate
35
4 types of teeth shape? `
square : complement square set face and strong features ovoid : create sifter appearance and complement delicate, rounded features tapering : tapering face rectangular : long square shaped faces
36
How does position of teeth change with age and how would you consider this in denture design?
attrition of natural teeth: incisal edge will tend to be flattened loss of muscular toe of lips and face: flanges and teeth need to attempt to restore 'appearance' (can be difficult) need to place anterior teeth in correct position: lip support but if too far anterior --> denture displacement amount of tooth showing : at rest and when smiling
37
positioning of posterior teeth?
38
3 compensating curves when positioning teeth?
anterior posterior- curve of spee laterally- curve of monson mediolaterl curve- curve of wilson
39
anterior posterior curve?
curve of spee
40
lateral curve?
curve of monson
41
mediolateral curve?
curve of wilson