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Occlusion > Optimal Functional Occlusion > Flashcards

Optimal Functional Occlusion Flashcards

1
Q

what we need to know (3)

A

optimal occlusion in a stationary position (position of teeth, TMJ, muscles)
optimally occlusion during excursive movements of the mandible
occlusal philosophies during excursive movements

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2
Q

occlusal philosophies during excursive movements (3)

A

canine guidance- anterior guidance
group function
balanced occlusion

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3
Q

BASELINE FOR EVALUATING PATIENT’S OCCLUSION (4)

A

teeth
TMJ
musculature
evaluate the entire masticatory system

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4
Q

a patient may have an orthodontically ideal angles class 1 occlusion, this does not mean that the patient has (3)

A

optimal occlusal contants,
optimal condyle/mandibular position and
ideal/optimal contacts in excursive movements

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5
Q

conversely someone with a class 2 or 3 occlusion although not orthondontcally idea, may have

A

an acceptable, function occlusion

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6
Q

patients may have a less than ideal occlusion, however, it may still be a (2)

A

functionally acceptable occlusion or a

physiologically acceptable occlusion

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7
Q

is treatment required?

A

asses the masticatory system for evidence of pathology

-tooth wear, tooth mobility, TMJ dysfunction, muscle dysfunction, etc

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8
Q

— capacity of a patient

A

adaptive

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9
Q

if treatment is rendered, what is the optimal position for the (3)

A

joints
muscles and
teeth

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10
Q

the TMJ are in an optimum, orthopedically stable joint position when the mandible is in

A

centric relation

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11
Q

CR

A

term used to define a position of the condyles in relation to the disc and fossa

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12
Q

CR is defined as when the

A

condyles are in the most anterior-superior position in the glenoid fossa. braced up on the intermediate zone of the disc, and the mandible is free to rotate about the terminal hinge axis (up to but not indulging the point of first tooth contact)

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13
Q

CR refers to –, not

A

joints

teeth

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14
Q

mandible can freely arc up and down along the

A

terminal hinge axis

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15
Q

teeth cant contact=

A

deflection

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16
Q

why is CR the ideal position? (2)

A

musculature in CR

TMJs in CR

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17
Q

musculature in CR (4)

the muscles function harmoniously in CR
the joint is stable because the muscles attached to the joint prevent dislocation of the articular surfaces
the muscles that stabilize the TMJs are mainly the (2). contraction of these muscles results in antero-superior vector of force (stability)
the (1) muscles are most relaxed in CR

A

masseter and the medial pterygoids

lateral pterygoid

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18
Q

TMJs in CR

A

condyles are in the most antero-superior position in the glenoid fossa

condyles rest against the posterior slope of the articular eminence (thickest bone) therefore can tolerate higher stresses

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19
Q

CR

condyles are braced gently/rest against the intermediate zone of the disc (non-innervated and avascular zone) therefore

A

higher stresses can be tolerated

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20
Q

there are - other definitions for CR

A

7

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21
Q

in the past: CR was called the most — position of the mandible

A

retruded

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22
Q

in the most retruded position: the retrosical tissues are

A

innervated and would not tolerate stress

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23
Q

in the most retruded position: the posterior wall of the articular fossa is

A

very thin

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24
Q

CR questions (5)

A

jaw or teeth position?
how are the condyles positioned in the fossa?
how do the condyles move, when the anterior teeth open 20-25mm?
what is the axis of rotation in that position called?
how do the condyles move, when the anterior teeth open further than 20-25mm?

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25
Q

the muscles function

A

harmoniously

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26
Q

the TMJS are in an

A

optimal, orthopedically stable joint position

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27
Q

the TMJs are stable even when

A

heavy loads/forces are applied

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28
Q

CR

this is the position to which we restore (3)

A

completely edentulous patients
partially edentulous patients, when there are so few teeth remaining that there is not a stable MIP
dentate patients who are going to receive extensive restorations which will alter their occlusion completely

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29
Q

Recording the CR position on a patient using an — — in order to deprogram the muscles of mastication

A

anterior deprogrammer

30
Q

optimal functional occlusion (3)

A
  1. the TMJ
  2. the teeth
  3. the excursive movements
31
Q

teeth relations in optimal function occlusion (2)

A

in stationary position

during excursive movements

32
Q

THE TEETH
(FOR OPTIMAL FUNCTIONAL OCCLUSION)
posterior teeth

A

multiple, even, bilateral and simultaneous occlusal contacts with the mandible in the CR position, are the most desirable

33
Q

the posterior teeth are loaded mainly along the

A

long axis of the tooth (axial loading)

34
Q

1) multiple

A

the more teeth that contact the more the stress is distributed throughout the arch

35
Q

2) even

A

all posterior teeth should contact evenly. this distributes the stress over all the teeth and does not concentrate it on one tooth causing harm

36
Q

3) bilateral

A

this is for stability. if tooth contacts occur only on the right side and not on the left, then the mandible will pivot around this right side contact and place increased pressure on the left TMJ causing problems

37
Q

4) simultaneous

A

all the contacts occur at the same time on both sides of the arch and on all the posterior teeth

38
Q

5) the teeth should be axially loaded: ie

A

through the long axis of the tooth. lateral forces on teeth are not well accepted. on the contrary though axial loading, heavier stresses can be applied

39
Q

anterior teeth should have — occlusal contacts when the posterior teeth are in occlusion

A

lighter

40
Q

since the anterior teeth are not loaded axially, they are not able to

A

withstand high loads

41
Q

why should there be any occlusal contacts on anterior teeth?

A
42
Q

canine guidance

A

also called canine discussion or canine rise. when the mandible moves laterally, the canines on the working side guide the movement, causing all other teeth to disclude

43
Q

anterior guidance

A

in protrusive movement, the anterior teeth should disclude the posterior teeth

44
Q

anterior guidance

the canines, central and lateral incisors disclude the posterior teeth, when the mandible is

A

protruded

45
Q

anterior guidance
contacts between the posterior teeth during excursive movements are considered —- and can create damaging effects on the teeth and periodontium

A

interferences

46
Q

WHY IS CANINE GUIDANCE/ANTERIOR

GUIDANCE THE OPTIMAL OCCLUSAL SCHEME? (3)

A

• MANDIBLE - CLASS III LEVER
the more anterior (away from the fulcrum), the resistance (load) occurs, the lesser the impact (magnitude)
the canines(s) has the longest root, and best bone support (canine eminence)

47
Q

OPTIMAL FUNCTIONAL OCCLUSION

ALSO REFERRED TO AS

A

MUTUALLY PROTECTED

OCCLUSION

48
Q

MUTUALLY PROTECTED OCCLUSION

A

multiple, even, bilateral simultaneous occlusal contacts of the posterior teeth in MIP with the mandible in CR position
(MIP and CR are coincident)

49
Q

MUTUALLY PROTECTED OCCLUSION

the anterior teeth exhibit lighter occlusal contacts as compared to posterior teeth in

A

MIP

50
Q

MUTUALLY PROTECTED OCCLUSION

posterior teeth are axillary loaded in

A

MIP

51
Q

MUTUALLY PROTECTED OCCLUSION

in excursive movements, what occurs?

A

canin guidance/anterior guidance

52
Q

MUTUALLY PROTECTED OCCLUSION

the posterior teeth withstand the majority of the load in MIP, protecting the anterior teeth from

A

high loads

53
Q

MUTUALLY PROTECTED OCCLUSION

the anterior teeth disclude the posterior teeth in excursive movements, thereby

A

protecting the posterior teeth from off-axis loading

54
Q

MUTUALLY PROTECTED OCCLUSION
posterior teeth can. tolerate axial loading well so they protect anterior teeth, which are not axillary loaded, in MIP. anterior teeth can tolerate lateral forces in excursive movements (off axial loading) since they are

A

further away from the fulcrum and the loads are less

55
Q

GROUP FUNCTION

A

when the mandible moves laterally, the mandible is guided by the outer inclines of the mandibular buccal cusps sliding along the inner inclines of the buccal cusps of the maxillary posterior teeth

56
Q

GROUP FUNCTION

the most desirable group function consists of the

A

canine, premolars and MB cusp of the first molar

57
Q

GROUP FUNCTION

the more posterior the contacts, the greater the force-closer to the source of power; the move — the forces

A

destructive

58
Q

GROUP FUNCTION
on the WS, only the — cusps of the mandibular teeth guide along the inner inclines of the maxillary teeth, as far posteriorly as the first molar (MB cusp)

A

buccal

59
Q

GROUP FUNCTION

there are no contacts on the

A

NWS

60
Q

GROUP FUNCTION is — but not —

A

acceptable

ideal

61
Q

GROUP FUNCTION

is the only option for patients who (4)

A 
have no anterior vertical overlap eg anterior open bite 
a very large anterior horizontal overall eg class 2 div 1
have a reverse overlap eg class 3 
you may see group function referred to as unilateral balance (not a term used today)
62
Q

BALANCED OCCLUSION (2)

A

simultaneous contacts on both sides (working and non working) during lateral excursive movements (working side contacts and balancing side contacts)
contacts between the posterior and anterior teeth during protrusive movement

63
Q

BALANCED OCCLUSIONif the mandible moves to the right:

on the right side (WS):

A

outer includes of mandibular buccal cusps contact inner inclines of max buccal cusps and at the same time

64
Q

BALANCED OCCLUSION
if the mandible moves to the right
on the left side (NWS):

A

inner inclines of mandibular buccal cusps contact inner inclines of maxillary lingual cusps

65
Q

BALANCED OCCLUSION

in protrusion:

A

there are contacts between posterior and anterior teeth

66
Q

BALANCED OCCLUSION

on the posterior teeth:

A

mesial inclines of mandibular cusps occlude with distal inclines of maxillary cusps

67
Q

BALANCED OCCLUSION

not acceptable for

A

dentate patients

68
Q

BALANCED OCCLUSION

not ideal for

A

dentate patients

69
Q

BALANCED OCCLUSION

promotes — on dentate patients

A

tooth wear

70
Q

BALANCED OCCLUSION

NWS contacts are extremely

A

destructive and must be avoided

71
Q

BALANCED OCCLUSION is an acceptable form of occlusion for

A

complete dentures

Occlusion (15 decks)

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