Optimal Functional Occlusion Flashcards
The dynamic relationship of the lower anterior teeth against the upper anterior teeth through all ranges of function
Anterior guidance
What teeth should be the only teeth touching ideally in lateral trusive movement?
Canines
Canines contacting during lateral trusion creates a Class _____ lever
Class III lever
How much shorter should lateral incisors be than central incisors?
.5-.75 mm
What are the functions of anterior teeth?
Incise, hold, tear, or puncture
What are the function of posterior teeth?
Chop, grind, mash, or mince
Function of ____ teeth: Protect the posterior teeth•Aid in guidance of the mandible•Esthetic representatives•Aid in speech•Incise food
Anterior teeth
According to Monson, condyles are a ____ not a _____ of mandibular movement
result not a guide
What are the guiding elements of mandibular movement?
Cusps of teeth
Without posterior support, the anterior teeth can ____ and become ______
flare and become mobile
In _____ occlusion: Posterior contacts in centric•Posterior working contacts in lateral•Posterior balancing contacts in lateral•Posterior contacts in protrusive
Balanced
____ occlusion is not acceptable for dentate pts •not ideal for dentate pts •promotes tooth wear on dentate pts
Balanced occlusion
_____ side contacts are extremely destructive and must be avoided
non-working side
______ occlusion is an acceptable form of occlusion for complete dentures but not for dentate patients
Balanced
_____ occlusion favors wear of the teeth and favors horizontal chewing
Balanced occlusion
______ occlusion: Several teeth on the working side contact during eccentric movements•Most favorable alternative to canine guidance
Group function
_____ contacts in group function•Either canine guidance or group function•Needs to provide adequate guidance to discludethe teeth on the opposite side of the arch
Laterotrusive Contacts (Working)
_____ occlusion: Posterior contacts in centric (maximum intercuspation)•Posterior working contacts in lateral •No posterior balancing contacts in lateral•No posterior contacts in protrusive anterior disclusion
Group function
____ occlusion is acceptable but not ideal
Group function
_____ occlusion is the only option for patients who:•have no anterior vertical overlap e.g. anterior open bite, •a very large anterior horizontal overlap e.g. Class II DivI •have a reverse overlap e.g. Class III
Group function
____ occlusion is ideal
Mutually protected/Cuspid protected
Physiologic position•A stable musculoskeletal position•Determined by joint anatomy•Determined by muscle forces
Centric Relation•
In ______ occlusion: Posterior contacts in centric•Cuspid contact only on working side in lateral•No posterior balancing contacts in lateral•No posterior contacts in protrusive anterior disclusion
Mutually protected occlusion
What tooth has greater proprioceptive sensitivity
Canine
What tooth contacts prevent periodontal fatigue and restoration failure
Canine
_____ are best suited to accept the horizontal forces that occur during eccentric movements
Canines
_____ Forces•Must be directed to the anterior teeth which are positioned farthest from the fulcrum and the force vectors
Horizontal
Longest and largest roots and therefore the best crown/root ratio
Canines
•Fewer muscles are active when ____ contact during eccentric movements than when posterior teeth contact
Canines
Each tooth should contact in such a manner that the forces of closure are directed through the _____ of the tooth.
long axis
Even and simultaneous contact of all possible teeth should occur when mandibular condyles are in their most ______ position resting on the posterior slopes of articular eminences with the disc properly interposed
superoanterior
stable, orthopedic position is essential to treatment. •Muscles stabilize joints, therefore every mobile joint has a musculoskeletally stable position
Centric relation
____ is achieved by cusp tip to flat surface and tripodization
Axial loading
Elevator muscles pull the mandible in _____ position.
anteriosuperior
If the mandible is not in CR, the _____ must keep some tension on the neck of the condyle to keep it slightly forward.
inferior lateral pterygoids
In _____ occlusion•Good function•Shows the least wear to the teeth•Minimal periotrauma•Minimal TMJ trauma•Comfortable muscle activity
Ideal Occlusion
Which tooth breaks muscle tension in masseter and temporalis?
Canine
We need enough ______ so when the patient goes into a lateral or protrusive movement, the posterior teeth will disclude or separate.
vertical overlap
How much clearance should there be at molars in protrusive?
1 mm
Who started the study of occlusion to make dentures that worked well; developed articulators?
Greene brothers
2 main school of occlusion that are relatively close in theory and philosophy; widely divergent in technique
Pankey-Mann-Schuyler and Gnathology
What type of occlusion do gnathologists use?
Cuspid protected
What type of occlusion do Pankey-Mann-Schuyler use?
Group function
____ concept:
Incisal guidance has “the most profound” influence on the occlusion of the posterior teeth
•The incisal guidance in the normal occlusion is the lingual contours of the upper anterior teeth
•By its proximity to the posterior teeth, it has a predominating influence upon posterior tooth function
Harmony of contact on all working inclines
•Unilateral balance
•Cusp to fossa relationship
•Single point contact
Pankey-Mann-Schuyler
\_\_\_\_ original concept: Frequently showed excessive wear •Led to occlusal instability •Provided poor usage of the teeth •McCollum died believing the original concept was correct
Gnathology
\_\_\_\_ concept: •The canine teeth should serve to guide the mandible during eccentric movements •Determines both lateral and protrusive movements of the mandible It is the science and study of: •Mandibular movement •Jaw relationships •Tooth morphology •Functional requirements
Gnathology
Baseline for evaluating patients’ occlusion include what 3 things?
•Teeth•TMJ•Musculature
T/F: A patient may have an orthodonticallyideal Angles Class I occlusion, this does not mean that the patient has optimal occlusal contacts, optimal condyle/mandibular position, and ideal/optimal contacts in excursive movements.
True
T/F: Patients may have a less than ideal occlusion, HOWEVER, it may still be a functionally acceptable occlusion or a physiologically acceptable occlusion
True
The TM Joints are in an optimum, orthopedically stable joint position when the mandible is in _____
CENTRIC RELATION
refers only to the joints and does not involve teeth•mandible can freely arc up and down along the Terminal hinge axis •Teeth cannot contact = deflection
CENTRIC RELATION
To determine if treatment is _____: (assess the masticatory system for evidence of pathology -tooth wear, tooth mobility, TMJ dysfunction, muscle dysfunction, etc)
required
____ is a repeatable position where the muscles are relaxed
Centric relation
What are the 2 main muscles that stabilize the TMJ?
Masseter and medial pterygoid
Which muscles are the most relaxed in CR?
Lateral pterygoids
In CR, condyles are is most ____ position of glenoid fossa
Superior-anterior
Condyles rest against ____ slope of articular eminence which can tolerate higher stresses in CR
Posterior slope
In the most retruded position the posterior wall of the articular fossa is very ______
thin
Is CR a jaw or teeth position?
Jaw
______ is the position to which we restore:•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 entirely
Centric relation
____ works to eliminate the habitual closing patterns of the patient
Leaf gauge key
How hard should the patient bite on the leaf gauge?
Half-hard pressure
With the centric relation interocclusal record between the teeth, the patient should be aware of no _____ whatsoever. There should be a feeling of equal pressure throughout the contact.
strain
The ____ relates the maxillary cast to the axis of rotation; accurate and convenient method to get the maxillary cast into the articulator
Facebow
All posterior teeth should ______ . This distributes the stress over all the teeth and does not concentrate it on one tooth causing harm.
contact evenly
Should contacts in CR be unilateral or bilateral?
Bilateral
All the contacts occur ______ on both sides of the arch and on all the posterior teeth
at the same time
The posterior teeth should be ______ i.e. through the long axis of the tooth. Lateral forces on teeth are not well accepted.
axially loaded
Are anterior teeth axially loaded?
No
______: also called canine disclusion or canine rise. When the mandible moves laterally, the canines on the working side guide the movement, causing all other teeth to disclude.
Canine guidance:
Anterior Guidance: in Protrusive Movement, the anterior teeth should _____ the posterior teeth
disclude
Contacts between the posterior teeth during excursive movements are considered ______ and can create damaging effects on teeth and periodontium.
interferences
What class of levers are created when interferences occur?
Class 1 and 2
The more _____ the resistance (load) occurs, the lesser the impact (magnitude)
anterior (away from the fulcrum),
The _____ has the longest root, and best bone support (canine eminence)
canine(s
_____ occlusion: Multiple, even, bilateral, simultaneous occlusal contacts of the posterior teeth in MIP with the mandible is CR position i.e. MIP and CR are coincident. •The anterior teeth exhibit lighter occlusal contacts as compared to posterior teeth in MIP•Posterior teeth are axially loaded in MIP •In excursive movements canine guidance/anterior guidance occurs
Mutually protected occlusion
The posterior teeth withstand the majority of the load in MIP, protecting the anterior teeth from high loads. •The anterior teeth disclude the posterior teeth in excursive movements, thereby protecting the posterior teeth from off-axis loading.•Posterior teeth can tolerate axial loading well so they protect anterior teeth, which are not axially loaded, in MIP. Anterior teeth can tolerate lateral forces in excursive movements (off-axial loading) since they are further away from the fulcrum and the loads are less.
Mutually protected occlusion
