RQs

Question 1

You have cemented an Enamic crown on #31, 2 days ago. Patient came to the clinic with limited mouth opening (34 mm) and pain on the right side of her jaw. She said she feels high contact on the right side when she bites down. When you tried to increase mouth opening with stretching, patient was able to increase opening 8 mm more. Maximum mouth opening with stretching is 42 mm. You checked the #31 crown occlusion and saw a high contact. After adjusting the occlusion patient felt better and left. Patient called back 3 days later and said pain and limitation is alleviated and she feels better when she bites down. Which one of the following is the possible diagnosis for this patient?

a) Disc displacement without reduction on the right
b) Muscle co-contraction due to the high occlusal contact
c) Disc displacement without reduction on the left side
d) Dislocation of the right TMJ

Answer 1

b) Muscle co-contraction due to the high occlusal contact

Question 2

Nociceptive (flexor) reflex is a protective reflex to a painful stimulus. It is activated when we bite on a hard object unexpectedly. Elevator muscles stop contracting and depressor muscles start contracting to open the jaw which prevent it from getting hurt.

a) True
b) False

Answer 2

a) True

Question 3

What is secondary occlusal trauma?

a. Injury resulting in tissues changes from normal occlusal forces applied to a tooth or teeth with reduced bone and attachment levels
* b. Injury resulting in tissues changes from normal or excessive occlusal forces applied to a tooth or teeth with reduced bone and attachment levels
c. Injury resulting in tissues changes from normal or excessive occlusal forces applied to a tooth or teeth with normal bone and attachment levels
d. Injury resulting in tissues changes from excessive occlusal forces applied to a tooth or teeth with normal bone and attachment levels

Answer 3

*b. Injury resulting in tissues changes from normal or excessive occlusal forces applied to a tooth or teeth with reduced bone and attachment levels

Question 4

Hard Occlusal devices:

1) can increase the contractile activity of the elevator muscles and therefore reduce bruxism habits.
2) have an 80% success rate in treating TMD.
3) are fabricated in CR because when the teeth are separated by the device, there is no MIP.
4) alter the VDO.

a. I only
b. 1 & 2 only
c. 2, 3, & 4 only
d. all of the above

Answer 4

• c. 2, 3, & 4 only
  2) have an 80% success rate in treating TMD.
  3) are fabricated in CR because when the teeth are separated by the device, there is no MIP.
  4) alter the VDO.

Question 5

Which of the following are clinical indicators of occlusal trauma?

a) Furcation involvement, mobility, gingival inflammation
b) Gingival inflammation, mobility, wear facets
c) Deep pockets, attachment loss, tooth fracture
d) Mobility, fremitus, wear facets, pain, tooth fracture

Answer 5

d) Mobility, fremitus, wear facets, pain, tooth fracture

Question 6

Periodontal health evaluation must always be achieved prior restorative treatment.

a. True
b. False

Answer 6

*a. True

Question 7

Temporomandibular disorders:
1. have been proven by controlled clinical trials to be caused by occlusal factors.

2. result from a CR-MIP discrepancy and should be treated by selective grinding of teeth to achieve equilibration.
3. are a group of clinical problems with a variety of signs and symptoms including orofacial pain, joint sounds and impaired function.
4. are most commonly treated by providing symptomatic relief through conservative therapies such as an occlusal device.

a. 1 & 2 only
b. 2 & 3 only
c. 1 & 3 only
d. 3 & 4 only

Answer 7

*d. 3 & 4 only

Question 8

In canine-guided occlusion, working and non-working occlusal contacts should be avoided in a single crown restoration on a maxillary second molar.

a. True
b. False

Answer 8

a. True

Question 9

What is primary occlusal trauma?
a. Injury resulting in tissues changes from excessive occlusal forces applied to a tooth or teeth with normal bone and attachment levels

b. Injury resulting in tissues changes from excessive occlusal forces applied to a tooth or teeth with reduced bone and attachment levels
c. Injury resulting in tissues changes from normal occlusal forces applied to a tooth or teeth with normal bone and attachment levels
d. Injury resulting in tissues changes from normal occlusal forces applied to a tooth or teeth with reduced bone and attachment levels

Answer 9

*a. Injury resulting in tissues changes from excessive occlusal forces applied to a tooth or teeth with normal bone and attachment levels

Question 10

Which are the basic principles of occlusal adjustment?

a. BULL rule for the working side
b. Have a mutually protective occlusion
c. Eliminate premature contacts
d. All of the above

Answer 10

*d. All of the above

Question 11

Each of the following is TRUE about your Denar Slidematic facebow assembly equipment EXCEPT:

a. There are 2 ear buds
b. There is one earbow
c. There is one anterior reference pointer
* d. It’s used to locate the true hinge axis.
e. The earbow is fully detachable from the transfer jig assembly

Answer 11

*d. It’s used to locate the true hinge axis.

NOTE: Denar Slidematic facebow assembly is NOT used to locate the true hinge axis

Question 12

In the sagittal view of Posselts Envelope of Motion, MIP is located more anteriorly than CR.

a. True
b. False

Answer 12

*a. True

Question 13

According to lecture, successful bimanual manipulation for CR capture involves all EXCEPT which of the following?

a. Patient comfort and relaxation
b. Guiding the Mandible into CR
* c. Load Testing of the TMJs PRIOR to hinging the mandible
d. Low masticatory muscle tonus

Answer 13

*c. Load Testing of the TMJs PRIOR to hinging the mandible

Correct NOTE: Load Testing of the TMJs AFTER hinging the mandible

Question 14

If posterior teeth on the left side contact occlusally, during a right lateral excursion of the mandible, the left side occlusal contact would be referred to as

A. Laterotrusive contact
B. Protrusive contact
C. Mediotrusive contact
D. Centric relation

Answer 14

*C. Mediotrusive contact

Question 15

Mandibular movement resulting from occlusal contacts of the teeth from premature contact (centric relation contact) to intercuspal position (slide in MIP) may show which of the following components in the sagittal plane?
A. Vertical component
B. Horizontal component
C. Lateral component

Answer 15

*A. Vertical component

Question 16

Which of the following is TRUE of your Denar Mark 320 Articulator?

a. Has adjustable Bennet Angles
b. Permits bilateral adjustment of Condylar Inclinations
c. Is of the non-arcon variety
d. The Slidematic Facebow Transfer Jig Assembly table

Answer 16

*b. Permits bilateral adjustment of Condylar Inclinations

Question 17

Which of the following is FALSE regarding Anterior Deprogrammers?
A. Used for TMD diagnosis.
B. Used during the creation of a CR Record
C. Used to maximize posterior tooth contacts
D. Certain types are shim stock bite leaf gauges
E. Can be customized or pre-fabricated

Answer 17

*C. Used to maximize posterior tooth contacts

Question 18

Which is the CORRECT order of steps (listed from left to right) for the mounting of diagnostic casts?

a. Facebow transfer, earbow, placement, mount maxillary & mandibular cast
b. Earbow placement, facebow transfer, mount maxillary cast, mount mandibular cast using a CR record.
c. Mount maxillary cast using CR record, mount mandibular cast using facebow transfer.
d. CR record mount mandibular cast, mount maxillary cast.

Answer 18

b.

• Earbow placement,
• facebow transfer,
• mount maxillary cast,
• mount mandibular cast using a CR record.

Question 19

The anterior reference point of the maxillary spatial plane used in this occlusion lab course is located:
a. coronal to tooth # 3
b. approximately 43mm superior to the incisal edge of
tooth # 7
c. along the mid-palatal suture
d. the tip of the nose.

Answer 19

*b. approximately 43mm superior to the incisal edge of

tooth # 7

Question 20

The main purpose of the facebow registration is to:

a. locate the true hinge axis
b. determine the incisal edge position
c. relate the maxillary arch to the hinge axis and cranial base
d. obtain an accurate centric relation record

Answer 20

*c. relate the maxillary arch to the hinge axis and cranial base

Question 21

Thielman’s Formula relates the 5 components of occlusion (Hanau’s Quint). Based on that formula, to maintain a constant relationship among the components, an increase in condylar inclination will require a/an:

a. increase in cusp inclination
b. decrease, in cusp inclination
c. no change in incisal guidance
d. decrease in compensating curve

Answer 21

*a. increase in cusp inclination

Question 22

Which is a CORRECT order of steps (listed from left to right) for using a facebow?

A. mark anterior reference point, make a facebow transfer, take bitefork registration

B. mark anterior reference point, take bitefork registration, make a facebow transfer

C. tighten screw #2, tighten screw #1, remove earbow from patient’s head

D. make a facebow transfer, take bitefork registration, remove earbow from patient’s head

E. take bitefork registration, make a facebow transfer, mark anterior reference point

Answer 22

• B.
• mark anterior reference point,
• take bitefork registration,
• make a facebow transfer

Question 23

Hanau’s Quint comprises the following, except:

a. Condylar inclination
b. Incisal guidance
c. Occlusal plane
d. Hinge axis
e. Compensating curve

Answer 23

*d. Hinge axis

Question 24

Fill in the 2 blanks in the following statement:

The most relaxed, centralized (supero-anteriorly), musculo-skeletally stable position of the condyles bilaterally within the _______ is called Centric Relation.

If the TM Joints are in a state of health, they tend to approximate this most repeatable & reproducible position whenever the teeth are slightly _______ and the muscles of mastication are relaxed.

a. glenoid fossae & discluded
b. infraorbital notches & occluded
c. retromylohyoid spaces & protruded
d. infraorbital notches & discluded

Answer 24

*a. glenoid fossae & discluded

Question 25

For ARCON articulators, guidance of condylar movements is controlled by the mandibular bow.

a. True
b. False

Answer 25

*b. False

Question 26

With fully adjustable articulators, a “true hinge axis” must be located.

a. True
b. False

Answer 26

*a. True

Question 27

From your understanding of the current state of clinical dentistry, which of the statements best describes a reasonable stance on the use of articulators:

a. the articulators are obsolete relics from the past and have no place in current modern dental practice
b. the articulators are used to mimic the jaw movements, and are necessary tools in communicating with the lab technicians; their usage is essential for fixed restorations treatments and it becomes extremely important as the complexity of the case increases
c. the articulators are only needed for direct restorations such as composite restorations

Answer 27

b. the articulators are used to mimic the jaw movements, and are necessary tools in communicating with the lab technicians; their usage is essential for fixed restorations treatments and it becomes extremely important as the complexity of the case increases

Question 28

Which of the following statements about the Temporomandibular Joint structures is FALSE?

a. Articular surfaces of the temporomandibular joint are covered with hyaline cartilage tissue, which has limited capacity to heal and repair itself.
b. The mandibular condyle is the top part of the mandibular neck. It articulates with the temporal bone of the cranium on a region called the glenoid (mandibular) fossa.
c. The primary function of the TMJ ligaments is to passively restrain TMJ functions
d. The articular disc is not innervated

Answer 28

*a. Articular surfaces of the temporomandibular joint are covered with hyaline cartilage tissue, which has limited capacity to heal and repair itself.

Question 29

In which of the following BOTH inter-incisal opening AND lateral movements are limited?

a. 41 mm inter-incisal opening AND 9 mm lateral movements
b. 32 mm inter-incisal opening AND 4 mm lateral movements
c. 38 mm inter-incisal opening with 6 mm overbite AND 5 mm lateral movements

Answer 29

*b. 32 mm inter-incisal opening AND 4 mm lateral movements

Question 30

Capsular ligament pain is provoked when the inflamed capsule is stretched. Which movement provokes the TMJ capsular ligament pain? 
A. Lateral movement 
B. Medial movement 
C. Wide opening of jaw 
D. All of the above

Answer 30

*D. All of the above

Question 31

Which of the following ligaments limits posterior movement of the condyle and the disc to protect the retrodiscal tissues, and may cause condylar neck fractures to prevent the condyle from entering the middle cranial fossa during extreme forces. 0

A. Collateral ligaments
*B. Temporomandibular ligaments
C. Stylomandibular ligaments
D. All of the above

Answer 31

*B. Temporomandibular ligaments

Question 32

Nociceptors (nociceptive sensory receptors) are found in all tissues of masticatory system for painful stimuli and are stimulated when there is an injury.
A. TRUE
B. FALSE

Answer 32

*A. TRUE

Question 33

Which of the following sensory receptors send signals to contract the masticatory muscles to resist the gravity force?

a. Golgi tendon organ
b. Nociceptors
c. Muscle Spindles
d. Pacinian corpuscle

Answer 33

*c. Muscle Spindles

Question 34

Which masticatory muscles can be palpated extraorally. during clinical examination?

a. Masseter muscle and Temporalis muscle
b. Masseter muscle and Mylohyoid muscle
c. Lateral Pterygoid muscle
d. Medial Pterygoid muscle

Answer 34

*a. Masseter muscle and Temporalis muscle

Question 35

The Temporomandibular Joint is considered as a gingimoarthroidal joint. Based on this information which of the following is TRUE? 
The TMJ does ... 
a. Ball and socket, and hinge movement 
b. Gliding and hinge movement 
c. Condyloid and Saddle movement

Answer 35

*b. Gliding and hinge movement

Question 36

Which of the following is FALSE about the TMJ clinical examination?

a. Patient should be upright in a chair, sitting comfortably.
b. Mouth should be closed and teeth should not be touching
c. Bite plates and other removable appliances that do not replace teeth should not be removed at the beginning of the examination.
d. All of the above.

Answer 36

*c. Bite plates and other removable appliances that do not replace teeth should not be removed at the beginning of the examination.

Question 37

Mutually protected occlusion includes:

A. Canine guidance only.
B. canine guidance and anterior guidance
C. bilateral posterior contacts in MIP
D. b & c

Answer 37

*D. b & c

B. canine guidance and anterior guidance
C. bilateral posterior contacts in MIP

Question 38

The Dentatus articulator is a Non-ARCON articulator.

a. True
b. False

Answer 38

*a.True

Question 39

Posterior dental implants favor _______, natural anterior teeth favor forces.

a. vertical; horizontal
b. vertical; vertical
c. horizontal;vertical
d. horizontal; horizontal forces

Answer 39

*b. vertical; vertical

Question 40

The determinants of tooth position include all of the following EXCEPT:

a. lips, cheeks, and oral habits
b. tongue
c. centric relation
d. occlusal contacts
e. proximal contacts

Answer 40

*c. centric relation

Question 41

The side away from which the mandible moves is the side

a. non-working side
b. working side.
c. none of the above

Answer 41

*a. non-working side

Question 42

The mesiobuccal cusp of the maxillary first molar opposes which of the following areas on the mandibular first molar in an ideal Class I imp/swat relation?

a. Buccal groove.
b. Central fossa
c. Distobuccal groove
d. Lingual grove.

Answer 42

*a. Buccal groove.

Question 43

Posterior tooth contacts in protrusive are highly desirable in the natural dentition occlusion.
A. True
B. False

Answer 43

*B. False

Question 44

Simultaneous uniform bilateral occlusal contacts are necessary to:

a. Maximize mandibular stability.
b. Minimize the overall force for each tooth.
c. Both a & b
d. None of the above.

Answer 44

*c. Both a & b

a. Maximize mandibular stability.
b. Minimize the overall force for each tooth.

Question 45

The movement of the mandible from maximum opening (MO) to maximum protrusion (MP) in the sagittal plane is described by which of the border movements listed below? 
A. Posterior opening border 
B. Anterior opening border 
C. Superior contact border 
D. Functional

Answer 45

*B. Anterior opening border

Question 46

Which of the following is/are non-functional cusps in the ideal Class I adult dentition?

a. Mandibular buccal
b. Mandibular Lingual
c. Maxillary buccal
d. Maxillary Lingual
e. a &d
f. b &c

Answer 46

*f. b &c

b. Mandibular Lingual
c. Maxillary buccal

Question 47

o conform to the curve of Wilson, the mandibular posterior crowns are inclined: 
A. Buccally 
B. Distally 
C. Lingually
D. Mesially

Answer 47

*C. Lingually

Question 48

In a left working movement, which cusps will be most involved in mastication? 
A. Left mandibular buccal cusps 
B. Left mandibular lingual cusps 
C. Right mandibular buccal cusps 
D. Right mandibular lingual cusps

Answer 48

*A. Left mandibular buccal cusps

Question 49

According to your first lecture, which of the following is FALSE concerning a Lucia Jig?

a. Made out of acrylic
b. Stable when placed in the mouth
c. Places posterior teeth in MIP
d. To be used in patients with upper and lower anterior teeth

Answer 49

*c. Places posterior teeth in MIP

Question 50

The curvature of the occlusal alignment of the teeth running medio-laterally, viewed frontally, following the cusps of the natural premolars and molars is known as the:

a. Curve of Monson
b. Curve of Wilson
c. Curve of ,Spese,
d. None of the above

Answer 50

*b. Curve of Wilson

Question 51

In the natural dentition:
a. centric relation and MIP always coincide
b. mutually protected occlusion is the preferred choice of occlusal scheme
c. group function is the preferred occlusal scheme
d. bilateral balanced occlusion is the preferred occlusal
scheme

Answer 51

*b. mutually protected occlusion is the preferred choice of occlusal scheme

Question 52

MIP is:

a. the most antro-superior position of the condyles against the slopes of the articular eminences
b. Is never a treatment position.
c. the best fit of teeth
d. none of the above

Answer 52

*c. the best fit of teeth

Question 53

Canines are best suited to accept horizontal forces for the following reasons:

a. they have the longest and largest roots
b. they are surrounded by dense compact bone
c. higher levels of muscular activity are detected
* d. A & B are correct
e. none of the above

Answer 53

*d. A & B are correct

a. they have the longest and largest roots
b. they are surrounded by dense compact bone

Question 54

The Bennett movement is the:

a. medial shift of the working condyle
b. lateral movement of the working condyle
c. lateral movement of the non-working condyle
d. bodily shift of the mandible in the direction of the non-working condyle

Answer 54

*b. lateral movement of the working condyle

Question 55

The area that supports the major forces of mastication is:

a. FOA
b. Central fossa
c. Occlusal Table.

Answer 55

*c. Occlusal Table

Question 56

The Bennett angle can be traced on:

a. the rotating condyle
b. the orbiting condyle
c. the non-working condyle
d. the fixed condyle
e. B & C are correct

Answer 56

*e. B & C are correct

b. the orbiting condyle
c. the non-working condyle

Question 57

Centric relation is:

a. a treatment position when MIP is non-physiologic or unavailable
b. repeatable and stable
c. Used in the fabrication of complete dentures.
d. all of the above

Answer 57

d. all of the above

Question 58

The curvature of the occlusal alignment of the teeth, beginning at the tip of the mandibular canine, following the buccal cusps of the natural premolars and molars is known as the:

a. Curve of Monson
b. Curve of Wilson
c. Curve of Spee

Answer 58

*c. Curve of Spee