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Perio 2 - SP19 > Tx of trauma from occlusion > Flashcards

Tx of trauma from occlusion Flashcards

1
Q

when is the best time to treat traumatic occlusal forces

A

Best time to do it is after SRP

We want to wait until all the inflammation is gone because inflammation leads to mobility

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2
Q

primary TFO results in _ PDL

primary TFO - excessive forces (e.g. high amalgam restoration, bruxism)
on normal periodontium (no bone loss)

A

widened PDL space

we want to put the forces in the axial direction
reducing PDL space and injury

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3
Q

what is secondary occusal trauma

A

occlusal trauma on a reduced periodontium
normal or excessive forces applied to a weakened periodontium (weakened tooth)

we want to corerct it with splints for stabilization

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4
Q

methods of occlusal therapy that are reversible

A

night guard - bite plane

extracoronal splints

muscle relaxants - meds

muscle exercises

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5
Q

methods of occlusal therapy that are irreversible

A

intracoronal splints - require tooth preparation

occlusal adjustment by selective grinding

orthodontics

orthognathics surgery

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6
Q

principles of Occlusal adjustment

oocclusal adjustment by _ is one of the most irreversible dental procedures you will ever do - know the limitations

A

selective grinding

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7
Q

principles of Occlusal adjustment

knowing the _ to occlusal adjustment is more important than knowing the indications to adjust

A

contraindications

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8
Q

occlusal adjustment by selective grinding _

periodontal occlusal trauma
post-orthodontics - fine tuning
prior to extensive restorations
certain types of TMD
certain wear patterns
A

indications

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9
Q

occlusal adjustment by selective grinding _

severe malocclusion
non-ideal but well tolerated occlusion
severe wear or if occlusal adjustment would expose dentin
patient in pain
if no suitable end point can be reached (because of malocclusion or tooth malposition)

A

contraindications

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10
Q

goals in occlusal adjustment

_ overtime

_ loading forces

_ guideance in excursions that are smooth gliding and unrestrained

A

occlusal stability over time

axial loading of forces

anterior guidance in excursions that are smooth gliding

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11
Q 
Occlusal adjustment by selective grinding
_
a. CR
b. excursions 
non-working side (balancing)
working side 
protrusive
A

comprehensive

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12
Q

Occlusal adjustment by selective grinding

  1. _: mainly excursive movements
    a. directed toward eliminating lateral “jiggling-type” forces
A

limited: mainly excursive movements

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13
Q

Occlusal adjustment: general concepts

  1. _ so that CR-to-CO is not an inclined deflective contact
  2. _ of forces to prevent jigglying buccolingual forces
  3. reduction of wear facets by _ _ _
  4. NO _ contacts
  5. working contacts = _ guided if possible. _ if needed(with less force on molars)
  6. Protrusive: anterior contacts no _ protrusive contacts
A
  1. long centric
  2. axial loading of forces
  3. grooving, spheroiding, pointing
  4. no non-working balancing contacts
  5. canine guided if possible, group function if needed
  6. no posterior protrusive contacts
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14
Q

steps in comprehensive occlusal adjustment by selective grinding

  1. _ hit and slide - eliminate or reduce
  2. non-working side “balancing inferences
  3. working contacts
  4. protrusive contacts
  5. sharp or irregular incisal edges
  6. _ all teeth that were adjusted
A
  1. CR-CO hit and slide - eliminate
  2. eliminate them
  3. canine guide smooth and gliding
  4. anterior
  5. recontour them
  6. polish all teeth that were adjusted
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15
Q

what jaw position do we adjust in

jaw positioning
contact relationships
occlusal adjustment in _

A

CR

chin grasp
bilateral mandibular manipulation
leaf gauge
patient determined

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16
Q

CR; patient determined

chair at _ degrees
patient open
ask patient to place tongue on _
patient closes into centric

A

chair at 60degrees

tongue on soft palate

17
Q

CR-CO deflection

direction: _ (upper or lower jaw) guides anterior and vertical

CR relation interferences usually the _ inclines maxillary against the _ inclines mandibular

A

mandible guides anterior and vertical

more than 2mm it is difficult to get a long centric relation

mesial inclines maxillary
against distal inclines mandibular - forward displacement so we trim those areas

18
Q

possible contact relationships

_ is ideal
_ acceptable
_ _ not good
_worse
_ worst
A

cusp to fossa ideal

cusp to flat area - acceptable

cusp to incline and cusp to embrasure not good

incline to incline worse

cusp to cusp worst

19
Q

flatten _ contacts to establish long centric

A

flatten inclined contacts

By adjusting the inclines we are able to get the cusp in the fossa

20
Q

reduce _
As teeth wear due to diet, parafunctional habits, age, they tend to become flattened

So we recontour the teeth - slightly smaller tooth with the same anatomical proportions

Within the scoop of not affecting the dentin

A

reduce wear facets

21
Q

CR doesn’t = CO

it is usually the mesial of max and distal of mandi so the premature posterior contact causes the mandible to displace in which direction

A

anteriorly

22
Q

CR mandibular cusp tip to incline

solution?

A

flatten maxillary mesial incline

23
Q

incline to incline contact

solution

A

recontour both maxillary mesial incline and mandibular distal incline

24
Q

when do you spheroid the maxillary palatal cusp

A

prematurity in centric, working and nonworking

25
Q

premature contact in centric only, working and nonworking are okay

A

deepen the fossa

26
Q

CR incline to incline contact on both maxillary and mandibular holding cusps

A

recontour cusp inner inclines (not cusp tips)

27
Q

incline to incline premature contact on maxillary palatal holding cuso

A

recontour both cusp inclines max and mandi

28
Q

incline to incline premature contact on mandibular buccal holding cusps

A

recontour both cusp inclines

29
Q

as a general rule do not reduce a _ cusp tip

A

holding or functional cusp tip

buccal of mandi
lingual of max

adjust on inclines

30
Q

flatten the cusp tip on when there is a _ relationship, then place the contact on flat areas

A

cusp to embrasure

31
Q

non-working side contacts = _ = _trusive

balancing is a denture term to stablize denture
these interferences are not desireable for natureal dentition (cause _ forces)

A

balanacing = mediotrusive

cause lateral jiggling forces

32
Q

rule or adjusting non-working-balanacing-mediotrusive contacts

A

we want to eliminate all

PUBL - functional cusps

palatal upper
buccal lower

33
Q

working-side contacts
canine guided is possible

group function is acceptable if posterior teeth not compromised

_ working slide contacts are interferences

decrease frictional contact

A

cross tooth (lingual cusp) working side

34
Q

rule for adjusting working side contacts

A

BULL

max inner incline buccal cusp

mand inner incline lingual cusp

35
Q

protrusive contacts should have _ guidance and no _ interferences

if there are which to eliminate?

A

anterior guidance

no posterior interferences

BULL
maxillary buccal
mandi lingual
nonfunctional

36
Q

polishing sequence
use _ midgets then _ midgets (color)

use fine _
make certain patient is comfortable

then follow-up _ months after

A

green

brown

fine polish

1 month follow up- allows tooth stabilization, refine adjustment

37
Q

appliance for the immobilization or stabilization of injured or diseased parts

A

periodontal splints

38
Q

these are indications for _

to immobilizae excessively mobile (class 2/3) teeth by sharing forces with more stable teeth

to stablize teeth in their new position after orthodontic treatment

A

periodontal splints

out come of spliting - while they stablize teeth, they do not decrease individual tooth mobility once the splint is removed

Perio 2 - SP19 (16 decks)

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