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Removable Pros > VDO > Flashcards

VDO Flashcards

1
Q

intermaxillary records are what number visit?

A

Third patient visit

  • 5th overall step
  • lab portions between visits
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2
Q

what do we have at the intermaxillary record phase - sequence of this step

A

occlusion rims – adjusted in mouth THEN facebow registration and centric relation record and then mounted on articulator

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3
Q

inter-ridge space

A

when natural teeth are in occlusion, ridge crests are approximately a minimum of 12 mm apart in the anterior

posterior? 1-2mm

or height of tongue blade in anterior and width of it in posterior

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4
Q

Freeway space

A

Inter-occlusal distance

between the teeth when the mandible is at rest (VDR)

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5
Q

when does VDR and VDO occur?

A

VDR- after swallow – like saying EMMA - after saying the word emma - after say this word the space is the freeway space

VDO - during /end of swallow

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6
Q

movement from VDR to VDO

A

2-3 mm change when mandible moves up to go to VDO traveling 2-3 mm

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7
Q

freeway space?

A

increases with age?

average is approx 2-3 mm

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8
Q

closest speaking space

A

smaller than freeway space

.5-1mm at max

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9
Q

neutral zone

A

the potential space between the lips and cheeks on one side and the tongue on the other

forces come together

  • where we put the teeth to remain in equilibrium

no equilibrium if push too far buccal/lingual

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10
Q

space of donders

A

space between palate and tongue in VDR - during rest

can be altered with VDO (increase VDO - increase this) and vise versa

can be altered independent of VDO if palate is too thick - can decrease this space

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11
Q

what do occlusal rims mimic?

A

temporarily the placement of teeth in the oral cavity for the purpose of making maxilla-mandibular relation records and arranging teeth

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12
Q

most clinically dense informational visit we have?

A

Intermaxillary Records

- adjust occlusion rim -VDO

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13
Q

sequence of intermaxillary records

A 
occlusal plane
vertical dimension of occlusion
facebow registration
centric relation registration
tooth selection
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14
Q

beginnings of occlusal plane - what do you know

A

2/3 height of retro pad we have marked so know the height of this in that area

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15
Q

where do we start

A

maxillary centrals

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16
Q

where do we begin when adjusting for VDO

A

start with the upper rim

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17
Q

flare in occlusal rims is there for what?

A

there is a concavity in the lips and accounts for this

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18
Q

if set rim too far forward?

A

lips out too far forward

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19
Q

Fricative sounds? what contacts at these sounds? what does it indicate?

A

Vermillion border contact @ F
F or V sound “55” which determine teh position of incisal edges of central incisors
where lip makes sound against teeth – hits at or near the wet-dry line

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20
Q

how much tooth visible at rest?

A

about 1-2 mm of teeth visible @ rest

lips slightly parted

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21
Q

full smile? what is revealed? where does lip end up?

A

maximum visibility and tooth length (CEJ)

free gingival margin - little above CEJ or the gingival zenith

have to record high smile line on rim

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22
Q

acute naso-labial angle?

A

can see that the pt. is now wearing denture vs. when not - it is more 90 degrees or less acute because the teeth support the lips

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23
Q

what do the teeth do?

A
  1. support the lip – there is an acute naso-labial angle
  2. thicker vermillion border (w/out teeth this flattens and rolls inward)
  3. esthetics
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24
Q

high smile line is where?

A

at the CEJ of the centrals

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25
Q

adjust area A with patient to when at rest?

A

so can see 1-2 mm of the rim

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26
Q

midline comes from?

A

face

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27
Q

two occlusal planes

A

lateral - horizontal

and anterio-posterior

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28
Q

lateral plane is parallel?

A

ALWAYS parallel to the inter-pupillary line

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29
Q

antero-posterior plane is initially parallel to? then modified?

A

parallel to the ala-tragus line first

then modified upward as needed during rim try in – adjustments made to area D

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30
Q

area on rims that gets most adjustment?

A

D

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31
Q

fox occlusal plane

A

permits viewing of both planes on Maxilla simultaneously

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32
Q

what determines if you need to make adjustments to area A?

A

Phonetics with the fricative sounds - F and V
indicates the position of incisal edges of the central incisors

if too long - interferences
if too short– patient will just be blowing air - will not find their teeth

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33
Q

Area A adjusted for?

A
  1. phonetics
  2. esthetics
    once complete
    DON NOT TOUCH
34
Q

after area A adjusted?

A

Go to the lower (leave area D alone for now)

35
Q

what if lip has too much support?

A

if teeth too far forward - more support and see more tooth than want

36
Q

adjustments to area B?

A

should be to lip length so B is AT HEIGHT OF LIP and approx. parallel to the dorsum of tongue

37
Q

Area C measurment?

A

1/2 or 2/3 height of retromolar pad

38
Q

flate plane tooth?

A

dont have to worry about curves - so starts and ends at 2/3 height retromolar pad

39
Q

what is area D based upon after adjustments to other areas have been made?

A

initially - siblant sounds

siblant sounds – so adjustments made last

40
Q

how to change area D?

A
  1. lubricate lower rim
  2. remove upper and warm area
  3. reset and close until A contacts B
41
Q

VD

A

distance between U/L arches

42
Q

VDO

A

vertical dimension of occlusion

- during occlusal contact

43
Q

VDR

A

vertical dimension of rest

-during muscular rest

44
Q

what hold VDO?

A

Posterior teeth

45
Q

how to measure distance from VDR to VDO?

A

using tongue blade and dots placed on nose and chin, the distance traveled from VDR and VDO can be measured

because mandible moves upward from VDR to VDO

46
Q

freeway space anterior posterior ratio?

what happens with age?

A

3:1

increases with age - but averages 2-3 mm

47
Q

therapeutic VDO?

A

we establish this for the patient with almost 2-3 mm of inter-occlusal rest distance

48
Q

minimum distance for freeway space of interocclusal distance

A

2-3 mm

49
Q

do teeth touch in closest speaking space?

A

NO

50
Q

Closest speaking space

A

is the small space between the occlusal surfaces during sibilant sounds
*about .5-1 mm
tiny space left after saying words like “66” mississippi
church

judge

51
Q

is clicking of teeth ever normal?

A

NO - no clicking is not normal when VDO is correct - even if patient has porcelain teeth

52
Q

examples of silibant sounds

A 
66
mississippi 
church
massachusettes 
sandwhich 
"j" jelly 
judge
53
Q

S sounds determine

A

Incisor position
premolar position - lateral border of tongue hits here
VDO

54
Q

sibilant sound on pre-molar area?

A

S sounds
if too constricted - whistle
too wide - like sh

55
Q

space of dondors implication which is independent of VDO

A

if palate is TOO THICK - it will decrease this space and the patient will have difficulty swallowing

56
Q

effect on space of dondors if increase or decrease VDO

A

increase VDO - increase space

decrease VDO - decrease space

57
Q

commercial guidelines on max and mandibular

A 
max = 22mm
mand = 18 mm
58
Q

anterior-posterior guidelines for anterior teeth position

A
  1. lip support
  2. naso-labial fold
  3. vermillion border of the lip
  4. Fricatives
59
Q

inciso-gingival guidelines for anterior teeth position

A
  1. rest position (reveal)
  2. high smile line
  3. fricatives
  4. sibilants
60
Q

incisal-occlusal plane orientation guidelines for determining teeth position

A
  1. 1/2-2/3 RMP

2. Inter-pupillary line

61
Q

Areas (A,B,C,D)

which are adjusted for VDO which are not?

A

A- not adjusted for VDO
C- not adjusted for VDO

B and D can adjust for the right VDO
- both contributing to “S” sound

62
Q

occlusal plane is determined by?

A

A and C

need an anterior and posterior component

63
Q

area A =

A

esthetics and phonetics

64
Q

area C=

A

anatomy of retromolar pad

65
Q

VDO is altered by?

determined by?

A

altering areas B and D
B sibilants with A
D sibilants with C

determined by ‘A’ + B’ and ‘C+D’

66
Q

VDR - VDO is about what?

A

3mm

67
Q

what to do if rims are not flush? what results?

getting VDO by changing plane

A

D is changed by taking just a WEDGE AWAY

- this raises the plane from the ala-tragus line

68
Q

Changing plane but NOT VDO

want to go from 2/3 to 1/2

A

changing C so you move from monoplane to curved

curved = 1/2 pad

69
Q

changing VDO and Occlusal Plane
describe what is done to A, B, C, D
how?

A 
A= NOT adjusted anteriorly
B= totally adjustable
C= NOT adjustable posteriorly 
D
totally adjustable

VDO AND PLANE ARE CHANGED BY TAPERING THE RIMS (adding or removing a WEDGE of wax)

70
Q

does changing the VDO always change the plane?

A

YES

71
Q

does changing the plane always change the VDO?

A

NO

- may just need to change plane to go from 2/3 to 1/2 for monoplane vs curved dentition

72
Q

plane of occlusion =

A

A + C

73
Q

Vertical Dimension of Occlusion =

A

A+B and C+D

74
Q

To change VDO, change

A

B+D

75
Q

VDR-FWS =

A

VDO

76
Q

which is posturial position?

A

VDR

77
Q

when are ridges parallel to each other?

A

when in VDO

78
Q

which is better or worse?
insufficient?
Excessive?

A

Excessive = INCREASE RIDGE RESORPTION

Insufficient may not be pretty - results in angular chelitis, possible muscle tone loss and hearing problems, esthetic problmes but excessive causes BONE LOSS and painful problems

79
Q

how do you change the occlusal plane without changing VDO?

A

make adjustments to area C to either 1/2 or 2/3
2/3 = flat plane
1/2 = curved plane

80
Q

can you change VDO without changing the occlusal plane?

A

NO
changing the VDO will always change the plane

see this with situations where D needs to be trimmed so we get flush
also see this with making adjustments to area B and D
bringing B up or D down by wedges of wax

81
Q

after rims are flush sequence of events to get flush AND VDO?

A
  1. adjust B and D for VDR and FWS
  2. adjust B and D for VDO
  3. Adjust B and D for Sibilants
    now flush and at VDO

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