Week 8 - Optimal Occlusion

Question 1

What are the goals of occlusal equilibration?

Answer 1

1) To improve functional & esthetic relationships between maxillary and mandibular teeth.2) To eliminate TMD*permanent occlusal therapy is indicated only when significant evidence exists to support that the occlusal condition is an etiological factor (cause) for TMD.

Question 2

What 4 procedures can be part of treatment planning for occlusal therapy?

Answer 2

1) Selective grinding2) Fixed prosthodontics3) Orthodontic therapy4) Orthognathic surgery*The least amount of dental alterations that will fulfill treatment goals is best.

Question 3

If the offensive contact is in the inner third of a slope, what procedure is used to correct it?

Answer 3

Selective grinding

Question 4

If the offensive contact is in the middle third of a slope, what procedure is used to correct it?

Answer 4

Fixed prosthodontics

Question 5

If the offensive contact is in the outer third of a slope, what procedure is used to correct it?

Answer 5

Orthodontic treatment

Question 6

What factors influence treatment planning?

Answer 6

1) Symptoms - Pt.’s can have slides but no symptoms, so tx. isn’t necessary 2) Condition of the dentition3) Systemic health4) Esthetics5) Finances

Question 7

Define selective grinding.

Answer 7

A procedure by which the occlusal surface of the teeth are altered to improve the overall contact pattern. It’s only appropriate when corrections are minimal enough that they can be made within the enamel structure.

Question 8

The shorter the slide (the closer to the center of the tooth it is), the more likely it is that _________

Answer 8

Selective grinding can be accomplished within the confines of the enamel.

Question 9

When the slide has a great horizontal component, it becomes difficult to ________

Answer 9

eliminate it within the confines of the enamel (usually happens in flat teeth)

Question 10

True or false: In selective grinding, it’s okay to grind the functional cusp.

Answer 10

False! Only grind the receiving surface (the fossa).

Question 11

How do you determine mandibular excursions?

Answer 11

1) Locate the tooth in the arch2) Determine if it moves - Yes if mandibular, no if maxillary3) Identify movement - Protrusive, working, nonworking etc.

Question 12

If mandible moves B, what is the movement called?

Answer 12

Working

Question 13

If mandible moves L, what is the movement called?

Answer 13

Non-working

Question 14

If mandible moves forward, what is the movement called?

Answer 14

Protrusive (also have lateral and medial protrusive)

Question 15

If maxillary functional cusp “moves” backward, what is the movement called?

Answer 15

Protrusive (also have lateral and medial protrusive)

Question 16

If maxillary functional cusp “moves” B, what is the movement called?

Answer 16

Nonworking

Question 17

If maxillary functional cusp “moves” L, what is the movement called?

Answer 17

Working

Question 18

What does MUDL mean?

Answer 18

You can selectively grind M inclines of upper cusps or D inclines of lower cusps, or a little of both to eliminate a slide.

Question 19

When is MUDL used?

Answer 19

To correct a forward deviation.

Question 20

What does BULL mean?

Answer 20

You can selectively grind B inclines of upper cusps or L inclines of lower cusps, or a little of both to eliminate a slide.

Question 21

When do you use BULL?

Answer 21

To correct a deviation toward the cheek.

Question 22

What does LUBL mean?

Answer 22

You can selectively grind L inclines of upper cusps or B inclines of lower cusps, or a little of both to eliminate a slide.

Question 23

When do you use LUBL?

Answer 23

To correct a deviation toward the tongue.

Question 24

What are your options for selective grinding on closing?

Answer 24

MUDL, BULL, LUBL

Question 25

What are your options for selective grinding on opening (guidance)?

Answer 25

Nonworking interferences (BULL), Working interferences (LUBL), Protrusive interferences (DUML)

Question 26

When do you use Nonworking interferences (BULL)?

Answer 26

To correct deviation toward tongue, you grind B incline of upper cusps or L incline of lower cusps. For a crossbite with balancing interferences, grind both BU and LL.

Question 27

When do you use Working interferences (LUBL)?

Answer 27

To correct a deviation toward the working side. Grind both LU and BL.

Question 28

When do you use Protrusive interferences (DUML)?

Answer 28

To correct a protrusive deviation. Grind D of upper most often.