D6317 E1 Occlusion Exam 1 Flash Cards

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D6317 E1 Occlusion Exam 1 Flash Cards Powered By Docstoc
					D6317 Dental Occlusion                                                                                     WS 2009


What are the articulating components of the TMJ?
Condyle of mandible articulates with temporal bone in the glenoid fossa

What is a compound joint?
Comprised of at least 3 bones

What is a glinglymoid joint?
Allows hinging motion

What is a arthrodial joint?
Allows gliding motion

What type of joint allows both hinging and gliding motion?
Glinglymoarthrodial joint (the TMJ is such a joint)

What is a complex joint?
Allows more than one type of movement

What are the two purposes of the synovial fluid in the TMJ?
Lubricant and provides metabolic requirements

Describe the shape of the articular disc.
Concave on the inferior part; concavoconvex on the superior part

Which zone of the articular disc is the thickest?
Posterior part

Which zone of the articular disc is the thinnest?
Intermediate zone

In a frontal section of the articular disc, which section is thicker: medial or lateral?
Medial

What two ligaments join the articular disc to the condyle of the mandible?
Medial and lateral discal ligament

Where is the articular disc posteriorly attached?
Retrodiscal tissue (via the superior and inferior retrodiscal lamina)

Where is the articular disc anteriorly attached? Is this elastic or collagenous?
Superior head of the lateral pterygoid muscle and to the capsular ligament (collagenous)

What type of movement occurs in the superior joint compartment of the TMJ?
Translation

What type of movement occurs in the inferior joint compartment of the TMJ?
Rotation

What are the functional ligaments of the TMJ?
Collateral ligament (Discal), Capsular ligament, TM ligament

What are the accessory ligaments of the TMJ?
Sphenomandibular ligament, Stylomandibular ligament

What is the function of the outer oblique portion of the TM ligament?
Prevents excessive dropping of condyle, limits mouth opening, prevents mandible from over rotating

What is the function of the inner horizontal portion of the TM ligament?
Limits posterior movement of the condyle and disc, protects lateral pterygoid muscle from over extension

This ligament will limit excessive protrusive (forward) movement of the mandible.
Stylomandibular ligament

What does the articulator replicate?
Jaw positions and movement; Guidances; Pathways; Timing of movements

What are the uses of articulators?
Diagnosis, Treatment planning, Treatment, Patient education

What is the most common articulator use?
Fabrication of prosthesis


E1 - Flash Card Questions                                             Page 1 of 10                          3/4/2009
D6317 Dental Occlusion                                                                                                                  WS 2009


What are the three classifications of articulators?
Simple/hinge/non-adjustable; semi-adjustable; fully adjustable

When would a fully adjustable articulator be used?
For full mouth restorations of many teeth

Describe an arcon articulator.
Condylar element is on lower member; guiding mechanism is on upper member

Describe a non-arcon articulator.
Condylar element is on upper member; guiding mechanism is on lower member

What are the basic components of an articulator?
Upper member (arm and frame); incisal guidepin and guidance table; lower member (arm, frame, and uprights); condylar guidance mechanism;
Mounting rings; Intercondylar distance adjustment

TRUE or FALSE. The simpler the articulator, the more adjustment will be needed in the patient's mouth.
TRUE

What distance are the condylar elements set apart in a semi-adjustable articulator?
110 mm

What are the four types of adjustment possible with a semi-adjustable articulator?
Condylar inclination; Bennett angle (inward movement of condylar housing); Incisal guidance angle; Intercondylar distance (on fully adjustable
models)

The two types of bite records that are measured on an articulator are?
Protrusive and lateral records

What is a protrusive record?
Records the slope of the posterior part of the articular eminence

What does a lateral eccentric record record?
Records the slope of the medial wall of the articular fossa; records how far medially the condyle moves

What type of bite record can record the Bennett angle?
Only the lateral record (NOT the protrusive record)

What is the Hanau formula?
L = (H/8) + 12 (where L = Bennett angle and H = condylar element angle)

What is vertical dimension?
The space between the jaws; therefore, as teeth wear down, people's vertical dimension decreases

What is the purpose of a facebow?
Orient the maxillary cast to the rotational axis in three planes; position the maxillary anterior teeth to the frontal plane; provide reproducible
mounting position for subsequent maxillary casts

What is the transverse horizontal axis?
Axis which passes through each of the mandibular condyles, and it is the axis around which rotational movement of the mandible occurs

This type of facebow is the most accurate and can locate the true physiological transverse horizontal axis of rotation.
Kinematic facebow

This type of facebow is less accurate and locates the transverse horizontal axis by using anatomical landmarks.
Arbitrary facebow

What is Beyron's point, as used in an arbitrary facebow?
A point 13 mm anterior to the posterior margin of the tragus/canthus line (corner of the eye)

According to Weinberg, if the location of the facebow is inaccurate by 5 mm, how much will the occlusion be affected?
By 0.2 mm

What are the 4 anatomic determinants of mandibular movement?
Right TMJ, Left TMJ, teeth/occlusion, neuromusculature


E1 - Flash Card Questions                                           Page 2 of 10                                                           3/4/2009
D6317 Dental Occlusion                                                                                                                 WS 2009


The two types of overall movement of the TMJ are?
Rotational movements (about an axis); translation movement (bodily movement in any direction)

In which joint compartment of the TMJ does rotational movement occur?
Inferior joint compartment

Rotational movements can occur for how many millimeters of jaw opening?
First 20 to 25 mm (after this, translation occurs)

The only rotational movement that can be isolated clinically is?
Rotation in the sagittal plane around a horizontal axis (opening of jaw)

These types of rotation occur during lateral excursive movements.
Rotation in the horizontal plane around a frontal axis; Rotation in the frontal plane around a sagittal axis

What is centric relation?
Position of mandible in which condyles are in most superior and anterior position in the articular fossae, resting against posterior slopes of
articular eminences

Pure rotation of the mandible occurs only under what conditions?
Only when condyles are in centric relation

TRUE or FALSE. MIP often coincides with centric relation.
False

In MIP position, where are the condyles located ?
Located anterior and inferior (compared to superior and anterior for centric relation)

What is maximum intercuspation?
Position in which maxillary and mandibular teeth make maximum surface contact with each other (mandible is elevated as superiorly as
possible in sagittal plane)

What is physiologic rest position?
Habitual postural position of the mandible when the patient is resting comfortably and the condyles are in the neutral, unstrained position in
the glenoid fossa; teeth are slightly apart

Where are the condyles compared to centric relation when the patient is in postural position?
Anterior and inferior to CR position

The wedge space between the teeth that exists when the patient is in physiological rest position is called?
Interocclusal space

How much space typically exists between anterior teeth in interocclusal space? Premolars? Molars?
3 mm; 2 mm; 1 mm

The outer range of movement of the mandible, as determined by ligaments, articular surfaces of TMJ, and alignment of teeth, is called?
Border movement

What are functional movements?
Occur during functional activity and are confined within the border movements; they begin and end in MIP

When is maximum opening of the posterior opening border movement reached?
When capsular and TM ligaments prevent further opening

What movement does the anterior opening border movement represent?
Movement from maximum opening to maximum protrusion

What ligaments determine maximum protrusion?
Stylomandibular ligaments

In the superior contact border movement, where does initial tooth contact occur?
Between mesial cusp arms of maxillary teeth and distal cusp arms of mandibular teeth

The average distance between centric relation and MIP in 90% of the population is?
1.25 mm (+ or - 1 mm)


E1 - Flash Card Questions                                           Page 3 of 10                                                          3/4/2009
D6317 Dental Occlusion                                                                                                             WS 2009


Where are the condyles compared to centric relation when the patient is in MIP?
Anterior and Inferior and/or Medial or lateral to CR

What is the plane of occlusion?
Plane that curves to fit the occlusal surfaces and incisal edges of all teeth

The mandibular anterior teeth are inclined in what direction in the sagittal plane?
Labially (20 degrees)

The mandibular premolars are inclined in what direction in the sagittal plane?
Mesially (6 degrees)

The mandibular molars are inclined in what direction in the sagittal plane?
Mesially (10 to 15 degrees)

The tooth with the greatest angulation on the sagittal plane is?
Maxillary central incisor (28 degrees)

The maxillary premolars are inclined in what direction in the sagittal plane?
Mesially (9 degrees)

The maxillary molars are inclined in what direction in the sagittal plane?
Mesially (9 degrees)

Which teeth display the greatest lingual inclination from the frontal plane?
Mandibular molars

The anteroposterior curvature of the occlusal plane is called?
Curve of Spee

The mediolateral curvature of the occlusal plane is called?
Curve of Wilson

The Curve of Wilson and Curve of Spee is concave in what arch?
Mandibular arch

The Curve of Wilson and Curve of Spee is convex in what arch?
Maxillary arch

The posterior teeth are designed to take heavy loads, and therefore, when they occlude, they are said to be loaded in what direction?
Loaded axially

What is the occlusal table?
The area defined by the cusp tups and the mesial and distal cusp arms (generally 50 to 60% the buccolingual width of the tooth)

Which arch width is wider?
Maxillary arch

Which arch length is longer?
Maxillary arch

What are the functional (supporting) cusps of the molars?
Maxillary lingual cusps and Mandibular buccal cusps

What are the non-functional (guiding) cusps of the molars?
Maxillary buccal cusps and Mandibular lingual cusps

What is the bucco-occlusal line?
Imaginary line drawn through the buccal cusp tips of the mandibular teeth

What is the lingual-occlusal line?
Imaginary line drawn through the lingual cusp tips of the maxillary teeth

What is the central fossa line?
Imaginary line that follows the central grooves and fossa of all posterior teeth


E1 - Flash Card Questions                                            Page 4 of 10                                                       3/4/2009
D6317 Dental Occlusion                                                                                                              WS 2009


What happens in a crossbite?
The buccal cusps of the maxillary teeth occlude with the central fossa of the mandibular teeth; the lingual cusps of the mandibular teeth
occlude with the central fossa line of the maxillary teeth

Class 1 molar relationship
1. MB of max. 1st molar aligned over buccal groove of mand. 1st molar;
2. MB of mand. 1st occludes in embrasure area between max 2nd premolar and 1st molar;
3. ML cusp of max 1st molar occludes in central fossa of mand 1st molar

Class 2 molar relationship.
1. MB of max. 1st molar aligned over embrasure between mand 2nd premolar and 1st molar
2. MB of mand 1st occludes in central fossa of max 1st molar;
3. DL cusp of max 1st molar occludes in central fossa of mand 1st molar

Class 3 molar relationship
1. MB of max 1st molar aligned over embrasure between mand 1st molar and 2nd molar;
2. DB of mand 1st occludes in embrasure between mand 2nd premolar and 1st molar;
3. ML cusp of max 1st molar occludes in mesial pit of mand 2nd premolar

What is the normal vertical and horizontal overlap in a class 1 anterior tooth relationship?
2 to 4 mm each

What happens in a class 2 Division 1 of anterior teeth
Great vertical overlap, mandibular teeth contact the gingival third of the maxillary anterior teeth (deep bite)

What is the shape of the plane of occlusion in the mandible?
Concave

The two maxillary bones are fused together at this structure.
Mid palatal suture

What is the superior aspect of the mandible?
Alveolar crest and Teeth

What is the posterior aspect of the mandible?
Mandibular ridge, ascending ramus, coronoid process and condyle

Which portion of the temporal bone articulates with the mandibular condyle?
Squamous portion (glenoid fossa)

Anterior to the glenoid fossa is this thick bony prominence that helps toleratate heavy forces and helps dictate the pathway of the condyle.
Articular eminence

The fibers of the superficial masseter muscle run in what direction?
Run inferior/posterior to insert on ramus/angle of mandible

What is the origin of the masseter?
Zygomatic arch

What is the insertion of the masseter?
Ramus/angle of mandible

What is the function of the masseter?
Elevates the mandible, chewing, superficial head aids in protrusion, deep head stabilizes the condyle against the eminence

What is the blood supply for the masseter?
Muscular branch of the maxillary artery

What are the two heads of the masseter?
Superficial and deep head

What nerve supplies the masseter?
Masseteric nerve of mandibular division of Trigeminal




E1 - Flash Card Questions                                          Page 5 of 10                                                        3/4/2009
D6317 Dental Occlusion                                                                                WS 2009


What are the three distinct divisions of the temporalis muscle?
Anterior, middle, posterior

The fibers of the anterior portion of the temporalis muscle run in what direction?
Vertically

The fibers of the middle portion of the temporalis muscle run in what direction?
Run obliquely across lateral aspect of skull

The fibers of the posterior portion of the temporalis muscle run in what direction?
Run horizontally

What is the origin of the temporalis muscle?
Temporal fossa and Lateral surface of skull

What is the insertion of the temporalis muscle?
Coronoid process and Anterior border of ascending ramus

What is the function of the anterior portion of the temporalis?
Mandible is raised vertically

What is the function of the middle portion of the temporalis?
Elevates and retrudes mandible

What is the function of the posterior portion of the temporalis?
Retrudes the mandible

What is the blood supply to the temporalis?
Muscular branch of the maxillary artery

What nerve supplies the temporalis?
Deep temporal nerve of mandibular division of Trigeminal

What are the two heads of the lateral pterygoid?
Superior and Inferior

Which is larger: the superior or inferior lateral pterygoid?
Inferior lateral pterygoid

What is the origin of the inferior lateral pterygoid?
Outer surface of lateral pterygoid plate

What is the insertion of the inferior lateral pterygoid?
Neck of the condyle

In what direction do fibers of the inferior lateral pterygoid run?
Backward, upward, and outward

What is the action of the inferior lateral pterygoid during bilateral contraction?
Causes condyles to be pulled down the articular eminences and the MANDIBLE IS PROTRUDED

What is the action of the inferior lateral pterygoid during unilateral contraction?
Causes mediotrusive movement of mandible to opposite side (if left contracts, mandible moves right)

The only muscle of mastication to depress the mandible is?
Lateral pterygoid (with the help of digastric, mylohyoid, and geniohyoid)

What is the origin of the superior lateral pterygoid?
Infratemporal surface of the greater sphenoid wing

What is the insertion of the superior lateral pterygoid?
Disk, capsule, and neck of the condyle

What is the blood supply to the lateral pterygoids?
Muscular branch of maxillary artery



E1 - Flash Card Questions                                            Page 6 of 10                      3/4/2009
D6317 Dental Occlusion                                                                                      WS 2009


What is the nerve supply to the lateral pterygoids?
Masseteric or buccal nerve of the mandibular division of the Trigeminal

What is the origin of the medial pterygoids?
Pterygoid fossa

What is the insertion of the medial pterygoids?
Medial surface of the mandibular angle

What is the action of the medial pterygoids?
Elevates and protrudes mandible; unilateral contraction results in mediotrusion

The major function of the medial pterygoids is?
Elevation of the mandible

What is the blood supply to the medial pterygoid?
Muscular branch of the maxillary artery

What nerve supplies the medial pterygoid?
Motor branch of the mandibular division of the Trigeminal

These two muscles will form a muscular sling that supports the mandible at the mandibular angle.
Medial pterygoid and Masseter

Name the four suprahyoid muscles.
Geniohyoid, mylohyoid, digastric, stylohyoid

What are the functions of the suprahyoid muscles?
Elevates the hyoid during swallowing, depresses the mandible when the hyoid bone is fixed

What is the origin of the geniohyoid?
Inferior tubercle on the inner surface of mandibular symphysis

What is the insertion of the geniohyoid?
Anterior surface of the body of hyoid

What is the origin of the mylohyoid?
Line from the last molar root to the mandibular symphysis

What is the insertion of the mylohyoid?
Median raphe from chin to hyoid bone

What is the origin of the posterior belly of the digastric?
Inferior surface of the skull from medial surface of the mastoid process

What is the origin of the anterior belly of the digastric?
Depression on inner side of lower border of mandible, close to symphysis

Where do the digastric muscles insert?
Hyoid bone

What is the origin of the stylohyoid?
Posterior border of styloid process

Depression of the mandible requires contraction of what muscles? Relaxation of what muscles?
Contraction of lateral pterygoid and digastrics; relaxation of masseter, medial pterygoid, and temporalis

Elevation of the mandible requires contraction of what muscles? Relaxation of what muscles?
Contraction of masseter, medial pterygoid, and temporalis; relaxation of lateral pterygoid and digastrics

Right lateral movement of the mandible requires contraction of what muscles? Relaxation of what muscles?
Contraction of left lateral pterygoid; relaxation of right lateral pterygoid

Protrusion of the mandible requires contraction of what muscles?
Contraction of lateral pterygoids, masseter, and medial pterygoids



E1 - Flash Card Questions                                         Page 7 of 10                               3/4/2009
D6317 Dental Occlusion                                                                                                                  WS 2009


A replica of a single tooth is called?
Die

The most widely used impression material is?
Alginate (an irreversible hydrocolloid)

This material makes up the largest component of alginate.
Silica filters (diatomaceous earth)

This chemical, found in alginate, works as a retarder to increase working time before the actual reaction to stiffen begins.
Trisodium phosphate

Which will decrease the strength of alginate gel: increased or decreased mixing time?
Both

The extrusion of water with gel network shrinkage in an alginate impression is called?
Syneresis

The absorption of water or disinfecant with gel network expansion in an alginate impression is called?
Imbibition

What are some disadvantages of alginate?
Low tear resistance; not accurate enough for crowns/bridges; dimensionally unstable; thickness is critical; no multiple pours

What is the minimal amount of space needed for alginate impression material in the tray?
2 mm

What are some common causes of inaccurate alginate impressions?
Grainy alginate, premature gelation of tray material, premature removal, surface bubbles, irregular voids, moving tray during setting, delayed
pouring after impression, alginate already on teeth from previous impressions

What is the best way to accelerate the set time for gypsum?
Slurry water

What are common causes for rough or chalky stone cast?
Excessive water left in impression; cast not separated from alginate within 45 to 60 minutes (water absorbed back into set gypsum)

What is the shape of the articular disc superiorly?
Concavoconvex

What is the shape of the articular disc inferiorly?
Concave

In normal joint position, the condyle is located on what section of the articular disc?
Intermediate zone (thinnest portion)

What is unique about the articular disc of the TMJ when compared to other joints?
It is composed of dense fibrous connective tissue rather than hyaline cartilage, which is less susceptible to aging and has a better ability to
repair

What nerve branches supply the TMJ?
Auriculotemporal, deep temporal, and masseteric nerve of Trigeminal

What arteries supply the TMJ?
Superficial temporal, middle meningeal, and internal maxillary artery

The superior retrodiscal lamina attaches the articular disc to what? Are the fibers elastic or collagenous?
To the tympanic plate (contains elastic fibers)

The inferior retrodiscal lamina attaches the articular disc to what? Are the fibers elastic or collagenous?
To the posterior margin of the articular surface of the condyle (contains collagenous fibers)

The anterior superior attachment of the articular disc to the capsular ligament occurs where?
Anterior margin of the articular surface of the temporal bone




E1 - Flash Card Questions                                           Page 8 of 10                                                           3/4/2009
D6317 Dental Occlusion                                                                                                                   WS 2009


The anterior inferior attachment of the articular disc to the capsular ligament occurs where?
Anterior margin of the articular surface of the condyle

The superior joint compartment of the TMJ is bordered by?
Glenoid fossa and Superior aspect of disc

The inferior joint compartment of the TMJ is bordered by?
Inferior aspect of disc and Superior aspect of condyle

What is the function of the collateral (discal) ligament?
Restrict movement of disc away from condyle and permits anterior/posterior rotation on articular surface of condyle; responsible for
hinging/rotation movements of TMJ

What are the attachments of the capsular ligament of the TMJ?
Superior = periphery of articular surface of mandibular fossa and articular eminence; Inferiorly = neck of condyle

What are the three functions of the capsular ligament of the TMJ?
1. Resists medial, lateral, and inferior forces that would separate the articular surfaces; 2. Divides the TMJ into two joint cavities and retains
synovial fluid in the joint; 3. Provides proprioceptive feedback

This ligament will support the lateral aspect of the capsular ligament.
Temperomandibular ligament

What are the attachments of the outer oblique TM ligament?
Extends from articular eminence and zygomatic arch to condylar neck

What are the attachments of the inner oblique TM ligament?
Extends from articular eminence and zygomatic arch to lateral pole of condyle and posterior articular eminence

This ligament is most commonly traumatized with inferior alveolar nerve anesthesia.
Sphenomandibular ligament

What are the advantages of a semi-adjustable articulator?
Uses facebow, can mount in MIP or CR, programmable condylar and anterior guidance, restorations requires less adjustment

In a semi-adjustable articulator, how should casts be mounted for MIP?
Should be hand articulated (do NOT use an interocclusal record)

In a semi-adjustable articulator, how should casts be mounted for centric relation?
Need to make an interocclusal record, and the teeth MUST NOT touch

How accurate is the earbow?
76% accuracy

During rotation in the horizontal plane around a frontal axis, the non working condyle will move what direction?
Medially and forward in the horizontal plane around the frontal axis

During rotation in the frontal plane around a sagittal axis, the non working condyle will move what direction?
Moves downward in the frontal plane around the sagittal axis

The point where all three axes meet (horizontal, facial, and sagittal) at the condyle is called?
Rotational center of the condyle

During translation of the mandible, in what direction will the non-working conydle move?
Downward, forward, and medially

What is the Bennett Movement?
The potential lateral shift of the working condyle that may occur during lateral translation of the mandible

What is the condylar angle?
The angle the condyle moves away from the horizontal reference plane

What is the condylar angle influence by during protrusive movements?
Influenced by posterior slope of articular eminence




E1 - Flash Card Questions                                           Page 9 of 10                                                            3/4/2009
D6317 Dental Occlusion                                                                                                              WS 2009


What is the condylar angle influenced by during lateral movements?
Influenced by steepness of medial wall of articular fossa of non-working side

What is Fischer's angle?
The angle formed by the intersection of the protrusive and non-working condylar paths as viewed in the sagittal plane

What is the Bennett angle?
The angle at which the non-working condyle moves medially away a sagittal reference plane during a lateral movement

How much greater is the vertical dimension at rest (physiologic rest position) than the Occlusal vertical dimension?
2 to 3 mm greater

From initial tooth contact in the superior contact border movement, what direction does the mandible move to reach MIP?
Superio-anteriorly (with potential lateral movement)

After the mandible reaches MIP position in the superior contact border movement, where does it move to next?
Forward from MIP into edge-to-edge position

What determines the edge-to-edge position of the teeth as seen in the superior contact border movement?
Lingual surfaces of maxillary anterior teeth

After reaching edge-to-edge position in the superior contact border movement, what direction will the mandible move?
Moves further horizontally for the width of the incisal edges

In a left lateral border movement, which muscle will contract to cause the right condyle to move anteriorly and medially?
Right inferior lateral pterygoid

After a left lateral border movement, which muscle will begin to contract to cause the left condyle to move anteriorly and medially to have the
mandible reach full protrusion?
Left inferior lateral pterygoid

The superior surface of the envelope of motion is determined by?
Tooth contacts

What is the shape of the plane of occlusion in the maxilla?
Convex

The mandibular anterior teeth are inclined what direction in the frontal plane?
Vertical (0 degrees)

The mandibular premolars are inclined what direction in the frontal plane?
Lingually (9 degrees)

The mandibular molars are inclined what direction in the frontal plane?
Lingually (20 degrees)

The maxillary anterior teeth are inclined what direction in the frontal plane?
Incisors are slightly distally inclined, canines are slightly mesially inclined

The maxillary premolars are inclined what direction in the frontal plane?
Slightly buccally inclined (5 degrees)

The maxillary molars are inclined what direction in the frontal plane?
Buccally (20 degrees)

In a normal bite, the mesiobuccal cusp of the mandibular first molar will occlude where?
With the mesial marginal ridge of the maxillary first molar

In a normal bite, the distobuccal cusp of the mandibular first molar will occlude where?
With the central fossa of the maxillary first molar

What happens in a class 2 Division 2 of anterior teeth?
Maxillary incisors are lingually inclined, laterals overlap the centrals labially

What happens in a Class III anterior tooth relationship?
End to end relationship of teeth, mandibular teeth are so far forward they overlap the maxillary teeth


E1 - Flash Card Questions                                             Page 10 of 10                                                    3/4/2009

				
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