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21092875
Occlusion (3 Determinants: MOM,TMJ & Teeth)
Description
First Year Dentistry Mind Map on Occlusion (3 Determinants: MOM,TMJ & Teeth), created by sanna pathy on 01/03/2020.
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pros
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dentistry
first year
Mind Map by
sanna pathy
, updated more than 1 year ago
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Created by
Zainab Patel
over 4 years ago
Copied by
sanna pathy
over 4 years ago
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Resource summary
Occlusion (3 Determinants: MOM,TMJ & Teeth)
Articulators
What are they?
Device to attach casts in order to simulate mandibular position and mandibular movement
AKA
Stimulates jaw movement
Why is that important?
Tells you the excursions, interferences
Types
Semi-adjustable articulators
Arcon
AKA articulating condyle
Condylar balls on lower member
E.g
Whipmix
Undergrads
Denar
Used in primary care
Similar to our anatomy
Non-Arcon
Condylar balls on upper member
E.g
Dentatus
Uses
Removeable pros
No C&B
ALL require the matching face bow
Indications
Multiple restorations
Increases in OVD
Change in anterior or lateral guidance
Providing a stabilisation splint
How do you mount them?
ICP
For single restorations or where the relationship of the teeth is to be largely maintained
CR (retruded arc of closure)
Indications
Re-organise occlusion
Existing relationship of teeth is lost
Alter OVD
TMD
C/C
Requires a wax-up to plan reconstruction
Definition
Head of the condyle is situated as far anterior and superior as it possibly can within the mandibular fossa/glenoid fossa.
Facebows
What do they tell you?
Intercondylar width (width between the condyles)
Distance from the condylar hinge axis (space between the hinge and the dentition)
Remember before you take a face bow do a full occlusal examination
Record
ICP contacts
RCP contacts
2 pairs of posterior & anterior contacts
Relationship between condyle & maxilla
Types
Whipmix
Uses Nation relator
Denar
Uses 43mm above incisor edge of lateral incisor
Dentatus
Uses orbital pin
Interocclusal records
Tells you the relationship between the maxilla & mandible
In RCP
Guidance
Anterior guidance
These are gliding contacts that should help to harmoniously guide the mandible in and out of ICP
Should start of shallow then deepen
Convex shape not tolerated well
Would be class III
If the patient currently has a suitable pattern of guidance, then it is important to conform to it
Top tips
Anterior RBB
Guidance
ICP on abutment & pontic
If not
Pontic will move around
Protrusive on ONLY the retainer
If on pontic then the tooth becomes compromised
Mobile
Drift
Always be thinking about ICP, lateral excursions and protrusive too!
Especially for re-organising
Group function
When several teeth are in contact on the working side during excursions
Usually premolars & canines
RCP
The first tooth contact when the condyles are seated in centric relation
Make sure RCP isn't on the tooth you re prepping. its only relevant for re-organising occlusion cases
When do you use CR as opposed to ICP
Re-organise occlusion from existing occlusal scheme into CR
When you don't have a reproducible ICP
When you want to increase the OVD as you no longer have stable ICP as teeth have been separated
Consequences of heavy contacts
TSL
Root fracture
Orthodontic tooth movement
Pulpitis +/- Apical periodontitis
Working side vs Non-working side
Working side
Side the patient moves their mandible towards.
Condyle rotates in excursion
Non-working side
Side that the mandible is moving away from
Condyle orbits
Interferences
Any tooth contacts that stop smooth guidance in excursions
To prevent
Take out of occlusion before crown prep
Avoid non-working side interferences!
Never load non-functional cusps
Splints
Uses
Managing TMD
Managing bruxism
Attrition is unlikely to occur alone
Testing increases in OVD
Used to be done now it's in composite
Can be used whilst provisional appliances are placed
Stabalisation of jaw position
Types
Hard
Lower = Tanner
Upper= Michigan
Design
Make sure all teeth that were in RCP are still in contact
Ant teeth contact slightly less than posterior teeth
Causes of error in reproducing RCP on articulator
Facebow errors
Bite fork
Not tightened
Wax not fixed
Maxillary teeth not centered
Jig assembly not tightened
Condylar arms not located in ear canal
Interocclusal record errors
Over softened BHW
Not sufficiently softened
If RCP is not stable on cast
Consider Blue moose
Impression taking
Mounting error
Study Models
Impression
Tray selection
Needs to record all teeth with a surrounding space of at least 3mm
Record free end saddles with compound
Dry occlusal aspects of teeth apply thin layer of alginate before seating tray to avoid air locks on occlusal aspect
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