Occlusion Lab Exam

The Facebow
Definition: - A caliper-like instrument used to record the spatial relationships of the Maxillary Arch to the same anatomic reference points and then transfer this relationship to an articulator Purpose: - The facebow orients the Maxillary Cast to the rotational axis in 3 Planes - It positions the Maxillary Anterior Teeth to the Frontal Plane - It provides a reproducible mounting position for subsequent Maxillary Casts - It allows the same path of opening and closure as in the mouth 3 Reference Points Used: - Arbitrary Hinge Axis o 1) Right o 2) Left An Arbitrary Hinge Axis is the axis passing through each of the Mandibular Condyles This is ~8mm under the soft tissue in front of the Tragus of the Ear This is also known as BERGSTROMs Point - Orbitale o This is the Infraorbital Notch Types of Facebows: Kinematic o This type of facebow locates the TRUE physiological axis of rotationthe Terminal Hinge Axis o This is the most accurate type of facebow, but it is very time-consuming

Arbitrary o This type of facebow locates an AREA near the axis by using anatomical landmarksthis is the type we use!

Occlusion Lab Exam

Dental Articulators
Definition: - A mechanical device to which the Mandibular and Maxillary Casts are attached and which simulates some jaw positions and movements Articulator Classifications: - 3 Basic Classifications: 1) Simple/Non-Adjustable 2) Semi-Adjustable 3) Fully-Adjustable -

LIKE OURS!!

Further Classification: o ARCON The Condylar Element is on the LOWER Member The guiding mechanism is on the Upper Member This is LIKE OURS! o NON-ARCON The Condylar Element is on the UPPER Member The guiding mechanism is on the Lower Member Non-Arcons CANNOT ACCEPT Lateral Records They ONLY use Protrusive Record

Occlusion Lab Exam

Semi-Adjustable Articulators
Type of Adjustments Allowed: Condylar Inclination / Angle Bennett Angle Anterior Guidance Condylar Guidance Angle: - The angle at which the Condyle moves away from a horizontal reference plane - BOTH Lateral & Protrusive Records are accepted on our Semi-Adjustable o The difference between these two records = FISHERS ANGLE This is generally 5 10 PROTRUSIVE Movement: o When a patient makes a posterior movement, the R & L Condyles move down the posterior slopes of the R & L Articular Eminences o This will measure: R & L Condylar Guidance Angles -& The Angle at which the Condyle moves away from a HORIZONTAL Reference Plane LATERAL Movement o The angle for Lateral Movement is generally LARGER than Protrusive Records o When a patient makes a Lateral Excursive movement: The WORKING Condyle Rotates The NON-WORKING Condyle moves downward, forward, & medially o We record the movement of the NON-WORKING Condyle o This will measure: Bennett Angle of the NWS This is the angle at which the NWS Condyle moves away from the Sagittal Reference Plane Condylar Guidance of the NWS This is the angel at which the NWS Condyle moves away from the Horizontal Reference Plane o To program RIGHT Condylar Guidance Record Left Lateral Movement o To program LEFT Condylar Guidance Record Right Lateral Movement

Bennett Angle: - The angle at which the NWS Condyle moves away from the sagittal reference plane - This is programmed by the LATERAL Movement Record L = H/8 + 12 o L= Bennett Angle o H= Condylar Angle (Lateral Record)

Occlusion Lab Exam

Anterior Guidance: - This customizes the Incisal Guidance - This is an occlusal philosophy in excursive movement stating: o Anterior Teeth (canines, laterals, centrals) should disclude the posterior teeth in excursive movements

Occlusal Philosophies in Excursive Movements

1) Canine / Anterior Guidance - This is the MOST IDEAL form of Occlusion Goal: - When the Mandible moves Laterally, the Canines make contact whereas ALL other teeth disclude immediately - In Protrusive Movement, the Anterior Teeth should disclude the Posterior Teeth o Contact between posterior teeth are considered an INTERFERENCE - This is Mutually Protected Occlusion b/c: o Posterior Teeth take the load in MIP protecting the Anterior Teeth from adverse loads o Anterior Teeth disclude Posterior Teeth in Excursive Movements, protecting them from adverse loads 2) Group Function - Group Function is Acceptable, but NOT Ideal - This is the ONLY option for patients with NO Anterior Vertical Overlap - Also referred to as Unilateral Balance Characteristics: - When the Mandible moves Laterally, the Mandible is guided by the OUTER Inclines of the Mandibular Buccal Cuspsguiding onthe INNER Inclines of the Maxillary Posterior Teeth - The Most Desirable Group Function: o Canines, Premolars, & MB Cusps of 1st Molars - The MORE Posterior the contacts = Greater the Force = MORE Destructive Forces possible Example of Group Function: - On the WORKING SIDE, the Buccal Cusps of the Mandible guide along the INNER Inclines of the Maxillary as far posteriorly as the MB Cusp of the 1 st Molar - NO Contacts exist on the NON-WORKING SIDE 3) Balanced Occlusion - This is an acceptable form of occlusion for Edentulous (Denture-Wearing) Patients, but NOT for Dentate patients Characteristics: - Simultaneous contacts occur on BOTH sides of the arch as the Mandible moves Laterally - This promotes TOOTH WEAR as Non-Working Side Contacts are EXTREMELY DESTRUCTIVE - As the Mandible moves towards the Working Side, there are tooth contacts on the WS & NWS BAD!!

Occlusion Lab Exam

Horizontal Factors of Occlusion

Mediotrusion: - Non-Working Pathways This is the same as LEFT LATERAL Movement - During Mediotrusion, the Mandible moves Medially - Therefore, Mediotrusion Right means that the Right Condyle moves Medially Laterotrusion: - Working Pathways - This is the same as RIGHT LATERAL Movement - During Laterotusion, the Mandible moves Laterally - Therefore, Laterotrusion Right means that the Right Condyle moves Laterally

Selective Grinding
Selective Grinding is a procedure by which the occlusal surfaces of the teeth are precisely altered to improve the overall contact pattern and establish a stable occlusion fulfilling treatment goals This procedure is IRREVERSIBLE The Maxillary Canine sometimes contact Mandibular 1st Premolars during Protrusive Movementthis is OKAY and does not require grinding AVOID Grinding Functional Cusps, if possible Grind Away IF: o Working-Side Interfering Contacts Eliminate these interferences by grinding NON-Functional Cusps o Eliminate any Balancing Interfering Contacts

Occlusion Lab Exam

Occlusal Interferences
This is an unwanted or- premature interocclusal contact Types of Interferences: o Centric o Working Side o Non-Working Side o Protrusive

1) Centric Interferences - This is a premature contact that occurs when condyles are manipulated into Centric Relation (CR) - Only adjust this type of occlusion when TRAUMA results from anterior teeth hitting one another forcefully o Characterized by wear of anterior teeth and mobility of 1+ tooth - Most of us live with Centric Interferences and are fine 2) Working Side Interferences - This is NOT Group Functionits Working Side Interference - This is the SAME as Laterotrusive Interference Characterized By: - Contact between the Maxillary and Mandibular POSTERIOR Teeth on the Working Side as the patient makes a Lateral Movement - These contacts may be heavy enough to disclude the anterior teeth 3) Non-Working Side Interferences - These are the MOST DESTRUCTIVE of ALL Interferences o They change the Class III Lever System of the Mandible, placing stress on the TMJ joints Characterized By: - Contact between the Maxillary and Mandibular Teeth on the Non-Working Side as the patient makes a Lateral Movement

Occlusion Lab Exam

Additional Junk that you probably know, but I had forgotten: Right Lateral Movement - A Right Lateral Movement (of the Mandible) means that: o o The Right Condyle is the WORKING Side Condyle It rotates (remains stable) The Left Condyle is the NON-WORKING Side Condyle It moves downward, forward, and medially

How Far DOWNWARD & FORWARD the Condyle moves gives us the: Condylar Guidance Angle How far MEDIALLY the Condyle moves gives us the: Bennett Angle Right Lateral Records program Left Condylar Settings Left Lateral Records program Right Condylar Settings Angles Class I - This is when the ML Cusp of the Maxillary 1st Molar occludes in the Central Fossa area of the Mandibular 1st Molar - The DB Cusp of the Mandibular 1st Molar occludes in the Central Fossa of the Maxillary 1st Molar