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54 Cards in this Set
- Front
- Back
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When should occlusal therapy be accomplished in a perio patient?
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After resolution of periodontal inflammation
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What are the indications for performing an Occlusal Adjustment in a perio patient?
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Increasing Mobility or Fremitus
Discomfort during function Parafunctional Habits Soft Tissue Injury - Palate Food Impaction - Plunger Cusp Occlusal Interferences |
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What are the indications for prescribing a removable splint in a perio patient?
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Treat Bruxism/Parafunction
Stabilize Occlusion During Perio Tx Maintain Occlusion after Tx |
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What are the indications for prescribing a fixed splint in a perio patient?
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Mobility interferes with patient comfort
Mobility interferes with patient function Prevent tipping or drifting of teeth Following Orthodontic therapy Following Acute Trauma to Teeth Esthetic and Prosthetic Demands |
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What is the internal mechanism that regulates when we feel sleepy and when we feel alert?
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Circadian Biological Clock
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What is the Circadian Biological Clock affected by?
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Light and Dark
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What are two marked changes during the sleep cycle?
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Body temperature lowers
Hormone levels rise and fall |
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Who is most at risk for snoring problems?
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Males who are overweight with a large neck size
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What is an abnormality of the upper airway that results in the cessation of breathing during sleep due to complete or partial airway obstruction?
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Obstructive Sleep Apnea
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How likely is a snoring, sleepy patient with an 18in neck to have clinically significant OSA?
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85-90%
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What diseases could also indicate the presence of OSA?
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Unexplained pulmonary hypertension
Unexplained dyspnea Metabolic Disorders (Diabetes Mellitus, Hypothyroidism, Hypogonadism in Males, PCO in Females) |
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What type of a pattern is normally seen on a pulse oximeter when a patient has OSA?
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Saw tooth pattern of desaturation
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When is a home sleep test contraindicated?
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The Elderly
CHF Neuromuscular Disease Significant Lung Disease Movement Disorders Suspected Sz d/o |
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What is often used to treat OSA?
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CPAP (Continuous Positive Airway Pressure)
BiPAP (Bi-level Positive Airway Pressure) |
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What is one treatment that is 100% effective in treating OSA?
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Tracheotomy
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What treatment of OSA is very effective in children?
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Tonsillectomy
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In which position is OSA usually worse?
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Supine
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What is AHI (Apnea/Hypopnea Index)?
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The number of apneic and hypopneic events that occur during the night. (A count of all the times a patient stops breathing)
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What AHI is considered severe?
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>30
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What is considered a large neck circumference in Males?
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>17
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When left untreated how many years on average does it take off a person's life?
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Eight Years
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What are High Risk factors for OSA in Children?
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Narrow Facial Bone Structure
History of Cleft Palate Down Syndrome Children with Allergies Asthma Reflux Frequent Sinus Infections Family History |
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What are the only type of orthotics recommended for treatment of sleep breathing disorders?
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Titratable Orthotics
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What are four examples of how an interference contact can be created?
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Developmental Origin
Faulty Dental Practice Orthodontic Treatment Corrective Jaw Surgery |
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What should a surface to surface contact of flat cusps be changed to?
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A Point to Surface Contact
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What are indications for occlusal adjustment?
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Periodontal (Bone Loss, Mobility)
Restorative-Prosthetic Abfractions Implants Adjunct to Ortho Tx Orthognathic Surgery Limited Movement of the Mandible Endodontics |
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What are four points that equilibration is not?
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Reversible
Benign A Routine Prophylactic Measure Sure Fix for Bruxism |
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What are contraindications for equilibration?
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Pt is symptomatic
Just because interferences exist Just because a joint clicks Lack of general physical and emotional stability of pt Lack of interest, concern, or compliance by pt Lack of maxillomandibular or dental stability of pt |
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When is equilibration indicated?
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Only following successful occlusal appliance therapy and after occlusion is clearly indicated in etiology of TMD (muscle origin)
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What is Neff's Rule of Thirds?
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Adjustment:
Near Groove - Okay Middle Third - Caution Near Cusp Tip - Stop |
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What are the guidelines of Occlusal Adjustment Technique?
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1. Equilibrate Teeth After (Resolving Symptoms)
2. Treatment Planning (On a cast) 3. Neff's Rule of Thirds 4. Maintain Vertical Dimension of Occlusion 5. Adjust Shear Cusps, Spare Stamp Cusps 6. Maintain at least one stabilizing stop for each tooth. 7. Provide anterior stops - When possible 8. Preserve or improve esthetics 9. Load the mandible during excursions when marking interferences 10. May take longer than one visit. |
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What are the first and second determinants of occlusion?
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The posterior determinants - The two condyles
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What is the third determinant of occlusion?
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The anterior determinant - The teeth
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What is the fourth determinant of occlusion?
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The neuromuscular determinant.
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What programs the fourth determinant of occlusion?
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The third determinant
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What is the effect of tooth inclines of the envelope of motion and the envelope of function?
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Anterior guidance
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Which is more important as a determinant of posterior occlusal form: Anterior guidance or Condylar Guidance?
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Anterior guidance
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What are four functions of anterior guidance?
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Incise food
Aid in speech Aid in esthetics Protect posterior teeth |
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What are indications for group function?
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When already present w/o adverse effects
In presence of bone loss around teeth Extensively restored teeth Loss of bony support around canine Canine wear |
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What does a pronounced vertical overlap provide for the posterior teeth?
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Permits posterior teeth to have longer cusps
Greater the degree of separation of back teeth in protrusion |
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What does pronounced horizontal overlap of anterior teeth provide?
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Requires short cusps of posterior teeth
Lessens the degree of separation of the back teeth in protrusion |
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How does condylar guidance influence the posterior cusps?
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Steeper the guidance the taller the posterior cusps
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How does the curve of spee influence the posterior cusps?
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The more acute curve of spee, the shorter the posterior cusps
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What is the tx for anterior crossbite?
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Selective grinding
Limited Orthodontics Extensive Rehab |
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What is the tx for posterior crossbite, unilateral, total intercuspation?
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Ortho
Grinding - Provide Canine guidance and preserve centric stops Restorative |
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What is the tx for posterior crossbite, unilateral involvement of cusp tips?
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Ortho
Grinding - Sliding ramps to correct crossbite Restorative |
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What is tx for bilateral posterior crossbite?
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Ortho
Restorative - Provide canine guidance Orthognathic Surgery |
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What can be done to help an anterior open-bite?
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Provisional plateau on lingual of max anterior teeth for guidance
Extraction of third molars Occlusal reducation of later teeth Create canine guidance with resin or porcelain on lingual Crown lengthening, endo, complex rehab. |
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What can be done to help a posterior open bite?
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Provisional overlay
Complex restorative Orthognathic Surgery |
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What are causes of midline deviation?
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Uneven position of condyles in TMJ
Mandibular Shift Occlusal discrepancies After orthognathic surgery |
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What are indications for increasing vertical dimension?
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Reestablishment of VDO loss
Need for restorative space Esthetic reclaim/enhancement |
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What is tx for a Class II/1 malocclusion?
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Restorative
Orthognathic surgery |
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What is tx for a Class II/2 malocclusion?
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Selective grinding or restorative to get centric contact in anterior region
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What is done for a Class III malocclusion?
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Ext M3s
Orthognathic Surgery w/restorative Nothing? |
