Secondary
Morning (8 am - 12 pm)
Ironwood lecture hall; no SimLab 1. Introduction to Occlusion 2. Characteristics of An Ideal Occlusion (Chapter 5, pp. 109-125 Ironwood lecture hall; no SimLab 1. Articular Disc Displacement 2. Review for Quiz #1
Afternoon (1 - 5 pm)
Ironwood lecture hall; SimLab available 3. TMJ Anatomy 4. Muscles of Mastication (Chapter 1 pp. 1-26) 5. Verification of Articulator mountings and settings Ironwood lecture hall; SimLab available 3. Video/PowerPoint of waxing technique for occlusal contacts and cusp/fossa relationships 4. Lab Project 1: Wax-up teeth # 8 and # 9 (Pass or Fail) Ironwood lecture hall; no SimLab 4. Interferences & Muscle Responses/Actions 5. Review for Occlusion Exam 1
Ironwood lecture hall; SimLab available 1. Quiz #1 on 2/23 & 2/24 material 2. Quiz #1 follow-up and discussion 3. Lab Project 2: Wax-up tooth # 12 (Pass or Fail)
Morning (8 am - 12 pm)
Ironwood lecture hall; no SimLab 1. Occlusion Exam 1 (covers Feb 23 25 material) 2. Mandibular Movement (Chapter 4 pp. 93108)
Afternoon (1 - 5 pm)
Ironwood lecture hall; no SimLab 3. Alignment, Static and Moving Occlusion (Chapter 3: pp. 67-91) 4. Determinants of Occlusal Morphology(Chapter 6 pp. 127-146)
Ironwood lecture hall; SimLab available 1. Quiz #2 Review 2. Laboratory Project 3: Wax-up tooth # 3 (Pass or Fail) Ironwood lecture hall; SimLab available
Need to finish at 11:30 and be back at 1:30 (vendor fair)
Ironwood lecture hall; SimLab available 3. Project 4: Wax-up tooth # 19 (Pass or Fail) 4. Review for Laboratory Practical Exam
1. Quiz 2 on 2/28 material 2. Articulators (Chapter 18 pp. 567-588) 3. Review for Occlusion Exam 2 1. Occlusion Exam #2 (covers Feb 28 Mar 2 material)
Ironwood lecture hall; SimLab available 4. Laboratory Practical Exam: Static and Moving Occlusion 5. Project 5: Wax-up tooth # 6 (Pass or Fail)
Introduction to Occlusion
% of total Grade
Assessment Methods
Final Grade A B+ B
90-100% 85-89%
Exam # 1
Exam # 2 Quiz # 1 Quiz #2 Practical Exam Sim-clinic projects Total
25 %
25% 10% 10% 20% 10% Pass* 100%
80-84%
75-79%
70-74%
All successfully remediated modules 69% or below 69% or below
C+
C
I* F**
Static & Moving Occlusion Diagrams Practical Examination: You will be given a flash card booklet with quadrant diagrams displaying various mandibular movements. This booklet will be the entire basis of the moving occlusion practical examination. The National Board has about 3 or 4 of these questions on the exam every year. Interferences and Muscle Actions Concept on Lecture Examination #1: It is important for the student to know the location of various mandibularmaxillary tooth interferences and which muscles are involved as a result of these types of interferences.
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Introduction to Occlusion
Two TMJ: When one moves, the other must move as well.
Articular eminence
Articular Disc
Condyle
>Mandibular/Glenoid Fossa >Articular eminence: 1) Posterior slope, 2) Steepness/flatness guides movement >Synovial cavities: 1) Joint lubrication, 2) boundary lubrication from motion
Basic Structures
Condyle
Anatomic variations guide mandibular movement
Retrodiscal
tissue
elasticity Highly innervated and vascular Loading is painful Trauma can cause inflammation
tissue Interface between bones, somewhat pliable Bi-concave shape Collateral ligaments No Innervation No Vascularization
connective
a.k.a. centric occlusion (CO) Habitual occlusion, habitual centric Maximum intercuspation describes an occlusal relationship Teeth are contacting in a position that the patient finds the most comfortable Easily achievable, but not always reproducible, by the patient
tooth dominance Anterior tooth passive contact Multiple contacts on all teeth adequately distributes forces
Centric Relation
A condylar position Superior and Anterior Thin portion of disc Describes the most stable position of the condyle Superior and anterior position of the mandible with the disc properly interposed
Relation
Why a superior and anterior position? The Muscles of Mastication drive this process
Maximum Intercuspation
An occlusal position If CR and MI do not coincide, the patient will have a slide Most patients have some degree of a slide into maximum intercuspation (approximately 1-2 mm) MI is simultaneous contact Forces concentrated on long axis Posterior contacts should dominate
Slide from CR to MI
Only 15% of the population have no CR to MI discrepancy After the first contact in CR (usually on 2 or more posterior teeth), the patient continues to close, and the teeth come together more completely (MI). The condyles must move out of their most ideal position when the teeth come fully together.
An ideal occlusion
Basic Premises:
The condyle seats in CR simultaneous with the teeth occluding in MI. No slide occurs.
Protrusive
This position is outside the envelope of function It is critical to the success of anterior restorations.
and MI occur simultaneously All teeth contact simultaneously All occlusal forces are longitudinal Posterior tooth contacts dominate Eccentric movements are anteriorguided No cross-over contacts on posterior teeth
Condylar position- Centric relation Tooth position- Maximum intercuspation Protrusive movements are guided by anterior teeth Lateral movements are canine guided. Axial loading of occlusal forces In MI, posterior tooth contacts dominate. During crossover, guidance is smoothly transferred to the incisors.