______ the relationship of the teeth in the mandibular arch to those in the maxillary arch as they are brought together.
is examined and recorded as part of the oral examination.
Recognition of malocclusion assists in:
the referral of patients to the orthodontist,
valuable points of reference for patient instruction
determines necessary adaptations in techniques.
Recognition of occlusion and problems of malocclusion can aid in:
providing information for the comprehensive assessment and planning dental hygiene care
planning personalized instruction in relation to oral habits, masticatory efficiency, and predisposing factors to dental and periodontal infections
adapting techniques of instrumentation to malpositioned teeth or groups of teeth
planning the frequency of maintenance appointments for professional care on the basis of deposit retention areas
providing the general features of malocclusion to consider when orthodontic referral is discussed with the patient.
_____ relationships are seen when the jaws are closed in centric relation. seen directly in the oral cavity when the lips and cheeks are retracted can be efficiently observed in occluded study casts
Normal (ideal) occlusion:
the ideal mechanical relationship between the teeth of the maxillary arch and the teeth of the mandibular arch is as follows: all teeth in the maxillary arch are in maximum contact with all teeth in the mandibular arch in a definite pattern. Maxillary teeth slightly overlap mandibular teeth on the facial surfaces.
______ any deviation from the physiologically acceptable relationship of the maxillary arch and/or teeth to the mandibular arch and/or teeth.
_____ is Having slightly protruded jaws, which give the facial outline a relatively flat appearance (straight profile).
____ is Having a prominent maxilla and a mandible posterior to its normal relationship (convex profile).
____ is Having a prominent, protruded mandible and normal (usually) maxilla (concave profile).
___ is the relationship of the occlusal surfaces of one arch to those of the opposing arch.
The determination of the classification of occlusion is based on the principles of _____ presented in the early 1900s.
Edward H. Angle
Types of facial profiles?
______ Maxillary or mandibular posterior teeth are either facial or lingual to their normal position. This condition may occur bilaterally or unilaterally
_____ Maxillary incisors are lingual to the mandibular incisors
_____ incisal surfaces of maxillary teeth occlude with incisal surfaces of mandibular teeth instead of overlapping as in normal occlusion.
___ molars and premolars occlude cusp to cusp as viewed mesiodistally.
_____lack of occlusal or incisal contact between certain maxillary and mandibular teeth because either or both have failed to reach the line of occlusion. The teeth cannot be brought together, and a space remains as a result of the arching of the line of occlusion.
____ the horizontal distance between the labioincisal surfaces of the mandibular incisors and the linguoincisal surfaces of the maxillary incisors. One way to measure the amount of overjet is to place the tip of a probe on the labial surface of the mandibular incisor and, holding it horizontally against the incisal edge of the maxillary tooth, read the distance in millimeters.
_____ maxillary teeth are lingual to mandibular teeth. Measurable horizontal distance between the labioincisal surfaces of the maxillary incisors and the linguoincisal surfaces of the mandibular incisors.
_______the incisal edges of the maxillary teeth are within the incisal third of the mandibular teeth.(overbite)
______the incisal edges of the maxillary teeth appear within the middle third of the mandibular teeth(overbite)
_______ incisal edges of the maxillary teeth are within the cervical third of the mandibular teeth.(overbite)
Deep (severe) overbite
______when in addition the incisal edges of the mandibular teeth are in contact with the maxillary lingual gingival tissue. (overbite)
Very deep overbite
(Malposition of Individual Teethtooth) that has assumed a position labial to normal
(Malposition of Individual Teethtooth)position lingual to normal
(Malposition of Individual Teethtooth)position buccal to normal
(Malposition of Individual Teethtooth)elongated above the line of occlusion
(Malposition of Individual Teethtooth)turned or rotated
(Malposition of Individual Teethtooth)depressed below the line of occlusion, for example, primary tooth that is submerged or ankylosed.
NORMAL OCCLUSION:Class I: NEUTROOCCLUSION
Molar Relationship: According to Angle, the MB cusp of the maxillary 1st molar aligns with the B groove of the mandibular 1st molar.
Canine Relationship: The maxillary canine occludes with the distal half of the mandibular canine and the mesial half of the mandibular first premolar
Class II or Distoclusion
Mandibular teeth posterior to normal
Retrognathic; mandible appears retruded
Molar relation: the buccal groove of the mandibular first permanent molar is distal to the MB cusp of the maxillary 1st permanent molar by at least the width of a premolar. When the distance is less than the width of a premolar, the relation should be classified as “tendency toward Class II.”
Canine relation: the distal surface of the mandibular canine is distal to the mesial surface of the maxillary canine by at least the width of a premolar. When the distance is less than the width of a premolar, the relation should be classified as “tendency toward Class II.”
Class II Division 1 & Division 2
Description: mandible is retruded and all maxillary incisors are protruded.
General conditions that frequently occur :
deep overbite, excessive overjet, abnormal muscle function (lips), short mandible, or short upper lip.
Class II, Division 2:
Description: mandible is retruded, and one or more maxillary incisors are retruded.
General conditions that frequently occur :
maxillary lateral incisors protrude while both central incisors retrude, crowded maxillary anterior teeth, or deep overbite.
Class III (Mesioclusion)
Mandibular teeth are anterior to maxillary
Prognathic: mandible is prominent / protrudes
Molar relation: the buccal groove of the mandibular 1st permanent molar is mesial to the MB cusp of the maxillary 1st permanent molar by at least the width of a premolar. When the distance is less than the width of a premolar, the relation should be classified as “tendency toward Class III.”
Canine relation: the distal surface of the mandibular canine is mesial to the mesial surface of the maxillary canine by at least the width of a premolar. When the distance is less than the width of a premolar, the relation should be classified as “tendency toward Class III.”
Occlusion of the Primary Teeth
Normal (ideal) occlusion
Primary canine relation is the Same as permanent dentition
Primary teeth with primate spaces. (A) Mandibular primate space between the canine and the first molar. (B) Maxillary primate space between the lateral incisor and the canine.
Types of occlusal contacts: Functional
contacts during chewing, swallowing
guide the teeth during eruption
provide functional stimulation for the preservation of the health of the attachment apparatus, namely, the periodontal ligament, the cementum, and the alveolar bone
Types of occlusal contacts:Parafunctional
contacts are those made outside the normal range of function
Tooth-to-hard-object contacts: nail biting; occupational use of such objects as tacks or pins; use of smoking equipment, such as a pipe stem or hard cigarette holder.
Tooth-to-oral-tissues contacts: lip or cheek biting.
proximal contacts serve to stabilize the position of teeth in the dental arches and to prevent food impaction between the teeth.
Proximal contacts: Attrition:
or wear of the teeth occurs at the proximal contacts.
Proximal contacts: Drifting:
When proximal contact is lost, teeth can drift into spaces created by unreplaced missing teeth. There is a natural tendency for mesial migration of teeth toward the midline. In the absence of disease, the surrounding periodontal tissues adapt to repositioned teeth.
Proximal contacts: Pathologic migration:
With destruction of the supporting structures of a tooth as a result of periodontal infection, and with a force to move a tooth weakened by disease and bone loss, migration of the tooth can result. Pathologic migration occurs when disease is present; in contrast, drifting is migration with a healthy periodontium.
Periodontal tissue injury caused by repeated occlusal forces that exceed the physiologic limits of tissue tolerance is called ____ from occlusion.
trauma; Other names are periodontal traumatism, occlusal traumatism, and periodontal trauma.
Types of trauma from occlusion: Primary trauma from occlusion
results when excessive occlusal force is exerted on a tooth with normal bone support. Example: the effect of a new restoration placed above the line of occlusion.
Types of trauma from occlusion: Secondary trauma from occlusion
occurs when excessive occlusal force is exerted on a tooth with bone loss and inadequate alveolar bone support. The ability of the tooth to withstand occlusal forces is impaired. A tooth has lost the support of the surrounding bone; even the pressures of what are usually considered normal occlusal forces may create lesions of trauma from occlusion.
Effects of trauma from occlusion:
the attachment apparatus (periodontal ligament, cementum, and alveolar bone) has as its main purpose the maintenance of the tooth in the socket in a functional state. In a healthy situation, occlusal pressures and forces during chewing and swallowing are readily dispersed or absorbed and no unusual effects are produced.
Trauma from occlusion does not cause:
gingivitis, periodontitis, or pocket formation
Circulatory disturbances, tissue destruction from crushing under pressure, bone resorption, and other pathologic processes
Recognition of Signs of Trauma from Occlusion: Clinical findings:
Tooth mobility / Fremitus / Sensitivity of teeth to pressure and/or percussion / Pathologic migration / Wear facets or atypical incisal or occlusal wear / Open contacts related to food impaction. Neuromuscular disturbances Temporomandibular joint symptoms.
Recognition of Signs of Trauma from Occlusion:Radiographic findings
Triangulation = widened periodontal ligament spaces, particularly angular thickening / Vertical bone loss in localized areas / Root resorption / Furcation involvement / Thickened lamina dura /
Factors to Teach the Patient:
Interpretation of general purposes of orthodontic care
Influence of masticatory efficiency
Role of malocclusion in biofilm retention and preventive techniques
Suggestion for correction of oral habits
During the exam you notice that your patient’s maxillary incisors are lingual to the mandibular incisors; this condition is called:
During your exam you noticed that the incisal edge of #8 and 9 occludes with the cervical third of the facial surface of #24 and 25; this would be identified as:
E) deep overbite
Occlusal contacts that are made outside of the normal range of function in occlusion are called: