Occlusion

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions. Remember, there's only one answer to each question.

1.	There exists only one concept dealing with occlusion.

a) true
b) false

2.	All patients react to specific stimuli in the same manner.

a) 'true
b) false

3.	Occlusion is defined as:

a) relationship of the maxilla to the mandible
b) mandibular movement as defined by guide planes
c) posterior superior position of the condyle in the glenoid fossa
d) contact between teeth

4.	The masticatory (or stomatognathic) system is considered to be made up of three parts: teeth, periodontal tissues and:

a) articulatory system
b) respiratory system
c) circulatory system
d) digestive system

5.	The teeth make up the most important part of the masticatory system.

a) true
b) false

6.	Does a change in any one component of the articulatory system affect the other components of the system?

a) true
b) false

7.	Centric Occlusion (CO) corresponds to:

a) centric relation
b) maximum intercuspation
c) intercuspation position (ICP)
d) b and c

8.	Unarticulated models are nearly always hand articulated in:

a) centric relation (CR)
b) bite of convenience or habitual bite
c) intercuspation position (ICP)
d) b and c

9.	Centric relation is dependent upon having teeth.

a) true
b) false

10.	The most popular definition of centric relation can be described anatomically with the intra articular disc in place,

a) when the head of the condyle is against the most superior part of the distal facing incline of the glenoid fossa (“uppermost and foremost”).
b) when the head of the condyle is “uppermost and midmost” position within the glenoid fossa.
c) when the head of the condyle is “uppermost and rearmost” position within the glenoid fossa.

11.	Conceptual centric relation can be described as that position of the mandible relative to the maxilla, with the articular disc in place, when the muscles that support the mandible are at their most relaxed and least-strained position.

a) true
b) false

12.	Geometrical centric relation can be described as the position of the mandible relative to the maxilla, with the intra-articular disc in place, when the:

a) occlusion is balanced
b) muscle attachments are shortened
c) head of the condyle is in terminal hinge axis

13.	Long centric cannot be affected by overbuilding the palatal surfaces of anterior crowns.

a) true
b) false

14.	An occlusion that may not permit a long centric occlusion:

a) angles CL2 div (11)
b) angles Cl 1
c) angle cl(111)
d) b and c

15.	Dynamic occlusion refers to the occlusal contacts that are made while the mandible is moving relative to the maxilla.

a) true
b) false

16.	The posterior guidance of the mandible is provided by the:

a) temporomandibular joints
b) anterior teeth
c) posterior teeth
d) the entire dentition

17.	Anterior guidance is determined by:

a) maxillary anterior teeth
b) whichever teeth touch during excentric movements of the mandible
c) mandibular anterior teeth
d) mandibular incisors

18.	Canine guidance (canine-protected occlusion) occurs on the canines during a lateral excursion of the mandible. Canine guidance is the only dynamic occlusal contact during this excursive movement.

a) true
b) false

19.	Group function is:

a) a type of anterior guidance where the contacts are shared between several teeth on the working side during lateral excursion. To qualify for the term group function the contacts would be toward the front of the mouth and the most anterior of the gr
b) a type of anterior guidance where the contacts are shared between several teeth on the non-working side during lateral excursion. To qualify for the term group function the contacts would be toward the front of the mouth and the most anterior of the group
c) a type of anterior guidance where the contacts are shared between several teeth on the working side during lateral excursion. To qualify for the term group function the contacts would be toward the front of the mouth and the most posterior of the group wo
d) b and c

20.	Non-working side interference is an anterior guidance on the back teeth on the non-working side during lateral excursion.

a) true
b) false

21.	Occlusion can only be judged on the reaction that it produces in the tissues of the system in which it interreacts. That reaction will be infinitely variable and will in some contexts (i.e., TMD pain) vary within an individual with time.

a) true
b) false

22.	Dentists need to examine and record the pre-existing occlusion before providing treatment which involves changes to that occlusion. The following may be used to record the pre-existing occlusion:

a) articulated study models mounted in centric relation
b) condylar guidance angles set so that dynamic occlusion is recorded
c) notes that describe the patient’s occlusion using ideal occlusion as a benchmark
d) all of the above

23.	When an ideal occlusion is provided for a patient with PDS (Pain Dysfunction Syndrome) this should always be initially in a temporary and reversible way, i.e., a stabilization splint.

a) true
b) false

24.	Bruxism is an important consideration in dentistry and its effects are determined by:

a) frequency of bruxism and the reaction it produces in the patient’s tissues
b) magnitude of the force being applied
c) mouth breathing
d) a and b

25.	The only muscle fibers that retract the mandible are the:

a) masseter muscle
b) horizontal fibers of the temporalis muscle
c) lateral pterygoid muscle fibers
d) digastric muscle fibers

26.	The most frequently tender muscle in bruxists is:

a) mylohyoid muscle
b) medial pterygoid muscle
c) temporalis muscle
d) digastric muscle

27.	When the active/passive cycle is altered in parafunction of this muscle, preauricular pain may occur; in addition, TMJ clicking and locking may occur.

a) temporalis muscle
b) lateral pterygoid muscle
c) digastric muscle
d) mylohyoid muscle

28.	According to this article, should dentists adjust the “occlusion” to treat head and neck muscle pain?

a) yes
b) no

29.	There are two systems that provide hard guidance during mandibular movements: the anterior and posterior guidance systems. The posterior guidance system is made up of the:

a) anterior teeth
b) masseter muscle
c) temporomandibular joint
d) head of the condyle, the intra-articular disc and the glenoid fossa
e) c and d

30.	During a lateral excursion of the mandible, the principal movement within the TMJs is on the ______ side.

a) non-working side
b) working side

31.	When the head of the condyle is moving purely in the rotational phase of its movement, then the mandible is in a “terminal hinge axis.”

a) true
b) false

32.	Guidelines for good occlusal practice include:

a) There is no such thing as an intrinsically bad occlusal contact, only an intolerable number of times to parafunction on it.
b) The patient’s occlusion should be recorded before any treatment is started.
c) Compare the patient’s occlusion against the benchmark of ideal occlusion.
d) A simple, two-dimensional means of recording the patient’s occlusion before, during and after treatment is an aid to good occlusal practice.
e) All of the above