Fixed Prosthodontics Lecture 10: Interocclusal Record
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Questions and Answers

What is a major disadvantage of making a bite rim under local anesthesia or conscious sedation?

  • The procedure is faster.
  • The patient is more comfortable.
  • The patient may have difficulty providing correct registration. (correct)
  • It is easier to achieve accurate registration.

    • Which material is known for its stability and transparency?

  • Glass (correct)
  • Luxa bite
  • Wax
  • CAD/CAM

    • What is an advantage of Luxa bite rigid bite registration?

  • It resists normal temporary variations. (correct)
  • It is difficult to trim.
  • It interferes with closure of teeth.
  • It is only used with bite registration trays.

    • In what way can digital bite registrations be recorded for CAD/CAM procedures?

    <p>Either indirectly or directly</p> Signup and view all the answers

    What is required for indirect scanning technique in digital bite registration?

    <p>An antagonist bite registration</p> Signup and view all the answers

    Why is a bite rim necessary when restoring anterior teeth and the posterior teeth are missing, leaving unstable opposing casts?

    <p>To replace the remaining teeth</p> Signup and view all the answers

    What happens to patients who have been anesthetized with mandibular blocks?

    <p>They lose proprioception ability into centric occlusion.</p> Signup and view all the answers

    What is an advantage of Luxa bite rigid bite registration over wax?

    <p>It resists normal temporary variations.</p> Signup and view all the answers

    What is the main difference between indirect and direct digital bite registration?

    <p>The location of the scanning.</p> Signup and view all the answers

    What is the purpose of a bite registration?

    <p>To determine the occlusal relationship.</p> Signup and view all the answers

    What is the primary goal of bite registration in fixed prosthodontics?

    <p>To transfer the relationship between the upper and lower jaw to the articulator</p> Signup and view all the answers

    What is the ideal position of the condylar head in the centric relation?

    <p>In the posterior superior position in the glenoid fossa</p> Signup and view all the answers

    What is the requirement for a bite registration material to remain rigid after setting?

    <p>It should have a little or no dimensional change during setting</p> Signup and view all the answers

    When is hand articulation of the casts not necessary?

    <p>When there are enough teeth in both dental arches</p> Signup and view all the answers

    What is the purpose of checking the interocclusal record several times inside the patient's mouth?

    <p>To ensure the material is accurate</p> Signup and view all the answers

    What is one of the materials used for bite registration?

    <p>Pink base plate wax</p> Signup and view all the answers

    What is the definition of centric relation?

    <p>The position of the condylar head of the mandible without stress</p> Signup and view all the answers

    Why is it important to establish and transfer the relationship between the maxillary and mandibular dental arches?

    <p>To ensure restorative procedures are fabricated without changing the patient's occlusion</p> Signup and view all the answers

    What is the purpose of bite registration paste?

    <p>To record the bite by using bite registration materials</p> Signup and view all the answers

    What is the result of inaccurate bite registration?

    <p>Inaccurate restorative procedures</p> Signup and view all the answers

    When is centric relation taken during teeth preparation?

    <p>When there are not enough occlusal stops left after preparation</p> Signup and view all the answers

    What is the main characteristic of centric occlusion?

    <p>Maximum intercuspation of maxillary and mandibular teeth</p> Signup and view all the answers

    What is the purpose of recording centric occlusion with maximum intercuspation?

    <p>To achieve an even distribution of load through the dentition</p> Signup and view all the answers

    What is used in Dowson's technique to record centric relation?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of using pink base plate wax or alu-wax in bite registration?

    <p>To record centric relation</p> Signup and view all the answers

    When is hand articulation of the cast possible?

    <p>When there are enough teeth in both upper and lower arches to stabilize their relationship</p> Signup and view all the answers

    What is the purpose of using occlusal rims in bite registration?

    <p>To record centric relation when insufficient number of teeth are present</p> Signup and view all the answers

    What is the characteristic of registration material in centric occlusion?

    <p>It shows perforation in the area of contact teeth</p> Signup and view all the answers

    In Dowson's technique, how is the patient's mandible brought into centric relation?

    <p>By gentle downward pressure by thumbs and upward pressure on the fingers</p> Signup and view all the answers

    What is the main difference between centric relation and centric occlusion?

    <p>Centric relation is the relationship between the condyles and the articular fossa, while centric occlusion is the maximum intercuspation of maxillary and mandibular teeth</p> Signup and view all the answers

    Where should absorbent cotton rolls be placed in the maxillary arch?

    <p>In the muco-buccal fold or in the sublingual area</p> Signup and view all the answers

    What is the purpose of a saliva ejector?

    <p>To remove fluids during impression and cementation procedures</p> Signup and view all the answers

    What type of medications may be used as antisialogogues?

    <p>Anticholinergics</p> Signup and view all the answers

    What is a side effect of certain anticholinergics?

    <p>Dry mouth</p> Signup and view all the answers

    Why may clonidine be used as an antisialogogue?

    <p>Because it is an antihypertensive drug</p> Signup and view all the answers

    What is an additional benefit of using local anesthetics during impression making?

    <p>Reduced salivary flow</p> Signup and view all the answers

    When is it usually necessary to place additional cotton rolls to block off the sublingual and submandibular salivary ducts?

    <p>During mandibular arch impressions</p> Signup and view all the answers

    What is a contraindication for the use of anticholinergic drugs?

    <p>All of the above</p> Signup and view all the answers

    What is the primary objective of fluid control in fixed prosthodontics?

    <p>To obtain a dry clean operating field</p> Signup and view all the answers

    What is the simplest method of fluid control and isolation?

    <p>Cotton roll</p> Signup and view all the answers

    What is the purpose of lubricating a rubber dam when used with elastomeric impression materials?

    <p>To remove the clamp</p> Signup and view all the answers

    What is one of the sources of fluid in the oral cavity during tooth preparation?

    <p>All of the above</p> Signup and view all the answers

    Why is a rubber dam not always effective in achieving optimal saliva control?

    <p>Because all margins are not always supra-gingival</p> Signup and view all the answers

    What is the purpose of multiple isolation techniques in fixed prosthodontics?

    <p>To achieve optimal fluid control and isolation</p> Signup and view all the answers

    What is the main objective of gingival retraction in fixed prosthodontics?

    <p>To obtain a dry clean operating field</p> Signup and view all the answers

    What is a potential source of fluid during tooth preparation?

    <p>All of the above</p> Signup and view all the answers

    What is the primary purpose of applying mechanical pressure on the gingiva in mechanical method of retraction?

    <p>To displace the gingiva away from the finishing line</p> Signup and view all the answers

    What type of retraction cord is impregnated with a hemostatic agent?

    <p>Impregnated retraction cord</p> Signup and view all the answers

    What is an advantage of knitted retraction cord over other types of retraction cords?

    <p>It affords greater inter-thread space than braided cord</p> Signup and view all the answers

    What is the primary purpose of retraction cord in mechanical method of retraction?

    <p>To displace the gingiva away from the finishing line</p> Signup and view all the answers

    What is the classification of retraction cords according to configuration?

    <p>Twisted, knitted, and braided</p> Signup and view all the answers

    What is the primary difference between mechanical and chemo-mechanical methods of retraction?

    <p>The use of medicament in chemo-mechanical method</p> Signup and view all the answers

    What is the purpose of using rubber dam in mechanical method of retraction?

    <p>To isolate the operating field</p> Signup and view all the answers

    What is the advantage of using twisted retraction cord?

    <p>It is less expensive than other types of cords</p> Signup and view all the answers

    What is the primary function of gingival retraction paste in impression making?

    <p>To achieve good haemostasis with less trauma</p> Signup and view all the answers

    What is the advantage of using rotary curettage in troughing technique?

    <p>It removes epithelial tissue in the sulcus</p> Signup and view all the answers

    What is the contraindication for using electrosurgery in gingival tissue removal?

    <p>All of the above</p> Signup and view all the answers

    What is the advantage of using soft tissue laser in gingival retraction?

    <p>It minimizes bleeding</p> Signup and view all the answers

    What is the disadvantage of using soft tissue laser in gingival retraction?

    <p>It is a slow technique</p> Signup and view all the answers

    What type of laser is used for gingival retraction?

    <p>Nd- YAG laser</p> Signup and view all the answers

    What is the benefit of laser procedures in dentistry?

    <p>They minimize bleeding</p> Signup and view all the answers

    What is the result of using gingival retraction paste in impression making?

    <p>It achieves good haemostasis with less trauma</p> Signup and view all the answers

    What is the primary objective of gingival retraction in tooth preparation?

    <p>To provide adequate reproduction of finish lines</p> Signup and view all the answers

    What is the purpose of using a saliva ejector during impression making?

    <p>To control the flow of saliva</p> Signup and view all the answers

    What is the definition of biological width?

    <p>The dimension of the soft tissue attached to the portion of the tooth coronal to the crest of alveolar bone</p> Signup and view all the answers

    Why are local anesthetics useful during impression making?

    <p>They provide pain relief during the procedure</p> Signup and view all the answers

    What is the purpose of placing additional cotton rolls to block off the sublingual and submandibular salivary ducts?

    <p>To reduce saliva flow</p> Signup and view all the answers

    What is the result of inaccurate gingival retraction?

    <p>Inaccurate impressions and poor fitting restorations</p> Signup and view all the answers

    What is the purpose of using antisialogogues in impression making?

    <p>To reduce saliva flow</p> Signup and view all the answers

    What is the definition of gingival sulcus?

    <p>A shallow groove around the tooth bounded by the surface of the tooth and the epithelial lining of the free margin of the gingiva</p> Signup and view all the answers

    Study Notes

    Interocclusal Record (Bite Registration Record)

    • Bite registration is a technique to transfer the relationship between the upper and lower jaw from the patient's mouth to the articulator.
    • It allows the dentist to observe tooth contact, occlusal discrepancies, and fabricate restorative procedures without changing the patient's occlusion.

    Requirements of Bite Registration Materials

    • The material should be stable with little or no dimensional change during setting.
    • It should give an accurate record of the occlusal surface and incisal edges of the teeth.
    • It should not affect normal closing of the mandible.
    • The material should remain rigid after setting.

    Bite Registration Materials

    • Pink base plate wax or compound
    • Bite registration paste (ZOE, Silicone)
    • Bite rim or occlusal rim

    Centric Relation

    • The physiological position of the condylar head of the mandible (without stress) from which all other movements are initiated.
    • Taken when no enough occlusal stops are left after teeth preparation, especially in cases of full mouth rehabilitation of fixed partial denture.

    Centric Occlusion

    • The maximum occlusal contact or intercuspation, irrespective of condylar position.
    • Maxillary and mandibular teeth should contact in a harmonious manner, allowing optimum function, minimum trauma to the supporting structure, and even distribution of load through the dentition.

    Dowson's Technique

    • Patient's chair is reclined, and the head is fixed by the dentist standing behind the patient.
    • The dentist applies gentle downward pressure with thumbs and upward pressure on the fingers to bring the patient's mandible into centric relation.

    Methods of Inter-occlusal Record

    • If enough teeth are present in both upper and lower arches, no bite registration is needed, and the relation can be transferred by hand articulation.
    • If the remaining teeth are insufficient, bite registration materials such as pink base plate wax, bite registration paste, or occlusal rims can be used.

    Glass Bite Material

    • Introduced between the dental arches with a special cannula and can be applied ideally between the dental arches much faster and more easily than other materials.
    • Stable and transparent.

    Luxa Bite Rigid Bite Registration

    • Highly accurate to the models
    • Can be used with or without bite registration trays
    • No interference with closure of teeth
    • Fast setting and easy to trim
    • Resist normal temporary variations better than wax
    • No compression on mounting

    Bite Registrations for CAD/CAM Procedures

    • Bite registration can be digitally recorded in the same way as digital impression, both procedures are employed in conjunction with computer-aided design/computer-aided manufacturing (CAD/CAM).
    • Digital bite registration can be taken indirectly using an extra oral scanner (in lab) or directly in the mouth at chairside using an intraoral digital camera (in office).

    Fluid Control and Isolation in Fixed Prosthodontics

    • Control of fluids and appropriate displacement of the gingiva are essential during tooth preparation to obtain accurate impressions and for cementation.

    Sources of Fluid in the Oral Cavity

    • Saliva from parotid, submandibular, and sublingual glands
    • Inflamed gingival tissues and iatrogenic soft tissue damage
    • Water and dental materials
    • Gingival crevicular fluid (sulcular fluid)

    Objectives of Fluid Control

    • To obtain a dry, clean operating field
    • For easy access and visibility
    • To improve the properties of dental materials
    • To protect the patient and the operator
    • To improve operating efficiency

    Methods of Fluid Control and Isolation

    • Rubber dam: used to isolate the tooth during restorative procedures
    • Cotton roll: simplest method of fluid control and isolation
    • Mechanical method of retraction: physically displaces the gingiva
      • Examples: retraction cord, rubber clamp, temporary crown with a long margin
    • Chemo-mechanical method: combination of mechanical and chemical methods
      • Examples: impregnated retraction cord with hemostatic agents, displacement polymer and paste
    • Surgical method: radical or surgical means or technique
      • Examples: electrosurgery, laser

    Retraction Cords

    • Classification:
      • According to chemical treatment: plain or impregnated with hemostatic agents
      • According to configuration: twisted, knitted, or braided
    • Advantages of knitted cord:
      • Affords greater inter-thread space than braided cord
      • Forms an interlocking chain of tiny loops, making it easy to pack below the gingival margin
      • Compresses upon packing, then expands for tissue displacement

    Gingival Retraction

    • Definition: deflection of the marginal gingiva away from a tooth
    • Indications:
      • To provide adequate reproduction of finish lines
      • To expose the prepared finish line and evaluate the depth and uniformity of it
      • To control the gingival crevicular fluid
      • To provide access for the impression material to record accurately
    • Objectives:
      • To obtain accurate marginal fit
      • To prevent periodontal disease
      • To fabricate accurate restorations
      • To help obtain accurate marginal fit, reducing marginal leakage and subsequent deterioration of the tooth

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    Description

    Learn about interocclusal record, also known as bite registration record, in fixed prosthodontics. Understand how it helps dentists observe tooth contact and occlusal discrepancies.

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