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Maxillofacial Surgery
Dental-Occlusal Relationships Terminology, Description and Classification
Built from Facial Aesthetics — Concepts and Clinical Diagnosis
What’s inside
11 sections · 118 slides
Overview
- What this topic covers
- Why the words come first
The vocabulary of the teeth
Names for tooth form, direction, position, movement and rotation
- Three basic tooth shapes
- Crown, root, and the line between them
- Landmarks on the biting surface
- Directions along the arch
- Directions across the arch: cheek side, tongue side
- Terms of direction around a tooth
- Where a tooth sits: position in three planes
- Moving a whole tooth: translation
- Tilting a tooth along the arch: angulation
- Tilting a tooth in or out: inclination
- Spinning a tooth: bodily rotation
- Tooth rotation around three axes
- Angulation and inclination are not the same word
- Words for the forces, not the position
Ideal, normal and malocclusion
What the three words mean, and where the boundaries lie
- What 'occlusion' means
- 'Ideal' occlusion is a theory, not a patient
- The skull Angle used to show 'normal' occlusion
- 'Normal' occlusion and malocclusion
- Three words for how the teeth meet
- How to look at the arches in clinic
- The order of an occlusal examination
The curves of the occlusion
Why the biting surfaces are not laid out flat
- The bite is curved, seen from the side
- What Spee actually described
- The curve of Spee
- When the curve is deepened or reversed
- Curves when the incisors overerupt past each other
- Skeletal or soft tissue? Read the pair of curves
- Curves when a forward tongue blocks eruption
- The bite is curved, seen from the front
- The curve of Wilson across the arch
Aims of treatment and the keys to an ideal bite
Andrews' six keys, and the seventh key added later
- Where the six keys came from
- Key I: the molar relationship
- Key II: crown angulation
- Key III: crown inclination
- Keys IV, V and VI
- Andrews' six keys to an ideal occlusion
- The seventh key: correct tooth size
- Tooth size as the seventh key
- Facial appearance outranks the perfect bite
Classifying the incisor relationship
Class I, II and III, plus overbite and the midlines
- Where the incisor classification came from
- Sagittal incisor relationships compared
- Class I incisor relationship
- Class I occlusion
- Class II incisor relationship
- Class II division 1 incisor relationship
- Class II division 2 incisor relationship
- Class III incisor relationship
- Class III incisor relationship
- Overbite: the vertical overlap
- Measuring incisor overbite
- Grades of overbite
- Classification of incisor overbite
- The midlines: transverse incisor relationship
Classifying the buccal segments
Canine, premolar and molar relationships in three planes
- Class I buccal segment relationship
- Class I buccal segment relationship
- Grading how far a bite is off Class I
- Class II full unit buccal segment relationship
- Class III full unit buccal segment relationship
- Buccal segments in the vertical plane
- Right-sided lateral open bite
- Buccal segments in the transverse plane
- Other names for a scissors bite
- Transverse buccal segment relationships
- Classification describes shape, not cause
- Two routes to the same increased overjet
What the word 'Class' really means
One label doing five separate jobs
- 'Class' is used for five different things
- What the word 'Class' can refer to
- 'Class' for the skeletal pattern
- 'Class' for the teeth
- 'Class' for the whole malocclusion
- 'Class' for the jaw growth pattern
- Average growth of the face over childhood
- Always keep the label in context
Why bites go wrong
Genetic, environmental and multifactorial causes
- What 'aetiology' means here
- Three kinds of cause
- Four practical headings for cause
- Dentoalveolar compensation
- The soft tissue envelope around the teeth
- How compensation hides a jaw problem
- Dentoalveolar compensation in Class II and Class III
- When compensation fails
- Compensation in the vertical plane
- Two kinds of anterior open bite
- Decompensation before jaw surgery
- The soft tissue envelope
- An incisor trapped in front of the lower lip
- The tongue
- Three signs that point to an endogenous tongue thrust
- Adenoids and the long face
- From a blocked nose to a long face
- Muscle disease and face height
- Vertical growth pattern in muscular dystrophy
- Local factors: how many teeth
- Local factors: how big the teeth are
- Local factors: where the teeth end up
- Local factors: the upper lip attachment
- Habits: prolonged digit sucking
- Open bite from a prolonged digit sucking habit
Oral health
Teeth, gums and mucosa belong to the same assessment
- Why oral health is part of the examination
- Three ways teeth wear away
- What worn teeth can reveal
- Plaque, gums and bone
- Recession and the mucosa
How the bite works in motion
Dynamic occlusal function and the jaw joint
- Static first, then moving
- Incisal guidance
- Working side and non-working side
- Two jaw positions that are easy to confuse
- Why centric relation matters
- The jaw joint itself
- Checking how the jaw opens
- Pain and joint noises
- Take-home points: the words and the ideal
- Take-home points: classifying and diagnosing
- References
- References (continued)
- Facial Aesthetics: Concepts and Clinical Diagnosis, 2nd Edition