Please enable JavaScript.
Coggle requires JavaScript to display documents.
Essay Questions (2) CR questions (Define CR
(A) Condyle in AS, against P…
Essay Questions
2) CR questions
Define CR
- (A) Condyle in AS, against P articular eminence. in glenoid fossa
- (A) Independent of tooth contact
- (A) Against the thinnest portion of avascular disc
- (C) Clinically reproducible
- (C) Effective MMR reference point in edentulous, aid denture fabrication
- (C) Stable orthopedic musculosketelal position, engage muscle tonus
- (M) TMJ restricted purely to rotation, on THA plane
Dawson's Bimanual
- Guide mandible into CR
- Predictable
- Combination of active and passive :explode:
- (P) Bilateral manipulation/guidance
- (A) Active closure
- Requires anterior jig, Operator guidance, Active closure
Patient
- Supine
- Head tilt, Chin lift
- Deprogram; Anterior Jig (All posterior teeth must disclude)
- Deprograming neuromusculature from habitual MI :explode:
Clinician
- Set up
- Seated behind
- 4 fingers on lower boarder of mandible :explode:
- Last finger on angle of mandible :explode:
- Thumbs on mentalis
- Locating CR
- Deprogram to remove guarding (2mm-4mm open) :explode:
- Firm, Gentle guiding (Mentalis down, Mandible up)
- Seat condyles AS position
- Locating CO
- Occlusion of teeth when joint is in CR
- Identify first occlusal contact
- Rely on patient's general description :explode:
Precautions
- Patient relax
- Jig: flat & no indentations
- Operator
- Fingers on bone NOT soft tissue (Will cause guarding protect vital organs)
- Fingers are not too anterior, vector distalizing force, push condyle to impinge on retrodiscal tissues
- Firm and gentle
- CR/CO small as possible
- Error in centre of rotation less
- Less regisil used (more accurate, it shrinks)
-
3) Envelope of mandibular incisor, ws, nsw
-
WS Conduyle
- Posterior wall of glenoid fossa
- Superior wall of glenoid fossa
NWS Condyle
- Medial wall of glenoid fossa
-
4) Eccentric Pathways, 2 ways of recording
Pathways
Protrusive
What: Mandible forward from MI (5-6mm) :explode:
Why: Linear part Sigmoid anatomy + Set condylar inclindation
-
-
-
-
Purpose of Anterior Jig
- Clinician's anterior reference point (patient must not know)
- Deprogram
- Regiseal with jig (Ensure CR + find incomplete Centric Occlusion)
- Space for regisil
- Before first contact (if same rotation why bother), arbitrary facebow, if axis is different there'll be a big difference
-
-
-
-
-
-