for second year students academic years 2011-2012

LinxYou.com
https://docs.google.com/document/d/1t99F8sauTW2hVLvfNX-G3YDIR3X_6vH_jTl8S9FvOTA/edit - the rest of the answers are here

Answers
Open Questions
(140 questions)

Orthopedic Dentistry Examination

Second year students
Academic years 2011-2012

Morphology, Bio-materials, Fixed prosthodontics, & Removable , Clinical examination (if there is 5th question)
The questions are not organized Correctly in categories. Most of the answers are from previous years.

for second year students academic years 2011-2012

...

1. Notion Prosthodontic dentistry. Compartments. Methods of treatment.

Notion Orthopedic dentistry is a science which studies etiology (causes), pathology (causes, process,
development, consequences), clinical pictures, prophylactic / preventing methods, and treats the affections of
stomatognat system using different methods (functional, device method, surgical devices, and prosthetic
devices).
The dental speciality pertaining to (which deals with) the diagnosis, treatment planing, rehabilitation and
maintenance of the oral function, comfort, appearance and health of patients clinical conditions associated with
missing or deficient teeth or oral and maxillofacial tissues using biocompatible (not harmful to living tissues)
substitutes. It also deals with the reestablishment of the dental arch.
Compartments - Orthopedic dentistry includes 2 disciplines:
1. Propedeutics of orthopedic dentistry - is a discipline which foresees learning the basics in profession
before clinical study.
Focuses on the general notions about orthopedic dentistry.
2. Clinical orthopedic dentistry -Study clinical picture and therapy of morphofunctional disturbances through
using different restorative techniques (dentures and devices manufacturing).
Focuses on the treatment of the patients.
Methods of treatment 1. Functional (e.g. Mechanotherapy).
2. Device method / special apparatus (orthodontics apparatus). (e.g. Braces)
3. Surgical devices (e.g. Implant).
4. Prosthetic devices (e.g. artificial crowns, dental bridge).
5. Mixed / Combined.
For example - Crowns, bridges, dentures, partial dentures, implants.

Prosthetics = Prosthetic dentistry = Prosthodontics = Orthopedic dentistry

Prosthodontics != Orthodontics
Prosthodontics / Dental prosthetics / Prosthetic dentistry / Prosthodontic dentsitry
Notion - The dental speciality pertaining to the diagnosis, treatment planing,
rehabilitation and maintenance of the oral function, comfort, appearance and health of patients
clinical conditions associated with missing or deficient teeth or oral and maxillofacial tissues
using biocompatible (not harmful to living tissues) substitutes.
Orthopedic dentistry / Dental orthopaedics / Orthodontia / Orthodontics / Orthodonture
Notion - The speciality of dentistry that is concerned with the study and treatment of
improper bites, which may be a result of tooth irregularity, disproportionate jaw relationships or
both.
Orthopedic treatment can focus on dental displacement only, or can deal with the control and
modification of facial growth. Can be carried out for purely aesthetic reasons with regards to
improving the general appearance of patients teeth.
Treatment is also after prescribed for practical reasons such as providing the patient with a
functional improved bite.
Orthopedic dentistry is a science which studies etiology (causes), pathology (causes,
process, development, consequences), clinical pictures, prophylactic / preventing methods,
and treats the affections of stomatognat system using different methods (functional, device
method, surgical devices, and prosthetic devices).
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OR
Prosthodontics / Orthodontics - The treatment of irregularities in the teeth (esp. of alignment and
occlusion) and jaws, including the use of braces.
The branch of dentistry concerned with the design, manufacture, and fitting of artificial replacements
for teeth and other parts of the mouth.

2. Notion stomatognat system. Component elements of stomatognat system.

Notion
Stomatognat system (SS) / Dento-maxillary system (Etymology: Gk, stoma = oral cavity + gnathos = jaw)
is a system which represents a complex of organs and tissues located in maxillo-facial region,
which directly or indirectly participate in the bodys basic functions:
1. Mastication / Chewing.
2. Swallowing.
3. Breathing.
4. Phonetics / Speaking.
is the structures of the mouth and jaws, considered collectively, as they subserve the functions
of mastication, deglutition, respiration, and speech.
Component elements:
In anatomy, the stomatognathic system consists of the mouth, jaws, and closely associated structures.
1. Skeleton, represented by jaw bones, nasal bone and zygomatic (some include also the frontal
bone).
2. Teeth, which form dental arches.
3. Masticatory muscles (MM) - Muscles that control the movement of the mandible.
4. Lips and oro-facial muscles (Cheeks muscles, muscles of the tongue, facial expression
muscles...).
5. Tongue, hard and soft palate, cheeks.
6. Fibromucosa of oral cavity.
7. Blood vessels, lymphatic and nerves .
8. Three paired salivary glands (parotid, submandibular, sublingual).
9. Temporomandibular joint (TMJ) .
10. Oro-Pharynx.
http://www.netterimages.com/image/stomatognathic-system.htm

3. Factors that influence on stomatognat system evolution. Interrelation between shape

and function (as ex. take the TMJ-temporo-mandibular-joint). Two steps of teeth
morphology.
Factors affecting the stomatognat system evolution:
1. Genetical factor - The stomatognat system changes with the age growth, under the influence of:
a. Exogenous factor / Extraoral factor - coming from outside.
b. Endogenous factor / Intraoral factor - coming from inside.
c. Pathological process - lose of an element or an organ.
2. Functional factor - Under the age, stress, and general disease & general health condition of the
patient, the mastication process develops the muscles.
e.g. Mastication develops better the muscles of stomatognate system, and masticatory pressure is a
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functional factor. Different morphology is formed in the area more used for mastication.

4. Basic and auxiliary (secondary) stomatognat system function. Characteristic.

Component elements of self-reservation function.
Functions:
Basic

Masticatory functions.
Speech / Phonation.
Deglutition / Swallowing.
Physiognomy / Facial expression & Appearance (Aesthetics).

Auxiliary
Maintaining postural control.
Taste sensation / Gustation.
Respiration.

Explanation on Postural control - http://www.scielo.br/scielo.php?script=sci_arttext&pid=S180759322009000100011

5. Mandibullar, maxillary butters. Argue what leaded to their formation and practical
importance.
These buttresses (( )bone-trajectories) represent regions of thicker bone, which provide support for the maxilla
in the vertical dimension (mod. a. Prein et al. 1998).
1. Anterior medial naso-maxillary buttress.
2. Lateral zygomatico-maxillary buttress.
3. 3 posterior pterygo-maxillary buttress.

Diagram of the vertical maxillary buttresses of the midface.

for second year students academic years 2011-2012

https://sites.google.com/site/drtbalusotolaryngology/rhinology/buttress-system-of-midface

Mandible : On the inner aspect of the mandible this thickening below the coronoid process is the buttress.
1.
2.
3.

Marginal
Radial
Basilar

http://books.google.md/books?
id=Jf9WZltV1BAC&pg=PA548&lpg=PA548&dq=mandibular+buttress&source=bl&ots=YzapACHGU&sig=Fe0-CouB5GAU1FEQKDRaPE7zJes&hl=en&redir_esc=y#v=onepage&q=mandibular
%20buttress&f=false

6. TMJ (temporo-mandibular-joint) elements. Three shapes of articular eminence.

Describe the usual mandible condyle position in the articular fossa.
Elements / Components of TMJ :
1. Cranial portion = Mandibular/Glenoid fossa.
Limited anteriorly by Articular eminence, & posteriorly by Postglenoid tubercle.
2. Mandibular component = Head/Condyle of the mandible.
Ellipsoid shape - with a lateral pole and a more prominent medial pole.
Diameter - Mesiolateral ~13-25, Anterioposterior ~5.5-16.
4. TMJ Capsule = a thin sleeve fibrous tissue, with a Synovial membrane inside.
5. Ligaments:
True:
Collateral.
Capsular.
Temporomandibular (horizontal & oblique)
False (accessory ligaments):
Sphenomandivular.
Stylomandibular.
6. Articular disc / Interarticular fibrous biconcave disc, separates the articular space into:
Superior - is bounded above by the Articular fossa & the Articular eminence.
Inferior - is bounded below by the condyle.

Articular eminance shapes (physiologic):

1. Box
2. Sigmoid
3. Flattened
The three shapes of articular eminence :
box - It is a deep fossa with steep posterior slope to the articular eminence .
sigmoid - when the slope is more gentle
flattened - in cases where the articular eminence is flattened .
deformed - in cases where the morphology of the upper component failed to fit
on one of the three previous categories
http://dmfr.birjournals.org/content/29/3/159.full.pdf
http://www.scielo.br/scielo.php?pid=S1806-83242007000300013&script=sci_arttext

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7. Elevator depressors propulsive mandible muscles and auxiliary functions.

Chewing / Masticatory muscles
Muscle

Origin

Insertion

Action

Temporal
- The largest of the
mastication m.

Temporal fossa, temporal

line

Coronoid process of the

mandible.

-Elevates the mandible.

-retracts the mandible at TMJ
to close the jaw.

Masseter
- The strongest of
mastication m.

Zygomatic arch

Masseteric tuberosirty (that is Elevates the mandible

on the lateral surface of the
and moves it laterally ..
mandible in the front of the
angle).

Medial / Internal
pterygoid

Pterygoid fossa of the

pterygoid process.

Medial aspect of the mandibule Elevates the mandible and

at the pterygoid tuberosity.
moves it laterally.

Lateral / External
pterygoid

Sphenoid bone.

Medial aspect of the

mandibular condyle. Articular
capsule and articular disc of
the temporomandibular joint.

-Depresses the mandible.

-Protracts forward the
mandible.

Posterior digastric

mastoid process of the

temporal bone.

An intermediate tendon (from

the muscle) is descended to
the junction between the hyoid
body and the greater horn .

- Depress the mandible .

(pulls hyoid back)

Geniohyoid

mental spines of
mandible

hyoid body

depress the mandible

mylohyoid

mylohyoid line of the

mandible. (from its

hyoid bone

depresses the mandible

and elevates the hyoid

corner of mouth

depress the mandible

whole length ).
platysma

pectoralis and deltoid

More information about anatomy and functions:

1. Mylohyoid (floor of the mouth):
Arises - mylohyoid line of the mandible .
insertion- body of the hyoid bone and median raphe.
Action- when the mandible is fixed the muscle puts the hyoid bone upward and forward .when the hyoid bone is fixed the
muscle help to lower the mandible .
2. Masseter m.

is a thick, Quadrilateral muscle

Consisting of two parts:
Superficial - The superficial part the larger :
Arises : from the zygomatic process of the maxilla, and from the anterior two-thirds of the lower
border of the zygomatic arch
Inserted : into the angle and lower half of the lateral surface of the ramus of the mandible.

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Deep - the deep part is much smaller :

Arises : from the posterior third of the lower border and from the whole medial surface of
zygomatic arch.
Inserted : into the upper half of the ramus and the lateral surface of the coronoid process of the
mandible.
Function: raise the mandible, superficial part of the muscle takes place in the protrusion (oppsite of
retraction) of the mandible.

3. Temporal m.
Largest mastication muscle.
Arises from the temporal fossa, and from the deep surface of temporal fascia. Its fibers end in a tendon,
which passes deep to the zygomatic arch.
Inserted into the medial surface, apex, and anterior border of the coronoid process and the anterior
border of the ramus of the mandible.
Function: contraction of all fibers raise the mandible, posterior fibers retract the mandible from the
protracted position.
4. Internal pretygoid m.
Is a thick, quadrilateral muscle.
Arises from the medial surface of the lateral pterygoid plate. It has a second slip of origin from the lateral
surfaces of pyramidal process of the palatine and tuberosity maxilla.
Inserted into the lower and back part of the medial surface of the ramus and angle of the mandible, as
high as the mandibular foramen.
Function: draws the mandible to the opposite side, bilateral contraction protrudes forward and raise the
mandible.
5. External pterygoid m.
Is a short thick muscle, which extends almost horizontally between infratemporal fossa and the condyle
of the mandible.
Arises by two heads:
An upper from the lower part of the lateral surface of the great wing of the sphenoid
and from the infratemporal crest;
A lower from the lateral surface of the lateral pterygoid plate. Its fibers pass
horizontally backward and lateralward.
Inserted into a depression in front of the neck of the condyle of the mandible, and in the front margin of
the articular disk of temporomandibular joint.
Function: draws the mandible to the opposite side, bilateral contraction of the muscle protrudes the
mandible forward.

http://web.donga.ac.kr/ksyoo/department/education/grossanatomy/doc/html/mandible.html - mandibles

anatomy .
8. Notion masticatory pressure What appliance and units we use for it determination.
Masticatory pressure - Is a force maked by the masticatory muscles when the mastication process of eating on
the individual surface . we use for determination the gnatodinamometer.
By dence: incisors 7-12.5 kg premolars:11.4-18 kg molars: 14.5-21.6 kg
By haber: in males : incisors :25kg canines : 36kg premolars : 40kg molars : 72kg
In females: incisors:18kg canines :22kg premolars:26kg molars : 46kg
http://en.wikipedia.org/wiki/Gnathodynamometer
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2204545/pdf/procrsmed00706-0146.pdf
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9. Enumerate average periodontal resistant coefficient by Haber for male and female.
Practical importance.
By haber:
in males : incisors :25kg canines : 36kg premolars : 40kg molars : 72kg
In females: incisors:18kg canines :22kg premolars:26kg molars : 46kg
10. What is an average muscle force necessary to food preparation? Notion
reserve periodontal force. Practical importance.
By harrilov: The averge force for the act chewing is 9-15kg which is form 0.1 from
the absolute muscles form and its reserve of absolute force and using in critical situation
for breaking something strong (45-102 kg) .
11. Point out general morpho-functional teeth description. Enumerate differentiate
anatomical signs of the teeth.
-cutting the food , tear the food
-keeping the food inside the mouth
-chewing the food
by the anatomical data (sign):
- angles sign
-root sign
-max. Convexity
-by the number and the shape of the crown
12. Incisors, canine, bicusps (premolars) functional morphology. Height of the crown
by Marseler.
In the maxilla
Central Incisors:
10mm
Lateral incisors :
8.8mm
Canines:
9.5mm
1st premolar:
8mm
2nd premolar:
7.5mm

In mandible
8.8mm
9.3mm
9.4mm
8mm
8mm

morphology to explain about the anatomy of teeth .

13. Molars functional morphology. Height of crown by Marseler, and particulartity of
teeth position on upper and lower jaw. Physiological shapes of dental arch.
In Maxilla
and
In Mandible
1st molar : 7.5mm
7.7mm
2nd molar: 7.2mm
6.9mm
3ed molar: 6.8mm
7.1mm
the mesiobuccal cusp of 1st molar of maxillary jaw located in occlusion between the
mesiobuccal and central buccal cusps of 1st molar of mandible.
The 3ed molar the distal cusp of maxillary jaw is free
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14. Notions dental arch, alveolar arch, basal (apical) arch, and its interrelations
between upper and lower jaws.
Dental arch: represents the totality of the dental crowns and the lines of the crowns.
Alveolar arch : represents the line which pass the tops of the alveolar process
Basal arch: line which pass the tops of the roots. Between those arches exist
interrelations:
On the maxilla: dental arch bigger than the alveolar arch
The teeth of the maxilla bent more toward the vestibular direction.
On the manible: the oposite
The form of dental arch is defined by the line ,which pass through the cutting borders of
incisors canines and vistibular cusps of the lateral teeth in the norm the upper dental
arch has form of the halflipse but the lower jaw has the parabela because of this the
special feature of the upper dental arch over lapes the lower dental arch .
15. What factors provide functional dental arch integrity? What is occlusal surface
represents? Occlusal plan (plan of occlusion).
Factors:
-interdental contact.
- alveolar process.
- Paradontium .
- Position of the teeth and direction of the crown and root
Occlusal sueface: is a line which pass through acting the borders of anterior teeth and
Surface of mastication of lateral teeth .
Occlusal plan : which pass over the cutting border of central incisors of the mandible to
the top of te buccal distal cusp of 2nd and 3ed molars.
16. Sagital occlusal curve by Spee. Biological aim of occlusal curves.
The curve is sigment of circumference ,which directs the convexity to the down . owing to
this position of teeth in time of any moving of mandible and there are 3 point of contact :
1 frontal and 2 lateral area of dental arches
this principle is using for making the artificial teeth in time of total adentia (absence of
teeth) .
https://docs.google.com/open?id=0B7TYevjcgCUYmFhMjgxZmQtMDNjZC00MDA4LThhZjYtOTU2MTdlZjNlODNm
page 28
17. What is transversal occlusal curve by Monson Wilson represents? What is
manifestation level depending on? Its purpose .
The curves which conects the (V) and (L) cusps one lateral side to another side of
maxilla and it can be various radius sizes of curve in each semetrical pair which starting
with the 2nd premolar and have a stright line of occlusal surface the 1st premolar have
curved directed to the upper one . the 1st molars have curve and is directed to the
down . the curvature of radius makes bigger
The goal: to use of this method for the staging the artificial teeth in the total adentia .

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18. Notion parodont. Components tissues description. Functions.

Periodontium refers to the specialized tissues that both surround and support the teeth,
maintaining them in the maxillary and mandibular bones.
The following four tissues make up the periodontium:
1. Alveolar bone
2. Cementum
3. Gingiva or gums
4. Periodontal ligament
- componentsa) cells - fibroblasts,cementoblasts,osteoblasts, osteoclasts,epithelial cells (Rests of
Malassez) and defence cells (macrophages, eosinophils and mast cells).
b) fibres - collagen principal fibres (crestal, horizontal, oblique, apical, inter-radicular),
oxytalan/elastin .
functions a) it is the tissue of attachment of tooth in its socket thereby resisting displacing forces on the
tooth and
b) protecting nerves and blood vessels at root apex.
c) it provides the force whereby a tooth attains and maintains its functional position.
d) its cells maintain (and remodel) alveolar bone and cementum.
e) it provides sensory input for jaw reflex activity.

19. Point out the periodontal space width in three known zones. Give a description of
Sharpey fibres group.
Width:1)cervical part-0,25-0,27 mm
2)middle part:- 0,08-0,14mm
3)apical part:- 0,16-019 mm
Principal fibers of the periodontal ligament
The periodontal fibers of the periodontal ligament are primarily composed of bundles of type
I , collagen fibrils. They have been classified into several groups on the basis of their
anatomic location. The following constitute the principal fiber groups of the periodontal
ligament :
1. Alveolar crest fibers
2. Horizontal fibers
3. Oblique fibers
4. Periapical fibers
5. Interradicular fibers

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In addition to the collagen fibers, the periodontal ligament also contains oxytalan fibers that
are related to the microfibrillar component of elastic fibers (They generally run parallel to the
root surface, although they can occasionally insert into cementum.
20. Notion Occlusion, static occlusion, dynamic occlusion, Occlusal
interrelations. Kinds of dynamic occlusion.
Static occlusion
Static occlusion is the contacts between the teeth when the jaw is not moving. The
contacts are points (seen as dots when articulating paper is used).
For example, closing the teeth in intercuspal position (i.e. where they meet best). Which
is bite heaviest on the back teeth Is it evenly spread over all the back teeth Is there
hardly any weight on the front teeth Top
Dynamic occlusion
Dynamic occlusion is the contacts that teeth make when the mandible is moving contacts
when the jaw moves sideways, forwards, backwards, or at an angle. The contacts are not
points, they are lines.
If the grinding their teeth in every direction on piece of articulating paper, you will see the lines
formed by dynamic occlusion
Although the jaw is moved by muscles, the contact lines depend on both the teeth positions
and shapes (obviously), and the shape of the TMJ. These shapes GUIDE the occlusion.
You may have heard the phrases posterior guidance and anterior guidance used when the
mandible moves about in protrusive and lateral excursions .
http://ortstom.odmu.edu.ua/en/methodical-work/3-kurs-5-semestr/98-morfologija-okkljuzionnojpoverhnosti-zubov

21. Notion rest of mandible position. Enumerate passive and active elements
providing rest mandible position. Donders space.
Mandibular position one of the articular position of mandibule due to minimal constriction of
masticatory muscles and total relaxation of mimic muscles.
This position is appeared when the mandibule doesnt participate in chewing, speach. Due to
this position there is interocclusal space between Jaws about 2-3mm. This space can cause
from 1-6 mm to pathological abrasion. In mandibular rest position participate active(tones of
muscles, elevator and depresser) and passive( TMJ,negative pressure on mandibule)element
for determination of mandibular rest position.
They are special test:1)Patient should speak and after finishing of speech the mandible will stop in position of
physiological rest.
2)to say words with a test of wild
3)to say words with c test of silvermann
4)to say words with f test of robinson
5) to count from 60 till 70
6)functional swallowing test .

22. Notion free speech space, and its description. Practical importance.
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For realising of phonetic function is need Free Speech space. The minimum space is created
when patient pronounce s miximum space when the patient pronounce AR.
This space is individual and his size depends on the character of phonation and his space can
change during the life, day and depend in central nerve system .
23. Test Wild, Silverman, Robinson. Importance.
In mandibular rest position participate active(tones of muscles, elevator and depresser) and
passive( TMJ,negative pressure on mandibule)element for determination of mandibular rest
position.
They are special test:1)Patient should speak and after finishing of speach the mandibule will stop in position of
physiological rest.
2)to say words with a test of wild
3)to say words with c test of silvermann
4)to say words with f test of robinson
5) to count from 60 till 70
6)functional swallowing test .

24. Notion central occlusion. Component parts. Point out four signs of central
occlusion (CO).
Central occlusion state with the maximal quantity of the dental contact between dental
arches , occur when face middle line passes between upper and lower central incisors .
Signs:
1. each tooth has 2 antagonists besides lower central incisors an 3ed molar of the maxilla
2.middle line of the face passes between upper and lower central incisors
3.anterior buccal cusps of the 1st molar of maxilla placed between anterior and middle
buccal cusps 1st molar of mandible
4.maxillary arch is wider and over lapse the mandible arch .

25. Notion Occlusion, dental arch interrelations. Give a description of two basic
types of occlusion.
Occlusion : the way teeth relate on closure to the teeth in opposite side
Dental arch interrelation : there are 2 types
1- physiological occlusion
2- pathological occlusion .
physiological occlusion interrelation : between dental arches which named the physiological
occlusion and all function like: chewing ,speeking , esthetic.
There are several types :
1- orthognatic
2- straight occlusion the edges of maxillary frntal teeth make contacts with mandibular
frontal teeth (key occlusion is normal )
3- biprognatic : frontal teeth of maxilla and mandibula with alveolar process have
vestibular slope (key occlusion is normal)
4- opistognat: slope of teeth and all processes in oral direction (key of occlusion is normal)
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pathological occlusion: is characterized by damage of functional chewing ,speeking , esthetic

1- prognatic
2- prognia
3- deep occlusion
4- cross occlusion
5- open occlusion
26. CO (central occlusion) general signs for all teeth and especial for frontal group of
the teeth in orhognatic bite.
Central occlusion from latin-to cotanct, to close. It means static contact between dental arches
not depending from mandibulo-cranion interrelations. Modern conception about occlusionstatic or dynamic contact between dental arches irrespective of the relation between them.
Occlusion situation of the lower jaw at which this or that quantity of teeth is in contact , that
is close . Distinguish four basic kinds of occlusion : central , forward, left lateral, right lateral.
Character of teeth close in the position of central occlusion is called occlusion..
Central occlusion sign at orthognatic occlusion:1) For all teeth
2) For frontal group of the teeth(
-face middle line passes between upper and lower central incisors
-upper frontal teeth cover the lower frontal teeth more than 1/3 .
3) For lateral group of teeth .

27. Signs of CO characteristic for lateral teeth in sagital and transversal plan in
orthognatic occlusion.

28. What plans and directions lower jaw move in? Two groups of lower jaw movements
by Costa.
I. medsagital
II. transverse
III. coronal
IV. parasagital
2. rotation about an axis when the mandible opening (high opening produce about 25mm of
separation of the anterior teeth.
3. protrusion :that the mandible can protrude about 10mm
4. the maximum opening about 50mm
5. lateral movement .
29. Lower jaw movement in sagital directions, point out the value of sagital articular
and incisor movement angles.
The movement in the sagital direction is made by constriction in both sides of lateral
pterygoid muscle and anterior bandle of temporal muscle ., for this movement in
occlusion the teeth will not make contacts . in this case mandible incisors slides on
palatine surface of maxilary incisors till make contacts between edges of frontal teeth .
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the way which pass the mandibullary incisors on the palatine surface of maxillary incisors
whish named the sagital incisors way
The line of this way crosses the occlusion and makes the incisor angle about 40-50.
The way whish passes condyle on slide of articular eminens named sagital articular way
about 1cm this way make angle with occlusal surface about 33 dgree
Importance: 1. the relationship between the frontal and posterior teeth
2. for regulation of articulator .
30. Lower jaw movements in vertical and transversal plans. Posselt diagram. point out
angles of transversal articular and incisors movement. Practical importance. Give a
description of working side (WS) and non-working side (NWS or balance side).
Movement in vertical plan (opening and closingof the mouth )
Opening: happen with help of anterior digastric muscle at the degining of the opening the
condyle rotating about the transversal axis the maximum oening when the condyle with
the articular disc slide in the articular eminens
Closing: with helping of costriction of the muscles of mastication temporal and medial
pterygoid muscles.
Movement in transversal plan : constriction of lateral pterygoid muscle just in one side
ande the opposite side of the moving
The side where the mandible is moving called working side
The opposite side called balance side
Posselt diagram: the grafical image of the mandible

the condyle on working sides makes rotational moving about vertical axis and on the
balance side the condyle go up and down on the slide of articular eminens
the way passed of the condyle called the transversal articular way and make angle 16
dgree till 17 dgree
in time of the moving :
on the working side present contact of the same teeth (buccal cusps of the maxillary
jaw contact with the buccal cusps of the mandible
on the balance side the different contacts (palatine cusps of the maxilla with the buccal
cusps of the mandible
the intraincisor point : make angle =110 dgree moving of this point in both sides .

31. Give a description of masticatory movement by Gysi.

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There are 4 phases in the time of mastication :

1. 0 phase- which be without moving and the movig start from the central
occlusion
2. first phase opening mouth and moving mandible forword
3. second phase- moves of mandible to the sides right and left
4. thired phase close the muoth in the lateral occlusion
5. forth phase- come back the mandible in 0 phase to central occlusion

32. Articulators. Structure. Medium values of Bonwil triangle and structure index of
stomatognat system included in articulator.
The articulaor D/F: is a mechanical device which casts of the maxillary and mandibular teeth are fixed and
reproduces recorded positions of the mandible in relation to the maxilla. An articulator assists in the fabrication of
removable prosthodontic (dentures), fixed prosthodontic restorations (crowns, bridges, inlays and onlays).
TYPES OF ARTICULATORS:
1. Semi-adjustable articulator An articulator which is adjustable in one or more, but
not all of the following areas: condylar angle, Bennett side-shift, incisal and cuspid
guidance, and shape of the glenoid fossae and eminintiae
2. Anatomical articulator: attempts to reproduce normal mandibular movements during
mastication.
3. adjustable articulator : accommodate the many movements and positions of the mandible in
relation to the maxilla as recorded in the mouth.
4. simple articulator
5. universal articulator
*Arcon = articular surface + Condyle
1. Non-ajustable
2. Semi-ajustable
a. Arcon
b. Non-arcon (condylar)
3. Fully ajustable
bonwill triangle: an equilateral triangle ( ) formed by lines from the contact points of the lower
central incisors (or the median line of the residual ridge of the mandible) to the mandibular condyle on each side
and from one condyle to the other .
this triangle is 4 inch (10 cm) for a side .

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33. Occludators. Structure Disadvantages.

,
The simple-hinge articulator (so-called occludator) is the simplest type of articulator. It does not allow
latero- pulse movements;

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The simple-hinge articulator (so-called occludator) is

the simplest type of articulator. It does not allow lateropulse movements; it allows only the hinge
closing movement. The casts in a simple-hinge articulator are in the relationship of the maximum
intercuspidation. The relationship of both occlusal planes to the skull is random
in all the three planes of space. The upper occlusal plane
is roughly parallel with the upper arm of the device. The
relationship of occlusal planes to the joint is indistinct
and the error of the relationship is often extended in the
so-called "crown occludators" with the non-anatomical
position of the joint axis of the device. The extent of this
error is largely eliminated in case of the so-called occludators, devices with single hinge joints that
respect the
Bonwill triangle .
http://www.orthodont-cz.cz/modul/casopis_clanek/soubory/Clanek-Ortodoncie-02-2006-02.pdf
Biomaterials

34. Notion prosthodontic technique and Biomaterials. Medico-biological

requirements to dental materials.
Biomaterial - Synthetic or natural material suitable for use in constructing artificial organs and
prostheses or to replace bone or tissue.

requirements to dental materials.:Is divided in two groups :

1)basic
2)axillary
1)basic:- or construction materials . Prosthetic metals, plastic and ceramic mass
2)axillary:- material use in laboratory for manifacturing of the models, wax
composition, ,instrument and material for polishing
The requirement for dental material:1)not be toxic for the oral cavity
2)without taste smell
3)To have a good technology, properties
4) to be mechanical strong and maintain form and volume
5) not make allergic reaction
35. Noble alloys using in prosthodontic , give a description of 900Au probe and 750
Au+Pt (platinum) alloys.
Indication of noble allys:Using for manifacturing of stamp and casting crown and bridge, and abutment for future metal
ceramic Crown/bridge denture
-900Au probe:Consist of
-90% Au
-4% silver
-6% Cu
Temperature:
1000-1040 celcius for stamp and casting crown
1070-1200 celcius 750 Au using in soldering of ceramic from Au Temperature 790-810
*For making the Au crown stronger:Add pt (750-Au+Pt) .
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36. Half noble alloys, Non-noble alloys, its description. Destination. Corrosion.
Noble alloys contain at least 25% by weight of noble metal. This can mean gold, palladium or
silver. Any combination of these metals totaling at least 25% places the alloy in this category.
They are the most diverse group of alloys. They have relatively high strength, durability,
hardness and ductility. They may be yellow or white in color. Palladium imparts a white color,
even in small amounts. Palladium also imparts a high melting temperature .
37. Classification of non nobel alloys by Craig for m/c.
Nickel-chromium alloys
These contain at least 60% nickel, and may contain a small amount of
carbon (about 0.1%) as a hardener. They also can contain either >20%
chromium or <20% chromium with or without beryllium. These are used
now mostly for removable partial denture frameworks.
Cobalt-chromium alloys
These are a nickel free alternative to the nickel-chromium alloys. They
seem to have become the most commonly ordered type of base metal for
removable partial denture frameworks. They can also be used for PFM
framework fabrication as well. The major problem with this formulation
is that it is more difficult to work with than the nickel-chromium alloy
due primarily to its high melting temperature. This necessitates the use
of specialized casting equipment. This alloy's high hardness and low
ductility also make it difficult to finish and polish.

38. Process of alloys structure moulding. What alloys according to its structure have
more higher quality and why?. Alloys structure net and its practical importance.
High noble alloys have a minimum of 60% noble metals (any combination of gold,
palladium and silver) with a minimum of 40% by weight of gold. They usually contain a
small amount of tin, indium and/or iron which provides for oxide layer formation which in turn
provides a chemical bond for the porcelain. High noble alloys have low rigidity and poor sag
resistance. They may be yellow or white in color. There are three general types of High noble
alloys:
Gold-Platinum alloy
Developed as a yellow alternative to otherwise white palladium alloys,
these can be used for full cast as well as metal-ceramic restorations.
More prone to sagging, they should be limited to short span bridges. A
typical formula is Gold 85%; Platinum 12%; Zinc 1%; silver to adjust the
expansion properties (in some brands).
Gold-Palladium alloy
Can also be used for full cast or metal-ceramic restorations. Palladium
has a high melting temperature, and even fairly small amounts of it will
impart a white or gray color to the finished alloy. The palladium content
reduces the tendency of the casting to sag during porcelain firing. These
alloys usually contain indium, tin or gallium to promote an oxide layer.
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A typical formula is Gold 52%; Palladium 38%; indium 8.5%; Silver to

adjust the expansion properties (in some brands).
Gold-copper-silver-palladium alloys
These have a low melting temperature and are not used for metal-ceramic
applications. They contain silver which can cause a green appearance in
the porcelain, and copper which tends to cause sagging during porcelain
processing. A typical composition is Gold 72%; Copper 10%; Silver
14%; Palladium 3% .

39. Demands to soldering alloys. Point out the soldering alloys components for
dentures that are manufactured from Cr-Ni and Au alloys.
- Component for dentures that are manufacturing from Cr-Ni and Au alloys
- 1) for noble alloys Au 750, paladii 140
- 2)for non-noble alloys-solder of silver consist of silver , Cu, Zn magnesium, Ni
and other PSR-36,40
- -In time of sodering must has temperature of melting no less than 50-100 celcius
then melting of details which soldering.
- Have enough anticorosion propertis and the colour be equal of soldering alloys.
Cr-Ni+Fe :- for making clasps elastic arches
-cr.Ni-alloys :
1)microlit
2)Crovan .
For making skelet of complete and partial removabial denture .

40. Acryls. Acryl components using in prosthodontist acryl classifications according to

type of cure. Monomer characterization.
CURE AND ACRYL: is a senthetic materials which get be the condensaton and
polymerization in the factory .
Classification of cure:
1. thermoplastic : in time of heating cure become plasty after return
hard
2. thermoreactive : in time of heating from plastic condition to hard
condition
3. thermostable: in time of heting cure dosent transfer into plastic
condition
cure in the bace of acryl:
consist of monomer and polymers:
-metacryl acid .
-butacryl acid .
- etacryl acid .
the most spred acryl is PMMA and polymethacryl .
41. Kinds of hot cure acryls. Cure condition. Indications.
-classic hot acryl .
- using the pathy in glasarin in tempreture of 120 c
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- liquid and powder for 1min

- sand stage 2min
- fiber stage 3min
- dough stage : fix: white color and removable rose
color for 1 hour
- hardening stage
materials: sinma acrel -ethacryl -ftorax .
42. Kind of cold cure acryls. Components and indication. What represent peroxoid of
benzoil.
Similar with the hot cure but eith small difference like pressuer and tempreture
The dough : fix with white color and removable with rose color
Names of materials : duracryl carbodent - portacryl redont
Indications: - temporary crown
- reline for repare the denture
- fixing.
43. Kids of elastic acryls. Components and indication
The elastis acryl after polymerization have the same level of elasticity by mean they are
not absolute hardly .
Names of material: valplast elastomer -verone orthosil -hydrocryl elastoplast elastent 100 .
44. Creamic. Point out it components. Using classifications
The contents :
1-quartz -silicon dioxide
2- white clay
3- dye stuff : Fe ,metalotetan oxide
4- feldspar : without color alumoselecates like K Na Ca
ceramic : this is a ceramical natural product which produced by burning
classification :
1. ceramic for tiling metal parts of the denture .
2. ceramic for making without metal details : crowns ,inlay, teeth .
45. Medical biological requirements for impression materials.
1.
2.
3.
4.
5.
6.
7.
8.
9.

Reasonable working and short sitting time

Adequate flow proprieties
To be cheep
To have a nice colour, good smell and taste
Easily applied and removed on prosthetic field
Quickly become hard and have essential elasticity in oral cavity
To have hardnedd and elasticity after making impression
Without deformation in time of machining impression
The material should clearly imprint to prosthetic field

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46. Impression materials classifications by Oxman, Napadov, Postolachi-Birsa. Give an

example of one representative in each group.
Impression materials classifications by Oxman, Napadov, Postolachi-Birsa. Give
an example of one representative in each group.
- material classification
Oxman:-1)crystalic (gypsum dental repin)
2)termoplastic (elastic in time of boling in the oral cavity-become hard), stens, orthocor
3)elastic alginat
4)autoharding cure
Napadov:1)hard
2)termoplastic
3)elastic
Clasification by postalchi Birsa
1)Elastic:a)reversible hydrocoloid (helon, dentakol)
b)non-reversible hydrocoloid (pen, chrompan, elstic)
c)sinthetic elastomers
-selicon(sielot, xantopren, optosil, dentaflex)
-polysulfate materials(tiodent, surflex)
-polyether materials (impregun, polygel)
2)hard material:-reversible-termoplastic masses .
-non-reversible-crystalic material (gypsum) .

47. Materials for model stones. Description. Technique of their manufacturing.

-divided in :1)metalic:-easymelting alloys
2)non metalic
--gypsum
-hard gypsum like moldane, moldarok
-super hard gypsum
tech

48. Kinds of waxes. Classification by origin and indications.

Wax is very often used in dentistry at the manifacturing of dentures( in laboratory steps and
also in clinical step). In general in this case is not used pure wax but different combinations
Known as dental wax. Classification There are:
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-natural, synthetic, and modificators

1)Natural wax:-by animal origin: bee wax, wool wax, China wax
-by vegetal origin: Carnauba wax(palm tree leaft), Japan wax(from fruits), Candelin
wax(herbal)
-by mineral origin: paraffin, ozokerit, Mountain wax, Cerzit.
2)Synthetic Wax:This group includes varieties of wax obtained as the result of chemical reactios or as the
result of chemical changing of natural wax.
Here are:- Avax, Acrosol, Durawax 1032, Aldo 33, Epolene
3)Modificators:There are different substances which adheres to the wax masses and change their physical,
chemical, and mechanical propereties. As modificators can be used: colofonium, Kopal,
Sandarac, colorants, Colofonial, ether, Elvax
Indication:1)For making model of base of removable denture
2)For making wax composions non-removable prosthesis
3)For making frame of bugel prosthesis
4)Casting wax
5)Sticky waxes
6)For making waxing for inlay, onlay, crow, and bridge denture

49. Point out basic waxes components and its influence on properties
Components:Organic formation
-2 atoms alcohol and compound fatty acids
-Hydrogen
Properietes:1)Plastic
2)Hydrophobic (not disolved in water)
3)Soluble in fats, chloroform,benzin, and mild alcohol

50. Grinding materials classifications used in prosthodontist by origin and indication.

Grinding materials for denture preparations and polishing.
Grinding materials:
Used for preaparation and polishing in prosthetic field. It can use for grinding of :
1)metal
2)ceramic
3)acryl
4) and for teeth preparation
*for preparation and polishing use diamond, stones, burs, disk
By origin:
1)diamond
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2)synthetic
3)metal
4)disk
5)stons

51. Notion impression. Impression classifications. Stages of taking out the

impression in two steps. Impression trays variety and demands to them.

52. Indications for coronary odontal lessions treatment with fixed unidental dentures.

53. Clinical, morphological and functional aspects of coronary odontal lessions.

Varieties of teeth hard tissue pathology which cause morfological and functional
disturbances.

54. Notion inlay. Classification by indication and design. Methods of inlay

manufacturing.

55. Demands to cavity under inlay. What is reason of indirect method of inlays
manufacturing? Enumerate clinic-laboratory stages

56. Notion artificial crown. Classification upon use material, indication and
manufacturing technique.

57. Enumerate the requirements for artificial crowns. Ground necessity of teeth
preparation as abutment.

58. Enumerate clinic-laboratory stages of stump crown manufacturing by mix method.

59. Describe three methods of stump crowns manufacturing.

60. Clinic-laboratory steps of casting crowns manufacturing.

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61. Mix crowns, component parts, materials used for manufacturing. Kinds of mix
crown based on stump crown with acryl facet.

62. Clinic-laboratory steps of mix (casting M/A) crown manufacturing. Kinds of

elements for retention.

63. Clinic-laboratory stages for acryl and ceramic crowns manufacturing.

64. Ground particularity of model stones manufacturing and necessity of Pt (platinum)

cap making for ceramic crown.

65. Types of ceramic fused to metal crowns. Clinic-laboratory steps of making.

66. Dowel crown. Components parts. Classifications.

67. Clinic-laboratory steps of simple dowel crown manufacturing.

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Partial denture

68. Definition partial denture. Kennedy classification.

69. Prosthetic elements description in partial edentia.

70. Bridge denture definition. Point out its parts. Give a pontic classification
according to alveolar ridge relationships.

71. Indications for partial edentia treatmnet with dental bridges.

72. Types of retainers use for bridge denture. Bridge denture classification by
Kopeikin.

73. Bridge denture classification by materials, fixation methods, by manufacturing

technique and design particularity. Describe the necessity and teeth preparation
particularity under bridge denture treatment.

74. Bridge denture parts making ready for soldering. Soldering technique.

75. Chemical bridge denture preparation after soldering process. Cleaning chemical
solution components (bleach) for bridge denture from noble and half noble alloys.

76. Clinic-laboratory steps (monolith) non-physiognomic casting bridge denture

manufacturing. Model stones manufacturing particularity.

77. Clinic-laboratory steps of M/C or CFM (Ceramic Fused to Metal) and M/A bridge
denture manufacturing.

78. Inzoma Wax model framework making technique for M/A bridge denture.

79. Clinic-laboratory steps of acryl and ceramic bridges dentures manufacturing.

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80. Describe a fusing of ceramic to metal.

81. Clinical aspects and componentelements characterization of prosthetic area in

extended partial edentia .

82. Indications for partial edentia treatment with acryl removable dentures.

83. Prosthetic area elements for partial edentia treatment with removable dentures.
Varieties of artificial teeth.

84. PARD border on upper and lower jaws

85. Clasps, clasp parts. Classification.

86. Give a description of special systems for fixation, stability, fastening of PARD.
87. Give a description of ring clasps Jackson and Adams. Indication.

88. Give a description telescopic system for PARD fixation

89. Enumerate clinic-laboratory steps of PARD manufacturing in second clinic situation

when high of occlusions is stable.

90. Give an occlusal rims and using materials description. Demands.

91. Clasps lines. Description. Principle of artificial teeth arrangement in PARD.

92. Artificial teeth arrangement in PARD with artificial gingiva, without artificial gingiva
and mix type. Ceramic teeth arrangement particularity.

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93. Component parts of flask. Describe methods of PARD fixation in flask.

94. PARD processing and polishing. Devices, tools and materials.

95. Laboratory stages removable denture manufacturing with metal major connector
or with classic acryl layer. Indication.

96. Indications for prosthetic treatment with Partial Arch Removable Denture.

97. Components of Partial Arch Removable Denture. Describe the types of major
connectors and there position on upper and lower jaws.

98. Casting clasps classification by Rindasu and requirements to casting clasps by

Lejoyeux.

99. Enumerate component parts of Ackers and Bonwill clasps and there position on
abutment.

100. What are represents the minor connectors in Arch Removable Denture, and
what kinds of clasps we will accord those criteria?

101. Describe the I-st type of Rouch clasps (GLUSTIR) and the II-nd type of Rouch
system too.

102. Component parts of Ackers clasps and pointed out there position on abutment.
Ney clasps. Characteristic.

103. Continuous clasps. Point out its size (dimension) and position on abutments.
Indication.

104. Kinds of connection between retainers elements and saddles (or connector).
How functional force spreads?

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105. Describe the attachment and stud-bottom systems, components parts and
there using in Arch Denture.

106. Stress-breaker system using in Arch Denture and its main function

107. Paralelograf. Structure. Destination.

108. Characteristic and succesion of study stages in paralelograf.

109. AR insertion and (pull out) disinsertion axis. Varieties. Its determination
methods

110. Methods of prosthetic equator determination for ARD manufacturing. Varieties

by topography. Practical importance.

111. Methods of retention zone determination for ARD manufacturing. Practical

importance.

112. Model stones preparation for making a duplicate model (from refractory or hot
resisting materials) for ARD manufacturing. What is point of refractory (duplicate)
model making?

113. Type of waxes use for Arch denture wax framework. What is the reason of wax
framework making?

114. Clinic laboratory stages of ARD manufacturing with cast framewok.

115. Metal framework of AD disadvantages in case of manufacturing by soldering

method.

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Complete denture

116. Definition prosthetic area of edentulous patient. Description of bearing zones

both jaws.

117. Clinical aspects of totally edentated prosthetic area. 26

118. Alveolar ridges classification of edentulous patient by Schroder, Koller

Lejoyeux. Practical importance.

119. Enumerate clinic-laboratory stages of Complete Removable Denture

manufacturing.

120. Ground the necessity of individual tray manufacturing for taking impression
stages of complete edentulous patient.

121. Materials use for individual tray making. Two methods of wax individual tray
manufacturing on preliminary cast.

122. The individual tray manufacturing technique from hot cure acryl.

123. Requirements for occlusal rims for edentulous patients. Point out their
dimensions.

124. Lines that should be marked on occlusal rims for artificial teeth arrangement
on casa of complete edentulous patient.

125. Artificial teeth arrangement rules by Gysi for edentulous patient.

126. Artificial teeth arrangement by Pedro Saizer, Vasiliev methods.

127. Full prostheses (denture) with elastic layer manufacturing technique.

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Enumerate elastic acryl materials.

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Examination

128. Patient examinations methods in prosthetic department.

129. Ground patients complain in prosthetic department. Describe disease history

and family history chapter, and its practical importance.

130. Order of clinic extraoral patient examination in prosthetic department.

131. Order of clinic intraoral patient examination in prosthetic department. Order of

clinic teeth examination. Importance.

132. Kinds of teeth notation: FDI, American, English-Saxon. Examples. Importance.

133. Describe physiological and pathologic teeth mobility according to their level
and clinic methods. Clinic importance.
134. Partial and complete edentulous alveolar ridge with oral cavity mucosa
examination.

135. Description of static and dynamic methods and masticatory efficiency

determination. Point out Agapov coefficient.

136. Diagnosis component parts in prosthodontics. Examples. General and local

indication and contraindication for prosthetic treatment.

137. Types of teeth hard tissues pathology caused by carries and non-carries origin.

138. Types of dental arch pathology intercalated by teeth absence .

139. Subjective and objective symptoms of dental disease that need prosthetic
treatment.

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140. Intraoral objective symptoms teeth hard tissue and periodontal lesion.

32