Appliance design and application

Self Instruction Exercise No. 320
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Exercise No. 320
Subject Code: 185
Appliance Therapy

The 15 questions for this exercise are based on the article Appliance design and application on pages e359-e377. This exercise was developed by Thomas C. Johnson, DMD, MAGD, FICOI, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing the exercise will enable you to understand:

  • the need for advanced, evidence-based training in appliance selection and use;
  • the benefits to patients of the various appliances;
  • the side effects of different appliances; and
  • the importance of realistic patient expectations related to appliance therapy.

Answers for this exercise must be received by October 31, 2013.

  1. Which of the following factors makes interpretation of the results of appliance studies difficult?

    A. A homogenous pool of patients
    B. Standardization of treatment outcomes
    C. Clear definitions of pathologies
    D. Multifaceted pathologies

  2. Some appliances may be used for bruxism but not for pain cases. Appliances may have side effects, damaging parts of the masticatory system.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  3. Which condition will require an orthotic with a design and accuracy that requires advanced training?

    A. Periodontal protection
    B. Trauma with joint effusion
    C. Clenching and grinding with no pain or joint damage
    D. Osteoarthritis

  4. Which is the most prevalent form of parafunction?

    A. Clenching
    B. Bruxism
    C. Dystonia
    D. Tongue thrust

  5. The orthotic appliance is versatile and may be used with all of the following conditions except one. Which is the exception?

    A. Osteoarthritis
    B. Completely displaced disc
    C. Nocturnal bruxism
    D. Joint trauma with effusion

  6. All of the following design components are characteristic of the orthotic appliance except one. Which is the exception?

    A. Evenly supported posterior contacts
    B. Posterior directing ramp
    C. Flat plane posterior
    D. Shallow anterior guidance

  7. A small percentage of patients will have increased parafunctional activity with appliance use. This reflects the multifactorial nature of articular disc disorders.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  8. Which appliance is contraindicated with a moderate to large discrepancy between centric relation and maximum intercuspation?

    A. Soft/hard
    B. Segmental
    C. Neuromuscular
    D. Aqualizer®

  9. Which appliance may be used to decrease muscle activity and deprogram muscles?

    A. Aqualizer®
    B. NTI
    C. Soft/hard
    D. Suckdown

  10. Load testing the jaw joint can help diagnose a completely displaced disc and osteoarthritis. The NTI appliance decreases joint load and will relieve pain with these cases.

    A. Both statements are true.
    B. The first statement is true; the second is false.
    C. The first statement is false; the second is true.
    D. Both statements are false.

  11. Which is a common side effect of soft material appliances?

    A. Posterior interferences in mandibular excursions
    B. Supereruption of posterior teeth
    C. Posterior open bite
    D. Growth of redundant retrodiscal tissues

  12. All of the following should be goals of therapy for MPD/TMD except one. Which is the exception?

    A. Improve the function
    B. Stop the clicking
    C. Stop the progression of the disease
    D. Reduce the pain

  13. All of the following are side effects of long-term use of an anterior repositioning splint except one. Which is the exception?

    A. Permanent posterior open bite
    B. Redundant retrodiscal tissue
    C. An increase in posterior superior joint space
    D. Posterior interferences in mandibular excursions

  14. Which of the following is synonymous with the neuromuscular device?

    A. Orthotic appliance
    B. NTI appliance
    C. Gelb/ARS
    D. Posterior segmental

  15. An anterior repositioning splint (ARS) can be used as an acute trauma appliance by pulling the condyle away from inflamed retrodiscal tissue. How soon should the patient be transitioned out of the ARS to avoid permanent joint changes?

    A. 1 week
    B. 1 month
    C. 90 days
    D. 6 months


Evaluation

Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent

Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
Did this exercise achieve its objectives? Yes No
Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins


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