Comprehensive restoration and mandibular incisor esthetic exposure: a clinical report

Self-Instruction Exercise No. 340
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Exercise No. 340
Subject Code: 250
Operative (Restorative) Dentistry

The 15 questions for this exercise are based on the article, Comprehensive restoration and mandibular incisor esthetic exposure: a clinical report, on pages 59-65. This exercise was developed by Thomas C. Johnson, DMD, MAGD, in association with the General Dentistry Self-Instruction committee.

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

  • the guidelines and criteria for the length and inclination of mandibular incisors;
  • a technique for establishing and testing mandibular incisal length and the incisal plane; and
  • the video method to evaluate esthetic exposure of the mandibular incisors.

Answers for this exercise must be received by October 31, 2014.
  1. Where should the relaxed lower lip contact the lower incisors?

    A. 1-2 mm inferior to the incisal edge
    B. centered in the middle one-third
    C. at the junction of the middle and gingival thirds
    D. at the junction of the incisal and middle thirds

  2. According to the 2007 van der Geld et al reference, how much lower incisor length is exposed during speech?

    A. 2.5 mm
    B. 4.3 mm
    C. 6.6 mm
    D. 7.0 mm

  3. According to da Motta et al, which group has the most exposure of lower incisors with lips at rest?

    A. young men
    B. older men
    C. young women
    D. older women

  4. The Pankey-Mann-Schuyler method of occlusal reconstruction involves restoring the mouth in a particular sequence. What is that sequence?

    A. maxillary anteriors, maxillary posteriors, mandibular anteriors, mandibular posteriors
    B. mandibular anteriors, maxillary anteriors, maxillary posteriors, mandibular posteriors
    C. mandibular anteriors, maxillary anteriors, mandibular posteriors, maxillary posteriors
    D. maxillary anteriors, mandibular anteriors, mandibular posteriors, maxillary posteriors

  5. More than _____% of the time, during resting and speaking facial expressions, the mandibular anterior teeth are found to be _____ visible than the upper anteriors.

    A. 50; less
    B. 50; more
    C. 75; less
    D. 75; more

  6. The average length of a mandibular incisor may not be an accurate guideline for a correct incisal plane height. The standard speaking space of <1 mm is a reliable guide for determining mandibular incisor height.

    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.

  7. The orthodontic treatment plan for the patient included

    A. intrusion of the maxillary teeth.
    B. LeFort I maxillary arch impaction.
    C. autorotation of the mandible to close the anterior open bite.
    D. bilateral palatal temporary anchorage devices.

  8. The patient’s video measurements were 2.68 mm in repose and 6.07 mm during speech. The difference between these is a good example of a patient with less than average activity of the lips.

    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.

  9. Which dimension of mandibular incisor esthetic exposure is most critical?

    A. when speaking
    B. relaxed smile
    C. forced smile
    D. in repose

  10. Compensation for a mandibular incisal plane with excessive height may include which of the following?

    A. distorted palatal contours for anterior guidance
    B. steep anterior guidance
    C. extension of the maxillary incisal plane
    D. mandibular protrusion during speech

  11. The literature describes a limited range of esthetic exposure values establishing specific guidelines. Conversely, there is a wide range of lip mobility creating different amounts of display with a correct incisal plane.

    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.

  12. Which of the following is true regarding the patient’s mandibular gingival margins?

    A. They needed no correction.
    B. They were corrected through periodontal surgery.
    C. They were elevated due to dental attrition.
    D. They were corrected via orthodontic forced eruption.

  13. Digital videography permits a dentist to view all of the following parameters except one. Which is the exception?

    A. lip function
    B. esthetic exposure of teeth
    C. arc of closure interferences
    D. the incisal plane and tooth arrangement

  14. A diagnostic wax-up and trial equilibration of diagnostic casts, verified in centric relation (CR), are used to create all of the following except one. Which is the exception?

    A. reduction guides
    B. trial incisal edge
    C. correct incisal exposure
    D. provisional restorations

  15. At what stage of the restorative process was digital videography used to evaluate esthetic exposure, speech, and lip activity?

    A. pre-orthodontic planning
    B. before and after orthodontics
    C. after long-term wear of the provisionals
    D. at the time of try-in of the provisionals

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
 
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Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins

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