2. Occlusion Flashcards
What is occlusal trauma
Injury causing changes in attachment apparatus as a result of occlusal forces
Major causes of primary occlusal trauma
Parafunction, Iatrogenic ( high restorations): Degree, duration and direction of forces
What are the clinical and radiographic signs of occlusal trauma
Mobility, Widened PDL, Crestal bone loss (vertical without loss of CT), Fremitus
Difference between frontal and rear resorption
Frontal: Along surface of bony socket assoc with lighter forces. Rear: In marrow spaces and more severe forces
What are the adaptive changes that occur
Widened PDL due to bone resorption at socket wall, this prevents vascular damage. Increase tooth mobility
What happens in an environment free of inflammation with occlusal trauma
Physiologic adaption. No loss of attachment, wide PDL, Crestal bone loss
What is Millers classification of mobility
- Less than 1 mm B/L
- 1-2 mm B/L
- Vertical component to mobility
What happens in an environment with inflammation present with occlusal trauma
Physiologic adaption does not occur. Increase mobility, increased widening of PDL, increased rate of CT loss (yes according to the Sweedish, NO according to the yanks).
What is Glickmans Co Destructive theroy
Some studies show that occlusal trauma worsens periodontal disease. But we can’t do the experiment to prove it ethically.
He feels that occlusal trauma alters the alignment of the trans septal fibers, thus allowing inflammation spread to the PDL spaces with resultant intra bony pocket formation.
What happens if you remove excess occlusal force in an inflamm free environment
Adaptive changes will reverse: reduce mobility, decrease PDL width, reform crestal bone that was lost.
What is bone loss without CT loss
Occlusal trauma
Are teeth with occlusal trauma more susceptible to inflamm periodontal disease
No.
Does occlusal force alter the pathway of inflammation
Controversial. Waerhaug says inflammation from supracrestal CT to bony crest and does Not enter PDL space
Are some patients more susceptible to combined effects of inflamm and increased occlusal force
Yes
What effect does plaque have on bone restoration
It inhibits it
What effect do supracrestal inflamm have on resolution
May prevent adaption to jiggling forces
Do infrabony pockets apply occlusal trauma
Not always
Can healing occur with hypermobility
Yes
When can one determine the aetiology of traumatogenic occlusion
Not until plaque induced inflamm eliminated. Why you do SRP before adjustments
All vertical defects are what
Infrabony
How do you decide when to do occlusal adjustment
Is mobility increasing. Positive fremitus with occlusion. Pt is uncomfortable. Does the operator have the skill.
What is fremitus
Functional tooth mobility
Are radiographs useful in assessing occlusal trauma
Yes; you can see the crestal bone changes
When does one perform occlusal therapy
After inflamm resolved. When you have seen pt several times and you know whether it is increasing or decreasing.
