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Keeling Spring Textbook > 2. Occlusion > Flashcards

2. Occlusion Flashcards

1
Q

What is occlusal trauma

A

Injury causing changes in attachment apparatus as a result of occlusal forces

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2
Q

Major causes of primary occlusal trauma

A

Parafunction, Iatrogenic ( high restorations): Degree, duration and direction of forces

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3
Q

What are the clinical and radiographic signs of occlusal trauma

A

Mobility, Widened PDL, Crestal bone loss (vertical without loss of CT), Fremitus

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4
Q

Difference between frontal and rear resorption

A

Frontal: Along surface of bony socket assoc with lighter forces. Rear: In marrow spaces and more severe forces

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5
Q

What are the adaptive changes that occur

A

Widened PDL due to bone resorption at socket wall, this prevents vascular damage. Increase tooth mobility

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6
Q

What happens in an environment free of inflammation with occlusal trauma

A

Physiologic adaption. No loss of attachment, wide PDL, Crestal bone loss

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7
Q

What is Millers classification of mobility

A
  1. Less than 1 mm B/L
  2. 1-2 mm B/L
  3. Vertical component to mobility
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8
Q

What happens in an environment with inflammation present with occlusal trauma

A

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).

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9
Q

What is Glickmans Co Destructive theroy

A

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.

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10
Q

What happens if you remove excess occlusal force in an inflamm free environment

A

Adaptive changes will reverse: reduce mobility, decrease PDL width, reform crestal bone that was lost.

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11
Q

What is bone loss without CT loss

A

Occlusal trauma

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12
Q

Are teeth with occlusal trauma more susceptible to inflamm periodontal disease

A

No.

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13
Q

Does occlusal force alter the pathway of inflammation

A

Controversial. Waerhaug says inflammation from supracrestal CT to bony crest and does Not enter PDL space

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14
Q

Are some patients more susceptible to combined effects of inflamm and increased occlusal force

A

Yes

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15
Q

What effect does plaque have on bone restoration

A

It inhibits it

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16
Q

What effect do supracrestal inflamm have on resolution

A

May prevent adaption to jiggling forces

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17
Q

Do infrabony pockets apply occlusal trauma

A

Not always

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18
Q

Can healing occur with hypermobility

A

Yes

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19
Q

When can one determine the aetiology of traumatogenic occlusion

A

Not until plaque induced inflamm eliminated. Why you do SRP before adjustments

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20
Q

All vertical defects are what

A

Infrabony

21
Q

How do you decide when to do occlusal adjustment

A

Is mobility increasing. Positive fremitus with occlusion. Pt is uncomfortable. Does the operator have the skill.

22
Q

What is fremitus

A

Functional tooth mobility

23
Q

Are radiographs useful in assessing occlusal trauma

A

Yes; you can see the crestal bone changes

24
Q

When does one perform occlusal therapy

A

After inflamm resolved. When you have seen pt several times and you know whether it is increasing or decreasing.

25
Q

Do you do surgery before treating occlusal trauma

A

No; Surgery will remove the granulation tissue that may have osteogenic potential

26
Q

What is physiologic occlusion

A

Anatomic Malocculsion

27
Q

What is pathological occlusion

A

Evidence of disease attributable to occlusal activity

28
Q

What is primary occlusal trauma

A

Excessive force on tooth with normal perioodntium

29
Q

What is secondary occlusal trauma

A

Normal or excessive forces on a tooth with reduced periodontium

30
Q

What happens in PDL injuries

A

Hemmorhage, Vasodilation, Loss of collagen, increased osteoclast and physiologic adaption

31
Q

Who were the 2 big research groups in occlusal forces

A
  1. Sweedish- used beagle dogs with a bar. 2. Americans used squirrel monkeys.
32
Q

What did the Scandinavians say about occlusal trauma in health

A

increase in mobility with widened PDL, loss of bone, reduced collagen and increased cellular elements, changes occured for 60 days then stabilized. The Americans agree with this.

33
Q

What did the Scandinavians say about occlusal trauma in periodontal disease patients

A

No physiologic adaption and increased bon loss and mobility. Americans not agree no increase in attachment loss.

34
Q

What did the Scandinavians say about occlusal trauma in patients in periodontal health on a reduced periodontium.

A

No different than normal periodontium

35
Q

Does occlusal trauma alter direction of perio destruction

A

Wienmann: No it spreads by blood vessels
Glickmann: Occlusal trauma changes direction of periodontal disease onto the periosteal side of bone.

36
Q

2 zones of co-destructive theory advocated by Glickmann

A

Zone of irritation: Inflamm occurs unaffected by occlusal trauma
Zone of Co-Destruction: Inflamm occurs from occlusal forces and gingival inflammation meets it.

37
Q

Does mobility alter treatment outcomes

A

Trejo: No
Schulz: Rigid splints increase outcomes

38
Q

What is the fremitus classification

A

Class 1: mild vibration.
Class 2: feel but no see vibration.
Class 3: Visible movement.
Its created by the patients own occlusion, NOT involve instruments.

39
Q

Discuss pressure and tension zones within the PDL in occlusal trauma

A

Pressure: Compression resorb bone along cribiform plate
Tension: Stretching deposition bone along cribform plate

40
Q

When you get bone loss as a result of occlusal trauma what do you do

A

Probe it… No pocket…

41
Q

When you get bone loss as a result of occlusal trauma what replaces the bone

A

Connective tissue NOT epithelium

42
Q

Can occlusion cause recession

A

NO.. Stillman’s cleft likely floss trauma not really a thing.

43
Q

Whats the difference between Harrel and Nunn and Deas and Mealey

A

Harrel and Nunn want to treat occlusion before it is a problem, Mealy and Deas argue that it should be done when it becomes a problem.

44
Q

Is there an association between tooth mobility and recession

A

No

45
Q

Does occlusion cause periodontal attachment loss

A

No

46
Q

Does mobility affect GBR

A

No

47
Q

Does mobility affect outcome of SRP, OFD and pocket elimination therapy

A

yes… They are all worse

48
Q

What % of population had NWS contacts

A

39%

Keeling Spring Textbook (7 decks)

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