Chapter 13 Effect Of Load On Periodontal and Peri-Implant Tissues

Question 1

Define:
- traumatic occlusal force
- occlusal trauma

Answer 1

2017 World Workshop on Classification of Periodontal and Periodontal-Implant Diseases and Conditions.
— Traumatic occlusal force was defined as any occlusal force resulting in injury of the teeth and/or the periodontal attachment apparatus.
— Occlusal trauma describes the injury to the periodontal attachment apparatus.

Question 2

Does tipping/bodily movement of teeth induce gingival inflammation or loss of connective tissue attachment?

Answer 2

Neither will occur at teeth with a healthy periodontium.

When the tooth has moved to a position where the effect of the forces nullified, healing of the periodontal tissues take place in both the pressure and the tension zones.

The supra-alveolar connective tissue is not affected by the force, either in conjunction with tipping or in conjunction with bodily movements of the tooth.

However, studies have demonstrated that gingival recession and loss of connective tissue attachment occurred at sites with gingivitis when, in addition, the tooth was moved through the envelope of the alveolar process. At such sites bone dehiscence became established and if the covering soft tissue was thin (in the direction of the movement of the tooth), recession (attachment loss) occurred.

Question 3

Do unilateral forces or juggling forces cause pocket formation or loss of connective tissue attachment?

Answer 3

Studies have produced convincing evidence that neither unilateral forces nor jiggling forces, applied to teeth with a healthy periodontium, results in pocket formation or in loss of connective tissue attachment.

🍄 Occlusal trauma cannot induce periodontal tissue breakdown.

Occlusal trauma does, however, results in resorption of alveolar bone, leading to an increased tooth mobility which can be of a transient or permanent character. This bone resorption with resulting increased tooth mobility should be regarded as a physiological adaptation of the periodontal ligament and surrounding alveolar bone to the traumatising forces, that is to altered functional demands.

In teeth involved in progressive periodontitis, occlusal trauma may, under certain conditions, enhance the rate of disease progression. In such cases, treatment directed towards the trauma alone, that is occlusal adjustment or splinting, may reduce the mobility of the traumatised teeth and result in some regrowth of bone, but it will not influence the features of the plaque-associated lesion.

Question 4

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