EndoPerio and Occlusal Trauma

Question 1

Injury resulting in tissue changes within the attachment
apparatus (periodontal ligament, cementum and supporting
bone) as a result of occlusal forces (etiology)

Answer 1

Occlusal trauma

Question 2

What are the 3 parts of periodontium affected by OT?

Answer 2

1. Cementum
2. PDL
3. Alveolar Bone Proper

Question 3

What are the 2 parts of periodontium not affected by OT?

Answer 3

Gingiva and Junctional epithelium

Question 4

What are the 4 variables of occlusal trauma?

Answer 4

1. Direction of force.
2. Magnitude of force.
3. Duration of force.
4. Frequency of occurrence.

Question 5

Are traumas from occlusion normal or pathologic?

Answer 5

Pathologic

Question 6

_____ OT
Traumatic occlusal forces applied to a tooth
or teeth with normal periodontal support
• With Primary occlusal trauma, clinically
may see adaptive mobility (does not
progress)
• Example is ‘high’ restoration with mobility
resolving following reduction.

Answer 6

Primary Occlusal Trauma 2017

Question 7

_____ occlusal trauma
Injury resulting in tissue changes from normal
or traumatic occlusal forces applied to a tooth
or teeth with reduced periodontal support
• May be seen as progressive mobility &/or pain

Answer 7

Secondary Occlusal Trauma

2017

Question 8

(palpable or visible
movement of a tooth when subject to
occlusal forces)

Answer 8

Fremitus

Question 9

Clinical Signs/Symptoms of
\_\_\_\_\_\_\_\_\_
1.  Mobility of affected teeth.*
2.  Radiographic evidence of thickened             
PDL.
3.  Positive Hx of clenching or bruxism.
4.  Missing or tilted teeth.
5.  Evidence of working and/or balancing  
side occlusal interferences.

Answer 9

Occlusal Trauma

Question 10

Miller Mobility INdex
= first distinguishable sign of
movement > than normal
(physiologic)

Answer 10

1

Question 11

Miller Mobility index
= movement which allows crown to
move 1 mm from its normal position
in any direction

Answer 11

2

Question 12

Miller Mobility index
____ = tooth may be rotated or depressed
in alveoli

Answer 12

3

Question 13

Grinding, clenching or clamping of the teeth.
• The force may damage tooth or
attachment apparatus

Answer 13

Bruxism

Question 14

Signs & symptoms of \_\_\_\_\_\_:
• Increased mobility
• Pulpal sensitivity / bite tenderness
• Non-masticatory / excessive occlusal  wear
• Dull percussion sound
• Muscle tenderness / spasm / hypertrophy / tiredness (am)
• TMJ pain / jaw lock
• Audible sounds

Answer 14

bruxism

Question 15

\_\_\_\_\_\_ for Occlusal 
Adjustment
• Traumatic injuries / soft tissue injury; food 
impaction
• Increasing mobility or fremitus
• Parafunctional habits
• In conjunction with orthodontic / 
orthognathic therapy

Answer 15

Indication

Question 16

______ to Occlusal
Adjustment
• Absence of a pre-treatment diagnosis
• As prophylactic therapy or only treatment for periodontal disease
• As primary therapy of bruxism
• Severe extrusion or malpositioned teeth
• When periodontal inflammation has not been controlled

Answer 16

Contraindications

Question 17

1. Slight increase in occlusal force.
2. Considered to be a physiologic adaptation
   and not a pathologic entity.

Answer 17

Occlusal hyperfunction

Question 18

1. A mild weakening of the tooth supporting
   structures due to lack of physiologic
   stimulation.
2. Considered to be a physiologic adaptation
   and not a pathologic entity.
3. Can only be diagnosed by histology.

Answer 18

Occlusal Hypofunction

Question 19

Total removal of occlusal forces resulting in
lack of the level of physiologic stimulation
required to maintain normal form and
function.
Physiologic adaptation and not considered
pathologic.

Answer 19

Disuse Atrophy

Question 20

T/F: Trauma from occlusion, in the absence of 
inflammation, does not cause:
• gingivitis
• periodontitis
• pocket formation

Answer 20

true

Question 21

Does TOF cause perio attachment loss in humans?

Answer 21

No

Question 22

Does TOF cause non-carious cervical lesions?

Answer 22

No

Question 23

Does TOF cause recession?

Answer 23

No

Question 24

Does TOF cause abfraction?

Answer 24

No

Question 25

Signs and Symptoms of ______
• Deep periodontal pockets (approaching apex)
• Altered or negative response to pulp vitality tests
• Bone resorption in apical or furcation region
• Spontaneous pain or pain on palpation/percussion
• Exudate
• Tooth mobility
• Sinus tract
• Crown and gingival color changes

Answer 25

EndoPerio lesions

Question 26

What is etiology of endo/perio ds?

Answer 26

Bacteria

Question 27

_____ lesion
• caries affecting pulp and subsequent periodontal
involvement

Answer 27

Primary Endodontic

Question 28

_______ lesion

• periodontal destruction that then affects the pulp

Answer 28

Primary Periodontic

Question 29

What percentage of molar furcations contain lateral canals?

Answer 29

28%

Question 30

The greater the periodontic

involvement, the ______ the prognosis

Answer 30

worse

Question 31

▪ Radiographic isolated vertical bone 
loss
▪ “Teardrop” radiolucency
▪ Can mimic both periodontal and 
endodontic symptoms
▪ May be seen as an incomplete 
crown, root, or tooth fracture

Answer 31

Incomplete Tooth Fracture

Question 32

▪ Gingival palatal groove incidence of
4-8% on maxillary incisors
▪ Localized osseous lesion
▪ “Peri-pulpal” line on radiograph

Answer 32

Developmental Grooves

Question 33

Does an acute or chronic abscess have a better prognosis?

Answer 33

Acute