EndoPerio and Occlusal Trauma Flashcards
Injury resulting in tissue changes within the attachment
apparatus (periodontal ligament, cementum and supporting
bone) as a result of occlusal forces (etiology)
Occlusal trauma
What are the 3 parts of periodontium affected by OT?
- Cementum
- PDL
- Alveolar Bone Proper
What are the 2 parts of periodontium not affected by OT?
Gingiva and Junctional epithelium
What are the 4 variables of occlusal trauma?
- Direction of force.
- Magnitude of force.
- Duration of force.
- Frequency of occurrence.
Are traumas from occlusion normal or pathologic?
Pathologic
_____ 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.
Primary Occlusal Trauma 2017
_____ 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
Secondary Occlusal Trauma
2017
(palpable or visible
movement of a tooth when subject to
occlusal forces)
Fremitus
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.
Occlusal Trauma
Miller Mobility INdex
= first distinguishable sign of
movement > than normal
(physiologic)
1
Miller Mobility index
= movement which allows crown to
move 1 mm from its normal position
in any direction
2
Miller Mobility index
____ = tooth may be rotated or depressed
in alveoli
3
Grinding, clenching or clamping of the teeth.
• The force may damage tooth or
attachment apparatus
Bruxism
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
bruxism
\_\_\_\_\_\_ for Occlusal Adjustment • Traumatic injuries / soft tissue injury; food impaction • Increasing mobility or fremitus • Parafunctional habits • In conjunction with orthodontic / orthognathic therapy
Indication
______ 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
Contraindications
- Slight increase in occlusal force.
- Considered to be a physiologic adaptation
and not a pathologic entity.
Occlusal hyperfunction
- A mild weakening of the tooth supporting
structures due to lack of physiologic
stimulation. - Considered to be a physiologic adaptation
and not a pathologic entity. - Can only be diagnosed by histology.
Occlusal Hypofunction
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.
Disuse Atrophy
T/F: Trauma from occlusion, in the absence of inflammation, does not cause: • gingivitis • periodontitis • pocket formation
true
Does TOF cause perio attachment loss in humans?
No
Does TOF cause non-carious cervical lesions?
No
Does TOF cause recession?
No
Does TOF cause abfraction?
No
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
EndoPerio lesions
What is etiology of endo/perio ds?
Bacteria
_____ lesion
• caries affecting pulp and subsequent periodontal
involvement
Primary Endodontic
_______ lesion
• periodontal destruction that then affects the pulp
Primary Periodontic
What percentage of molar furcations contain lateral canals?
28%
The greater the periodontic
involvement, the ______ the prognosis
worse
▪ 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
Incomplete Tooth Fracture
▪ Gingival palatal groove incidence of
4-8% on maxillary incisors
▪ Localized osseous lesion
▪ “Peri-pulpal” line on radiograph
Developmental Grooves
Does an acute or chronic abscess have a better prognosis?
Acute
