Exam 2 Flashcards
Define trauma from occlusion.
Damage to the periodontium caused by stress on the teeth produced directly or indirectly by teeth in opposing jaw
Trauma from occlusion happens when? And is considered to be?
Considered to be pathologic.
Forces of occlusion that exceed the adaptive capacity of the periodontium.
What are the variables to the relationship of occlusal trauma to periodontal disease?
- Direction of force
- Magnitude of force
- Duration of force
- Frequency of occurance
What parts of the periodontium are affected by occlusal forces?
- Cementum
- PDL
- Alveolar bone proper
- NOT - the gingiva and junctional epithelium
What is fremitus?
A tremulous vibratory movement of a tooth when teeth come into functional contact - generally detected by a finger palpation
What happens during trauma from occlusion on the compression side?
- Compression of PDL fibers - initial decrease in width of PDL space
- Loss of fiber orientation
- Rupture of capillaries and hemorrhage into PDL spaces
- Resorption of alveolar bone proper followed by widening ot PDL space
- Root resorption if severe
What happens during trauma from occlusion on the tension side?
- Tension (stretching) of fibers with initial increase in PDL space
- Rupture of PDL fiber bundles
- Compression of PDL capillaries and hemorrhage into PDL perivascular spaces
- Apposition of new alveolar bone proper followed by decrease in PDL space
- Cemental tearing
When does Primary Occlusal Trauma occur?
When occlusal forces are excessive (increased) and the amount of alveolar bone support is normal.
When does Secondary Occlusal Trauma occur?
When occlusal forces are normal or excessive and the amount of alveolar bone support is reduced.
What is occlusal hyperfunction, and what is it considered to be?
Slight increase in occlusal force, considered to be a physiologic adaptation and not a pathologic entity.
What are the clinical characteristics of Occlusal Hyperfunction?
- Increase in # and diameter of collagen fiber bundles in PDL
- Increased width of PDL
- Increased density and thickness of alveolar bone proper (lamina dura)
- Radiographic evidence of osteosclerosis of alveolar bone with PDL insertions
- Slight or undetectable tooth mobility
What are the characteristics of Occlusal Hypofunction?
- Mild weakening of the tooth supporting structures due to a lack of physiologic stimulation
- Considered to be a physiologic adaptation and not a pathologic entity.
- Can only be diagnosed by histology
- Decrease in # of PDL fiber bundles but normal orientation
- Decrease physiologic turnover and remodeling of alveolar bone
- Narrowing of PDL space, no change in tooth mobility
What is the total removal of occlusal forces resulting in lack of the level of physiologic stimulation required to maintain normal form and function called?
Disuse Atrophy
What is disuse atrophy considered to be?
A physiologic adaptation rather than a pathologic feature of disease
What are the clinical characteristics of disuse atrophy?
- Radiographic evidence of decreased width of PDL space
- Increased tooth mobility - always
- Absence of occlusal antagonist
- Loss of orientation of principle fiber bundles of PDL
- Significant decrease in # of bone trabeculae (localized osteoporosis)
Trauma from occlusion, in the absence of inflammation does not cause:
- Gingivitis
- Periodontitis
- Pocket formation
But it makes these worse
What is the key concept of the animal study dealing with occlusal trauma and periodontal disease?
- Periodontitis with superimposed occlusal trauma produces more bone loss than periodontitis alone
What is the key concept in the human study dealing with occlusal trauma and periodontal disease?
- Strong association between initial occlusal discrepancies and periodontal prognosis and increased periodontal probing depth of posterior teeth
- Strong association between untreated occlusal discrepancies and the progression of periodontal disease.
- Occlusal treatment significantly reduces the progression of periodontal disease over time.
What is the creation of additional problems or complications as a result of treatment called?
Iatrogenic Disease
Gingival margin overhangs are associated with what?
- Gingival inflammation
- Bone loss
- Microbial plaque and calculus accumulation
For a furcation involvement - how much bone loss must there be?
33%
What are some characteristics of interproximal caries?
- Occur below the contact point
- Follows the direction of enamel rods
- Cone-shaped radiolucency
- Spreads along the DEJ
What is the microbial agent for interproximal caries?
Streptococcus Mutans
What are some characteristics of Root Caries?
- Involves cementum and dentin
- Initiated in areas of food impaction
- Common in periodontal patients following surgical exposure of root surfaces
- Saucer-shaped morphology
- Enamel is not involved
- Microbial agent:
- Actinomyces viscosus
- Candida albicans?
