Lecture 9- Trauma from occlusion- natural teeth

Question 1

Primary occlusal trauma is … .force applied to a …. periodontium

Answer 1

excessive

normal

Question 2

Secondary occlusal trauma is … applied to a …. periodontium

Answer 2

normal (or excessive)

weakened

Question 3

occlusal trauma can lead to …

Answer 3

progressive mobility

fremitus

functional mobility

infrabony pockets(controversial)

butressing (thickened) bone (controversial)

Question 4

what might you see in a radiograph with occlusal trauma

(these changes may represent adaptation or may be due to extension of inflammatory periodontal disease w/o occlusal trauma as a factor)

Answer 4

widened PDL space and/or thickened radicular lamina dura

Question 5

you may also see … bone loss and … in radiographs for occlusal trauma but this may be due to anatomy and/or the progression of inflammatory periodontal disease

Answer 5

angular

furcations

Question 6

The co-destruction theory by Glickman says that occlusal trauma may be a co-destructive factor that alters the …. and … of inflammatory periodontal disease

Answer 6

severity and pattern

Question 7

the co-destruction theory says that periodontal disease may find pathway into the ..

Answer 7

PDL

Question 8

The advancing plaque front theory by Waerhaug says what about occlusal trauma’s role in the severity and pattern of periodontal disease?

Answer 8

it has no role

Question 9

in TFO without periodontitis there is :

… destruction
… resorption
… loss
No …. loss

Answer 9

PDL collagen destruction

cementum resorption

bone loss

no attachment loss

Question 10

In TFO without periodontitis, … may occur where the tooth becomes … but no further injury

Answer 10

adaptation

mobile

Question 11

If there is TFO without periodontitis, with occlusal therapy signs of occlusal trauma may ….

Answer 11

diminish

Question 12

What are the 3 models for role of occlusal trauma?

Answer 12

Trauma from occlusion without periodontitis

Trauma from occlusion with periodontitis but no co-destruction

Trauma from occlusion with periodontitis: co-destruction occurs

Question 13

T/F if a tooth has reduced periodontium from previous disease but the disease is no longer active, the tooth can still withstand TFO and adapt

Answer 13

true

Question 14

In TFO with periodontitis, how can there be no co-destruction?

Answer 14

the TFO and periodontitis are independent processes that have not merged because the periodontitis is supracrestal

Question 15

In TFO with periodontitis there will be ….

Answer 15

adaptation

Question 16

Which should you do first in TFO with periodontitis?

occlusal therapy
control periodontitis

Answer 16

control periodontitis 1st!

Question 17

In TFO with periodontitis with co-destruction, the periodontitis is …. so the two lesions merge

Answer 17

subcrestal

Question 18

with co-destruction there is enhanced …

Answer 18

attachment loss

Question 19

when there is TFO w/ periodontitis, there is no enhanced….

Answer 19

attachment loss

Question 20

4 methods of occlusal therapy that are reversible

Answer 20

nightguard (bit plane)

extracoronal splints

muscle relaxants

muscle exercises

Question 21

4 methods of occlusal therapy that are irreversible

Answer 21

intracoronal splints (need to prep tooth)

occlusal adjustment by selective grinding

orthodontics

orthognathic surgery

Question 22

Occlusal adjustment by selective grinding indications (5)

Answer 22

periodontal occlusal trauma

post-ortho

prior to extensive restorations

certain types of TMD

certain wear patterns

Question 23

5 contraindications to occlusal adjustment

Answer 23

severe malocclusion

non-ideal but tolerated occlusion

severe wear

patient in pain

no suitable endpoint

Question 24

occlusal therapy is especially indicated prior to …

Answer 24

periodontal regenerative therapy

Question 25

T/F occlusal adjustment is justified in the absence of periodontal disease as a periodontal disease preventative measure

Answer 25

false