Occlusal Trauama Flashcards
Primary Occlusal trauma
Exessive force on normal periodontium
Secondary Occlusal trauma
Normal or excessive force on weakened periodontium
Fremitis
vibrate when they move
Infrabony pockets
Pocket depths are deeper than the crest of the bone
Buttressing Bone
apatation result from occlusal trauma. Outgrowth of alveolar bone
Changes from occlusal trauma can be related to:
- changes in adaptaion
or - extension of inflammation periodontal disease w/o occlusal trauma
Responses to occlusal trauma
Widened PDL space or thickened radicular lamina dura
Angular bone loss and furcations
Controversial and could be due to toothy and bony anatomy and progression of inflammatory periodontal disease
Co-destruction theory
Occlusal trauma may be a co-destructive factor that alters the severity and pattern of inflammatory periodontal disease. Merges with bacteria reaction to create different pattern and severity of periodontal progression and change the pathway and cause issues like infrabony pockets.
Advancing plaque front theory
Occlusal trauma has no role in severity and pattern of periodontitis
Trauma from occlusion w/o periodontitis
Injury results in acute inflammation PDL collagen destruction cementum resorption bone loss NO attachment loss Tooth may become mobil
How to help with occlusal trauma
Occlusal therapy
Reduced periodontium w/o periodontitis
Reduced but healthy and causes no further attachment loss. Occlusal therapy helps aid with problems
Reduced periodontium and periodontitis and occlusal trauma
Supracrestal periodontitis with occlusal trauma lesion are independent processes so things dont get worse.
MUST control periodontitis first
Reduced periotdontium with subcrestal periodontitis
conditions are established for co-destruction. Must control periodontitis first before occlusal therapy
Methods of occlusal therapy: Reversible
night guard
extracoronal splints
muscle relaxants
muscle exercies
Methods of occlusal therapy: Irreversible
Intracoronal splints
Occlusal adjustment by selective grinding
orthodontics
surgery
Occlusal adjustmet by selective grinding: indications
periodontal occlusal trauma
post orthodontics
prior to extensive
Occlusal adjustment by selective grinding: contraindications
severe malcocclusion
Non-ideal but tolerating occlusion
severe wear
patient in pain or no suitable end point
When is occlusal therapy indicated?
when in conjuction with periodontal treatment when occlusal trauma is present
ESPECIALLY indicated prior to perodontal regenerative surgery
