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Classic Lit > Occlusal Trauma > Flashcards

Occlusal Trauma Flashcards

1
Q

Fan and Caton 2018

A

Excessive occlusal force: “Occlusal force that exceeds the reparative capacity of the periodontal attachment apparatus, which results in occlusal trauma and/or causes excessive tooth wear.”

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2
Q

Primary occlusal trauma

A

Tissue damage from excessive occlusal forces applied on a tooth with normal periodontal support.

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3
Q

Secondary occlusal trauma

A

Tissue damage from normal occlusal forces applied on a tooth with inadequate periodontal support.

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4
Q

, when the crown is subjected to excessive, non-axial (horizontal) forces, pressure and tension zones will develop

A

(Carranza 2015)

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5
Q

Pressure zone

A

the periodontal ligament fibers display disorganization and decreased fiber production, cell production will decrease in the pressure side. These changes will eventually lead to increased vascularization and permeability, hyalinzation and necrosis of PDL fibers, hemorrhage and bone resorption should be expected, and in some cases root resorption and cemental tears.

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6
Q

Tension zone

A

stimulated PDL fibers stretch resulting in increased fiber production, alveolar bone and cementum deposition

(Carranza 2015) (Fan and Caton 2018)

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7
Q

Fan and Caton 2018

A

TFO requires histologic confrimation for true diagnosis

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8
Q

Glickman 1965

TFO

A
  • Widening of PDL
  • Increased mobility
  • Root resorption
  • Angular bony defects
  • Bone condensation
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9
Q

Ramfjord & Ash 1981

TFO

A

Increased mobility, discomfort

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10
Q

Fan and Caton 2018

Proposed clinical and radiographic signs of TFO

A
  1. Fremitus
  2. Mobility
  3. Occlusal discrepencies
  4. Wear facets
  5. Tooth migration
  6. Fractured tooth
  7. Thermal sensitivity
  8. Discomfort/pain on chewing
  9. Widned PDL space
  10. Root resorption
  11. Cemental tear
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11
Q
A
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12
Q

Excessive occlusal force:

A

Occlusal force that exceeds the reparative capacity of the periodontal attachment apparatus, which results in occlusal trauma and/or causes excessive tooth wear.” (Fan and Caton 2018)

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13
Q

Primary occlusal trauma

A

Tissue damage from excessive occlusal forces applied on a tooth with normal periodontal support.

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14
Q

Secondary occlusal trauma:

A

Tissue damage from normal occlusal forces applied on a tooth with inadequate periodontal support.

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15
Q

Pressure zone

Carranza 2015

A

PDL fibers necrose from too much pressure. Bone resorption and root resorption can occur.

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16
Q

T

Tension zone

Carranza 2015

A

PDL thickening with increased fiber production, bone and cementum deposition

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17
Q

TFO requires what for confirmation/diagnosis

A

Histology (Fan and Caton 2018)
We use clinical and radiographic signs as a proxy

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18
Q

Glickman 1965

Radiographic and clinical signs and symptoms of TFO

A
  • Widening of PDL
  • Increased mobility
  • Root resorption
  • Angular bony defects
  • Bone condensation
19
Q

Ramfjord and Ash 1981

Radiographic and clinical signs and symptoms of TFO

A
  • Increasing mobility
  • Persistent discomfort or tenderness reported by the patient
  • Radiographic signs of bone resorption +/- root resorption
20
Q

Fan and Caton 2018

Radiographic and clinical signs and symptoms of TFO

A
  1. Fremitus
  2. Mobility
  3. Occlusal discrepencies
  4. Wear facets
  5. Tooth migration
  6. Fractured tooth
  7. Thermal sensitivity
  8. Discomfort/pain
  9. Widened PDL space
  10. Root resorption
  11. Cemental tear
21
Q

Jin and Cao 1992

cross sectional human study

A

**Trauma from occlusion index:
**Signs: widened PDL and fremitus, increased CALoss, less bone height and deepr PD
Result: Susceptible to TFO

**Adaptability index:
**Sings: Wear facets, thickened lamina dura. less CALoss, more bone height
Result: Resistant to TFO

22
Q

Karolyi 1901

A

Teeth with excessive forces have more periodontal disease

23
Q

Gotlieb and Orban 1931

Dog study

A

Concluded TFO did not cause periodontitis

induced occlusal forces in dogs did not result in CALoss

24
Q

Glickman’s camp for TFO

A

Occlusion acts as a co-destructive factor in periodontal disease

Glickman 1963

25
Q

Glickman 1963

Glickman camp (co-destruction)

A

Zone of irritation: marginal gingiva, papillae.
Local irritants cause inflammation

Zone of co-destruction: supporting PDL, alveolar bone and cementum.
Inflammation and occlusionare co-destructive factors.

TFO alone does not cause periodontal disease, just worsens it.

26
Q

Glickman and Smulow 1965

Glickman camp (co-destruction)

human histologic study of 3 human jaws

A
  • They concluded that when inflammation is confined to the marginal gingiva and transseptal fibers, TFO has no influence.
  • When the inflammation extends beyond the confines of marginal gingiva, TFO can act as a co-destructive factor in the periodontal disease.
27
Q

Glickman 1967

Glickman camp (co-destruction)

Review

A

TFO is reversible, and results in angular defects

28
Q

Lindhe and Svanberg 1974

Glickman camp (co-destruction)

6 beagle dogs, Ligature induced periodontitis, histology

A
  • Horizontal bone loss in perio group and perio+TFO group
  • Angular defects ONLY in TFO+perio group
29
Q

Nyman 1978

Glickman camp (co-destruction)

5 dogs, jiggling forces with ligature induced perio

A

Jiggling forces caused increased mobility, 8/10 test teeth showed CALoss

30
Q

Waerhaug 1979a

Waerhaug camp (TFO is not a factor in perio)

Cadaever study

A

Bone loss related to plaque downgrowth
vertical defects found equally in TFO and nonTFO groups

Distance from PDL to apical border of plaque called plaque free zone esd 0.2-1.8mm

31
Q

Waerhaug 1979b

Waerhaug camp (TFO is not a factor in perio)

Human study

A

Plaque free zone was 0.2-2.2mm
Apical border of plaque to oposite wall of infrabony defect is 1-3mm

TFO not a factor

32
Q

Polson 1974a

Waerhaug camp (TFO is not a factor in perio) MAIN SUPPORTER

Monkey study (n=28), ligature induced perio

A

Angular defects around ligatures, not from Thermal trauma

33
Q

Polson 1974b

Waerhaug camp (TFO is not a factor in perio) MAIN SUPPORTER

squirrel monkey study

A

toothpick wedging group had similar PDL width as only ligature perio group
No sig diff in disease progression between groups

34
Q

Polson and Zander 1983

Waerhaug camp (TFO is not a factor in perio)

Monkey study with orthdontic jiggling forces

A

Alveolar bone height was SSD reduced in jiggling group
Tooth mobility also greater in jiggling group
CT attachment showed no SSD

35
Q

Waerhaug vs Glickman differences

A

(G) had longer studies (6 months) vs 10 weeks (W)

(G) used infrabondy defects. (W) had supracrestal defects

G had heavy forces for short period
W had light forces for 2 days (long)

36
Q

Nunn and Harrel 2001

2 part study

Effect of occlusal discrepencies on periodontitis

A
  • There’s a** sig, association** between occlusal discrepancies and mobility, +/- Periodontitis
  • There is a strong association between occlusal discrepancies and clinical parameters indicative of periodontitis such as pocket depth (SS), worse prognoses (SS)
    • Teeth treated for occlusal discrepancies had sig. deeper PDs/ year compared to those without and teeth which were treated.
37
Q

Harrel and Nunn 2004

The effect of occlusal discrepancies on gingival width

A
  • NSSD between the presence of occlusal discrepancies and occlusal therapy and gingival width (KT= FGM-MGJ)
38
Q

Harrel and Nunn 2009

The effect of occlusal discrepancies on probing depth

A
  • Occlusal discrepancies were sig. associated with deeper PD and the assignment of less than “Good” prognosis
39
Q

Ericsson & Lindhe 1977

dog study, jiggling forces

The effect of plaque and physical stress on periodontal tissues

A
  • Traumatic occlusion did not initiate destruction in reduced but non-inflamed periodontium
  • There was no apical migration of JE caused by traumatic occlusion
40
Q

How would normal/excessive occlusion affect implants?

Berglundh et al 2005

6 beagle dog study

A
  • Functional loading may enhance osseointegration, and does not result in marginal bone loss (MBL)
41
Q

How would normal/excessive occlusion affect implants?

Isidor 1996

4 monkeys

A
  • No loss of osseointegration observed in implants w/plaque accumulation.
  • Loss of osseointegration observed in implants w/ occlusal load.
42
Q

Splinting mobile teeth?

Schulz et al in 2004

A

there is no significant difference (NSSD) in PPD, CAL gain and horizontal mobility if splinting was done** post-surgically** compared to non-splinted teeth

pre-surgical splinting resulted in statistically significant (SS) better PPD reduction, CAL gain and reduction on horizontal mobility compared to non-splinted and pos-sx splinted teeth

43
Q

Occlusal adjustment:

Burgett et al 1992

A

investigated the effect of adjusting occlusal discrepancies following SRP +/- Modified Widman flap and found that occlusal adjustments improved CAL gain compared to not

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