Occlusion and perio Flashcards
What are the 2 main functions of the PDL?
Attach the teeth to the jaw
Absorb and dissipate occlusal forces
Factors that impact tooth mobility
The height of the PDL
The width of the PDL
Inflammation
Number and shape of roots
Tooth mobility is okay unless what 3 things are happening?
Tooth mobility is progressive
Impacting on the function and causing discomfort
Effecting the placement of restorations and Tx
What is some possible Tx of increased tooth mobility?
Correct occlusal relations
splinting
Treating period with HPT
Describe primary occlusal trauma?
This is when extra force is placed upon certain teeth with a healthy PDL. As a result, the PDL widens temporarily to dissipate these extra forces
What are the histological changes as a result of primary occlusal trauma? (On the tension side and pressure side)
Tension side - The PDL is widened - apposition of alveolar bone and cementum (side by side) Pressure side - increased vascularisation and permeability - hyalinisation/necrosis of PDL - Haemorrhage - Thrombosis - Bone resorption
Describe hyalinisation in terms of the PDL.
Ischemic injury and necrosis of the PDL as a result of strong mechanical forces
Describe secondary occlusal trauma.
Injury resulting in tissue changes from normal or excessive occlusal forces applied to a tooth with reduced periodontal support (as a result of bone loss etc)
What is fremitus a strong indicator of?
Occlusal trauma
How do you test for fremitus?
You place your finger on the patient’s tooth and ask them to close, if the tooth is mobile then this is a strong indicator of occlusal trauma
Does occlusal trauma on its own cause irreversible bone and CT loss?
No
However, combined with plaque-induced inflammation it can accelerate this in the zone of co-destruction.
When should you splint teeth?
When the mobility is too great and is causing discomfort and impact on function
Mobility due to advanced L.O.A
To stabilise teeth for debridement
What is the downside to splinting of teeth?
It is the last resort Tx
This Will cause increased difficulty with OH and this may worsen the prognosis.
How to manage tooth migration?
Stabilise the perio, with HPT Stabilise the occlusion. Either accept the position of the teeth and stabilise or reposition the teeth with ortho and then stabilise.
