Occlusion and perio

Question 1

What is a healthy periodontium response to traumatic occlusion/

Answer 1

Widening of the PDL
No LOA or inflammation
Will resolve once occlusion is amended

Question 2

What is a healthy response to traumatic occlusion with reduced periodontium?

Answer 2

No LOA or inflammation
Will resolve once occlusion is amended
Reduced PDL so there will be increased mobility of tooth

Question 3

What is the pathological (periodontitis) response to traumatic occlusion?

Answer 3

Widening of the PDL
Loss of attachment
May have some increase in mobility
BOP
Plaque present

Question 4

How do you manage traumatic occlusion in a patient with periodontal disease?

Answer 4

Address the causative problem - high restorations, parafunction
Use of a bite raising appliance
HPT and OHI

Question 5

What factors can influence localised mobility?

Answer 5

Existing periodontal disease
Occlusal trauma causing widening of the PDL
Alveolar bone loss
Resorption/ trauma
Smoking

Question 6

When might splinting be advised?

Answer 6

When there is increased mobility due to advanced LOA making it difficult for the patient to eat or clean
Splinting can also facilitate HPT including subgingival pmpr as teeth will be more stable

Question 7

Why is there a decrease in mobility of teeth following HPT?

Answer 7

Due to increased tissue tone and long junctional epithelium attachment with successful HPT

Question 8

What can you do if the PDL is widened after successful treatment?

Answer 8

Reduce contacts within the occlusion that is causing the traumatic occlusion or fremitus (vibration or movement of a tooth when teeth come into contact together) on that given tooth