Occlusion and Periodontal tissues Flashcards
name 2 functions of the periodontium
attach teeth to jaws
dissipate occlusal forces
excessive occlusal force
forces of magnitude, direction or duration that exceed the reparative capacity of the periodontal apparatus. Results in occlusal trauma and/or excessive tooth wear
primary occlusal trauma
injury resulting in tissue changes within periodontal apparatus (PDL, alveolar bone, cementum) due to excessive occlusal forces applied to teeth with normal periodontal support.
So - normal attachment levels, normal bone and excessive occlusal forces
what factors influence tooth mobility
width of PDL , height of PDL, inflammation , number/shape/length of roots
e.g tooth with wide and short PDL , single root and experiencing inflammation will be mobile.
the location of the fulcrum of tipping teeth is dependent on the height of what
alveolar bone
diagram in notes
higher alveolar bone = less movement than shorter
result is same amount of force applied will see varying degrees of movement of the coronal aspect
what circumstances, other than pathology, might cause a tooth to become mobile
successful adaptation of the perioodontium to meet functional demands.
e.g increased occlusal load, orthodontic appliance
how can teeth adapt to a greater occlusal load/ force of an ortho appliance
PDL space widens allowing forces to be dissipated
allows teeth to become more viscoelastic
name 3 situations in which increased mobility, not from pathology, would not be accepted
it is progressively increasing
giving rise to symptoms e.g impaired function
creates difficulty with restorative treatment
Name 3 possible therapies for treating mobile teeth
Control plaque induced inflammation
correct occlusal relations e.g high restorations taking excessive occlusal load
splinting - load shared between teeth
secondary occlusal trauma
injury resulting in tissue changes within periodontal apparatus from normal or excessive forces applied to a tooth with a reduced periodontal support.
So - attachment loss, bone loss and normal or excessive forces
Reduced alveolar bone means extreme mobility will be experienced
what happens in primary occlusal trauma
(excessive occlusal trauma to healthy teeth/periodontium)
- PDL width will increase until forces can be adequately dissipated. Width should then stabilise
- Tooth mobility will increase as a result of this
- if demand is reduced , PDL width should return to normal
Fremitus
palpable or visible movement of a tooth when it is subject to occlusal forces
what happens to the periodontium if sustained occlusal trauma
decreased alveolar bone density and increased PDL space
why might bone loss be amplified in a patient with periodontitis that is also experiencing secondary occlusal trauma
they are experiencing 2 osteolytic processes at once
- Perio
- dissipating occlusal forces
what might happen to the positioning of teeth in patients with perio AND secondary occlusal trauma
might develop into a ‘splayed position’
first treat perio to stabilise then address the occlusal relations
