Occlusion and Periodontium

Question 1

What is the masticatory system composed of?

Answer 1

TMJ, mm of mastication, and teeth

Question 2

What is the excessive occlusal force?

Answer 2

force that exceeds reparative capacity of periodontal attachment

Question 3

What can excessive occlusal force lead to?

Answer 3

occlusal trauma

Question 4

What is difference between primary and secondary occlusal trauma?

Answer 4

both are tissue damage due to excessive force around teeth but secondary involves attachment and bone loss while primary does not

Question 5

Does acute or chronic trauma typically have pain when biting a hard object?

Answer 5

acute

Question 6

Which type of trauma is more common?

Answer 6

chronic

Question 7

Which type of trauma is produced from clenching/bruxism habits?

Answer 7

chronic

Question 8

Which type of trauma can involve restorations that interfere with direction of occlusal forces?

Answer 8

acute

Question 9

What is the first thin you will see with signs of occlusal trauma?

Answer 9

fremitus

Question 10

What is fremitus?

Answer 10

a vibration palpable/visible when teeth come in contact

can also be called “functional mobility”

Question 11

What are 2 common signs of occlusal trauma?

Answer 11

fremitus and widened PDL space on radiograph

Question 12

What can happen if you don’t treat fremitus due to occlusal trauma?

Answer 12

mobile tooth

Question 13

Which way do you check tooth?

Answer 13

buccal/lingually

can’t move mesial/distally

Question 14

What is pathological migration?

Answer 14

change in tooth position due to forces which maintain teeth in normal position in reference to SKULL

Question 15

What is occlusal discrepancies?

Answer 15

contacts of opposing surface of teeth are not in harmony with each other or not with anatomic/physiologic control of mandible

example: forward displacement due to posterior teeth not in contact while anterior are

Question 16

If there is more trauma from occlusion, what do we expect to see in a radiograph?

Answer 16

bigger space for PDL or cemental tear

controversial: angular defect, furcation radiolucency

Question 17

What are the stages of response to increased occlusal forces?

Answer 17

injury, repair, and adaptive remodeling of periodontium

Question 18

In stage I tissue response, what do you see?

Answer 18

more resorption, less formation

Question 19

In stage II, what do you see?

Answer 19

more formation, less resorption

Question 20

In stage III, what do you see?

Answer 20

balance/normal formation and resorption

Question 21

What is Glickman’s concept?

Answer 21

if trauma from occlusion in a periodontal patient, angular defect

if no trauma from occlusion, horizontal bone loss

depends on trauma from occlusion

Question 22

What is Waerhaug’s concept?

Answer 22

periodontal patient can have angular defect or horizontal bone loss independent of trauma from occlusion

depends on the patient’s body reacts to plaque

Question 23

If tooth is being orthodontically moved mesially where will resorption and formation occur?

Answer 23

resorption will occur mesially and formation will occur distally

Question 24

In humans, how do occlusal forces work? REMEMBER SENTENCE

Answer 24

occlusal forces act alternatively in one and then the opposite direction. these forces have been termed jiggling force.

Question 25

In trauma from occlusion with healthy periodontium and normal height, what do you expect to see?

Answer 25

acute inflammation, collagen resorption, bone resorption, cementum resorption. adaptation occurred by increasing mobility and widening PDL space. **goes back to normal with treatment**

Question 26

In trauma from occlusion with healthy periodontium and reduced height, what do you expect to see?

Answer 26

same as normal height **goes back to normal with treatment**

Question 27

In trauma from occlusion with progressive periodontal disease and NO co-destruction, what do you expect to see?

Answer 27

destruction is done supragingival it will adapt with the periodontal ligament space but no further loss of connective tissue attachment **can treat mobility** MUST control periodontitis first

Question 28

In trauma from occlusion with progressive periodontal disease and co-destruction, what do you expect to see?

Answer 28

destruction is done infragingival can be associated with an enhance loss of connective tissue **can improve mobility but not on attachment level**

Question 29

T/F: if you have a stable periodontal health, occlusal trauma will still cause bone loss.

Answer 29

False

Question 30

T/F: in a periodontal patient, treat periodontitis first and then occlusal trauma.

Answer 30

True

Question 31

What are some reversible occlusal therapies?

Answer 31

occlusal/night guard extracoronal splints mm relaxants mm exercise