perio.3.02 perio response to occlusion Flashcards
What happens when you take codeine?
I get super sick to my stomach.
How important is an allergy to codiene?
Important enough that we should absolutely ask about it.
What is co-destruction theory with respect to occlusal trauma?
Theory that occlusal trauma may be a co-destructive factor that ALTERS the severity and pattern of inflammatory disease
At what point does can gingivitis clearly be described as periodontitis?
When the inflammation extends into supporting periodontal tissues.
What tissues must be involved for plaque-induced inflammation to be able to be influenced by occlusion?
Supporting perio tissues
When are excessive forces purposely exerted on teeth?
Orthodontics
As forces are exerted on the crown, bone density will increase until…:
… the force EXCEEDS the adaptive capacity of the periodontal unit
Greater pressure exerted on a tooth leads to a(n) _______ blood flow.
decreased
In response to excess forces, which “force regions” are responsible for tooth movement through apposition and resorption of bone?
Bone resorption -> regions of compression Bone apposition -> regions of tension
Define physiologic occlusion.
Occlusion in harmony with the functions of the masticatory system
Intercuspal position is a synonym for what occlusion type?
Centric relation (centric occlusion in her slide)
_____trusion is a working movement.
Laterotrusion
_____trusive side is the balancing or non-working side.
Mediotrusive
Define occlusal trauma:
An injury to the periodontal attachment apparatus as a result of excessive occlusal forces.
Does occlusal trauma refer to the tissue injury or to the occlusal force?
It refers to the tissue injury, which was caused by the occlusal force
Principle fibers of the PDL are best able to accommodate forces along the ____________ of the tooth.
Long axis
Occlusal forces not directed along the long axis of the tooth can be either ________ (horizontal) or ________ (rotational) forces.
Lateral -> horizontal Torque -> rotational
How do the PDL and alveolar bone respond to an increased MAGNITUDE of force (still within the adaptive range)?
PDL space will WIDEN to accommodate the force (done by inc. number and width of fibers). Alveolar bone will INCREASE in density.
Which does more damage to a tooth, constant pressure or intermittent forces?
Constant pressure is the worst. The more frequent the intermittent forces become, the more injury they will cause.
What are the 3 stages of adaptive response to occlusal trauma?
Stage I - Injury from excessive occlusal forces Stage II - Repair (only if force is diminished for any reason, i.e. tooth drifts away from opposing force) Stage III - Adaptive Remodeling (only applies if repair cannot keep pace with destruction; widens the PDL, leads to possible angular defects and loosening of tooth. **NO POCKETS** created)
Which stage of the adaptive response to occlusal trauma is responsible for PDL widening?
Stage III - Adaptive Remodeling
Can adaptive remodeling lead to pocket formation?
No, pockets are not formed in adaptive modeling
Define primary occlusal trauma.
Excessive force applied to a normal periodontium.
Define secondary occlusal trauma.
Normal to excessive forces placed on a weakened periodontium. (picture example is bone loss giving less support or CAL doing the same)
When trauma from occlusion is the primary etiologic factor in periodontal destruction, how is inflammation involved?
The trauma was caused from occlusion, and not from inflammation induced by plaque accumulation. Because of this, we see perio changes without causing any inflammation.
Are perio pockets formed in primary or secondary occlusal trauma?
Secondary
In secondary, what causes previously well-tolerated occlusal forces to become traumatic?
Perio disease reduce attachment and alters leverage of previous forces.
How do clenching and bruxism differ in their associations with mobility and tooth wear?
Clenching is a more static vertical force. Associated with more mobility and less tooth wear than bruxism. Bruxism is a more active lateral movement of the teeth under pressure. Associated with more tooth wear and less mobility than clenching.
What is fremitus?
Functional mobility that can be detected on vertical or lateral jaw movement. Perhaps the most important clinical sign of occlusal trauma.
Occlusal trauma alone leads to:
A wider PDL space
Inflammation alone in the periodontium leads to:
Tissue destruction
Inflammation combined with occlusal trauma in the periodontium leads to:
A rapid loss of attachment and rapid bone loss.
What is the most common treatment for secondary occlusal trauma?
Splints
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