Periodontal Considerations 2 - Occlusion and Periodontium

Question 1

what are the functions of the periodontium

Answer 1

attach the teeth to the jaw
dissipate occlusal forces

Question 2

what are the three forces that occur when a tooth has a load applied down the long axis in normal function

Answer 2

tension
compression
viscous forces

Question 3

what is the factor that causes horizontal forces to be applied

Answer 3

orthodontics

Question 4

with regards to remodelling of bone, what occurs in area of tension

Answer 4

deposition of bone

Question 5

with regards to bone remodelling what occurs in areas of compression

Answer 5

resorption of bone

Question 6

what kid of force does a juggling movement produce

Answer 6

horizontal forces

Question 7

what are examples of what might cause jiggling forces

Answer 7

an ill-fitting clasp or bruxism

Question 8

what is the definition of excessive occlusal forces

Answer 8

occlusal forces that exceeds the reparative capacity of the periodontal attachment apparatus - resulting in occlusal trauma and tooth wear

Question 9

what is the definition of occlusal trauma

Answer 9

an injury resulting in tissue changes within the attachment apparatus including the PDL, supporting alveolar bone and cementum as a result of occlusal forces

Question 10

does occlusal trauma only occur in diseased periodontium

Answer 10

no it can also happen in intact periodontium

Question 11

what are the four main factors for tooth mobility

Answer 11

width of PDL
height of PDL
inflammation
number, shape and length of roots

Question 12

for what reasons might teeth be mobile other than bone loss from periodontitis

Answer 12

successful adaptation of the periodontium to functional demands (eg high restorations and bruxism)

Question 13

what are three indicators of not accepting tooth mobility

Answer 13

it is progressively getting worse
gives rise to symptoms
creates difficulty with restorative treatment

Question 14

what are three treatments to reduce tooth mobility

Answer 14

control of plaque induced inflammation
correction of occlusal relations
splinting

Question 15

what is the theory of primary occlusal trauma

Answer 15

occurs within normal periodontal tissue and normal bone levels but excessive forces applied to the tooth

Question 16

what should happen to a healthy periodontium when the demand for a physiologically wider PDL is reduced

Answer 16

should return to normal

Question 17

what histological changes will happen on the side of tension of periodontium

Answer 17

elongation of periodontal ligament fibres and apposition of alveolar bone and cementum

Question 18

what histological changes will happen at the pressure side of the periodontium

Answer 18

increased vascularisation and permeability, haemorrhage, thrombosis, bone resorption, root resorption, cemental tears

Question 19

what causes secondary occlusal trauma

Answer 19

injury resulting in tissue changes from normal or excessive forces on a tooth with reduced periodontal support

Question 20

what aspect on a radiograph would suggest there is tooth mobility

Answer 20

v-shaped defect at apex of tooth

Question 21

what are clinical signs of trauma

Answer 21

fremitus
bruxism or tooth grinding
wear facets
tooth migration
widening of PDL space on radiograph

Question 22

what is fremitus

Answer 22

put your finger on tooth and get pt to close
if the tooth is hit at the same time as all other teeth there will not be any movement
if the tooth has premature occlusion it will move slightly

Question 23

what causes the ‘zone of mass destruction’

Answer 23

two bone destroying processes occurring simultaneously
physiological adaptive one and the inflammatory infection one

Question 24

what is the management of tooth migration

Answer 24

treat periodontitis
correct occlusal relations
accept position of the teeth and stabilise or move teeth orthodontically and stabilise

Question 25

what is the thought processing behind a vertical bone defect occurring

Answer 25

feature of the mesio-distal width of the inter-radicular bone (how much bone between the two teeth)

Question 26

what width of bone is more likely to cause a horizontal bone loss pattern

Answer 26

narrow

Question 27

what width of bone is more likely to cause a vertical bone loss pattern

Answer 27

wide

Question 28

when may splinting be appropriate

Answer 28

mobility is due to advanced loss of attachment
mobility is causing discomfort or difficulty chewing
teeth need to be stabilised for debridement

Question 29

what are the negatives to splinting

Answer 29

may create hygiene defects

Question 30

what are constant horizontal forces

Answer 30

orthodontic

Question 31

what are intermittent horizontal forces

Answer 31

occlusal - jiggling
clasp thats too tight

Question 32

other than pathology why may teeth be mobile

Answer 32

adaptation to occlusal loads such as bruxism or a high occlusion

Question 33

what will happen to the PDL if there is excessive occlusal forces

Answer 33

widening of the PDL

Question 34

definition of fremitus

Answer 34

palpable or visible movement of a tooth when subjected to occlusal forces

Question 35

what occurs as well as resorption of the bone with occlusal forces

Answer 35

drifting of the teeth

Question 36

what are abnormal occlusal contacts associated with

Answer 36

deeper probing depths and greater clinical attachment loss