Periodontal Considerations 2 - Occlusion and Periodontium Flashcards
what are the functions of the periodontium
attach the teeth to the jaw
dissipate occlusal forces
what are the three forces that occur when a tooth has a load applied down the long axis in normal function
tension
compression
viscous forces
what is the factor that causes horizontal forces to be applied
orthodontics
with regards to remodelling of bone, what occurs in area of tension
deposition of bone
with regards to bone remodelling what occurs in areas of compression
resorption of bone
what kid of force does a juggling movement produce
horizontal forces
what are examples of what might cause jiggling forces
an ill-fitting clasp or bruxism
what is the definition of excessive occlusal forces
occlusal forces that exceeds the reparative capacity of the periodontal attachment apparatus - resulting in occlusal trauma and tooth wear
what is the definition of occlusal trauma
an injury resulting in tissue changes within the attachment apparatus including the PDL, supporting alveolar bone and cementum as a result of occlusal forces
does occlusal trauma only occur in diseased periodontium
no it can also happen in intact periodontium
what are the four main factors for tooth mobility
width of PDL
height of PDL
inflammation
number, shape and length of roots
for what reasons might teeth be mobile other than bone loss from periodontitis
successful adaptation of the periodontium to functional demands (eg high restorations and bruxism)
what are three indicators of not accepting tooth mobility
it is progressively getting worse
gives rise to symptoms
creates difficulty with restorative treatment
what are three treatments to reduce tooth mobility
control of plaque induced inflammation
correction of occlusal relations
splinting
what is the theory of primary occlusal trauma
occurs within normal periodontal tissue and normal bone levels but excessive forces applied to the tooth
what should happen to a healthy periodontium when the demand for a physiologically wider PDL is reduced
should return to normal
what histological changes will happen on the side of tension of periodontium
elongation of periodontal ligament fibres and apposition of alveolar bone and cementum
what histological changes will happen at the pressure side of the periodontium
increased vascularisation and permeability, haemorrhage, thrombosis, bone resorption, root resorption, cemental tears
what causes secondary occlusal trauma
injury resulting in tissue changes from normal or excessive forces on a tooth with reduced periodontal support
what aspect on a radiograph would suggest there is tooth mobility
v-shaped defect at apex of tooth
what are clinical signs of trauma
fremitus
bruxism or tooth grinding
wear facets
tooth migration
widening of PDL space on radiograph
what is fremitus
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
what causes the ‘zone of mass destruction’
two bone destroying processes occurring simultaneously
physiological adaptive one and the inflammatory infection one
what is the management of tooth migration
treat periodontitis
correct occlusal relations
accept position of the teeth and stabilise or move teeth orthodontically and stabilise
what is the thought processing behind a vertical bone defect occurring
feature of the mesio-distal width of the inter-radicular bone (how much bone between the two teeth)
what width of bone is more likely to cause a horizontal bone loss pattern
narrow
what width of bone is more likely to cause a vertical bone loss pattern
wide
when may splinting be appropriate
mobility is due to advanced loss of attachment
mobility is causing discomfort or difficulty chewing
teeth need to be stabilised for debridement
what are the negatives to splinting
may create hygiene defects
what are constant horizontal forces
orthodontic
what are intermittent horizontal forces
occlusal - jiggling
clasp thats too tight
other than pathology why may teeth be mobile
adaptation to occlusal loads such as bruxism or a high occlusion
what will happen to the PDL if there is excessive occlusal forces
widening of the PDL
definition of fremitus
palpable or visible movement of a tooth when subjected to occlusal forces
what occurs as well as resorption of the bone with occlusal forces
drifting of the teeth
what are abnormal occlusal contacts associated with
deeper probing depths and greater clinical attachment loss
