Periodontal Considerations - occlusion & periodontal tissues Flashcards
what is the function of the periodontium?
- to attach the teeth to the jaws
- to dissipate occlusal forces
what are examples of horizontal forces?
Constant - orthodontic
Intermittent - occlusal (jiggling)
What is occlusal trauma?
used to describe injury resulting in tissue changes within the attachment apparatus, including periodontal ligament, supporting alveolar bone and cementum as a result of occlusal forces
what is tooth mobility dependant on?
- width of PDL
- height of PDL
- inflammation
- number, shape and length of roots
what can tooth mobility indicate?
- indicate successful adaptation of the periodontium to functional demands
- reflect the nature of the remaining attachment
Tooth mobility can be accepted, unless:
- it is progressively increasing
- it gives rise to symptoms
- it creates difficulty with restorative treatment
what therapy options are available to reduce tooth mobility?
- control of plaque-induced inflammation
- correction of occlusal relations
- splinting
What is the response of the healthy periodontium to primary occlusal trauma?
- PDL width increases until forces can be adequately dissipated, PDL width should then stabilise
- tooth mobility will be increased as a result
- this can be regarded as successful adaptation to increased demand and therefore physiological
- if demand is reduced, PDL width should return to normal
what occurs to the health periodontium if the demand of occlusal forces is too great of the adaptive capacity of the PDL is reduced?
PDL width may continue to increase
- tooth mobility fails to reach a stable phase
- failure of adaptation regarded as pathological
How does the periodontium change histologically in response to forces?
Pressure side = increased vascularisation, necrosis of periodontal ligament, haemorrhage, thrombosis, bone resorption
Tension side = elongation of PDL fibres, apposition of alveolar bone and cementum
What is the effect of “abnormal” occlusal forces on teeth dependant on?
IF the periodontium is:
- healthy
- healthy but reduced periodontium
- diseased periodontium
What do the histologic changes reflect?
An adaptive response within the periodontium to occlusal trauma
What is secondary occlusal trauma?
Injury resulting in tissue changes from normal or excessive occlusal forces applied to a tooth or teeth with reduced periodontal support
- it occurs in the presence of attachment loss, bone loss and normal/excessive occlusal forces
what is meant by Fremitus?
palpable of visible movement of a tooth when subjected to occlusal forces
Should occlusal therapy be included in the management of periodontal disease?
- occlusal therapy is not a substitute for perio treatment
- may be beneficial in conjunction with perio treatment in the presence of occlusal trauma
