periodontal occlusal trauma

Question 1

trauma from occlusion

Answer 1

1) occurs when occlusal forces exceed the adaptive capacity of the tissues and tissue injury results
2) occlusal trauma
3) bone loss
4) periodontal pocketing
5) illustrated posterior bite collapse and splaying of anterior teeth due to trauma from occlusion

Question 2

clinical symptoms

Answer 2

1) excessive mobility (check with two instruments)
2) sensitivity to temperature
3) obvious wear facets
4) dramatic relief with equilibration

Question 3

primary occlusal trauma

Answer 3

1) excessive occlusal forces applied to teeth with normal attachment apparatus
2) adaptive changes of the ligament and alveolar may occur but not apical migration of the JE
3) remove the traumatic force, may restore alveolar bone height

Question 4

secondary occlusal trauma

Answer 4

1) normal force that applies to teeth with inadequate support
2) may occur with active periodontitis or may persist after periodontitis has been resolved

Question 5

infrabony pocket

Answer 5

1) can occur secondary to occlusal trauma
2) vertical bone loss - 3 wall defect at mesial of second premolar

Question 6

histologic signs of periodontal occlusal trauma

Answer 6

1) thrombosis and hemorrhage in PDL
2) root fracture and resorption
3) hyalinization of PDL

Question 7

mobility

Answer 7

1) miller scale 1-3

Question 8

occlusal treatment equilibration

Answer 8

1) occlusal trauma may accelerate bone resorption and loss of attachment, but occlusal trauma by itself does not cause loss of attachment level

Question 9

treatment of occlusal trauma

Answer 9

1) equilibration
2) splinting versus non splinting
3) bruxism appliances
4) pulpal considerations
5) occlusal splinting

Question 10

occlusal adjustment

Answer 10

1) explain why and that it will feel different
2) do small adjustments or reductions on each involved tooth
3) ask them to close in maximum MI, ask if they know which tooth feels high, palpate and visualize for fremitus
4) mark prematurity with articulating paper

Question 11

supporting cusps and fossa

Answer 11

1) buccal of mandible and lingual of maxilla
2) try not to change them too much

Question 12

adjust the inclines

Answer 12

1) small dots on cusp tips and fossas
2) you can reduce non supporting cusps if necessary
3) on a meal crown, use shimstock to cheap if there is heavy contact