Periodontology

Question 1

What is the definition of excessive occlusal force?

Answer 1

It is defined as occlusal
force that exceeds the
reparative capacity of the
periodontal attachment
apparatus, which results in
occlusal trauma and/or
causes excessive tooth wear

Question 2

What size is the crest of the alveolus in a healthy patient?

Answer 2

In health, the crest of
the alveolus lies about 2 mm apical
to the cementoenamel junction

Question 3

What is the definition of occlusal trauma?

Answer 3

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

Question 4

Signs of occlusal trauma?

Answer 4

• progressive tooth - mobility,
• fremitus,
• occlusal discrepancies/disharmonis
• wear facets
• tooth migration
• tooth fracture,
• thermal sensitivity, discomfort or pain on chewing
• root resorption
• cemental tear, and widening of the periodontal ligament space on radiographs

Question 5

Histological findings of periodontal tissue undergoing occlusal trauma?

Answer 5

Distinct zones of tension and pressure are seen within the
periodontium. The location and severity of the lesions vary
based on the magnitude and direction of applied forces.
On the pressure side, the changes are increased vascularisation
& permeability, hyalinisation/necrosis of the periodontal
ligament (PDL), haemorrhage, thrombosis, bone resorption &
in some instances root resorption & cemental tears
On the tension side the changes seen are elongation of the PDL
fibres and apposition of alveolar bone and cementum

Question 6

How does sustained occlusal trauma affect the periodontium?

Answer 6

Sustained occlusal trauma result in decreased density of the
alveolar bone while the width of the PDL space increases,
which leads to increased tooth mobility and often a
radiographic widening of the PDL space, either limited to the
alveolar crest or through the entire width of the alveolar bone
Hence fremitus or palpable functional mobility of the affected
tooth (teeth) is a clinical sign of occlusal trauma

Question 7

What is the definition of primary occlusal trauma?

Answer 7

resulting in tissue changes from
excessive occlusal forces applied to a tooth or
teeth with normal periodontal support

Question 8

What is the definition of secondary occlusal trauma?

Answer 8

resulting in tissue changes from normal or excessive
occlusal forces applied to a tooth or teeth with reduced
periodontal support

Question 9

What is the definition of Fremitus? and its causes?

Answer 9

palpable or visible movement of a tooth
when subjected to occlusal forces
occlusal interferences
causing occlusal trauma, normal occlusion and
occlusal forces but with reduced periodontium

Question 10

What is the defintiion of bruxism?

Answer 10

habit of grinding, clenching, or clamping
the teeth

Question 11

What are the effects of excessive occlusal load?

Answer 11

The suggestion that the combined effect of occlusal trauma and bacterial
plaque-induced inflammation caused periodontal destruction was termed
co-destruction, which interestingly started the concept of multiple risk
factors being the cause for initiation and progression of periodontal disease