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Occlusion > Role of Occlusion on Perio Disease Progression > Flashcards

Role of Occlusion on Perio Disease Progression Flashcards

1
Q

What is there controversy on the role of occlusion?

A

1 - Different experimental Designs
2 - Different disciplines involved have different experiences
3 -Occlusal trauma can only be confirmed histologically
4 - Multiple definitions making the topic seem more complex than it is

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2
Q

What were the different models and their researchers?

A

Sheep model (Box)
Human necropsy (Waerhaug, Glickman)
Squirrel (Polson)
Beagle Dog (Lindhe)

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3
Q

Occlusion

According to the glossary of periodontal terms

A

Any contact of opposing teeth

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4
Q

Centric occlusion

According to the glossary of periodontal terms

A

The maximum intercuspation of the teeth of opposing arches - AKA Acquired centric AKA habitual occlusion

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5
Q

Eccentric occlusion

According to the glossary of periodontal terms

A

Any relation outside of centric

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6
Q

Centric relation

According to the glossary of periodontal terms

A

The most retruded position of the mandible from which lateral movements can be made
The most posterior position at the established VDO

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7
Q

Abfraction

According to the glossary of periodontal terms

A

Theoretical tooth surface abrasion in conjunction with occlusal forces

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8
Q

Attrition

According to the glossary of periodontal terms

A

Physiological wearing away of a substance or structure, such as teeth

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9
Q

Bruxism

According to the glossary of periodontal terms

A

Habit of clenching, grinding, or clamping of teeth ; Forces generated may damage tooth and/or tooth supporting structures

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10
Q

Buttressing bone

According to the glossary of periodontal terms

A

Marginal linear aspect of bone - MAY be formed in response to heavy occlusal forces

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11
Q

Facet

According to the glossary of periodontal terms

A

Flattened/worn spot on tooth surface

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12
Q

Fremitus

According to the glossary of periodontal terms

A

Palpable or visible movement of tooth in response to occlusal forces

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13
Q

Occlusal interferiences

According to the glossary of periodontal terms

A

Any contact that inhibits the remaining surfaces from achieving stable/harmonious contact

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14
Q

Occlusal prematurity

According to the glossary of periodontal terms

A

Contact before desirable intercuspation

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15
Q

Trauma from occlusion/Occlusal Trauma

A

A DIAGNOSIS
Injury that results in tissue changes within the attachment apparatus (including PDL, bone, cementum) as a result of occlusal forces

(must be confirmed histologically for definitive diagnosis)

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16
Q

Occlusal Traumatism

A

Updated definition of TFO - Functional loading of teeth, usually off axis, that is sufficient to cause changes to the teeth (fractures/wear/etc) or supporting structures. Temporary or permanent

17
Q

Excessive occlusal forces

A

Forces that exceed the reparative capacity of the periodontium

18
Q

Traumatic Occlusal Force (TOF)

Fan & Caton 2018

A

Any occlusal force that results in injury to the tooth or attachment apparatus

19
Q

How does a leasion progress on the compression side?

A

Compression of the PDL with pressure
Loss of fiber orientation
Rupture of blood vessels/Hemmorage/Edema in PDL perivascular space
Resorption of alveolar bone proper (PDL Widening)

20
Q

How does a lesion progress on the tension side with bodily movement?

A

Increase in PDL space
Ruption of PDL fibers
Hemorrhage into perivascular space
Deposition of new alveolar bone and decrease PDL space - cemental tears if severe

21
Q

Where are the compression/tension zones in jiggling forces?

A

no clear zone

22
Q

What are the current conclusions on TFO?

A

1 - it does not initiate disease
2 - weak evidence that it can increase prate of progression
3 - still need to eval/address occlusion in perio patients

23
Q

What were some of the early thoughts on TFO?

A

Its the primary etiology of perio (Karolyi/Stillman/Bunting)
It has no impact on perio (Gotlieb & Orban)
May lead to increased PD - but does not induce (Box/Stones)

24
Q

What is the “Pathways of inflammation” Theory and how does it progress on the Buccal/Lingual sides?

A

Weinman et al. 1941
Histologic analysis of 32 Human Jaws

Buccal Lingual: Follows course of the periosteal side, then penetrates into the bone -

Buccal/Lingual
25
Q

How does inflammation progress in the interproximal sites?

A

Interproximal: Follows course of interseptal artery - Supporting bone destroyed first, then alveolar bone proper

26
Q

Does inflammation penetrate the PDL without trauma?

A

RARELY (Weinman 1941)

27
Q

Where does inflammation spread with trauma?

A

Macapanpan & Weinman 1954

Rat study - rubber dams placed between contacts - trauma caused inflammation in both pressure and tension side - TENSION SIDE: INFLAMMATION GOES DIRECTLY INTO PDL
Trauma alone does not cause boneloss

28
Q

Pathway of inflammation with Perio + Trauma

A

Comar, Kollar and Gargoiulo 1969

Rhesus Monkeys
High crown with overhanging margins
Resorption at crest and furcation
Most in 1st 14 days
Increased “pseudo PD”
No altered pathway of inflammation
No Apical migration of JE
Bone loss, but no PD

29
Q

Stahl et al. 1968

A

4 human jaws removed from cancer surgery - did histology
inflammation and destruction have limited predictability with occlusal trauma
Only 1 infrabony defect with TFO

30
Q

Summarize the pathways of inflammation

A
31
Q

What is EOF? who looked into this?

A

Muhlemann
0-100grams: movement within the alveolus (initial tooth movement)
>100grams: Elastic deformation of the alveolar bone (Secondary tooth movement)

32
Q

How often does trauma need to happen to have an impact? What kind of forces?

A

With Jiggling forces - 4-5x/day
Muhlemann

33
Q

Muhlmann & Herzog 1961

A

LIVE HUMAN STUDY
14yo girl had teeth scheduled for extraction
Put a high inlay in and had patient cause self jiggling movements
Started 4/day every other day (no trauma)
Increased to 4/day every day (Mobility/Acute trauma) 4-6weeks
After 3-4mo, NO PAIN (adaptation happened)
Increased again - acute trauma again

34
Q

What are the components of occlusal forces?

A

Magnitude, direction, duration, Frequency
Components focused on by Muhlmann

35
Q

Does splinting decrease mobility?

A

No
Wust

36
Q
A
37
Q

What is the difference between simple and compound periodontitis?

A

Simple: Perio alone
Compound: Perio + Trauma

38
Q

What is the problem with Polson’s studies?

A

Only 2 days of jiggling forces - not enough to cause acute trauma (found by Muhlmann)

39
Q

What are the differences between the LIndhe and Polson studies?

A

Occlusion (1 decks)

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