Session 8: Local Periodontal Predisposing Risk Factors

Question 1

What are Risk Factors?

Answer 1

An attribute or exposure that increases the probability of disease
Local Risk Factors
• Increase biofilm retention
• Increase biofilm pathogenicity
• Cause direct damage to the periodontium

Question 2

Dental Calculus

Answer 2

Surface of the calculus deposit is irregular and covered with disease-causing bacteria. Forms ledges on teeth.

• Acquired pellicle, Irregular tooth surface, Direct contact -> calculus attachment
• Plaque control becomes difficult, increases risk for disease

Question 3

Tooth Morphology

Answer 3

• Developmental defects- grooves
• Tooth and root concavities
• Poorly contoured restorations
• Carious lesions
• Calculus deposits in cracks in the tooth surface, tiny openings from PDL detachment, or grooves in the cementum from over instrumentation
• Deposit removal is difficult because deposits lie sheltered in tooth defects

Question 4

Malpositioned Teeth

Answer 4

• Hinder proper plaque removal

Question 5

Open contact & plunger cusp

Answer 5

• Trapped food between teeth
• OHI can be a challenge
• Alteration on gingival contour
• May lead to periodontal breakdown

Question 6

Dental restorations and appliances

Answer 6

• Poorly contoured restorations
• Poorly constructed prosthesis
• Difficult or even impossible to remove biofilm effectively from the tooth surface adjacent to an overhang
• Difficulties in cleaning the tooth surface results in biofilm retention and can lead to increased severity of disease

Question 7

Occlusal forces

Answer 7

• Functional occlusal forces – normal forces produced during chewing 
• Parafunctional occlusal forces – result from tooth-to-tooth contact when not eating. clenching & bruxing
Signs of Trauma from occlusion
• tooth mobility
• sensitivity to pressure
• migration of teeth
• Enlarged, funnel-shaped PDL space
• alveolar bone resorption

Question 8

Primary occlusal trauma

Answer 8

Primary Trauma from Occlusion• Excessive forces on healthy periodontium
• Excessive forces on the abutment teeth
• Widening of the periodontal ligament space
• High restorations
• Sensitivity
• Mobility
• Pain
• No apical migration of JE
• Adjustment reverses trauma

Question 9

Secondary Trauma from Occlusion

Answer 9

• Excessive forces on unhealthy periodontium
• JE apical migration, loss of connective tissue
• Unhealthy periodontium with secondary occlusal forces will result in rapid bone loss, pocket formation

Question 10

Oral hygiene habits

Answer 10

Tongue thrusting, Mouth breathing (dehydration), Improper use of interdental aids, Ineffective and/or traumatic
toothbrushing

Question 11

Oral hygiene habits

Answer 11

Floss will not dislodge the biofilm from the base of a root concavity. Interdental brushes can effectively remove the biofilm