The Role of Occlusion in the Development and Progression of Periodontal Disease Flashcards
What does the periodontium do?
It attached the tooth to the alveolar bone
This soft tissue dissipates forced of occlusion to surrounding tissues
Define occlusal trauma
Describes injury resulting in tissue changes within the attachment apparatus (including the periodontal ligament, supporting alveolar bone and cementum) as a result of occlusal forces
Define traumatic occlusal force
Any occlusal force resulting in injury of the teeth and or the periodontal attachment apparatus
How do define and diagnose trauma from occlusion
By histological changes
We do this through clinical and radiographic findings
Give examples of clinical findings that may indicate occlusal trauma
- Mobility
- Wear facets
- Root resorption
- Occlusal discrepancias
- Discomfort/ pain on chewing
- Fremitus
- Thermal sensitivity
- Cemental tears
- Fractured tooth
- Tooth migration
What is fremitis
The tooth moving as occluded teeth slide laterally or in protrusion
What radiographic sighs might indicate occlusal trauma
- Widening of PDL space
- Vertical infra bony defects
- Crescent shaped bone loss
What might the patient complain of that could indicate occlusal trauma
TMJ pain or tenderness of the muscles of mastication (Hypertrophy)
Name the 2 types of occlusal trauma
- Direct
2. Indirect
What is direct trauma
Trauma directly applied to the periodontal tissues
What is indirect trauma
Trauma indirectly applied to the periodontal tissue eg through the teeth
How do we classify developmental or acquired deformities and conditions
Armitage classification 1999
Talk through the Armitage classification
A. Localised tooth related factors that modify or predispose to plaque-induced gingival diseases/periodontitis
B. Mucogingival deformities and conditions around teeth
C. Mucogingival deformities and conditions on edentulous ridges
D. OCCLUSAL TRAUMA
What is occlusal trauma split into according tot eh Armitage classification
- Primary occlusal trauma
2. Secondary occlusal trauma
Which category does periodontal disease due to occlusal trauma fall under
other conditions affect the periodontium
What categories fall under other factors affecting the periodontium
- Systemic disease or conditions affecting the periodontal supporting tissue
- Periodontal abscesses and Endodontic-Periodontal lesions
- Mucogingival Deformities and Conditions
- Traumatic occlusal forces
- Tooth and prosthesis related factors
What is primary traumatic occlusal force
Excessive occlusal forces on teeth with normal periodontal support
What is secondary traumatic occlusal force
Normal or excessive forces on teeth with reduced periodontal support
What concepts were discovered following cadaver studies looking at traumatic occlusal forces
1, Glickman concept
2. Waerhaug’s Concept
What is the glickman concept
Postulated that the type of attachment loss was different for teeth undergoing the application of forces of abnormal magnitude than for those undergoing normal loading
What does Glickmans concept not take into account
Does not take into account form of interdental bone or thickness of bone
What did Waerhaug’s Concept lok at
Autopsy material and apical extension of sub gingival plaque relative to the inflammatory cell infiltrate and the level of the adjacent alveolar bone
What did Waerhaug’s Concept conclude
That the loss of attachment was entirely due to inflammatory factors
What are the problems with cadaver studies
- Impossible to accurately assess the pre death occlusion
- No way to establish cause and effect
- No knowledge of cadavers habits or parafunction
