trauma from occlusion

Question 1

what is primary occlusal trauma?

Answer 1

Excessive force (e.g.: “high restoration”) to NORMAL periodontium

Question 2

what is secondary occlusal trauma?

Answer 2

Normal (or excessive forces) Applied to a weakened periodontium

Question 3

what is “fremitus”?

Answer 3

palpable vibrations or movement of a tooth, usually due to excessive contact with another tooth.

Question 4

what are the 2 types of mobility caused by “teeth moving teeth”?

Answer 4

Fremitus and functional mobility

Question 5

what is pathogenic migration? what causes

Answer 5

tooth displacement that results when the balance among the factors that maintain physiologic tooth position is disturbed by periodontal disease

Question 6

T/F: pathogenic migration is a sign of unstable periodontium

Answer 6

true

Question 7

what are the Possible Radiographic signs of occlusal trauma?

Answer 7

• Some may be due to extension of inflammatory periodontal disease without occlusal trauma as a factor
• Widened PDL Space and/or Thickened Rad. Lamina Dura

Question 8

hypofunction and hyperfunction can both occur in ____________ bone

Answer 8

trabecular bone

Question 9

________ of trabecular bone is a result of a lack of occlusal forces

Answer 9

hypofunction

Question 10

T/F: angular bone loss & furcations have been a proven result of occlusal trauma

Answer 10

FALSE

May purely be due to tooth and bony anatomy and the progression of inflammatory periodontal disease

Question 11

what is the Co-Destruction theory?

Answer 11

Occlusal trauma may be a co-destructive factor that alters the severity and pattern of inflammatory periodontal disease

Question 12

T/F: occlusal trauma can allow periodontal disease to find a way into the PDL

Answer 12

true

Question 13

what theory claims that: Occlusal trauma has no role in the severity and pattern of inflammatory periodontal disease progression

Answer 13

Advancing Plaque Front Theory

Question 14

In trauma from occlusion, crushing of tooth against bone causes injury to the periodontal ligament at what sites?

Answer 14

at sites of pressure and tension

can cause tipping of the tooth

Question 15

T/F: tipping of a tooth due to occlusal forces can result in inflammation

Answer 15

true

the necrosis of the PDL when pulled apart can cause inflammation

Question 16

an injury from TFO without periodontitis results in what?

Answer 16

Injury results in acute (not plaque associated) inflammation

Question 17

in TFO without periodontitis, PDL collagen fibers are destroyed ________

Answer 17

subcrestally

Question 18

T/F: attachment loss is seen in a majority of TFO cases without periodontitis

Answer 18

FALSE

no perio- no attachment loss

Question 19

how do teeth adapt to TFO without periodontitis?

Answer 19

increased mobility, widened PDL Space

Question 20

T/F: in patients with only TFO (no periodontal issues), occlusal therapy may diminish the signs of occlusal trauma

Answer 20

true

Question 21

what types of occlusal therapy can be used to reduce Traumatic occlusal forces?

Answer 21

• Re-contour high filling to resolve problem
• Splint teeth together to reduce force
• Bite planes

Question 22

what causes secondary occlusal trauma?

Answer 22

normal occlusal forces are placed on teeth with compromised periodontal attachment

Question 23

T/F: occlusal trauma and periodontitis can occur on the same tooth, but can be completely independent of one another

Answer 23

true

its the “No co-destruction” type

Question 24

what happens when you have Jiggling type occlusal forces with periodontitis?

Answer 24

inflammatory infiltrate occupied by occlusal trauma lesion.

Question 25

before you can address the issues associated with traumatic occlusal forces, you must take care of any existing __________

Answer 25

periodontitis

Question 26

what happens due to the Downgrowth of junctional epithelium during TFO?

Answer 26

Enhanced loss of connective tissue

Question 27

if periodontitis merges with increased tooth mobility (due to TFO), you will have _____________

Answer 27

co-destruction

Question 28

Downgrowth (apical migration) of pocket epithelium, and enhanced (accelerated) attachment loss are both characteristics of what condition?

Answer 28

Co-destruction | combination of perio and TFO

Question 29

T/F: If TFO and inflammatory periodontitis are separate (independent) processes, there will be enhanced attachment loss

Answer 29

FALSE there will be no enhancement of attachment loss

Question 30

what are the reversible treatments for TFO?

Answer 30

Night Guard (bite plane) Extracoronal Splints Muscle relaxants (medications) Muscle exercises

Question 31

what are the irreversible treatments for TFO?

Answer 31

Intracoronal splints Occlusal adjustment by selective grinding Orthodontics Orthognathic surgery

Question 32

what are the indications for selective occlusal grinding?

Answer 32

1) Periodontal Occlusal Trauma 2) Post-orthodontics 3) use prior to extensive treatments 4) Certain types of TMD 5) Certain wear patterns

Question 33

when would you NOT want to use occlusal adjustment?

Answer 33

Severe malocclusion Non-ideal but tolerated occlusion Severe wear Patient in pain If no suitable end point

Question 34

T/F: No TMO repair can occur unless inflammatory periodontal disease is first resolved

Answer 34

true

Question 35

Occlusal trauma superimposed on an existing periodontitis may under certain conditions accelerate _____________

Answer 35

attachment loss

Question 36

when is Occlusal therapy in conjunction with periodontal treatment indicated?

Answer 36

when occlusal trauma is present

Question 37

Occlusal therapy is especially indicated prior to what?

Answer 37

periodontal regenerative therapy