Trauma From Occlusion - Natural teeth 10/15/15

Question 1

Trauma from occlusion =

Answer 1

An injury to the attachment apparatus as the result of excessive occlusal forces.

Question 2

What are the 2 types of occlusal trauma?

Answer 2

Primary = Excessive force (High restoration) *Normal periodontium

Secondary = Normal (Or excessive force) *weakened Periodontium

Question 3

What are the Clinical signs of Occlusal trauma?

Answer 3

• Progressive tooth mobility
• Teeth are moving Teeth
• Pathological Migration
• Infrabony pockets
• Buttressing of bone (controversial)

Question 4

What are the radiographic signs of occlusal trauma?

Answer 4

• Widened PDL space and/or Thickened Rad. Lamina Dura
• Hyper or hypo function of trabecular bone
• Ang. bone loss and furcations (Controversial)

Question 5

What is the CO-destruction theory?

Answer 5

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

Question 6

What is the Advancing Plaque Front theory?

Answer 6

Occlusal Trauma has no role in the severity and pattern of inflammatory periodontal disease progression.

Question 7

Describe the model of Trauma from occlusion without Periodontitis…

Answer 7

• injury results in acute (not plaque associated) inflammation
• PDL collagen destruction
• Cementum resorption
• Bone loss
• No attachment loss!
• Adaptation may occur: tooth may become mobile, but no further injury.
• Signs of occlusal trauma may diminish after occlusal therapy.

Question 8

Describe the model of Trauma from Occlusion with Periodontitis (But no co-destruction)…

Answer 8

• Supracrestal Periodontitis lesion
• Occlusal trauma lesion (Independent of periodontal lesion)
• MUST CONTROL PERIODONTITS BEFORE OCCULSAL THERAPY!

Question 9

Describe the Model of Trauma From Occlusion with Periodontitis (with co-destruction)…..

Answer 9

• Sub-crestal (infra bony pocket) with inflammatory infiltrate.
• Occlusal trauma lesion
• The combination of SUB-crestal lesion and TFO creates an environment conducive to Co-destruction.
• The periodontitis merges with increased tooth mobility = co-destruction occurs.
• ENHANCEMENT OF ATTACHMENT LOSS OCCURS!
• MUST CONTROL PERIODONTITIS BEFORE OCCUSAL THERAPY!

Question 10

T or F, If TFO and Inflammatory Periodontitis are separate/independent processes, there is no enhancement of attachment loss.

Answer 10

True

Question 11

What are the Reversible methods of occlusal therapy?

Answer 11

• Night guard (bite plane)
• Extracornal splints
• Muscle relaxants
• muscle exercise

Question 12

What are the Irreversible methods of occlusal therapy?

Answer 12

• Intracoronal splints (require tooth prep.)
• occlusal adjustment by selective grinding
• orthodontics
• orthognathic surgery

Question 13

What are the indications for adjustment via selective grinding?

Answer 13

• Periodontal Occlusal trauma
• Post-orthodontics
• Prior to extensive
• Certain types of TMD
• Certain wear patterns

Question 14

What are the Contraindications to occlusal adjustment?

Answer 14

• Severe malocclusion
• Non-ideal but tolerated occlusion
• Severe wear
• Patient in pain
• If no suitable endpoint