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Periodontics I > Traumatic occlusal forces > Flashcards

Traumatic occlusal forces Flashcards

1
Q

Injury resulting in tissue changes within the attachment apparatus (PDL, cementum, & supporting bone) as a result of occlusal forces:

A

Occlusal trauma

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2
Q

Occlusal forces =

A

Teeth

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3
Q

T/F: OT may occur in an intact periodontium or in a reduced periodontium affected by perio disease

A

True

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4
Q

Reduced periodontium =

A

60% of bone loss

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5
Q

Gold standard for periodontal disease is:

A

attachment loss

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6
Q

Terminology in the 2017 AAP World Workshop changes the word excessive to:

A

traumatic

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7
Q

T/F: Overall, past studies showed lack of “cause & effect” such as OT did NOT cause pocket formation or lead to loss of connective tissue

A

True

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8
Q

List the parts of the periodontium affected by occlusal forces:

A
  1. cementum
  2. PDL
  3. Alveolar bone proper
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9
Q

T/F: The gingiva & JE are not affected by occlusal forces

A

True

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10
Q

List the categories of occlusal trauma:

A

1a) primary
1b) secondary
1c) orthodontic

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11
Q

Controlled occlusal trauma to change the relationship of the teeth to one another:

A

Orthodontics

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12
Q

What are the variables of occlusal trauma:

A
  1. DIRECTION of force
  2. MAGNITUDE of force
  3. DURATION of force
  4. FREQUENCY of occurrence

(direction, magnitude, duration, frequency)

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13
Q

Bone should be ____mm from the CEJ

A

1-2

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14
Q

Trauma from occlusion is considered to be:

A

Pathologic

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15
Q

Forces of occlusion _____ the adaptive capacity of the periodontiun

A

Exceed

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16
Q

List from pathological to physiologica:

A

PATHOLOGICAL
-occlusal trauma
-hyperfunction
-normal
-hypofunction
-disuse atrophy
PHYSIOLOGICAL

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17
Q

Occlusal trauma & hyperfunction are considered:

A

pathological

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18
Q

Hypofunction & disuse atrophy are considered:

A

Physiological

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19
Q

Placing a high amalgam restoration is an example of:

A

Hyperfunction

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20
Q

Tooth that is barely occluding is an example of:

A

Hypofunction

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21
Q

Traumatic occlusal forces applied to a tooth or teeth with normal periodontal support:

A

Primary occlusal trauma

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22
Q

With PRIMARY occlusal trauma we may clincially see _____ that _____

A

ADAPTIVE mobility that does NOT progress

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23
Q

Give an example of PRIMARY occlusal trauma:

A

High restoration with mobility resolving following reduction

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24
Q

T/F: SECONDARY occlusal trauma tends to happen in a fairly late stage of perio disease with nearly 60% bone loss

A

True

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25
Q

Injury resulting in tissue changes from normal or traumatic occlusal forces applied to a tooth or teeth with reduced periodontal force:

A

SECONDARY occlusal trauma

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26
Q

SECONDARY occlusal trauma may be seen as:

A

progressive mobility and/or pain

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27
Q

Moving tooth #19 towards tooth #18

Compression side=

Tension side=

A

Compression side= direction tooth is moving

tension side= direction opposite that tooth is moving

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28
Q

Direction that the tooth is moving due to OT:

A

Compression side

29
Q

Direction OPPOSITE to moving tooth due to OT:

A

Tension side

30
Q

As fibers are compressed due to OT, ____ is reduced

A

PDL space

31
Q

Compression side results in loss of:

A

fiber orientation

32
Q

Compression side results in increased capillary permeability, rupture of blood vessels and hemmorhage into PDL vasculature spaces ultimately resulting in:

A

edema

33
Q

T/F: With compression, resorption of alveolar bone proper (root resorption if severe) and widening of the PDL will occur

A

true

34
Q

-increased capillary permeability, dilation
-edema, disturbed fluid exchange
-vascular damage with stasis, clotting, thrombosis
-lowered periodontal resistance
-acommpanying tissue effects, usually minor

A

Minor trauma from occlusion

35
Q

What happens to the PDL on the tension side?

A

lenghtening resulting in increase in PDL space

36
Q

Lengthening occurs on the tension side resulting in:

A

increased PDL space

37
Q
  • increase in PDL space
    -rupture of PDL fiber bundles
  • compression of PDL blood vessels & hemorrhage into perivascular space
    -deposition of new alveolar bone & DECREASE in PDL space if severe cemental tears
A

Tension side

38
Q

This act results in RESORPTION of alveolar bone proper & WIDENING of the PDL space (root resorption):

This act results in DEPOSITION of new alveolar bone & DECREASE of the PDL space (if severe cemental tears):

A

Compression side

Tension side

39
Q

-crushing (pressure) injury, necrosis at furca, alveolar crest
-extravasated RBCs, hematoma, necvrosis, vascular damage

A

SEVERE trauma from occlusion

40
Q

Traumatic occlusal forces applied to tooth or teeth with NORMAL periodontal support:

A

PRIMARY occlusal trauma

41
Q

What is a manifestation of PRIMARY occlusal trauma:

A

adaptive mobility (not progressive or pathologic)

example: hyper occlusion

42
Q

NORMAL or TRAUMATIC occlusal forces applied to tooth or teeth with REDUCED periodontal support:

A

Secondary occlusal trauma

43
Q

What is a manifestation of SECONDARY occlusal trauma:

A

progressive mobility

44
Q

What is the ONLY true way to determine occlusal trauma occurance?

A

BIOPSY

45
Q

PROPOSED clinical & radiographic indicators of occlusal trauma:

A
  1. fremitus
  2. mobility
  3. occlusal discrepencies
  4. wear facets
  5. tooth migration
  6. fractured tooth
  7. thermal sensitivity
  8. discomfort/pain on chewing
  9. widened PDL ligament space
  10. root resorption
  11. cemental tear
46
Q

A palpable or visible movement of a tooth when subjected to occlusal force:

A

fremitus

47
Q

Clinical signs & symptoms of occlusal trauma:

A
  1. MOBILITY of affected teeth
  2. radiographic evidence of THICKENED PDL
  3. positive history of clenching or bruxism
  4. missing or tilted teeth
  5. evidence of occlusal interferences
48
Q

What is the mobility index we currently use for occlusal trauma?

A

Miller

49
Q

Classify the miller status

-first disntinguishable sign of movement greater than normal

A

Miller 1

50
Q

Classify the miller status

-movement that allows the crown to move 1mm from its normal position in any direction

A

Miller 2

51
Q

Classify the miller status

-tooth may be rotated or depressed in alveoli

A

Miller 3

52
Q

T/F: It is acceptable to use fingers when determining miller class

A

False- MUST USE TWO RIGID INSTRUMENTS

53
Q

Grinding, clenching or clamping of teeth. The force may damage tooth or attachment apparatus:

A

Bruxism

54
Q

-Increased mobility
-Pulpal sensitivity
-Bite tenderness
-Non-masticatory/excessive occlusal wear
-Dull percussion sound
-Muscle tenderness/spasm/HYPERtrophy/tiredness
-TMJ pain
-Jaw lock
-Audible sounds

A

Bruxism indicators

55
Q

What type of percussion sound will be heard with a bruxer?

A

Dull

56
Q

Other manifestations of traumatic occlusal force include:

A
  1. malocclusions
  2. tooth migration
  3. fractured tooth
57
Q

Radiographic signs of traumatic occlusal forces:

A
  1. WIDENED PDL space
  2. Thickening of lamina dura
  3. Vertical (angular) bone loss
  4. Furcal bone loss
  5. Alveolar radiolucency and/or condensation
58
Q

The PDL is thickest at ____ & ____

A

apices & alveolar crest (0.20mm)

59
Q

What is the measurement of the PDL at the mid-root?

A

0.15 mm

60
Q

What is the biggest contraindication to occlusal adjustment?

A

When periodontal inflammation has NOT been controlled

Other contraindications include:
1. absence of pre-treatment diagnosis
2. prophylactic therapy or sole treatment of perio disease
3. as primary treatment of bruxism
4. severe extrusion or malpositioned teeth

61
Q

T/F: Tooth mobility positively affects outcome of periodontal therapy and maintenance

A

False- negatively affects

62
Q

T/F: Tooth mobility will generally decreases once inflammation is controlled

A

True

63
Q

Occlusal adjustment is best done in conjunction with:

A

periodontal therapy

64
Q

Hyperfunction is a slight increase in occlusal force. This is considered to be a ____ adaptation

A

Physiologic

65
Q

Trauma from occlusion in the absence of inflammation does not cause:

A
  1. gingivitis
  2. periodontitis
  3. pocket formation
66
Q

T/F: There is NO EVIDENCE that TOF causes no-carious cervical lesions (NCCLs)

A

True

67
Q

NCCLS may result from:

A
  1. abrasion
  2. erosion
  3. corrosion

(NOT TOF)

68
Q

T/F: Evidence from observational studies reveal that traumatic occlusal force does cause gingival recession

A

False- TOF does NOT cause gingival recession

69
Q
A

Periodontics I (17 decks)

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