Traumatic Occlusal Forces Flashcards
What conditions affect the periodontium?
- systemic disease
- periodontal abscess or periodontal/endodontic lesion
- mucogingival deformities and conditions
- traumatic occlusal forces
- tooth and prosthesis related factors
What is the etiology of occlusal trauma (OT)?
Injury resulting in tissue changes within the attachment apparatus (periodontal ligament, cementum and supporting bone) as a result of occlusal forces
What type of periodontium can occlusal trauma (OT) occur in?
May occur in an intact periodontium or in a reduced periodontium affected by periodontal disease
cannot happen in a patient without teeth
What is a reduced periodontium?
- reduced is loss of >60% of bone support
- any attachment loss = reduced periodontium
definition is a little confusing
Over 100s of years of studies on many types of animals it was discovered that occlusal trauma does or does not have an effect on pocket formation or loss of connective tissue?
DOES NOT
What are the parts of the periodontium affected by occlusal forces?
- Cementum
- PDL
- Alveolar Bone Proper
The gingiva and junctional epithelium are or are not affected by occlusal forces
are not
What are the classifications of traumatic occlusal forces on the periodontium (2017)?
A. Primary occlusal trauma
B. Secondary occlusal trauma
C. Orthodontic forces
What are the variables of occlusal trauma?
- Direction of force
- Magnitude of force
- Duration of force
- Frequency of occurrence
Trauma from occlusion is considered to be…
pathologic
Trauma from occlusion happens when forces of occlusion ________ the adaptive capacity of the periodontium
exceed
Is hyperfunction (high occlusion) pathologic, normal, or physiological?
moving towards pathologic
Is hypofunction (tooth not in occlusion) pathologic, normal, or physiological?
moving towards physiological
Is disues/atrophy pathologic, normal, or physiological?
physiological
A tooth opposing an implant will likely experience…
hypofunction
A tooth opposing a high restoration will likely experience…
hyperfunction
What are examples primary occlusal trauma?
- With Primary occlusal trauma, clinically may see adaptive mobility (does not progress)
- Example is ‘high’ restoration with mobility resolving following reduction
What is primary occlusal trauma?
Traumatic occlusal forces applied to a tooth or teeth with normal periodontal support
What is secondary occlusal trauma?
Injury resulting in tissue changes from normal or traumatic occlusal forces applied to a tooth or teeth with reduced periodontal support
What are the signs/symptoms of secondary occlusal trauma?
May be seen as progressive mobility &/or pain
What happens on the compression side of a tooth moving?
area that the teeth is moving toward
- PDL space is reduced as fibers are compressed
- Loss of fiber orientation
- Increased capillary permeability, rupture of blood vessels and hemorrhage into PDL perivascular spaces (edema)
- Resorption of alveolar bone proper (root resorption if severe) then widening of PDL space
What are the symptoms of minor trauma from occlusion?
- Increased capillary permeability, dilation
- Edema, disturbed fluid exchange
- Vascular damage with stasis, clotting, thrombosis
- Lowered periodontal resistance?
- Accompanying tissue effects, usually minor
What happens on the tension side of a tooth moving?
area that the teeth is moving from
- Increase in PDL space
- Rupture of PDL fiber bundles
- Compression of PDL blood vessels and hemorrhage into perivascular spaces
- Deposition of new alveolar bone and decrease in PDL space (If severe, cemental tears)
What are the symptoms of severe trauma from occlusion?
- Crushing (pressure) injury - necrosis at furca, alveolar crest
- Extravasated RBCs, hematoma, necrosis, vascular damage
- Well-defined necrosis, including PDL, cementum, bone
- Degenerative changes (hyaline, mucoid, liquefaction)
- Repair from PDL, endosteal cells, bone marrow, Haversian systems (rear resorption)