Occlusal Trauma (E2,L4)

Question 1

_________: Defined as damage to the periodontium caused by stresses on the teeth produced directly or indirectly by teeth in the opposing jaw.

Answer 1

Perio Trauma from Occlusion

Question 2

Trauma from occlusion is considered to be _________. Forces of occlusion that _______ the adaptive capacity of the periodontium.

Answer 2

PATHOLOGICAL…..EXCEED

Question 3

The 4 variables of occlusal trauma to Perio disease are direction, magnitude, duration, and frequency of the _______.

Answer 3

FORCES

Question 4

What are the three periodontal components affected by occlusal trauma? What 2 components of the periodontium are NOT affected by occ trauma???

Answer 4

Affected: 1.Cementum 2.PDL 3.Alveolar Bone Proper….NOT affected: 1. Gingiva 2.Junctional Epithelium

Question 5

Clinical Symptoms of Occlusal Trauma: Radiographic evidence of “ ________”/”_______” PDL.

Answer 5

“thickened”/”widened”

Question 6

Clinical Symptoms of Occlusal Trauma: Evidence of occlusal _____ in centric relation or centric occlusion

Answer 6

slide

Question 7

Clinical Symptoms of Occlusal Trauma: Evidence of occlusal interference in ________ mandibular movement.

Answer 7

protrusive

Question 8

Clinical Symptoms of Occlusal Trauma: Evidence of ______ and/or balancing side occlusal interferences.

Answer 8

working

Question 9

YAY LATIN!!!! _______: a tremulous vibratory movement of a tooth when teeth come into functional contact – generally detected by finger palpation.

Answer 9

Fremitus!

Question 10

Trauma from occlusion on the compression side: Compression of PDL fibers with INITIAL decrease in _____ of PDL space.

Answer 10

width

Question 11

Trauma from occlusion on the compression side: Loss of _____ orientation.

Answer 11

PDL fiber

Question 12

Trauma from occlusion on the compression side: Rupture of capillaries and hemorrhage into ____ perivascular spaces.

Answer 12

PDL

Question 13

Trauma from occlusion on the compression side: Resorption of alveolar bone proper followed by _______ of PDL space.

Answer 13

widening

Question 14

Trauma from occlusion on the compression side: If SEVERE, _____ resorption may occur

Answer 14

root!

Question 15

WHICH SIDE displays surface resorption of bone and compacting of PDL?

Answer 15

Compression side of tooth movement! (like in ortho!)

Question 16

Trauma from Occlusion: Tension side– Tension (stretching) of fibers with initial ______ in PDL space.

Answer 16

INCREASE

Question 17

Trauma from Occlusion: Tension side–Rupture of ____ fiber bundles.

Answer 17

PDL

Question 18

Trauma from Occlusion: Tension side– _______ of PDL capillaries and hemorrhage into PDL perivascular spaces.

Answer 18

Compression

Question 19

Trauma from Occlusion: Tension side– _______ of new alveolar bone proper followed by _______ in PDL space.

Answer 19

Apposition…Decrease!

Question 20

Trauma from Occlusion: Tension side– the cementum shows ______

Answer 20

tearing

Question 21

Which type of occlusal trauma? Occurs when occlusal forces are excessive (increased) and the amount of alveolar bone support is normal.

Answer 21

PRIMARY occlusal trauma

Question 22

Primary Occlusal Trauma from NON-Vertical Forces: Pressure points on bone and PDL with forces NOT in ______ of the tooth during excursive movements.

Answer 22

long axis

Question 23

Which type of occlusal trauma? Occurs when occlusal forces are NORMAL OR EXCESSIVE and the amount of alveolar bone support is REDUCED.

Answer 23

SECONDARY occlusal trauma

Question 24

Occlusal HYPERfunction: _______ increase in occlusal force. Considered to be a ________ adaptation and not a _______ entity.

Answer 24

Slight….. physiologic…pathologic

Question 25

Occlusal HYPERfunction: ______ in number and diameter of collagen fiber bundles in PDL...._______ width of PDL

Answer 25

INCREASE....INCREASED

Question 26

Occlusal HYPERfunction: What happens to the density and thickness of alveolar bone proper (lamina dura)?

Answer 26

INCREASES density/thickness

Question 27

Occlusal HYPERfunction: Radiographic evidence of _________ of alveolar bone with PDL insertions.

Answer 27

osteosclerosis

Question 28

Occlusal HYPERfunction: ______ or ________ tooth mobility

Answer 28

slight or undetectable

Question 29

Occlusal HYPOfunction: A mild ________ of the tooth supporting structures due to lack of physiologic stimulation

Answer 29

weakening

Question 30

Occlusal HYPOfunction: Considered to be a ________ adaptation and not a ________ entity.

Answer 30

physiologic....pathologic

Question 31

Occlusal HYPOfunction: What is the ONLY method of diagnosing this condition?

Answer 31

HISTOLOGICALLY!

Question 32

Occlusal HYPOfunction: we see a _______ in number of PDL fiber bundles but normal _______.

Answer 32

decrease....orientation

Question 33

Occlusal HYPOfunction: ________ physiologic turnover and remodeling of alveolar bone.

Answer 33

decreased

Question 34

Occlusal HYPOfunction: ________ of PDL space.

Answer 34

NARROWING

Question 35

Occlusal HYPOfunction: what happens to tooth mobility?

Answer 35

no change

Question 36

_________: Total removal of occlusal forces resulting in lack of the level of physiologic stimulation required to maintain normal form and function. AGAIN: Considered to be a physiologic adaptation rather than a pathologic feature of disease.

Answer 36

Disuse Atrophy

Question 37

DISUSE ATROPHY: Radiographic evidence of _______ width of PDL space.

Answer 37

decreased

Question 38

DISUSE ATROPHY: _______ tooth mobility is always present.

Answer 38

increased

Question 39

DISUSE ATROPHY: Absence of occlusal ________

Answer 39

antagonist

Question 40

DISUSE ATROPHY: Loss of ________ of the principle fiber bundles of the PDL

Answer 40

orientation

Question 41

DISUSE ATROPHY: Significant ________ in number of bony trabeculae, i.e., localized osteoporosis

Answer 41

decrease

Question 42

Really Big Take Home Message! Occ Trauma&Perio Disease: Trauma from occlusion, in the absence of inflammation DOES NOT CAUSE 1._________ 2.________ 3.________. They are caused by bacteria, but yes occ trauma can exacerbate these.

Answer 42

1.gingivitis 2.periodontitis 3.pocket formation

Question 43

Monkey & Dog Research: When bone loss is the result of periodontitis in the presence of occlusal trauma, removal of the occlusal trauma will not result in ________ of crestal bone.

Answer 43

regeneration

Question 44

Monkey & Dog Research: Bone alterations resulting from occlusal trauma alone are ________ when the trauma is removed.

Answer 44

REVERSIBLE!

Question 45

Monkey & Dog Research: When bone loss is the result of periodontitis in the presence of occlusal trauma, removal (treatment) of both will result in a remarkable, but not complete, _________ of bone .

Answer 45

regeneration

Question 46

Boom. Main Point..Monkey & Dog Research: Periodontitis with superimposed occlusal trauma produces ______ bone loss than periodontitis alone.

Answer 46

MORE

Question 47

Human Research: Study provides strong evidence of an association between untreated occlusal discrepancies and the progression of periodontal disease. In addition, the study shows that occlusal treatment significantly ______ the progression of periodontal disease over time.

Answer 47

REDUCES

Question 48

What is usually the first treatment for malocclusion/palatal impingement?

Answer 48

ortho!

Question 49

_______ disease: The creation of additional problems or complications as a result of treatment.

Answer 49

IATROGENIC

Question 50

_______ of crowns and gingival ______ of crowns and restorations were important determinants of periodontal health.

Answer 50

contour....margins

Question 51

Gingival margin ________ of interproximal restorations are associated with periodontal pockets that are significantly deeper than sites where there is no restoration.

Answer 51

OVERHANGS

Question 52

Gingival inflammation and plaque retention scores show significant decreases following removal of the _______.

Answer 52

overhang

Question 53

Gingival Margin _______ are associated with gingival inflammation, bone loss, and microbial plaque and calculus accumulation.

Answer 53

overhangs

Question 54

What is the optimal CROWN to ROOT ratio??

Answer 54

C1:1.5-2R

Question 55

Force vectors outside the long axis of the roots tend to produce a rocking motion and _____ bone loss

Answer 55

vertical