Trauma

Question 1

Primary Occlusal Trauma

Answer 1

Excessive force

Normal periodontium

Question 2

Secondary Occlusal Trauma

Answer 2

Normal or excessive forces

Applied to a weakened periodontium

Question 3

Orthodontic occlusal trauma

Answer 3

Create forces on the periodontium that simulate occlusal trauma

Question 4

Possible signs of clinical trauma

Answer 4

Progressive tooth mobility 
Fire it is
Functional mobility
Pathologic migration 
Infrabony pockets 
Buttressing bone

Question 5

Radiographic signs of traum may represent

Answer 5

Adaption

Some ay be due to extension of inflammatory periodical disease without occlusal trauma as a factor

Question 6

Angular bone loss and furcation may be due to

Answer 6

Tooth and bony anatomy and the progression of inflammatory periodontal disease

Question 7

Co-Destruction Theory

Answer 7

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

Question 8

Co-destruction: Periodontal disease may find a pathway into

Answer 8

The PDL

Question 9

Advancing Plaque front Theory

Answer 9

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

Question 10

In trauma from occlusion, rushing of tooth against bone causes injury

Answer 10

To the periodontal ligament at sites of pressure and tension

Question 11

TFO without periodontitis

Answer 11

Injury results in acute inflammation

PDL collagen destruction

Cementum resorption
Bone loss

NO attachment loss

Adaption may occur tooth may become mobile but no further injury

Question 12

Functional mobility

Answer 12

Tooth is in occlusion and as chew you can see tooth move

Question 13

Tooth moving teeth

Answer 13

fremitis

Functional mobility

Question 14

During periodontal disease teeth begin to shift

Answer 14

Pathologic migration

Due to weakened periodontium

Question 15

Infrabony pockets

Answer 15

When the probe extends apical to the crest of bone

Inside pocket

Question 16

Occlusal Trauma possible signs

Answer 16

Progressive tooth mobility
Teeth moving teeth
Pathologic migration
Infrabony pockets buttressing bone

Question 17

Widened PDL will be usually seen in

Answer 17

Coronal 1/3

Apical 1/3

The tooth fulcrum is near middle and apical 1/3

Question 18

trabecular hyperfunction

Answer 18

Buttressing bone

Build up more bone

Question 19

Angular bone loss extends

Answer 19

Apical to crest of bone

Question 20

Will there be attachment loss with TFO without periodontitis

Answer 20

NOPE

Adaption may occur; tooth may become mobile but no further injury

Question 21

In injury spike in ______ and diminished ______

Answer 21

Spike in bone resorption and diminishing bone apposition

Followed by repair stage

Question 22

TFO W/ periodontitis but no co-destruction

Answer 22

Supracrestal periodontitis with occlusal trauma lesions: INdependent processes

Question 23

TFO W/ periodontitis what must be treated first

Answer 23

Periodontitis before occlusal adjustment

Question 24

TFO w/periodontist and co-destruction

Answer 24

Subcrestal periodontis with TFO: Conditions are established for co-destruction

Question 25

Co-destruction occurs when

Answer 25

The periodontis merges with increased tooth mobility (trauma)

Question 26

TFO & periodontitis no co-destruction IF

Answer 26

TFO and inflammatory perio are separate No attachment loss

Question 27

TFO & periodontitis co-destruction IF

Answer 27

With increasing mobility and inflammatory infilatre occur at same site Downgrowth of pocket epithelium Enhanced attachment loss

Question 28

Occlusal therapy reversible

Answer 28

Night guard Extracoronal splints Muscle relaxants Muscle exercises

Question 29

Irreversible occlusal therapy

Answer 29

Intracoronal splints Occlusal adjustment by selective grind Orthodontics Orthographic surgery

Question 30

Selective grinding indications

Answer 30

``` Perio occlusal trauma Post ortho Prior to extensive restoration Certain types of TMD Certain wear patterns ```

Question 31

Contraindications to occlusal adjustment

Answer 31

``` Severe malocclusion Severe wear Pain No suitable end point Non ideal but tolerated occlusion ```

Question 32

Occlusal trauma superimposed on an existing periodontist may

Answer 32

Accelerate attachment loss

Question 33

Occlusal trauma in the absence of periodontitis may be

Answer 33

Reversible and may results in adaptation (mobile but healthy)

Question 34

_____ must be present for attachment loss

Answer 34

Periodontitis (Inflammation)

Question 35

Weak evidence that occlusal trauma

Answer 35

Alters the progression of periodontitis

Question 36

Lack of evidence that periodontal occlusal trauma leads to

Answer 36

Gingival recession

Question 37

Occlusal trauma does not

Answer 37

Initiate periodontist

Question 38

Natural Teeth

Answer 38

PDL attachment apparatus Can adapt to heavy forces Tooth mobility as a physiological/pathological phenomena

Question 39

Dental Implants

Answer 39

Direct bone implant surface mechanical binding Continuous bone remodeling at bone implant surface interface Implant mobility as a path phenomena

Question 40

Primary Stability

Answer 40

Stability of the implant at the time of placement

Question 41

Primary stability based on

Answer 41

Bone density (cortical bone) (spongyeous bad) Implant fixture design

Question 42

Healing at the interface

Answer 42

Bone formation and remodeling

Question 43

Mandible wait

Answer 43

3 months

Question 44

Maxilla wait

Answer 44

6 months

Question 45

What bone is better for implants

Answer 45

Cortical

Question 46

Functional Loading of the implant

Answer 46

``` Immediate loading (at time of placement) Early loading ( before conventional healing) Late loading (3-6 months) ```

Question 47

Implants dont take ____forces well

Answer 47

Lateral forces No cantilevers

Question 48

Detection in thickness of natural vs implant

Answer 48

20um thickness 1-2 g loading 50-100um 50-100 g

Question 49

Static forces

Answer 49

Constant forces applied as in orthodontic movement

Question 50

Functional forces

Answer 50

Expected intermittent multidirectional forces that would occur when a tooth is in normal function

Question 51

Excessive forces

Answer 51

Forces that well exceed those of teeth/implants in function

Question 52

Loading time depends on

Answer 52

Primary stability Design Restorative design Prescient/absence of risk factors

Question 53

Functional load may

Answer 53

Increase bone to implant contact BUT 100% bone implant surface contact is not possible

Question 54

Average bone implant contact

Answer 54

60%

Question 55

Occlusal trauma is ______ etiologic all factor for periodontal disease but it can be ______ etiologic all factor for perimpalnt disease

Answer 55

Secondary Primary

Question 56

How to deal with implants that are for bruxism patients

Answer 56

Longer and wider implants Surrounded with thick bone support

Question 57

Lateral loads induced

Answer 57

High bone strain and implant stress than vertical loads

Question 58

Implant ______ is more critical than _______

Answer 58

Diameter Length in reducing the bone stress