Flashcards in Trauma From Occlusion- Natural Teeth Deck (35):
What is trauma from occlusion?
an injury to the attachment apparatus as the result of excessive occlusal forces
*May also be a "normal amount of force" but when applied to a damaged periodontium it is excessive and has the same effect*
______ occlusal trauma is classified as excessive force on a normal periodontium
______ occlusal trauma is classified as "normal force" applied to a weakened periodontium.
Secondary occlusal trauma is associated with which two conditions?
1. with periodontitis
2. with reduced, but otherwise healthy periodontium
Clinical signs of occlusal trauma may represent ____ or an _____ __ ____.
adaptation to injury
What are the 5 clinical signs of "trauma from occlusion"?
1. progressive tooth mobility
2. teeth moving teeth
3. pathologic migration
4. infrabony pockets (controversial)
5. buttressing bone (controversial)
What are 4 radiographic signs of possible trauma from occlusion?
1. Widened PDL space
2. Thickened Radicular Lamina Dura
3. Trabecular Bone (hypo or hyperfunction)
4. Angular Bone Loss and Furcation Loss
True or False: Some of the radiographic changes may represent adaptation to occlusal trauma and some may be due to extension of periodontal disease without occlusal trauma.
True or False: The Widening of the PDL space is not necessarily a bad thing because it creates a more resistant periodontium.
Increased impact results in _____ trabecular bone. Decreased impact (anti-gravity of astronauts) results in _____ trabecular bone.
increased...hyperfunction (trauma from occlusion)
Why is angular bone on radiographs controversial in its relation to trauma from occlusion?
angular bone loss may purely be due to tooth and bone anatomy and the progression of inflammatory perio disease
What is the "co-destruction theory" involving occlusal trauma?
occlusal trauma may be a CO-destructive factor that ALTERS the severity and pattern of inflammatory periodontal disease
In the co-destruction theory, bacteria initiate periodontitis in the zone of _______ and the addition of trauma from occlusion causes progression toward periodontal disease in the zone of ________.
True or False: According to the co-destruction theory, periodontal disease follows the same path but is more rapidly progressing in the presence of trauma.
Perio Disease without TFO progresses facial to the bone
Perio Disease with TFO progresses in the PDL space****
The co-destruction theory predicts that perio disease will find a pathway into the _____ when trauma from occlusion is also present.
What is the "Advancing Plaque Front" theory?
occlusal trauma has NO ROLE in the severity or pattern of inflammatory periodontal disease inflammation
Trauma from occlusion causes tipping of the tooth and subsequent injury to the ________ at sites of ______ and ______.
pressure and tension
What are the three models for "role of occlusal trauma"?
1. TFO without periodontitis
2. TFO with periodontitis but no co-destruction
3. TFO with periodontitis and co-destruction
Which model for occlusal trauma is described as "injury that results in acute inflammation, PDL collagen destruction, cementum resorption, bone loss, no attachment loss, and possible mobility?"
TFO without periodontitis
****no attachment is lost****
**NOT PLAQUE ASSOCIATED destruction**
True or False: If TFO occurs without periodontitis, occlusal therapy will result in diminished signs and a return to normal.
True, no attachment was lost
In TFO without periodontitis, when does the spike in resorption occur?
at the time of injury
True or False: If TFO occurs on a healthy but reduced periodontium, signs of trauma will not go away even after occlusal therapy.
False: splinting and bite guards MAY diminish signs of trauma
Which model for occlusal trauma is classified as having "supracrestal periodontitis with occlusal trauma acting independently"?
TFO with periodontitis but no co-destruction
If there is no co-destruction, what does that mean?
one situation is not being potentiated by the other
When treating TFO with periodontitis, which must be controlled first?
Control perio FIRST
then, occlusal therapy may be attempted
What is the difference between "TFO + Perio without co-destruction" and "TFO + Perio + Co-destruction"?
without co-destruction =
two diseases act at sep. locations
no enhancement of attachment loss
with co-destruction =
two diseases act at same location
enhancement of attachment loss
Methods of Occlusal Therapy can be ______ or _____.
Name four reversible methods of occlusal therapy.
1. Night Guards/bite planes
2. Extracoronal Splints
3. Muscle Relaxants
4. Muscle Exercises
Name four irreversible methods of occlusal therapy.
1. Intracoronal splints (with tooth prep)
2. Occlusal adjustments/selective grinding
4. Orthognathic surgrery
Periodontal occlusal trauma, post-orthodontics, prior to extension, types of TMD, and specific wear patterns are indications for _____ ______.
What are the contraindications to selective grinding?
non-ideal but tolerated occlusion
severe wear (bruxers)
patient in pain
end-point can't be reached (articulator attempt)
True or False: If a tooth wiggles, it is bad.
False. Not always the case.
True or False: Occlusal trauma without periodontitis may be reversible and may result in a mobile but otherwise healthy tooth.
True or False: Occlusal therapy is indicated prior to periodontal regeneration therapy.