Traumatic occlusal forces

Question 1

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

Answer 1

Occlusal trauma

Question 2

Occlusal forces =

Answer 2

Teeth

Question 3

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

Answer 3

True

Question 4

Reduced periodontium =

Answer 4

60% of bone loss

Question 5

Gold standard for periodontal disease is:

Answer 5

attachment loss

Question 6

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

Answer 6

traumatic

Question 7

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

Answer 7

True

Question 8

List the parts of the periodontium affected by occlusal forces:

Answer 8

1. cementum
2. PDL
3. Alveolar bone proper

Question 9

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

Answer 9

True

Question 10

List the categories of occlusal trauma:

Answer 10

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

Question 11

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

Answer 11

Orthodontics

Question 12

What are the variables of occlusal trauma:

Answer 12

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

(direction, magnitude, duration, frequency)

Question 13

Bone should be ____mm from the CEJ

Answer 13

1-2

Question 14

Trauma from occlusion is considered to be:

Answer 14

Pathologic

Question 15

Forces of occlusion _____ the adaptive capacity of the periodontiun

Answer 15

Exceed

Question 16

List from pathological to physiologica:

Answer 16

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

Question 17

Occlusal trauma & hyperfunction are considered:

Answer 17

pathological

Question 18

Hypofunction & disuse atrophy are considered:

Answer 18

Physiological

Question 19

Placing a high amalgam restoration is an example of:

Answer 19

Hyperfunction

Question 20

Tooth that is barely occluding is an example of:

Answer 20

Hypofunction

Question 21

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

Answer 21

Primary occlusal trauma

Question 22

With PRIMARY occlusal trauma we may clincially see _____ that _____

Answer 22

ADAPTIVE mobility that does NOT progress

Question 23

Give an example of PRIMARY occlusal trauma:

Answer 23

High restoration with mobility resolving following reduction

Question 24

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

Answer 24

True

Question 25

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

Answer 25

SECONDARY occlusal trauma

Question 26

SECONDARY occlusal trauma may be seen as:

Answer 26

progressive mobility and/or pain

Question 27

Moving tooth #19 towards tooth #18 Compression side= Tension side=

Answer 27

Compression side= direction tooth is moving tension side= direction opposite that tooth is moving

Question 28

Direction that the tooth is moving due to OT:

Answer 28

Compression side

Question 29

Direction OPPOSITE to moving tooth due to OT:

Answer 29

Tension side

Question 30

As fibers are compressed due to OT, ____ is reduced

Answer 30

PDL space

Question 31

Compression side results in loss of:

Answer 31

fiber orientation

Question 32

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

Answer 32

edema

Question 33

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

Answer 33

true

Question 34

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

Answer 34

Minor trauma from occlusion

Question 35

What happens to the PDL on the tension side?

Answer 35

lenghtening resulting in increase in PDL space

Question 36

Lengthening occurs on the tension side resulting in:

Answer 36

increased PDL space

Question 37

- 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

Answer 37

Tension side

Question 38

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):

Answer 38

Compression side Tension side

Question 39

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

Answer 39

SEVERE trauma from occlusion

Question 40

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

Answer 40

PRIMARY occlusal trauma

Question 41

What is a manifestation of PRIMARY occlusal trauma:

Answer 41

adaptive mobility (not progressive or pathologic) example: hyper occlusion

Question 42

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

Answer 42

Secondary occlusal trauma

Question 43

What is a manifestation of SECONDARY occlusal trauma:

Answer 43

progressive mobility

Question 44

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

Answer 44

BIOPSY

Question 45

PROPOSED clinical & radiographic indicators of occlusal trauma:

Answer 45

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

Question 46

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

Answer 46

fremitus

Question 47

Clinical signs & symptoms of occlusal trauma:

Answer 47

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

Question 48

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

Answer 48

Miller

Question 49

Classify the miller status -first disntinguishable sign of movement greater than normal

Answer 49

Miller 1

Question 50

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

Answer 50

Miller 2

Question 51

Classify the miller status -tooth may be rotated or depressed in alveoli

Answer 51

Miller 3

Question 52

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

Answer 52

False- MUST USE TWO RIGID INSTRUMENTS

Question 53

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

Answer 53

Bruxism

Question 54

-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

Answer 54

Bruxism indicators

Question 55

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

Answer 55

Dull

Question 56

Other manifestations of traumatic occlusal force include:

Answer 56

1. malocclusions 2. tooth migration 3. fractured tooth

Question 57

Radiographic signs of traumatic occlusal forces:

Answer 57

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

Question 58

The PDL is thickest at ____ & ____

Answer 58

apices & alveolar crest (0.20mm)

Question 59

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

Answer 59

0.15 mm

Question 60

What is the biggest contraindication to occlusal adjustment?

Answer 60

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

Question 61

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

Answer 61

False- negatively affects

Question 62

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

Answer 62

True

Question 63

Occlusal adjustment is best done in conjunction with:

Answer 63

periodontal therapy

Question 64

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

Answer 64

Physiologic

Question 65

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

Answer 65

1. gingivitis 2. periodontitis 3. pocket formation

Question 66

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

Answer 66

True

Question 67

NCCLS may result from:

Answer 67

1. abrasion 2. erosion 3. corrosion (NOT TOF)

Question 68

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

Answer 68

False- TOF does NOT cause gingival recession