Traumatic Occlusal Forces- Final

Question 1

Injury resulting in tissue changes within the attachment apparatus (PDL, cementuman supporting bone) as 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 periodontal or in a reduced peridontium affected by perio disease

Answer 3

True

Question 4

Reduced periodontium =

Answer 4

60% of bone loss

Question 5

What is the gold standard for determining periodontal disease?

Answer 5

attachment loss

Question 6

Terminology in the 2017 AAP world workshop changed 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 and JE are NOT affected by occlusal forces

Answer 9

true

Question 10

List the categories of occlusal trauma:

Answer 10

1A: primary occlusal trauma
1B: secondary occlusal trauma
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 ____ from the CEJ

Answer 13

1-2mm

Question 14

Trauma from occlusion is considered to be:

Answer 14

pathologic

Question 15

Forces of occlusion ____ the adaptive capacity of the periodontium

Answer 15

exceed

Question 16

List from pathological to physiological:

Answer 16

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

Question 17

Occlusal trauma & hyper function 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

A 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 clinically 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 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 support

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

Question 29

Direction OPPOSITE to moving tooth due to OT:

Answer 29

tension

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 hemorrhage into PDL perivascular 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 - accompany tissue effects, usually inor

Answer 34

minor trauma from occlusion

Question 35

What happens to the PDL on the tension side?

Answer 35

lengthening resulting in increased 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 and hemmorheage in perivascular - Deposition of new alveolar bone and DECREASE in PDL space (if severe, cemental tears)

Answer 37

Tension side

Question 38

This act results in RESORPTION of alveolar bone proper and WIDENING of the PDL space (root resorption if severe): This act results in DEPOSITION of new alveolar bone and DECREASE of the PDL (if severe cemental tears)

Answer 38

compression side tension side

Question 39

- Crushing (pressure injury)- necrosis at furca, alveolar crest - Extravasated RBCs, hematoma, necrosis, & 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 the 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 a tooth or teeth with REDUCED peridontial support

Answer 42

SECONDARY occlusal trauma

Question 43

What is the manifestation of SECONDARY occlusal trauma?

Answer 43

progressive mobility

Question 44

What is the only TRUE way to determine occlusal trauma occurrence?

Answer 44

Biopsy

Question 45

PROPOSED clinical and radiographic indicators of occlusal trauma:

Answer 45

1. fremitus 2. mobility 3. occlusal discrepancies 4. wear facets 5. tooth migration 6. fractured tooth 7. thermal sensitivity 8. discomfort/pain on chewing 9. widened PDL ligament space 10. root resoprtion 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 and 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 miller status: First distinguishable sign of movement greater than normal

Answer 49

miller 1

Question 50

Classify miller status: movement which allows crown to move 1mm from its normal position in any directon

Answer 50

miller 2

Question 51

Classify miller status tooth may be rotated or depressed in alveoli

Answer 51

miller 3

Question 52

T/F: It is acceptable to use fingers to determine miller classifciation

Answer 52

False- MUST USE 2 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 bruxir?

Answer 55

dull

Question 56

Other manifestations of traumatic occlusal force include:

Answer 56

1. malocclusions 2. tooth migration 3. fractured teeth

Question 57

Radiogrpahic signs of traumatic occlusal forces =

Answer 57

1. WIDENED PDL space 2. THICKENED lamina dura 3. vertical (angular) bone loss 4. furcal bone loss 5. alveolar radiolucency &/or condensation

Question 58

The PDL is thickest at the ___ &___

Answer 58

apices & alveolar crest (0.20mm)

Question 59

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

Answer 59

0.15mm

Question 60

What is the biggest contraindication to occlusal adjustment?

Answer 60

WHen periodontal inflammation has NOT been controlled (other contraindications include) - abscence of pre-treatment diagnosis - prophylactic therapy or sole treatment of periodontal disease - as primary treatment of bruxism - severe extrusion or malpositioned teeth

Question 61

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

Answer 61

FALSE- negatively affects

Question 62

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

Answer 62

true

Question 63

Occlusal adjustment is best done in conjunction with:

Answer 63

periodontal therapy

Question 64

Hypefunction 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. peridontitis 3. pocket formation

Question 66

T/F: There is NO EVIDENCE that TOF causes non-carious cervical lesions (NCCLs). Most studies use finite element analysis

Answer 66

TRUE

Question 67

NCCLs may result from:

Answer 67

1. abrasion 2. erosion 3. corrosion

Question 68

T/F: evidence form observational studies reveal that traumatic occlusal DOES cause gingival recession

Answer 68

FALSE- TOF does NOT cause gingival recession