Trauma From Occlusion- Natural Teeth Flashcards

1
Q

What is trauma from occlusion?

A

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

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2
Q

______ occlusal trauma is classified as excessive force on a normal periodontium

A

primary

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3
Q

______ occlusal trauma is classified as “normal force” applied to a weakened periodontium.

A

secondary

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4
Q

Secondary occlusal trauma is associated with which two conditions?

A
  1. with periodontitis

2. with reduced, but otherwise healthy periodontium

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5
Q

Clinical signs of occlusal trauma may represent ____ or an _____ __ ____.

A

injury

adaptation to injury

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6
Q

What are the 5 clinical signs of “trauma from occlusion”?

A
  1. progressive tooth mobility
  2. teeth moving teeth
  3. pathologic migration
  4. infrabony pockets (controversial)
  5. buttressing bone (controversial)
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7
Q

What are 4 radiographic signs of possible trauma from occlusion?

A
  1. Widened PDL space
  2. Thickened Radicular Lamina Dura
  3. Trabecular Bone (hypo or hyperfunction)
  4. Angular Bone Loss and Furcation Loss
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8
Q

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.

A

True

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9
Q

True or False: The Widening of the PDL space is not necessarily a bad thing because it creates a more resistant periodontium.

A

True

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10
Q

Increased impact results in _____ trabecular bone. Decreased impact (anti-gravity of astronauts) results in _____ trabecular bone.

A

increased. ..hyperfunction (trauma from occlusion)

decreased. ..hypofunction (astronauts)

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11
Q

Why is angular bone on radiographs controversial in its relation to trauma from occlusion?

A

angular bone loss may purely be due to tooth and bone anatomy and the progression of inflammatory perio disease

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12
Q

What is the “co-destruction theory” involving occlusal trauma?

A

occlusal trauma may be a CO-destructive factor that ALTERS the severity and pattern of inflammatory periodontal disease

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13
Q

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 ________.

A

irritation

co-destruction

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14
Q

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.

A

False:
Perio Disease without TFO progresses facial to the bone
Perio Disease with TFO progresses in the PDL space**

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15
Q

The co-destruction theory predicts that perio disease will find a pathway into the _____ when trauma from occlusion is also present.

A

PDL

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16
Q

What is the “Advancing Plaque Front” theory?

A

occlusal trauma has NO ROLE in the severity or pattern of inflammatory periodontal disease inflammation

17
Q

Trauma from occlusion causes tipping of the tooth and subsequent injury to the ________ at sites of ______ and ______.

A

Periodontal Ligament

pressure and tension

18
Q

What are the three models for “role of occlusal trauma”?

A
  1. TFO without periodontitis
  2. TFO with periodontitis but no co-destruction
  3. TFO with periodontitis and co-destruction
19
Q

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?”

A

TFO without periodontitis

  • no attachment is lost*
  • *NOT PLAQUE ASSOCIATED destruction**
20
Q

True or False: If TFO occurs without periodontitis, occlusal therapy will result in diminished signs and a return to normal.

A

True, no attachment was lost

21
Q

In TFO without periodontitis, when does the spike in resorption occur?

A

at the time of injury

22
Q

True or False: If TFO occurs on a healthy but reduced periodontium, signs of trauma will not go away even after occlusal therapy.

A

False: splinting and bite guards MAY diminish signs of trauma

23
Q

Which model for occlusal trauma is classified as having “supracrestal periodontitis with occlusal trauma acting independently”?

A

TFO with periodontitis but no co-destruction

24
Q

If there is no co-destruction, what does that mean?

A

one situation is not being potentiated by the other

25
Q

When treating TFO with periodontitis, which must be controlled first?

A

Control perio FIRST

then, occlusal therapy may be attempted

26
Q

What is the difference between “TFO + Perio without co-destruction” and “TFO + Perio + Co-destruction”?

A

without co-destruction =
SUPRAcrestal periodontitis
two diseases act at sep. locations
no enhancement of attachment loss
with co-destruction =
SUBcrestal periodontitis
two diseases act at same location
enhancement of attachment loss

27
Q

Methods of Occlusal Therapy can be ______ or _____.

A

Reversible

Irreversible

28
Q

Name four reversible methods of occlusal therapy.

A
  1. Night Guards/bite planes
  2. Extracoronal Splints
  3. Muscle Relaxants
  4. Muscle Exercises
29
Q

Name four irreversible methods of occlusal therapy.

A
  1. Intracoronal splints (with tooth prep)
  2. Occlusal adjustments/selective grinding
  3. Orthodontics
  4. Orthognathic surgrery
30
Q

Periodontal occlusal trauma, post-orthodontics, prior to extension, types of TMD, and specific wear patterns are indications for _____ ______.

A

selective grinding

31
Q

What are the contraindications to selective grinding?

A
severe malocclusion
non-ideal but tolerated occlusion
severe wear (bruxers)
patient in pain
end-point can't be reached (articulator attempt)
32
Q

True or False: If a tooth wiggles, it is bad.

A

False. Not always the case.

33
Q

True or False: Occlusal trauma without periodontitis may be reversible and may result in a mobile but otherwise healthy tooth.

A

True

34
Q

True or False: Occlusal therapy is indicated prior to periodontal regeneration therapy.

A

True

35
Q

True or False: Occlusal adjustment is justified in the absence of perio disease as a perio disease preventative measure.

A

FALSE, do not change the occlusion unless they are experience occlusion-related symptoms