Definitions
Occlusal Trauma: An injury to the attachment apparatus as a result of
excessive occlusal force. Occlusal trauma is the tissue injury, and not
the occlusal force. Occlusal trauma can be divided into 3 general categories:
1) Primary Occlusal Trauma: Injury resulting from excessive occlusal
forces applied to a tooth or teeth with normal support. Examples
include high restorations, bruxism, drifting or extrusion into edentulous
spaces, and orthodontic movement.
2) Secondary Occlusal Trauma: Injury resulting from normal occlusal
forces applied to a tooth or teeth with inadequate support.
3) Combined Occlusal Trauma: Injury from an excessive occlusal force
on a diseased periodontium. In this case, there is gingival inflammation,
some pocket formation, and the excessive occlusal forces are generally from
parafunctional movements.
In primary trauma from occlusion we don't see-
Occlusal Trauma: An injury to the attachment apparatus as a result of
excessive occlusal force. Occlusal trauma is the tissue injury, and not
the occlusal force. Occlusal trauma can be divided into 3 general categories:
1) Primary Occlusal Trauma: Injury resulting from excessive occlusal
forces applied to a tooth or teeth with normal support. Examples
include high restorations, bruxism, drifting or extrusion into edentulous
spaces, and orthodontic movement.
2) Secondary Occlusal Trauma: Injury resulting from normal occlusal
forces applied to a tooth or teeth with inadequate support.
3) Combined Occlusal Trauma: Injury from an excessive occlusal force
on a diseased periodontium. In this case, there is gingival inflammation,
some pocket formation, and the excessive occlusal forces are generally from
parafunctional movements.
In primary trauma from occlusion we don't see-
- Gingivitis
- Periodontitis
- Pocket formation
- Changes in clinical attachment loss
1) Mobility (progressive)
2) Pain on chewing or percussion
3) Fremitus
4) Occlusal prematurities/discrepancies
5) Wear facets in the presence of other clinical indicators
6) Tooth migration
7) Chipped or fractured tooth (teeth)
8) Thermal sensitivity
Radiological features
1) Widened PDL space
2) Bone loss (furcations; vertical; circumferential)
3) Root resorption
4) Thickening of lamina dura
5) Root # and Cemental tear
Trauma caused by occlusion is reversible.
Trauma from occlusion + Periodontitis = More bone loss
Inflammation inhibits potential of bone healing,repair and regeneration-Inflammation must be eliminated.
Therapeutic goals and treatment considerations-
Treat Inflammation of periodontium prior to the treatment of trauma from occlusion.
1) Occlusal adjustment
2) Management of parafunctional habits
3) Temporary, provisional or long-term stabilization of mobile teeth
with removable or fixed appliances
4) Orthodontic tooth movement
5) Occlusal reconstruction
6) Extraction of selected teeth
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