Occlusal considerations in Periodontics

• What is occlusal trauma?

  a lesion of the supporting tissues due to the effects of abnormal or excessive forces
• What is primary occlusal trauma?

  The result of excessive occlusal force appliedto a tooth or teeth with normal and healthy supporting tissues - no period or history of perio
• What is secondary occlusal trauma?

  Refers to the harmful effect of normal or abnormal forces on the supporting tissues of teeth already weakened by loss of connective tissue attachment due to perio or history of perio It may arise :In periodontal tissues restored to health byperiodontal treatmentTissues which are affected by an ongoingdestructive lesion
• What can cause occlusal trauma?

  Tooth to tooth contact

  Tooth to soft tissue

  Tooth to foreign body
• What are the signs and symptoms of occlusal trauma?

  • Mobility
  • Pain
  • Drifting
  • Wear facets
  • Fremitus
  • Muscle hypertrophy
  • TMJ Dysfunction
  • Radiographic signs
• What are the intra-oral hard tissue signs of occlusal trauma? Fractured teeth -enamel or restorations

  Wear facets

  Tooth mobility

  Pain on chewing or sensitivity on percussion

  Fremitus - tooth moves as occluded teeth slide laterally or in protrusion.
• What are the intra-oral soft tissue signs of occlusal trauma?

  Tongue scalloping

  Trauma to the buccal mucosa
• What are the radiographic signs of occlusal trauma?

  Widening or funnelling of the Periodontal ligament

  Discontinuity of the lamina dura

  Root resorption

  Alveolar bone radiolucency

  Hypercementosis
• What secondary occlusal trauma bone loss can be seen in this radiograph?

  crescent shaped

  
• What secondary occlusal trauma is seen in this radiograph?

  Vertical infrabony defect