Occlusal trauma

Occlusal trauma

It is the pathological alterations which developed in periodontium as a result undue force produced by the masticatory muscles

The periodontium attempts to accommodate the forces exerted on the crown. This adaptive capacity varies in different persons and in the same person at different times.

When manitude of occlusal forces is increased The periodontium responds with:

1. widening of the periodontal ligament space.
2. An increase in the number and width of periodontal ligament fibers.
3. Increase in the density of alveolar bone

• When occlusal forces exceeds the adaptive and reparative capacity of the periodontal tissues, tissue injury results (trauma from occlusion) .

CLINICAL FEATURES OF TFO

1) Mobility (progressive)
2) Pain on chewing or percussion
4) Occlusal prematurities/discrepancies
5) Tooth migration
6) Chipped or fractured tooth (teeth)
7) Thermal sensitivity


RADIOGRAPHIC FINDINGS OF TFO
• Increased width of periodontal ligament
space.
Thickening of lamina dura.
• Vertical or angular bone loss.
• Radiolucency in furcation areas.
• bone loss.

Types of occlusal trauma

Primary Trauma from occlusion
Secondary Trauma from occlusion

• In this case even comparatively small forces may produce traumatic lesions or adaptive changes in the periodontium.

Effect of Trauma from occlusion on periodontium:

On healthy periodontium:
forces when applied to teeth with a healthy periodontium, can not result in pocket formation or in loss of connective tissue attachment. It does, however, result in resorption of alveolar bone leading to an increased tooth mobility

• On diseased periodontium

Trauma from occlusion may enhance the rate of progression of the disease, and act as a co-factor in the destructive process. So proper treatment of plaque associated with periodontal disease will arrest the destruction of the periodontal tissues even if the occlusal trauma persists.


• Treatment directed towards the trauma alone as occlusal adjustment or splinting, may reduce the mobility of the traumatized teeth and result in some regrowth of bone, but it will not arrest the rate of further breakdown of the supporting apparatus caused by plaque.

TREATMENT

A goal of periodontal therapy in the treatment of occlusal traumatism should be to maintain the periodontium in comfort and function.

In order to achieve this goal a number of treatment considerations must be considered including one or more of the following :
1. Occlusal adjustment.
2. Management of parafunctional habits.
3. Orthodontic tooth movement .
4. Occlusal reconstruction .
5. Extraction of selected teeth.

6)Temporary, provisional or long-term stabilization of mobile teeth with removable or fixed appliances.


7)bite plane,night guard,now called [inter-occlusal appliance] a-prevent teeth from fully interdigitating. b-help in preventing or minimizing isomeric contraction of muscles