Effect of Occlusal Trauma on Periodontium

Definitions It is a term used to describe pathological alterations or adaptive changes which develop in the periodontium as a result of undue force produced by the masticatory muscles. (OR) An injury to the attachment apparatus as a result of excessive occlusal force.

Types Primary Secondary Tissue reaction around a tooth with normal height of the periodontium. Secondary Related to a situation around a tooth in which occlusal forces causes injury in a periodontium of reduced height.

Trauma form occlusion and plaque – associated periodontal disease Glickman’s Concept (1955 –1970) Chemical that the pathway of the spread of a plaque – associated gingival lesion can be changed if forces of an abnormal magnitude are acting a teeth having sub gingival plaque.

Trauma form occlusion and plaque – associated periodontal disease Glickman’s Concept (1955 –1970) Character of the progressive tissue destruction of the periodontium at a traumatized tooth will be different from that characterizing a non-traumatized.

Trauma form occlusion and plaque – associated periodontal disease Glickman’s Concept (1955 –1970) Zone of irritation  Marginal and inter dental gingiva. Zone of condensation  Periodontal ligament root cementum and alveolar bone.

On Non Traumatized Tooth First involve Alveolar bone, the P.D ligament, Bone destruction horizontal and uneven.

On Traumatized Tooth Direct involve P.D. ligament angular bone loss.

Trauma from occlusion played a role in the spread of a gingival lesion into zone of codestruction Codestruction means: Loss of connective tissue Resorption of bone Increased tooth mobility Depends upon: Force of a magnitude Frequency Duration

Diagnosis Probing depth, tooth mobility plaque, calculus, bone height widened periodontal space (X-Ray).

Tissue Reaction Under Pressure Increased vascularization – increase permeability, disorganization of cells of collagen fibers bundles.

Treatment Scaling – root planning Pocket elimination Occlusal adjustment

Effect of Orthodontic Therapy on Periodontium