Perio_III

Periodontics III Summary Notes Enoch Ng
Occlusion and Orthodontics
Occlusion
o
o
o
Physiologic – no signs of dysfunction or disease
Traumatic – occlusion associated with dysfunction or disease
• More rapid progression of periodontally involved teeth
• Primary – excessive occlusal force on normal dentition
• Secondary – normal force on a periodontally compromised tooth
Therapeutic – specific interventions designed to treat dysfunction
• Stable endpoint of Mn closure
• Bilateral distribution of occlusal forces
• Axial loading of teeth
- Therapeutic priority – control inflammation
o After inflammation, THEN address residual mobility
- Clinical Features of Occlusal Trauma
o Tooth mobility, increased displacement, stable pattern adaptation
o Tooth migration, pain on percussion, radiographic changes (widened PDL, apical resorption, etc)
o TMJ dysfunction
o Excessive wave facets, fractures
o Fremitus – vibration of palpation
- Treatment
o Evaluate vitality and parafunctional habits
o Occlusal adjustments – prophylactic equilibration is contraindicated
o Splitting
o Orthodontic tooth movement
o Occlusal reconstruction
o Extraction
- Outcome Assessment
o Decreased mobility or stable pattern
o Decreased migration of teeth
o Stable of decreased radiographic changes
o Relief of pain, fremitus, occlusal interferences
o Stable, functional, physiologic and esthetically acceptable occlusion