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LOCAL PREDISPOSING RISK FACTORS FOR PERIODONTAL DISEASE (ANATOMICAL…
LOCAL PREDISPOSING RISK FACTORS FOR PERIODONTAL DISEASE
TRAUMA FROM OCCLUSION
Traumatic incisor relationships
Akerly Class
II = trauma to palatal gingiva on upper anterior
III = trauma to labial gingiva on lower anterior
Factor 1 = Severe Class II Div 2 skeletal base
Factor 2 = No posterior contacts to overclosure of anteriors
Factor 3 = Poor anterior restorations with no occlusal stops, so overeruption of incisors
Management - OHI; Non-surgical management; Soft splint
Traumatic Occlusal Contacts/Interferences
Premature/deflective contacts
Anatomical
High restorations
After orthodontics
Primary = no pre-existing perio disease, Secondary = pre-existing perio disease
Signs and symptoms
TMD
Pain
TTP
Bruxism (due to early contacts)
Mobile teeth
Tooth wear/fracture
ANATOMICAL PREDISPOSING FACTORS
ENAMEL PEARL
PDL fibres only attach to cementum, not to this pearl, therefore in this area can be localised deep pocket
ROOT MORPHOLOGY
E.g. palatal grooves that are deep and run below the ginigval margin, hard to instrument and keep clean
GINGIVAL RECESSION
TOOTH/ARCH RELATIONSHIPS
E.g. crowding/overlapping of teeth
IATROGENIC
E.g. overhanging restorations, partial dentures, poor crown margins
FURCATIONS
Mesial ~3.5mm, Buccal ~4mm and Distal ~5mm apical to CEJ, and MB root has concavity on furcal surface of root, hard to instrument
Classified: I = <1/3 of tooth width (loss of attachment), II = >1/3 of tooth width, III = 'through and through', done using a furcation probe