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TRAUMA FROM OCCLUSION(TFO) - Coggle Diagram
TRAUMA FROM
OCCLUSION(TFO)
when occlusal forces exceed the adaptive capacity of tissue, injury results. The resultant injury is TFO
CLASSIFICATION
Depending on cause
Primary TFO
Result of alteration of occlusal forces
example:
insertion of high filling
orthodontic movement of teeth
Drifting movements
features:
Tooth mobility
does not produce pocket and attachment loss
Secondary TFO
Results from reduced ability of tissue to resist occlusal forces
example:
Normal periodontium with reduced bone height
Marginal periodontitis
features:
Most common
Decreased bone height
Depending on onset
and duration
Acute TFO
Occurs due to abrupt occlusal impact
example:
Olive pit
Restoration
prosthetic appliances
features:
Tooth pain
fractured cusp
increased mobility
sensitivity
Chronic TFO
Changes produced by tooth wear, drifting movement, extrusion of teeth.
example:
tooth wear
Drifting of teeth
extrusion of teeth
features:
tooth mobility
occlusal facets
positive fremitus test
CLINICAL
FEATURES
Recession
still man’s cleft
no pocket formation
occlusal facet
PDL widening
periodontal abscess
Tooth pain
increased mobility
hypersensitivity
Alveolar bone loss
DIAGNOSIS
clinical features:
Excessive occlusal wear
tilting & migration
infrabony pocket
presence of stillman’s cleft and McCall’s festoon.
radiographic features:
widening of pdl
root resorption
3.vertical bone loss
furcation involvement
buttressing bone formation
Thickening of laminate propria
diagnostic test:
fremitus test
plapation test
percussion test
TREATMENT
Coronoplasty
Temporary splints
PATHOLOGICAL FEATURES
Stage 1: injury
Tooth exposed to occlusal forces
Periodontal tissue unable to withstand force
Lead to well defined reaction in PDL and alveolar bone
Adaptation of periodontal structures
Tilting leads to pressure and tension zone
Histological changes based on type of force
Stage 2: repair
increased reparative activity
Buttressing bone formation
Central
Peripheral
Usually occurs on facial and lingual plates of alveolar bone - shelf like thickening of bone referred as
lipping
Stage 3: adaptive remodeling of periodontium
If repair and destruction processes do not occur
simultaneously it may lead to:
remodeling occurs which includes:
Thickened PDL
Angular bone defect
No pocket formation
Mobility
Increased vascularization
ROLE OF TFO IN
PERIODONTAL DISEASE
Glickman's Concept:
Periodontal structure is divided into two zones - zone of irritation and zone of codestruction based on the effect of TFO on plaque associated lesions
warhaug’s concept:
the loss of periodontium was a result of inflammatory lesions associated with subgingival plaque. He conduced that the angular defect occur when subgingival plaque on one tooth has reached more apically than the microbiology of the adjacent tooth and when volume of surrounding bone is actively large