Definition and Types of Occlusal Trauma - Occlusal trauma is the damage to teeth caused by excessive forces and misalignment. - There are two types of occlusal trauma: primary and secondary. - Primary occlusal trauma occurs when excessive forces are placed on teeth. - Secondary occlusal trauma occurs when normal or excessive forces are placed on teeth with compromised periodontal attachment. - The distinction between primary and secondary occlusal trauma is important for diagnosis and treatment.

Causes and Effects of Occlusal Trauma - Excessive occlusal forces can be caused by off-axis loading, parafunctional habits (such as bruxism), and chewing or biting habits involving objects like pens or fingernails. - Excessive forces can be categorised into duration, frequency, magnitude, and direction. - Occlusal trauma can lead to tenderness, pain, tooth damage, and tooth movement. - Traumatic occlusion may cause thickening of the cervical margin of the alveolar bone and widening of the periodontal ligament. - Widening of the periodontal ligament is a functional adaptation to changes in functional requirements. - Teeth are constantly subjected to horizontal and vertical occlusal forces. - Resorption and disappearance of bone occur adjacent to the pressured side of the tooth, while apposition and increased volume occur adjacent to the tensioned side. - Tooth mobility may develop over time in both primary and secondary occlusal trauma. - Mobility is more prevalent in secondary occlusal trauma and requires splinting of teeth. - Occlusal trauma can lead to bone loss and patterns of bone destruction.

Treatment of Occlusal Trauma - In primary occlusal trauma, the cause of mobility and pain should be eliminated. - Treatment may involve removing high spots on restored teeth or altering parafunctional habits. - For bruxers, selective grinding or nightguards can be used to protect teeth from excessive forces. - In secondary occlusal trauma, splinting of teeth may be necessary to eliminate mobility. - Treatment of secondary occlusal trauma also involves managing the loss of clinical attachment and bone through surgical periodontal procedures and restoration.

Effects of Occlusal Trauma - Teeth are constantly subjected to horizontal and vertical occlusal forces. - Resorption and disappearance of bone occur adjacent to the pressured side of the tooth, while apposition and increased volume occur adjacent to the tensioned side. - Tooth mobility may develop over time in both primary and secondary occlusal trauma. - Mobility is more prevalent in secondary occlusal trauma and requires splinting of teeth. - Occlusal trauma can lead to bone loss and patterns of bone destruction.

References - Bibb, CA: Occlusal Evaluation and Therapy in the Management of Periodontal Disease. - Hinrichs, JE: Occlusal The Role of Dental Calculus and Other Predisposing Factors. - Carranza, FA: Bone Loss and Patterns of Bone Destructions. - Trauma from Occlusion Handout, Dr. Michael Deasy, Department of Periodontics, NJDS 2007. - Carranza, FA; Bernard, GW: The Tooth-Supporting Structures.