Orban and Glickman et al (1968): truma from occlusion  is defined as  when occlusal forces exceed the adaptive capacity of the periodontal tissues , the tissue injury results. This resultant injury is termed as trauma from occlusion.

TYPES OF TRAUMA FROM OCCLUSION

Clinical features of TFO

1) Tooth mobility
2) Pain on chewing or percussion
3) Fremitus
4) Occlusal prematurities/discrepancies
5) Wear facets
6) Tooth migration
7) Chipped or fractured tooth (teeth)
8) Thermal sensitivity

Radiographic changes

a) Increase in width of the periodontal ligament space often with thickening of the lamina dura along the lateral borders of the root, apical and bifurcation areas.
b) Vertical rather than horizontal destruction of the inerdental septum.
c) Radioucency and condensation of the alveolar bone
d) Root resorption

TfO and Plaque-Associated Periodontal Disease

Glickman’s Concept

Pathway of spread of a plaque-associated gingival lesion can be changed if abnormally strong forces are acting on teeth with subgingival plaque

Waerhaug’s Concept

Waerhaug measured distance between the subgingival plaque and

• The perimeter of the associated inflammatory infiltrate

• The surface of the adjacent alveolar bone
• He concluded that angular defects and infrabony pockets occurred equally frequently in teeth with TfO and in teeth without TfO
• loss of attachment and bone are the result of inflammation induced by subgingival plaque

stages of tissue response to increased occlusal forces

3 stages

• Stage I: injury

• Stage II: repair
  • central buttressing
  • peripheral buttressing
• Stage III: adaptive remodeling of periodontium

TREATMENT OF TFO

A goal of periodontal therapy in the treatment of occlusal traumatism should be to maintain the periodontium in comfort and function.

PROPOSED BY AAP (1996)

1. Reduce /eliminate tooth mobility
2. Eliminate occlusal prematurities and fremitus
3. Eliminate parafunctional habits
4. Prevent further tooth migration
5. Decrease / stablize radiographic changes

MCQS

1. Buttressing bone formation is a;

A. congenital abnormality
B. occurs endosteally
C. occurs periosteally
D. due to trauma from occlusion

Answer D