Occlusal trauma

Occlusal trauma is the damage to teeth when an excessive force is acted upon them and they do not align properly. When the jaws close, for instance during chewing or at rest, the relationship between the opposing teeth is referred to as occlusion. When trauma, disease or dental treatment alters occlusion by changing the biting surface of any of the teeth, the teeth will come together differently, and their occlusion will change. When that change has a negative effect on how the teeth occlude, this may cause tenderness, pain, and damage to or movement of the teeth. This is called traumatic occlusion. Traumatic occlusion may cause a thickening of the cervical margin of the alveolar bone and widening of the periodontal ligament, although the latter can also be caused by other processes. Clinically, there is a number of physiological results that serve as evidence of occlusal trauma:, Progressive Tooth mobility Fremitus Tooth migration Pain Thermal sensitivity Pain on chewing or percussion Wear facets Microscopically, there will be a number of features that accompany occlusal trauma: Hemorrhage Necrosis Widening of the periodontal ligament, or PDL (also serves as a very common radiographic feature) Bone resorption Cementum loss and tears It was concluded that widening of the periodontal ligament was a "functional adaptation to changes in functional requirements". There are two types of occlusal trauma, primary and secondary. Primary occlusal trauma occurs when excessive occlusal forces are placed on teeth, as in the case of off axis loading, parafunctional habits, such as bruxism or various chewing or biting habits, including but not limited to those involving fingernails and pencils or pens. The associated excessive forces can be grouped into four categories. Excesses of: Duration Frequency Magnitude, and Direction (off axis loading) Primary occlusal trauma will occur when there is an adequate periodontal attachment apparatus. It is reversible if the cause of the trauma is corrected.