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Two studies supported Karolyi’s hypothesis 5, 6. Since then a lot of research has been done using autopsy studies, animal studies, and human studies. Karolyi (1901) 4 implied a cause and effect relationship between traumatic occlusion and periodontal disease progression. The association of excessive occlusal forces and their deleterious effects on tooth and tooth-supporting structures has been established for over 100 years now. Other factors include food impaction, overhanging fillings, poorly contoured crowns and bridges and ill-fitting partial dentures.Parafunctional habits as a result of neurosis.Injudicious bone resection during surgical periodontal therapy or oral surgical procedures.Fabrication of long span bridges on few teeth, thus overloading them.Local factors such as plaque which predisposes to the alveolar bone loss.the quality and the quantity of the alveolar bone play an important role in absorbing the occlusal forces. The morphology of the alveolar process, i.e.In general, short, conical, slender or fused roots are more vulnerable to TFO. The size, shape and number of the roots determine how occlusal forces are dissipated. The morphological characteristics of the roots.The orientation of the long axis of the teeth in relation to the forces to which they are exposed.These can be divided into intrinsic and extrinsic factors, But, if the direction of occlusal forces is changed, these fibers are not able to efficiently bear the occlusal forces, hence injury results.ĭuration of force application: If the abnormal occlusal forces are subjected to a tooth for a longer duration of time, they cause injury to the periodontal tooth-supporting structures, which can be seen histologically.įrequency of force application: Frequent application of abnormal occlusal forces results in more damage to the periodontal tooth supporting structures than less frequent application. Normally, they are oriented in such way that they are best capable of withstanding the occlusal forces. There is widening of the periodontal ligament space, an increase in the number of PDL fibers, an increase in the width of PDL fibers and an increase in the density of alveolar bone.ĭirection: The principal fibers of the periodontal ligament play an important role in withstanding the occlusal forces and transferring them to the alveolar bone. Magnitude: When the magnitude of occlusal forces exceeds the normal range of forces for a tooth, due to natural adaptive response, some changes can be appreciated in the periodontal ligament (PDL). The occlusal forces when within the normal range can be well adapted by tooth-supporting soft tissues. Precipitating factors:Īs already stated, destructive occlusal forces are the precipitating or the primary etiology of TFO. They include intrinsic and extrinsic factors. The predisposing factors are those which contribute to the development of TFO indirectly. In TFO, the precipitating factors are the destructive occlusal forces. Broadly, they can be divided into two categories: precipitating factors and predisposing factors. There are many factors involved in the etiology of TFO.
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According to world health organization (WHO), 1978, trauma from occlusion is “damage in the periodontium caused by stress on the teeth produced directly or indirectly by the teeth of the opposing jaw.”.The resultant injury is termed as trauma from occlusion 1. When occlusal forces exceed the adaptive capacity of tissues, tissue injury results.Definitionįollowing definitions are commonly used to describe trauma from occlusion, In the following discussion, we shall try to analyze our current understanding of TFO and its association with inflammatory periodontal diseases. Although many studies have been done to evaluate any relation between progressions of gingival inflammation and trauma from occlusion, conflicting results have been encountered. But, when both the conditions are present simultaneously, it becomes a matter of discussion to designate them as entirely non-associated, partially associated or completely associated conditions. It is generally accepted that trauma from occlusion (TFO) or occlusal traumatism is a separate entity, not related to periodontitis. Periobasics Clinical Periodontology, Recent Posts Introduction to trauma from occlusionĭo abnormal occlusal forces play a significant role in the initiation and progression of periodontal diseases? This question has been our focus of attention for many years.