Periodontium Case Study

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Forces acting on periodontium Introduction : During the development, the tooth is enclosed in the bony crypt and protected from the external environment. As it erupts, it is subjected to various external forces such as pressure from lips, tongue, cheeks, fingers, the pacifier, and exposure to food. These external forces positions the tooth in neutral position of the oral cavity ( 2 ) . To tolerate the forces, an in built shock absorber is created by nature for each individual tooth called periodontal ligament which develops around the root during eruption. It anchors the tooth to the surrounding bone by collagenous connective tissue fibres which are directed obliquely upwards from the cementum to the alveolus. In the absence of periodontal…show more content…
OCCLUSAL FORCES WITHIN PHYSIOLOGIC LIMITS occur during chewing and swallowing. They provide the positive functional stimulation for a healthy periodontium. 2. IMPACT FORCES: mainly high magnitude but of short duration. But if it exceeds the viscoelastic buffer capacity, it causes fracture of tooth and bone 3. CONTINUOUS FORCES: very low forces (for example, orthodontic forces), but continuously applied in one direction are effective in displacing a tooth by remodeling the alveolus. 4. JIGGLING FORCES: intermittent forces in two different directions (premature contacts on, for example, crowns, fillings) result in widening of the alveolus and in increased mobility The tolerance capacity of periodontal ligament to the occlusal forces will depend upon the magnitude, duration and frequency of the forces. As the magnitude of force increases, widening of periodontal ligament space, an increase in the number and width of periodontal ligament fibers, and an increase in the density of alveolar bone occurs. As the direction of occlusal forces changes, reorientation of the stresses and strains within the periodontium occurs(1). cclusal forces along the long axis of the tooth are well tolerated whereas lateral and axial forces are injurious. Intermittent frequency of occlusal forces is less injurious compared to the constant pressure. Thus Occlusion is the life line for periodontium which provides the mechanical stimulation that marshals the complex biologic mechanisms responsible…show more content…
Causative factors for primary occlusal trauma • Increase in occlusal forces ( direction and quantity) • High restorative filling • Prosthetic replacement or failure to replace tooth • Orthodontic tooth movement to unfavourable functional position EXCESS FORCES ON DISEASED PERIODONTIUM Secondary occlusal trauma was defined as “injury resulting in tissue changes from excessive or normal occlusal forces applied to a tooth or teeth with reduced supporting structures” (11-14). As long as inflammation is confined to the gingiva, the inflammatory process is not affected by occlusal forces . 42 When inflammation extends from the gingiva into the supporting periodontal tissues (i.e., when gingivitis becomes periodontitis), plaque-induced inflammation enters the zone influenced by occlusion, which Glickman has called the zone o f co-destruction. 23,25,27 Causative factors for secondary occlusal trauma • Adaptive capacity of tissue is impaired as a result of bone loss • Previously well tolerated forces become excessive CLINICAL SIGNS FOR TRAUMA FROM OCCLUSION Clinical Features 1. Tooth mobility 2. Tooth

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