Academic literature on the topic 'Occlusal trauma'

Comprehensive and appropriate occlusion reconstruction therapy is necessary for orthodontic treatment of adult patients with malocclusion with periodontal disease associated with occlusal trauma. We report the case of a patient with extensive moderate chronic periodontitis associated with occlusal trauma. The patient was diagnosed with extensive moderate chronic periodontitis associated with occlusal trauma and underwent thorough treatment for periodontal disease, oral management, and 20 months of orthodontic therapy. Moreover, reconstructed occlusion was performed to evaluate occlusal trauma for visualization using Brux Checker (BC) analysis before and after active orthodontic treatment. The patient acquired stable anterior guidance and a functional occlusal relationship. BC findings revealed weakening of the functional contact between the lateral occlusal force of the dentition and the front teeth and alveolar bone regeneration. The laminar dura became clearer, and the periodontal tissue improved. Our results suggest that assessment of occlusion function using BC analysis and periodontal examination was effective in enabling occlusal treatment goal clarification through orthodontic treatment in case of periodontal disease associated with occlusal trauma.

The aim of this study was to evaluate the differences in RANKL levels in crevicular fluid (GCF) in patients with chronic periodontitis, with or without chronic occlusal trauma. The study group consisted of 40 patients from whom 72 samples of crevicular fluid were collected. RANKL levels were analyzed by ELISA. We noticed significantly higher differences in RANKL levels for the study group (occlusive trauma patients) than for systemic healthy patients (p = 8.008). Research has shown that secondary occlusal trauma associated with periodontal disease is characterized by significantly higher RANKL levels in patients with chronic occlusal trauma. This partially clarifies the molecular mechanisms that underlie more severe tissue destruction in patients with occlusal trauma.

The mechanisms of tissue changes induced by occlusal trauma are in no way comparable to orthodontic movement. In both events the primary cause is of a physical nature, but the forces delivered to dental tissues exhibit completely different characteristics in terms of intensity, duration, direction, distribution, frequency and form of uptake by periodontal tissues. Consequently, the tissue effects induced by occlusal trauma are different from orthodontic movement. It can be argued that occlusal trauma generates a pathological tissue injury in an attempt to adapt to new excessive functional demands. Orthodontic movement, in turn,performs physiological periodontal bone remodeling to change the position of the teeth in a well-planned manner, eventually restoring normalcy.

<p>The occlusal trauma is an injury to the insertion apparatus as a result of excessive occlusal force, and its interaction with periodontal/peri-implant disease remains controversial topic in the literature. The aim of this study was to review the literature about the relationship between occlusal trauma and periodontal/peri-implant disease, through an analysis of experimental studies in humans and animals, as well as systematic reviews that discussed the role of occlusal factor as etiological or aggravating periodontal/peri-implant disease. It was concluded that, although not considered a cause for the development of periodontitis and peri-implantitis, occlusal trauma can exacerbate bone loss around the teeth or implants. Moreover, the diversity of methodologies in studies on the subject might contribute to the conflicting results available, highlighting the importance of standardization and more detailed research criteria.</p><p><strong> </strong></p><strong>Keywords:</strong> Dental implants; Periodontal diseases; Peri-implantitis; Traumatic dental

Apesar dos conhecimentos atuais mostrarem que a oclusão desempenha um papel relativamente pequeno na etiologia multifatorial das DTMs, publicações recentes demonstraram que algumas alterações oclusais e/ou esqueléticas aumentam o risco do indivíduo apresentar DTM. Dentre estas alterações está a diferença entre RC e MIH no sentido horizontal maior que 4mm. No entanto, ainda não se sabe qual o papel de uma interferência desta magnitude, no sentido vertical, como fator contribuinte para as DTMs. Este estudo verificou a relação de causa e efeito das interferências oclusais no sentido vertical avaliando a relação entre a magnitude da interferência oclusal com a presença de sinais sintomas de trauma oclusal e sinais e sintomas de DTM. Foram avaliados 43 pacientes, independente do gênero e idade, que não poderiam ser desdentados totais, não poderiam apresentar ausência de 5 ou mais unidades oclusais posteriores não substituídas e não poderiam estar em tratamento ortodôntico. O registro da magnitude da interferência oclusal foi feito na região anterior, através da borda incisal do incisivo superior, na face vestibular do incisivo inferior, nas posições de MIH e contato interferente em RC. A diferença em milímetros desta posição determinou a magnitude da interferência oclusal. Os resultados mostraram que as evidências de interferência oclusal estão presentes nos pacientes com e sem sinais e sintomas de DTM e sinais clínicos de trauma oclusal. Concluiu-se que não houve associação entre a magnitude das interferências oclusais e sinais clínicos de trauma oclusal e sinais e sintomas de Desordens Temporomandibulares.
In the present days, occlusion has not been considered important etiologic factor for the development of temporomandibular disorders(TMD) symptoms. However, some features seems to be specially important as contributory factor. Slides from retruded position(RP) to intercuspal position(IP) greater than 4mm are judged as one of those itens. The aim of this study was to evaluated the cause/ effect relationship those interfernces and different clinical signs, including TMD. Sample was constructed by 43 patients with the great interference, recorded in the anterior region in both positions. Patients with 5 or more posterior missing teeth or perform by orthodontic therapy were excluded. There was no relationship or any association between the interferences and clinical signs, including TMD. Author concluded that slides from RP to IP can not be considered a potential risk factor for TMD.

Orientadores: Paulo Henrique Ferreira Caria, Felippe Bevilacqua Prado
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Os fenômenos mecanobiológicos envolvem as características mecânicas do tecido, a nível microscópico, relacionadas às mudanças de metabolismo, apresentando mudanças estruturais e fisiológicas. Os estímulos mecânicos na estrutura óssea implicam na presença de tensões e deformações que resultam alterações na remodelação óssea. Nos tecidos dentoalveolares, especialmente no periodonto de suporte, são conhecidas as alterações estruturais resultantes da perda do equilíbrio da oclusão, especialmente no trauma oclusal. Para entender como ocorrem tais alterações mecânicas e respostas biológicas específicas nestes locais, estudos recentes propõem a aplicação da teoria do mecanostato associada à simulação computacional por análise de elementos finitos. Foram apresentados dois estudos para demonstrar as alterações nos estímulos mecânicos computacionalmente e relacionar com as respostas biológicas que alteraram estruturalmente o osso alveolar de suporte na região dos molares. No primeiro estudo foram utilizados animais que se submeteram à cirurgia de extração do segundo e terceiros molares inferiores, unilateralmente, permanecendo o primeiro molar em oclusal isoladamente, o qual ficou sujeito a um trauma oclusal. A oclusão no primeiro molar foi simulada por análise de elementos finitos e os resultados foram comparados com resultados em análise histológica. O estudo conclui que as regiões com aumento de compressão mecânica devido ao dente estar isolado foram compatíveis com áreas de reabsorção observadas histologicamente. O segundo estudo apresentou um modelo experimental de trauma oclusal em animais com a cimentação de resina sobre a superfície oclusal dos molares superiores, unilateralmente. A mordida posterior foi simulada em análise de elementos finitos para observar os estímulos mecânicos no osso alveolar de suporte tanto no primeiro molar superior quanto no inferior do lado com o trauma. Em comparação foi realizada microtomografia computadorizada para avaliar os efeitos biológicos resultando em alteração estrutura, na qual o volume da crista óssea alveolar foi mensurado. O estudo conclui que aumento da compressão observada computacionalmente, possibilita entender a causa da redução de volume óssea na região de interesse, sendo essa redução maior no molar superior, ou seja, com a presença do material cimentado
Abstract: The mechanobiology phenomena involve the mechanical characteristics of tissue in microscopic level, which is related to changes of metabolism and presenting structural and physiological alterations. The mechanical stimuli in bone structure imply in stresses and strain in the tissue which results in changes in bone remodeling. In dentoalveolar tissues, mainly in the supportive periodontium, the structural changes resulted by the loss of occlusal equilibrium are known. To understand how these mechanical changes occurs and its consequent biological responses, recent studies proposed the application of mechanostat theory associated to computational simulation by finite element analysis. Two studies were presented to demonstrate by computational method the changes in mechanical stimuli and relate to biological responses that resulted in structural changes in the alveolar bone support in molar region. In the first study, animals were submitted to extraction of second and third lower molars, unilaterally, and the first lower molar was kept, which was subject to occlusal stress. The molar occlusion was simulated by finite element analysis and the results were compared with histological analysis. The study concluded that the regions with increase of mechanical compression in isolated molar were compatible with resorption areas in histological observation. The second study presented an experimental model of occlusal stress in animals, where a resin block was cemented on the occlusal surface of upper molars, unilaterally. The posterior occlusion was simulated by finite element analysis to observe the mechanical stimuli both first upper and lower molars, in the same side of occlusal stress. In comparison, the micro-CT was performed to evaluate the biological effect resulting in structural changes, in which the alveolar bone crest volume was measured. The study conclude that the increase of compression, observed in computational analysis, gives the possibility to understand the cause of bone volume reduction in the region of interest, being this reduction was major in the upper molar support tissue, i.e. with the presence of cemented material
Doutorado
Anatomia
Doutor em Biologia Buco-Dental

O ajuste oclusal (AO) como parte da terapia periodontal é um tema controverso, principalmente porque a literatura não fornece evidências suficientes sobre a influência do trauma de oclusão (TO) na doença periodontal (DP). A necessidade de ajuste oclusal na terapia periodontal é considerada incerta e requer investigação. O objetivo desta revisão sistemática foi identificar e analisar estudos que investigaram os efeitos do AO associado à terapia periodontal, sobre os parâmetros periodontais. Um protocolo foi desenvolvido incluindo todos os aspectos de uma revisão sistemática: estratégia de busca, critérios de seleção, seleção de métodos, coleta de dados e extração de dados. A pesquisa bibliográfica foi realizada utilizando MEDLINE via PubMed, Cochrane Central Register de estudos controlados e EMBASE. Os títulos e resumos de artigos foram selecionados de acordo com critérios estabelecidos na metodologia. Cada artigo que indicava uma possível correspondência com estes critérios, ou não poderia ser excluído baseado nas informações presentes no título ou no resumo, foi considerado e avaliado. Na seleção final, quatro artigos foram incluídos. Embora os estudos selecionados sugerem uma associação entre AO e uma melhora nos parâmetros periodontais, suas questões metodológicas (exploradas nesta revisão) sugerem a necessidade de novos estudos com maior qualidade. Atualmente as evidências presentes são insuficientes para presumir que AO é necessário para reduzir a progressão da doença periodontal.
Occlusal adjustment (OA) as part of periodontal therapy is a controversial theme, mostly because the literature does not provide enough evidence regarding the influence of trauma from occlusion (TO) on periodontitis. The need for occlusal adjustment in periodontal therapy is considered uncertain and requires investigation. The aim of this systematic review was to identify and analyze those studies that investigated the effects of OA, associated with periodontal therapy, on periodontal parameters. It was developed a protocol, which included all aspects of a systematic review: search strategy, selection criteria, selection methods, data collection and data extraction. A literature search was conducted using MEDLINE via PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE. Titles and abstracts of articles were selected according to established criteria. Every article that indicated a possible match, or could not be excluded based on the information given in the title or abstract, was considered and evaluated. On final selection, four articles were included. Although the selected studies suggest an association between OA and an improvement in periodontal parameters, their methodological issues (explored in this review) suggest the need for new trials of a higher quality. There is insufficient evidence at present to presume that OA is necessary to reduce the progression of periodontal disease.

Introdução: O papel do trauma oclusal na etiologia das recessões gengivais (GR) e das lesões cervicais não cariosas (LCNC) é um tema relevante na Medicina Dentária moderna, dada a elevada prevalência e implicações estéticas e funcionais que acarretam. Contudo, o seu papel como fator causal ou contribuinte permanece ainda alvo de debate e controvérsia, em particular no que respeita às recessões gengivais. Com vista a esclarecer esta temática, delineou-se como objetivo principal do estudo, realizar uma revisão sistemática para se verificar a possível influência dos fatores oclusais na ocorrência de LCNC e RG. Metodologia: Para se responder à questão de investigação formulada (“Existe uma relação entre a presença de trauma oclusal e o aparecimento de recessões gengivais ou lesões cervicais não cariosas?”) efetuou-se uma pesquisa bibliográfica de artigos respeitantes ao tema, publicados desde março de 2010 a março de 2020, com termos de pesquisa e critérios de inclusão e exclusão bem definidos. Os artigos obtidos foram primeiramente sujeitos a uma análise do título e/ou abstract e, finalmente, a leitura integral. Dada a quantidade e diversidade dos estudos, foi efetuada uma análise qualitativa dos mesmos. Resultados: Com base nos critérios estabelecidos foram obtidos 757 artigos iniciais. Após revisão, 19 artigos foram sujeitos a análise de texto completo, restando 5 artigos para inclusão (1 case-control e 4 cross-sectional). Os resultados descritos nos artigos revelam-se distintos, dada a heterogeneidade de artigos sujeitos a análise. Conclusão: Considerando as limitações desta revisão sistemática foi possível concluir: poucos estudos relativos a este tema foram publicados nos últimos 10 anos, em particular, respeitante à associação entre RG e fatores oclusais; LCNC e RG apresentam etiologia multifatorial; trauma oclusal parece estar associado com a ocorrência das LCNC; não foi possível tirar conclusões a respeito da associação entre trauma oclusal e RG.
Introduction: Occlusal trauma in the etiology of gingival recession (GR) and noncarious cervical lesion (NCCL) remains of great relevance in modern dentistry, given the increased prevalence and its esthetic and functional implications. However, its role as a causal or contributing factor remains a matter of debate and controversy, particularly concerning GR. To clarify this theme, the main objective of this research was to carry out a systematic review (SR) to verify the possible influence of occlusal factors on the occurrence of GR and NCCL. Methods: In order to answer the research question ("Is there a relationship between the presence of occlusal trauma and the appearance of gingival recessions or non-carious cervical lesions?"), a bibliographic search was conducted focusing on articles published since March 2010 to March 2020, with well-defined search terms for inclusion and exclusion criteria. Firstly, it was analyzed the title and/or abstract of the articles obtained and, finally, full-text reading was carried out. Given the amount and diversity of final studies, a qualitative analysis was carried out. Results: Based on the established criteria, it was possible to obtain an initial 757 articles. After screening, 19 articles were excluded after full-text read, remaining 5 articles for inclusion (1 case-control, and 4 cross-sectional studies). The results described in the articles were different, given the heterogeneity of articles subject to analysis. Conclusion: Within the limitation of this SR, it was possible to conclude that: few studies regarding the topic have been published in the past 10 years, in particular, about the association of GR with occlusal factors; NCCL and GR present a multifactorial etiology; traumatic occlusion seem to be associated with the occurrence of NCCL; it is not possible to draw any conclusions regarding the association between occlusal trauma and GR.

碩士
高雄醫學大學
牙醫學研究所碩士在職專班
98
The patient who have suffered periodontitis usually combine tooth loss, and must face the problem of prostheses restored. But the type of patient that have periodontal destruction, tooth condition usually not ideal. They usually combine some complications, such as progressive tooh mobility and migration, posterior bite collapse combine vertical dimension loss, poor crown to root ratio, tooth loss, tooth position is not good, poor prostheses induced periodontal and traumatic diseases, loss of occlusal stability…………….etc. In this thesis, we include 9 cases with gingivitis to advanced periodontitis. After data collection, full mouth evaluation, model analysis, diagnostic wax up fabrication before treatment, and then give the placement of temporary prostheses. After the combination of periodontic and prostheses treatment, we can follow the improvement of periodontal condition and the stability of prostheses. After these treatment procedures, follow and re-evaluation, then we can give the final prostheses fabrication. But after the treatment, if we want to have long term success rate, it must have good cooperation from patient to keep good oral hygiene and visit recall every 3 to 6 months.

This textbook has covered the common causes of broken down teeth: dental caries, tooth wear, and trauma. In addition, long-term failure of parts, or all, of the existing tooth–restoration complex can be significant and may require further operative intervention for its successful management (see Chapter 9). Many intra-coronal defects can be repaired with direct adhesive restorations, as discussed in Chapters 5 and 9. However, the situation can be complicated by the loss of significant portions of existing restoration or tooth structure (e.g. cusps, buccal/lingual walls), which influence the restorative procedures used in an attempt to maintain the tooth longevity, as well as pulp viability, for as long as possible. For direct restorations to succeed clinically, they require healthy dental tissues to aid support, retention, and ideally provide an element of protection from excessive occlusal loads. With diminishing amounts of tooth structure to work with, greater thought and care are required to manage and prepare the remaining viable hard tissues to support and retain the larger restoration. The core restoration describes the often large direct plastic restoration used to build up the clinically broken down crown. It is retained and supported by remaining tooth structure wherever possible (sometimes including the pulp chamber and posts in root canals of endodontically treated teeth). These large restorations often benefit from further overlying protection to secure their clinical longevity, by means of indirect onlays, and partial or full coverage crowns. Before carrying out a detailed clinical examination of the individual tooth and the related oral cavity, it is always important to justify your clinical decisions, for both operative and non-operative preventive interventions. The five key reasons for minimally invasive (MI) operative intervention are:… • to repair hard tissue damage/cavitation caused by the active, progressing caries/tooth-wear process (where non-operative prevention has failed repeatedly) • to remove plaque stagnation areas within cavities/defects which will increase the risk of caries activity due to the lack of effective plaque removal by the patient • to help to manage acute pulpitic pain caused by active caries by removing the bacterial biomass and sealing the defect, thereby protecting the pulp • to restore the tooth to maintain structure and function in the dental arch • aesthetics.