Functional – mechanical equilibrium

of the periodontium.

Muscles forces. Masticatory

pressure. Periodontal pressure

PERIODONTAL ALTERATIONS

• SHAPE, FUNCTION, REACTION

Custom cast post and core

•LALORATORY STAGES

Factors for dental crown developing

Alveolar ridges atrophy

Margin edge damage

Mechanism of the changed periodontal

activity

Clinical crown- visible part of tooth above the gum line.

Anatomical crown

Clinical crown

The number and site of tooth contacts in the intercuspal position and in eccentric jaw positions

may be altered. These alterations all produce alteration of muscle activity during functional and

parafunctional acts

Morphologic changes on the muscular system can be

accurately predicted

Chewing muscle activity can be altered to a more favorable situation for each individual

The elevator muscles demonstrate maximum activity when even bilateral occlusal contacts occur

during clenching in the intercuspal position.

The elevator muscles are activated together in the intercuspal zone of tooth contact during chewing

when the occlusal contacts are balanced bilaterally in this intercuspal position

Increasing the number of eccentric tooth contacts increases the muscle activity during

both chewing and clenching.

• Stress-induced changes in the functional electromyographic activity of the masticatory muscles

• The activity of the masseter and anterior temporalis muscles usually are recorded bilaterally by means of surface EMG

• The EMG activity during the stress

situation was significantly greater than for the non-stress situation.

Tooth surface loss (TSL)

Tongue scalloping

Cheek ridging.

• tooth wear

• aetiological models

• malocclusion

• physiological stress

• pathological tooth surface loss

• Physiological tooth wear

Occlusal therapy

Occlusal splint

Reconstruction of a worn out dentition

Treating the underlying medical disorder or disease

• Modifying the pH of the food

• Changing lifestyle to avoid the food

Decrease abrasive forces

• Use a soft toothbrush and brush gently.

• Rinsing with water after consuming acidic foods and drinks.

Using a remineralizing agent, such as sodium fluoride solution in the form of a fluoride

Applying fluoride gels

• Using a neutralizing agent such as antacid tablets

•Dentine bonding agents applied to areas of exposed dentin

• Trauma from Occlusion: • Pathologic or adaptive changes which develop in the periodontium as a

result of undue force produced by the masticatory muscles.

• Stillman (1917): A condition where injury results to the supporting structures of the teeth by the act of bringing the jaws into a closed position

• WHO (1978): Damage in the periodontium caused by stress on the teeth produced … by the teeth of the opposing jaw.

• AAP (1986): An injury to the attachment apparatus as a result of excessive occlusal force.

Trauma from Occlusion Primary TO: A tissue reaction, which is elicited around a tooth with normal height of the periodontium (no attachment loss!) Secondary TO: Related to situations in which occlusal forces cause damage in a periodontium of reduced height (attachment loss present)

I st degree

II degree III degree

DIAGNOSTIC PROCESS

CLINIAL OBSERVATIO

N

INDICATIONS

COMPLETED DIAGNOSIS

MEDICAL HYSTORY REVIEW

SUBJECTIVE HISTORY

OBJECTIVE TESTING

ANALYSIS OF DATA COLLECTED

PLANE OF ACTION

VAS, ANOVA, NRMH (GERD);

INDEXES;

ALERGIC STATUS (NKDA);

ANGLE MALOCLUSIONS;

ENDODONTICS STATEMENT.

PARAFUNCTIONS;

RANDOMIZED CLINICAL

INVESTIGATIONS;

• Indices for determining the norm - maximum opening to 42mm without deviation of the mandible

• • Headache

• Bruxism (5-8 years before)