Occlusal Evaluation And Therapy In The Management Of Periodontal Disease Short Essay Question And Answers

Occlusal Evaluation And Therapy In The Management Of Periodontal Disease Long Essays

Question 1. Enumerate occlusal evaluation procedures.
Answer:

Clinical Occlusal Evaluation Procedures:

1. TMJ screening examination

• TMJ screening evaluation includes
  1. Interincisal opening
     • Interincisal distance is recorded in millimeters
  2. Opening/closing pathway
     • Any deviations from the midline path are noted
  3. Temporomandibular joint sounds
     • Clicking or crepitus is noted
  4. Temporomandibular joint tenderness
     • Bilateral palpation over condyles is examined
  5. Muscle tenderness
     • Masseter, pterygoid and temporal muscles are examined

2. Intraoral evaluation of occlusion

• It includes
  • Identification of occlusion in maximum inter-occupation or intercuspal position
    • The patient is asked to close into the maximum inter-cuspal position
    • The presence or absence of contacts is examined
  • Excursive movement
    • The patient is asked to move into right and left excur- sions and observe tooth contact patterns
  • Initial contact in centric relation
    • Guide patient’s mandible in centric relation
    • Record any deflection present
  • Tooth mobility
    • Mobility of the tooth is recorded
  • Attrition
    • It is defined as wear caused by tooth-to-tooth contact
    • Significant attrition of teeth indicates bruxism

3. Role of articulated casts

• Identifies occlusal contacts that can deflect mandible, deflect mobile teeth or cause trauma to teeth
• Localizes wear facets, trial occlusal adjustment

Read And Learn More: Periodontics Question and Answers

Question 2. Describe the steps of occlusal adjustments.
Answer:

• Occlusal adjustments also called occlusal equilibration or coroplast is the selective reshaping of occlusal surfaces with the goal of establishing a stable, non-traumatic occlusion

Steps:

1. Removal of retrusive prematurities

• Remove retrusive prematurities and eliminate the deflective shift from retruded contact position to in a tra-occlusal position
• Retrusive prematurities are located on the mesial inclines of maxillary cusps and distal inclines of mandibular cusps

2. Adjustments of the intercuspal position

• Adjustment of intra-occlusal position relieves su- pra contacts and achieves occlusal stability
• It can be achieved by reducing in size of the cusp and deepening the fossa

3. Test for excessive contact on incisive teeth in intra- cuspal position

• Contact relationship may be tested with Mylar strips and checking for fremitus
• Supracontacts are marked and reduced

4. Remove posterior protrusive supra contacts

• Obtain bilateral protrusive movement
• Prematurities are corrected by grinding maxillary teeth

5. Correct prematurities on the balancing side

• Prematurities on the balancing side are corrected next
• It is present on the inner inclines of mandibular buccal cusps and the inner inclines of maxillary lingual cusps of the first and second molars

6. Reduce supra-contacts on the working side

• Reduce supra contacts on laterotrusive side
• They are reduced by reducing inclines of buccal up-per and lingual lower cusps (BULL)

7. Elimination of undesirable gross occlusal features

• Extruded teeth, plunger cusp, uneven marginal ridges of adjacent teeth, rotated or malposed teeth, occlusal wear facets, etc are corrected

8. Recheck the occlusal contact relationship in all positions

• Recheck occlusal contact relationship in all positions

9. Finishing and polishing

• Adjusted surfaces of the teeth are smoothened and polished

Occlusal Evaluation And Therapy In The Management Of Periodontal Disease Short Essays

Question 1. Indications and steps of coroplast
Answer:

Indications:

• Trauma-occlusal trauma
• TMJ problems
• After the elimination of gingival and infra bony pockets

Steps:

1. Removal of retrusive prematurities
2. Adjustments of the intercuspal position
3. Test for excessive contact on incisive teeth in intra- cuspal position
4. Remove posterior protrusive supra contacts
5. Correct prematurities on the balancing side
6. Reduce supra contacts on the working side
7. Elimination of undesirable gross occlusal features
8. Recheck the occlusal contact relationship in all positions
9. Finishing and polishing

Question 2. Effects of orthodontic treatment on periodontal tissues
Answer:

Effects Of Orthodontic Treatment On Perio- Dental Tissues:

1. Iatrogenic effects associated with orthodontic treatment

• Orthodontic treatment may cause injuries to the teeth and periodontium in most of the cases
• Usually, these changes are reversible, and regeneration and repair of the tooth structures and period-dental tissues can occur while in some cases the changes may result in irreparable damage

2. Root resorption

• During orthodontic therapy some amount of root resorption is unavoidable

3. Effects of orthodontic bands on the periodontium

• Gingivitis and gingival hyperplasia are short-term effects
• Long-term effects are loss of attachment, root resorption, or no effects

4. Effects of orthodontics on dentition with normal height of attachment apparatus

• Orthodontic forces cause no damage to the supra- Time of treatment: alveolar connective tissue

Question 3. The rationale for orthodontic tooth movement in periodontal therapy
Answer:

Rationale For Orthodontic Treatment:

1. Reducing plaque retention:

• Crowded teeth and mesially inclined teeth create plaque accumulation sites that are difficult to clean
• Crowding creates enlarged contact surfaces and al-tiered embrasure spaces that are displaced apically

2. Improving gingival and osseous form:

• There is an interrelation between the position of the tooth, the shape of the gingiva, and the bone that surrounds it
• Orthodontic treatment may improve the shape of the periodontium and reduces the need for bone surgery

3. Facilitating prosthetic replacements:

• The uprighting of tilted abutment teeth may be im- important for a better-contoured crown which will benefit the surrounding periodontal condition

4. Improving esthetics:

• Correction of pathologic tooth migration and di-asthma between anterior teeth results in improved esthetics

Occlusal Evaluation And Therapy In The Management Of Periodontal Disease Short Answers

Question 1. Coronoplasty.
Answer:

• The procedure of selective reshaping of the occlusal surface with the goal of establishing a stable – nontraumatic occlusion.

It Is an Invasive Procedure:

Goals:

• Reshaping crown surface
• Elimination of supra contacts
• Creation of stable occlusion

Indications:

• Trauma-occlusal trauma
• TMJ problems

Time of treatment:

• After the elimination of gingival inflammation and periodontal pockets

Question 2. Forced eruption
Answer:

• Forced eruption applies to procedures that involve orthodontic movement with gentle forces
  The purpose is the coronal shift of the bone at the base of infrabony defects, thus reducing the depth of the de-fact
• The elongated tooth thereafter can be reduced in height by grinding and elimination of the infra-bony pocket Forced eruption can also be done to manage teeth that have fractures to make possible the restoration of the tooth
• To erupt the tooth forcefully, either the adjacent teeth must be bracketed and a wire placed or a wire must be bonded directly to the adjacent teeth and an elastic trac- tion applied from the wire to the tooth

Occlusal Evaluation And Therapy In The Management Of Periodontal Disease Viva Voce

1. The location of bands and brackets determines the outcome of orthodontic therapy
2. Orthodontic brackets on the posterior teeth are positioned relative to the marginal ridges and cusps
3. Orthodontic brackets on the anterior teeth are positioned relative to the incisal edges
4. The tooth should erupt 4 mm orthodontically for the purpose of restoration if a tooth fracture extends to the level of alveolar bone
5. To avoid relapse and intrusion of an orthodontically erupted tooth 6 months time period is necessary for stabilization