Chronic Periodontitis Exacerbated by Occlusal Trauma: Report of A Case and Revision of Literature

Ma Lourdes Rodriguez,Iturralde M,Pinos X,Vega J

doi:10.4172/2161-1122.1000426

Abstract

Occlusal trauma has been associated with periodontal disease 100 years ago, but only observationally. Since the 1930s, the effect of excessive occlusal forces on the periodontium has been evaluated at the pre-clinical level. At first, studies on animal and human autopsy material showed no association between occlusal discrepancies and periodontal destruction. However, in the last 10 years new evidence has emerged that today allows us to establish a relationship between both clinical entities. The latest review on the subject published in 2015, states that at the moment there is a lack of strong evidence to assume a relation of cause/effect between periodontitis and excessive occlusal forces. The objective of this study is to report a clinical case related to a patient with no previous medical history, with an oral diagnosis of an advanced chronic periodontitis, in which the existing occlusal trauma was recognized as a possible accelerating and/or aggravating factor. In addition there is an update of the focused theme.

Highlights

A variety of occlusal conditions have been adjudged to have a dynamic interactive impact on the periodontium, among which we can mention bruxism, mal occlusion, abfraction, etc
The objective of this study is to report a clinical case related to a patient with no previous medical history, with an oral diagnosis of an advanced chronic periodontitis, in which the existing occlusal trauma was recognized as a possible accelerating and/or aggravating factor
For example Orban and Weinmann in 1933 [6], and Weinmann in 1941 [7], using human autopsy material, evaluated the effect of excessive occlusal forces (EOF) on the periodontium. They concluded that there was no relationship between EOF and periodontal destruction, and suggested that occlusal forces have no effect on periodontal destruction

Summary

Introduction

A variety of occlusal conditions have been adjudged to have a dynamic interactive impact on the periodontium, among which we can mention bruxism, mal occlusion, abfraction, etc. The International Working Group for the Classification of Periodontal Diseases and Conditions in 1999 defined occlusal trauma as an injury to the attachment apparatus or teeth as a result of excessive occlusal forces (EOF). Occlusal trauma can be divided in two general categories [1,2,3,4,5,6,7,8,9,10,11,12,13,14]: 1) Primary occlusal trauma is an injury resulting from EOF applied to a tooth or teeth with normal support [14]. 2) Secondary occlusal trauma is an injury resulting from normal or excessive occlusal forces applied to a tooth or teeth with inadequate or reduced periodontal support [14]. Stillman stated that occlusal forces should be controlled both to prevent and treat periodontal disease. These early reports created a background for a controversy that does not yet have international consensus on whether there is a causal relationship between occlusal discrepancies and periodontal disease, independently of the presence or absence of the factor of irritation, or whether occlusal trauma only acts as a factor that promotes the progression of plaque-induced periodontal disease

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Results

Conclusion