Radiographic signs of occlusal trauma are associated with marginal bone loss: a retrospective clinical study.

Abstract

Work in animal models has implicated excessive occlusal forces and occlusal trauma as co-destructive factors for periodontitis. The main aim of the present study was to make a radiographic assessment of the effects of excessive occlusal forces i.e. occlusal/incisal tooth wear (TW), widening of the periodontal space (PDLw), and the presence of a mandibular torus (TM), on interproximal marginal bone loss (MBL) in a large series of patients. A secondary aim was to evaluate the statistical correlation between the parameters in specific two teeth and those of 12 teeth for MBL and six teeth for TW within the same individual. A total of 1950 full-mouth radiographic surveys were analyzed retrospectively. MBL was quantified relative to the root length ("Schei's ruler technique"). In addition, TW and PDL widening of the periodontal space were assessed, as well as the presence of TM. Odds ratio and logistic regression analysis were used to determine the association between occlusal trauma and MBL. The correlation of the measured parameters between the values for specific teeth and the whole dentition was evaluated from data from the first 400 radiographs. Teeth 41 and 33 showed the best correlation to the whole dentition: 0.85 for MBL, 0.83 for PDLw, and 0.97 for TW. The results of a logistic regression analysis with age as an independent variable, revealed a significant association between bone loss and both tooth wear (OR=2.767) and bone loss and PDLw (OR=2.585). TW is positively correlated to both PDLw and MBL. No correlation was found between the presence of TM and MBL.