Role of occlusion in the etiology and treatment of periodontal disease.

Abstract

Early in this century, trauma from occlusion* (also occlusal trauma, traumatism) was recognized as a pathologic change occurring in the periodontium,1 but it was considered a separate condition from periodontitis, the common form of chronic destructive periodontal disease. It was the prevailing concept that periodontitis was purely an inflammatory disease, in which periodontal pockets and tissue destruction were produced by inflammation alone. When trauma from occlusion was also present, it was thought to be unrelated to the destruction, and tooth loss was attributed to inflammation.2 This separation of periodontitis and trauma from occlusion seriously influenced the development of periodontal practice. It led many practitioners to minimize the significance of trauma from occlusion in periodontal disease and to question the treatment value of occlusal correction. Two particular research findings led to the impression that trauma from occlusion was not necessarily a serious matter in periodontal diagnosis and treatment: (1) trauma from occlusion does not cause periodontal pockets3-5; and (2) trauma from occlusion is a reversible tissue change. Both findings were valid insofar as they went, but they were extrapolated to justify erroneous conclusions. Because trauma from occlusion did not cause periodontal pockets, the misconception arose that it did not influence periodontal pockets originating from other factors. Some