Role of trauma from occlusion in periodontal disease- A controversy

Abstract

For more than a century, dental care professionals have debated whether or not trauma from occlusion is associated with periodontal disease. Both occlusal trauma and periodontitis result in injury to the attachment apparatus because the periodontium is unable to cope with the pathological insult which it experiences. Occlusal traumatism is nowadays generally accepted as a distinct pathologic entity unassociated with periodontitis, related tissue changes are regarded as microscopic, non-inflammatory and limited to attachment apparatus. The effects of excessive occlusal force and the destructive, adaptive and reparative response of the periodontium has been complicated by a relative lack of evidence based on well controlled prospective studies in human beings. A clinician's decision whether or not to use occlusal adjustment as a component of periodontal therapy should be related to an evaluation of clinical factors involving patient comfort and function, and not based on the assumption that occlusal adjustment is necessary to stop the progression of periodontitis. The present article discusses the role of trauma from occlusion in periodontal disease.