ABP ABP Occlusion and Biomechanics 1 — Questions and Answers
Question 1: In periodontal co-destruction theory, what is the primary role of occlusal trauma in the presence of plaque-induced periodontitis?
- Initiates periodontal pocket formation independently
- Acts as a co-destructive factor accelerating bone loss in already-inflamed tissue (Correct answer)
- Causes gingival recession without bone involvement
- Eliminates the inflammatory infiltrate through increased blood flow
Correct answer: Acts as a co-destructive factor accelerating bone loss in already-inflamed tissue
Occlusal trauma acts as a co-destructive factor that accelerates alveolar bone loss when combined with existing plaque-induced inflammation, but does not initiate pocket formation alone.
Question 2: What term describes the adaptive widening of the periodontal ligament space without attachment loss in response to increased occlusal forces?
- Secondary occlusal trauma
- Primary occlusal trauma
- Adaptive remodeling (Correct answer)
- Fremitus
Correct answer: Adaptive remodeling
Adaptive remodeling refers to the reversible widening of the PDL space that occurs when the periodontium accommodates increased occlusal loads without inflammatory bone loss.
Question 3: Which clinical sign is MOST indicative of primary occlusal trauma in a periodontally healthy patient?
- Increased probing depths
- Furcation involvement
- Pathologic tooth mobility with normal bone levels radiographically (Correct answer)
- Generalized gingival recession
Correct answer: Pathologic tooth mobility with normal bone levels radiographically
Primary occlusal trauma manifests as tooth mobility from excessive forces on a periodontally healthy tooth with normal or slightly widened PDL space but no attachment loss.
Question 4: Fremitus is best defined as which of the following clinical findings?
- Mobility detected by bimanual palpation during excursive movements
- Pain on percussion of a tooth with occlusal prematurity
- Vibration or movement of a tooth felt by the examiner's finger during occlusal contact (Correct answer)
- Radiographic widening of the periodontal ligament space
Correct answer: Vibration or movement of a tooth felt by the examiner's finger during occlusal contact
Fremitus is the palpable or visible movement of a tooth when the patient taps or moves through occlusal contacts, indicating excessive occlusal forces on that tooth.
Question 5: According to the 2017 World Workshop classification, occlusal trauma is categorized under which major disease group?
- Periodontal diseases modified by systemic factors
- Periodontal conditions associated with endodontic lesions
- Traumatic occlusal forces and occlusal trauma (Correct answer)
- Non-plaque-induced gingival conditions
Correct answer: Traumatic occlusal forces and occlusal trauma
The 2017 classification system places traumatic occlusal forces, including primary and secondary occlusal trauma, under a distinct category of periodontal conditions not caused by plaque.
Question 6: When treating a patient with secondary occlusal trauma (reduced periodontium with normal forces), what is the FIRST priority in the treatment sequence?
- Occlusal adjustment to eliminate prematurities
- Periodontal debridement and infection control (Correct answer)
- Fabrication of a night guard appliance
- Extraction of mobile teeth
Correct answer: Periodontal debridement and infection control
In secondary occlusal trauma, inflammation from plaque must be eliminated first before occlusal adjustments can be accurately assessed or performed.
ABP ABP Occlusion and Biomechanics 1
In periodontal co-destruction theory, what is the primary role of occlusal trauma in the presence of plaque-induced periodontitis?