Occlusal trauma

Occlusal trauma is a dental term that refers to the damage incurred when teeth are left in traumatic occlusion without proper treatment.

When the maxillary and mandibular dental arches approach each together, as they do, for example, during chewing or at rest, the relationship between the opposing teeth is referred to as occlusion. If this occlusal relationship is not balanced properly it may result in pain, tenderness and even mobility of the affected teeth.

When the natural course of trauma, disease and dental treatment alters an individual's occlusion by removing or changing the occlusal (biting) surface of any of the teeth, that individual's teeth will come together, or occlude, differently, and their occlusion will change. When that change is detrimental to the manner in which the teeth occlude, the patient is said to possess a traumatic occlusion. Traumatic occlusion may cause a thickening of the cervical margin of the alveolar bone and widening of the periodontal ligament, although the latter is not pathognomonic for this condition.

Microscopically, there will be a number of features that accompany occlusal trauma:

It was concluded that widening of the periodontal ligament was a "functional adaptation to changes in functional requirements".

Clinically, there are a number of physiologic results that serve as evidence of occlusal trauma:,

There are two types of occlusal trauma, primary and secondary.

Primary occlusal trauma occurs when greater than normal occlusal forces are placed on teeth, as in the case of parafunctional habits, such as bruxism or various chewing or biting habits, including but not limited to those involving fingernails and pencils or pens.

The associated excessive forces can be grouped into three categories. Excesses of:

Primary occlusal trauma will occur when there is a normal periodontal attachment apparatus and, thus, no periodontal disease.

Secondary occlusal trauma occurs when normal occlusal forces are placed on teeth with compromised periodontal attachment, thus contributing harm to an already damaged system. As stated, secondary occlusal trauma occurs when there is a compromised periodontal attachment and, thus, a pre-existing periodontal condition.

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