Maxillary Mandibulal Disease

Occlusion is the relationship between the opposing teeth, when the maxillary mandibular dental arches approaches each other as in chewing or at rest. If this occlusal relationship is not well balanced it can cause pain, tenderness or mobility of the affected teeth, dysfunctions of the masticatory muscles1 and even TMJ problems.2 In spite of the number of studies done over the years, the relationship between occlusion and periodontal disease still remains an area of considerable interest and controversy. The present clinical update try to review the signs and symptoms of trauma from occlusion, and the orthodontic aspects based on previous research works done in this field.: it refers to an occlusion which produces forces that can cause

Clinical Features And Management

Review of literature shows that clinical features of trauma from occlusion include 4,8,9 progressive mobility of tooth, pain on chewing or percussion, positive fremitus test, occlusal prematurities/ discrepancies, wear facets, migration of tooth, chipped or fractured tooth (teeth), thermal sensitivity etc. There are other signs also which can be assessed radiographically. Radiographic signs include presence of widened perodontal ligament space, thickening of the lamina dura, bone loss (furcations) and root resorption , increase in bone in density or apical bone sclerosis .

Management of trauma from occlusion is done by removal of the excessive occlusal forces and attaining optimum functional occlusal relationships comfortable to the teeth and periodontium by methods such as occlusal adjustment, dental restorations, removal of selected teeth, occlusal reconstruction, management of parafunctional habits, stabilization of mobile teeth with removable or fixed appliances, orthodontic tooth movements and orthognathic

A study done by Burgett 12found that patients in whom occlusal adjustment was done as a part of periodontal treatment showed an improvement in attachment level than those in whom occlusal adjustment was not done, though it was only statistically relevant. A pair of studies done in humans, found that teeth with occlusal discrepancies in the beginning had significantly greater initial probing depths, greater mobility and a worse prognosis than teeth without occlusal discrepancies to begin with13. It was also found that correction of occlusal discrepancies significantly reduced the progression of periodontal disease and also helps to optimize the treatment outcome. However there are studies reporting against the role of occlusal discrepancies in increased rate of periodontal destruction 14,15,16. Occlusal adjustment by selective grinding is indicated to eliminate premature contacts or occlusal interferences and it helps in equal distribution of all forces on the teeth and also establishes a harmonious relationship among the components of the stomatognathic system. (17-24). Though occlusal adjustment is