Influence of occlusal interferences on the periodontium in patients treated with fixed prosthesis

The Influence of Dynamic Occlusal Interferences on Probing Depth and Attachment Level: Results of the Study of Health in Pomerania (SHIP)

BACKGROUND

The purpose of this study was to investigate potential associations between dynamic occlusal interferences and signs of periodontal disease in posterior teeth based on dental and medical measurements obtained from a population-based sample in the cross-sectional epidemiological study entitled, "Study of Health in Pomerania" (SHIP).

METHODS

Medical history and dental and sociodemographic parameters of 2,980 representatively selected dentate subjects, 20 to 79 years of age, were collected. The analysis was performed on posterior teeth only using a mixed linear model that considers the clustered structure of the data. The model also was adjusted with respect to known risk factors for periodontal disease.

RESULTS

The presence of non-working side contacts only was significantly related to probing depth (P<0.0001) and attachment loss (P=0.001). The presence of non-working side contacts and working side contacts on the same tooth was significantly related to increased probing depth (P=0.004) but not attachment level. The effect magnitude was a mean increase of 0.13 mm for probing depth and 0.14 mm in attachment loss. Known risk factors for periodontal disease that also showed significant associations with probing depth and attachment loss included male gender, age, smoking, education, and plaque score. Other factors significantly related to probing depth and/or attachment loss were tilted teeth, restored occlusal surfaces versus sound surfaces, elongated teeth, and tooth type (molar versus premolar).

CONCLUSION

The effect of non-working contacts on periodontal disease status was discernible, but weak in terms of magnitude and specificity.

Occlusal interferences related to dental panoramic radiographic changes in subjects treated with fixed prosthesis

Because of contradictory reports between clinical and radiographic findings, occlusal analysis correlated to dental panoramic findings was completed in 147 patients treated with fixed prosthesis. Both occlusal interferences and radiographic changes in the TMJ area and/or in dentition were frequently discovered. Dysfunction and occlusal indices gave statistically significant correlations to radiographic changes (P less than 0.01 and P less than 0.05, respectively) in the TMJ area. Periodontal changes with vertical bone pocket formation and sclerotic lamina dura seem to be early radiographic findings and occlusal interferences were the only means to give a clear-cut correlation to the radiographic changes (P less than 0.001). However, if periodontal tissues with supporting bone structure fail to respond to occlusal trauma, changes in the TMJ area will probably appear. From the clinical changes the deviation on mouth opening, tenderness to palpation of TMJ, and slide from retrusion to intercuspidation (RP-IP) explained most of the radiological TMJ changes when tested by the discriminant analysis. The value of radiographic follow-up of subjects following prosthetic treatment is emphasized.