Signs of occlusal trauma full#
Signs of occlusal trauma free#

Understanding the great importance of occlusion and occlusal management improves the quality of dentistry, and the health of patients because: (c) Red showing clear lateral interference. (b) Second patient with severe pain blue marks centric contacts. (b) Tooth fractured to gum line.įigure 12.5 (a) Two-year gold onlay on a first molar, causing severe pain, due primarily to lateral interference (red outside of blue).

Signs of occlusal trauma free#

Restorative success will encompass leaving the teeth needing repair or restoration in a healthy state, free of pulpal damage, and periodontal disease, and a patient who is satisfied with the esthetics of the restoration.įigure 12.4 (a) Tooth fractures. Restorative success is far more than a restoration which does not break. Although the restoration did not break and it had great margins, the improper occlusal management led to patient dissatisfaction, long-term discomfort and almost an unnecessary endodontic procedure. After differential diagnosis, occlusal trauma was considered to be a possible etiology for the pain, and within 2 days of a bite adjustment, the tooth stopped hurting permanently. She was scheduled for root canal treatment in the next few days. Figure 12.5a shows the gold onlay of a patient who suffered from postoperative pain and sensitivity for almost 2 years. The following is a clinical example of how improper occlusal management can lead to restorative failure ( Figure 12.5a–c). The uncontrolled occlusal forces are great and will be expressed in many other ways, such as loose restoration, loose teeth, pain and sensitivity, tooth fractures at the neck or root level ( Figure 12.4a,b), periodontal damage, headaches, migraines, and others. If unbreakable restorations are used without proper occlusal management, the unbreakable restoration will only transfer the forces and the damage into deeper tissues, or create other problems. (f) Restorative correction of the cross-bite using porcelain veneers. (e) Finished esthetic rehabilitation using Noritake feldspathic porcelain veneers. (d) Traumatic occlusion, which can lead to failure of any restoration. (c) Patient in need of esthetic treatment. (b) A 15-year postoperative image of porcelain veneers with Noritake feldspathic porcelain. (b) Failing porcelain-fused-to-metal restoration caused by occlusal disease.įigure 12.3 (a) Severely worn dentition. (b) Fractured veneers.įigure 12.2 (a) Cervical abfraction compromising a gold crown. Ultimately, parafunctional activity combined with a traumatic bite (occlusal disease) is the reason for restoration failures, and good occlusal management can lead to success even in difficult cases ( Figure 12.3a–h).įigure 12.1 (a) Fractured onlay.

Signs of occlusal trauma full#

Because of the fear of fractured restorations, many contraindicate partial coverage ceramic restoration, thus suggesting the use of more aggressive procedures such as full crowns of any type, including full zirconia crowns. The reality of the shorter durability of bonded ceramic restoration should be tempered with the reality that all restorations and the teeth restored, including porcelain-fused-to-metal and gold crowns, will have shorter durability and other problems when the patient has a severely traumatic occlusion and parafunctional activity ( Figure 12.2a,b).

In fact, longevity studies point to the decrease in durability of ceramic restorations in patients with parafunctional habits ( Figure 12.1a,b).

The Occlusal Connection to Restorative Dentistry SuccessĬeramic restorations are at an increased risk when a patient suffers from a traumatic occlusion combined with a parafunctional activity (occlusal disease). (b) Eighteen-year old with severe occlusal disease, showing severe wear, as well as many other signs and symptoms. (a) Fifty-five-year-old with severe occlusal disease, who has severe wear, multiple fractures, missing multiple teeth, as well as many other signs and symptoms. The Importance of Occlusion and Occlusal Diagnosis in Restorative Dentistry