Prevention in occlusodontics
- Reminder on occlusion.
- According to CHAPUT:
It is a static state obtained by the contact ratio between the occlusal surfaces of the antagonist teeth whatever the position of the mandible.
- According to Glikman: the term occlusion concerns tooth contact relationships resulting from neuromuscular control of the masticatory system.
- The ability to adapt to occlusal forces:
The periodontium needs functional stimulation, these being represented by the physiological forces produced during the different functions (mastication, etc.).
When there is an increase in functional demands on the periodontium, it tries to meet these demands; its ability to adapt varies between individuals and at different times in the same individual.
The effect of occlusal forces on the periodontium is influenced by their intensity, direction, frequency and duration.
- Intensity of occlusal forces:
A physiological force is one that does not exceed the adaptation threshold of the tissues, this adaptation can be represented by an increase in desmodontal fibers as well as by an increase in the density of the alveolar bone.
- Direction of occlusal forces:
Physiological forces are multidirectional, both horizontal represented by the fibers resulting from the balance of the castle corridor and axial forces during chewing for example.
Noting that the main fibers of the periodontium are arranged in such a way that they can best support occlusal forces, along the long axis of the tooth.
- The duration and frequency of the forces:
Constant pressure on bone causes resorption, while intermittent force promotes bone formation.
The time between pressure applications appears to influence bone response.
Recurring forces at short time intervals have essentially the same resorbing action as constant pressure.
Once the forces exceed the adaptation threshold of the periodontium, a lesion called occlusal trauma results.
And if this situation persists, dysfunction of the masticatory system sets in.
- Prevention in occlusodontics:
Prevention can be classified into:
- Primary prevention: involves eliminating etiological factors before they cause damage.
- Secondary prevention: includes the suppression of signs of the disease already established, thus preventing its worsening.
- Tertiary prevention: focuses on maintaining therapeutic results through periodic check-ups, preventing the disease from recurring.
Thus, it can also be classified as mass or individual prevention.
- Preventive therapies:
– We need to re-educate patients with bad habits.
– As many teeth as possible should be preserved and extracted teeth should be replaced.
– Any periodontal disease must be treated early to avoid bone loss.
– Conservative and prosthetic devices must be designed in such a way that they do not cause occlusal imbalances.
– Orthodontic treatment to distribute occlusal forces along the axes of the teeth.
– Grinding to eliminate prematurities and interferences for preventive purposes.
- Emergency treatment:
In the case where the patient presents with muscular and joint signs (pain, spasm)
- Drug prescription: painkillers, anti-inflammatory and muscle relaxant.
- Occlusal release plates (splints) allow for a release and proportional distribution of occlusal forces across the entire dentition.
- Application of dry heat
- Local infiltration anesthesia without vasoconstrictor at the muscle level and corticosteroids at the ATM level.
- Physiotherapy and massage
- Curative treatment:
Once the diagnosis has been made, treatment should include both the removal of the causes and the treatment of the lesions caused by it by establishing symptomatic treatment and functional treatment which consists of occlusal equilibration by:
a- Selective grinding:
It is a procedure for reorganizing the dental-dental relationships undertaken on healthy, cleaned teeth; it can be carried out in an emergency.
It represents a very delicate irreversible treatment phase, can be done after orthodontic treatment , before and after occluso-prosthetic treatment.
b- Orthodontic treatment:
Correction of malpositions by moving dental organs without altering them.
c- Prosthetic rehabilitation:
Restoring missing, damaged or misaligned teeth, it has several roles:
- Increase the masticatory coefficient.
- Distribute the loads across all the teeth.
- Psycho-aesthetic role.
d- Treatment by restraint:
It is a symptomatic therapeutic procedure which allows dental organs to be immobilized temporarily while awaiting definitive consolidation when mobility has become irreversible.
It also allows the distribution of forces over all the teeth.
There are different types of restraints:
- Temporary restraint
- Semi-permanent retention
- Final contention
- Conclusion :
In all situations, prevention should be given priority over curative treatment. Indeed, the combination of treatments gives the best clinical results by favorably modifying the terrain and harmonizing the occlusion.
Prevention in occlusodontics
Wisdom teeth can cause infections if not removed.
Dental crowns restore the function and appearance of damaged teeth.
Swollen gums are often a sign of periodontal disease.
Orthodontic treatments can be performed at any age.
Composite fillings are discreet and durable.
Composite fillings are discreet and durable.
Interdental brushes effectively clean tight spaces.
Visiting the dentist every six months prevents dental problems.