Occlusal trauma and excessive occlusal forces: Narrative review, case definitions, and diagnostic considerations
Occlusal trauma and excessive occlusal forces: Narrative review, case definitions, and diagnostic considerations
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DOI：
10.1111/jcpe.12949
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发表时间：
2018-06-01
影响因子：
6.7
通讯作者：
Caton, Jack G.
中科院分区：
文献类型：
--
作者：
Fan, Jingyuan;Caton, Jack G.
目的：本综述旨在确定咬合创伤和过度咬合力对牙周组织的影响，包括牙周炎的发生和发展、脱落和牙龈退缩。病例定义，诊断考虑，和咬合治疗的影响也进行了审查和讨论。ImportanceThe咬合创伤的作用，在牙周炎的启动和进展仍然是一个有争议的课题，在牙周病学。由于咬合创伤只能在组织学上确认，其临床诊断取决于临床和放射学的替代指标，使临床试验困难。FindingsInvestigations已普遍同意，咬合创伤和过度咬合力不启动牙周炎或结缔组织附件的损失。当牙菌斑引起的牙周炎和咬合创伤同时存在时，没有足够的证据表明咬合创伤可能会增加结缔组织损失的速度。咬合治疗是牙周治疗的一部分，以减少流动性和增加患者的舒适度和咀嚼功能。现有的数据不支持存在abfraction作为牙龈recessions.ConclusionsOcclusal创伤的原因不启动牙周炎，并有微弱的证据表明，它改变了疾病的进展。没有可信的证据支持存在的abfraction或牵连它作为一个原因牙龈萎缩。减少牙齿松动度可提高牙周治疗的效果。
ObjectivesThis narrative review determines the effects of occlusal trauma and excessive occlusal forces on the periodontium, including the initiation and progression of periodontitis, abfraction, and gingival recession. Case definitions, diagnostic considerations, and the effects of occlusal therapy are also reviewed and discussed.ImportanceThe role of occlusal trauma in the initiation and progression of periodontitis remains a controversial subject in periodontology. Because occlusal trauma can only be confirmed histologically, its clinical diagnosis depends on clinical and radiographic surrogate indicators which make clinical trials difficult.FindingsInvestigations have generally agreed that occlusal trauma and excessive occlusal forces do not initiate periodontitis or loss of connective tissue attachment. When plaque-induced periodontitis and occlusal trauma are present at the same time, there is weak evidence that the occlusal trauma may increase the rate of connective tissue loss. Occlusal therapy is indicated as part of periodontal therapy to reduce mobility and increase patient comfort and masticatory function. Existing data do not support the existence of abfraction as a cause for gingival recession.ConclusionsOcclusal trauma does not initiate periodontitis, and there is weak evidence that it alters the progression of the disease. There is no credible evidence to support the existence of abfraction or implicate it as a cause of gingival recession. Reduction of tooth mobility may enhance the effect of periodontal therapy.