![]() During and after treatment, when evaluating the success in stabilizing the occlusion, remember that a negative fremitus test is an absolute must. Obtain accurate and complete records in order to systematically treatment plan the best option for stabilizing the occlusion. Note: if fremitus is present with active inflammation, the periodontium must be treated as well as occlusal adjustments alone will not solve this problem. Without treatment, fremitus can progress to hypermobility, excessive wear, and/or shifting of anterior teeth. Occlusal trauma is defined as trauma to the periodontium from functional or parafunctional forces causing damage to the attachment apparatus of the periodontium by exceeding its adaptive and reparative capacities.ĭiscovering fremitus requires further investigation, not a wait and see approach.Fremitus = occlusal trauma = occlusal instability. It is important to check for fremitus both with the patient reclined and with the patient sitting up. If you feel ANY movement or vibration? fremitus is present. Identifying fremitus only requires placing the fingernail/tip of our index finger lightly on the facial surfaces of the teeth and asking patient to tap-tap, gently and firmly, then grind around. Failure to provide for long centric on anterior teeth postural freedom from centric relation. ![]() An envelope of function that has been restricted in some way? think iatrogenic.A deflective posterior incline contacts that drives the mandible forward.It is a clinical sign that is often overlooked during both the examination and the restorative process. The main sources of fremitus are: Fremitus: a vibration perceptible on palpation in dentistry, a vibration palpable when the teeth come into contact.Ĭhecking for fremitus of each tooth is an absolute necessity if we are to consider our exam complete.The presence of fremitus is indicative that the patient’s occlusion is not stable! Fremitus is a more subtle, but nevertheless important sign of occlusal instability that will be the focus of this discussion. Stress from microtrauma results in what we see clinically as occlusal disease or occlusal instability, an entity that can be more challenging to manage. Microorganisms (bacteria, viral, fungal)ĭental school trained us exceptionally well in treating the microorganism component caries and periodontal disease. Not including macro-trauma, there are only two simple reasons for the system to break down:ġ. These findings may improve the clinical assessment of occlusal trauma and related periodontal conditions for better patient management and treatment outcomes.Good Vibrations? As clinicians, the very purpose of our dental exam is to thoroughly evaluate each patient for any sign of instability that will lead to breakdown of the masticatory system. The fixed-effect analysis showed that HOF was positively correlated with PD and BOP (P < 0.05) in posterior teeth widened periodontal ligament space on radiographs in upper (r = 0.179, P < 0.01) and lower posterior teeth (r = 0.205 P < 0.05) as well as functional mobility in upper posterior teeth (r = 0.168 P < 0.05).Ĭonclusion: This study suggests that the posterior teeth with HOF in subjects with chronic periodontitis may reflect occlusal trauma-associated periodontal conditions that could probably increase the risk of further periodontal destruction. Results: Overall, the teeth with HOF existed mainly in molars and presented with deeper probing depth (PD) and higher frequency of bleeding on probing (BOP) than those without HOF. The correlation of HOF with periodontal parameters and signs of occlusal trauma was analysed. The T-scan II occlusal analysis system determined the HOF during maximum intercuspation, lateral excursion and protrusive excursion. Methods: Periodontal parameters and signs of occlusal trauma were recorded for 807 teeth in 30 subjects with untreated chronic periodontitis. Periodontitis The result of an interaction between a susceptible host and bacterial factors in dental plaque, which exceeds the protective mechanisms of the host. Objective: To determine the association of high occlusal force (HOF) with the signs of occlusal trauma and periodontal conditions in periodontitis patients, and elaborate the relevant clinical implications. Occlusal trauma Injury to the periodontium resulting from occlusal forces which exceed the reparative capacity of the attachment.
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