15
Occlusion and periodontal diseases
The periodontium attaches the tooth to the alveolar bone and dissipates the forces of occlusion to the surrounding tissues. If the occlusal load is abnormally high or the periodontium is reduced in height due to periodontal disease, tissue changes may be seen (Fig. 15.1) (Lindhe et al. 2008).
Tissue changes in response to occlusal load
Experiments in beagle dogs designed to mimic prolonged traumatic occlusion by applying alternate mesial and distal ‘jiggling-type’ trauma to a tooth (Lindhe & Ericsson, 1982) have shown the following:
• A healthy periodontium remodels in response to the occlusal forces.
• The periodontal ligament space widens if:
• the periodontium is of normal height (Fig. 15.2a, b);
• the periodontium is of reduced height due to past periodontal disease (Fig. 15.3a, b).
• The tooth shows non-progressive increased mobility.
• The periodontal ligament returns to its normal width following occlusal adjustment (Figs 15.2c,/>