Trauma from occlusion in periodontics: A detailed review

Trauma from occlusion (TFO) is a crucial aspect of periodontics, influencing both the progression of periodontal disease and overall oral health. It refers to injury to the supporting structures of the teeth caused by excessive occlusal forces that exceed the adaptive capacity of the periodontium. While TFO does not directly cause periodontitis, it can exacerbate periodontal breakdown when inflammation is present. The relationship between occlusal trauma and periodontal disease progression remains a subject of debate, with historical theories such as Glickman’s Theory of Co-Destruction and Waerhaug’s opposing views shaping our understanding.

This review explores the pathophysiology, classification, clinical manifestations, diagnostic approaches, and management strategies for TFO, incorporating the most recent literature. Key clinical signs include increased tooth mobility, fremitus, widened periodontal ligament space, occlusal wear facets, and discomfort upon mastication. Diagnosis requires a combination of clinical evaluation, radiographic assessment, and advanced occlusal analysis techniques such as T-Scan and electromyography. Management strategies include occlusal adjustments, splinting, orthodontic corrections, behavioral therapy, periodontal interventions, and prosthetic rehabilitation.

With advancements in digital occlusal analysis and interdisciplinary approaches, clinicians can better understand and manage occlusal trauma. Future research should focus on long-term clinical trials to establish standardized treatment protocols for optimizing periodontal health and function.