Role of Occlusion as a Risk Factor in Periodontal Disease

Occlusion can be described in very simple terms as an intercuspal relationship between the set of maxillary and mandibular teeth. It plays an important role in the pathogenesis of periodontal diseases and traumatic lesions are often manifestation of faulty occlusion. Mc neil defined occlusion as the functional relationship between the components of the masticatory system, temporomandibular joint (TMJ), and craniofacial skeleton. From a research point of view, the TMJ serves primarily as a reference from which mandibular movements are duplicated. Most patients function with the built-in discrepancies in occlusion throughout their life. Periodontal treatment modalities may be required when alterations or abnormalities in the occlusal relationship place undue stress on the periodontium and TMJ, thereby causing dysfunction. The role of trauma from occlusion (TFO) in periodontal disease is still controversial. According to American Academy of Periodontology (AAP), the lesion of TFO may occur in conjunction with, or independent of, inflammatory periodontal diseases. Pathologic occlusion has been proposed as a risk factor for periodontitis. In certain cases, traumatogenic occlusion can cause periodontal destruction, and therefore, occlusal adjustment occasionally is indicated as part of periodontal therapy. The present review focuses on TFO as a risk factor and its impact on the periodontium and its treatment.