normal support (primary occlusal trauma) and to progressive mobility in teeth with reduced support (secondary occlusal trauma), usually requiring splinting. There is no evidence from human studies that traumatic occlusal forces accelerate the progression of periodontitis or that they can cause non-carious cervical lesions or gingival recessions.
Cervical enamel projections are an example of tooth-related factors that can predispose to loss of periodontal supporting tissues – in this case severe buccal furcation involvement of the first molar. (Photo: K. & S. Jepsen).
Prosthesis-related and tooth-related factors
Classification of factors related to teeth and to dental prostheses that can affect the periodontium
A. Localised tooth-related factors that modify or predispose to biofilm-induced gingival diseases/periodontitis
1. Tooth anatomical factors 2. Root fractures 3. Cervical root resorption, cemental tears
5. Altered passive eruption 4. Root proximity
B. Localised dental-prosthesis-related factors
1. Restoration margins placed within the supracrestal attached tissues 2. Clinical procedures related to the fabrication of indirect restorations 3. Hypersensitivity/toxicity reactions to dental materials
This section is expanded in the new classification. It comprises all factors that modify or predispose to biofilm-induced gingival diseases/periodontitis.
• The term “biologic width” is replaced by “supracrestal tissue attachment”, consisting of junctional-epithelium and supracrestal connective tissue. • An infringement of restorative margins within the supracrestal connective-tissue attachment is associated with inflammation and loss of periodontal supporting tissue.
Systemic and other periodontal conditions
5
Guidance for clinicians
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