PERIODONTITIS
If pt c/o pain on chewing, cold test is normal, but sensitivity otherwise and pain on biting !
o Here pulp is normal acc to pulp test
o Pdl is affected –pain on biting
o Sensitivity is due to the cementum tear in th epdl- through which dentine is exposed and hence the sensitivity (its not the pulp that is affected here so no pulpitis here okay )
WIDENING OF PDL SPACE
Periodontitis
Osteosarcoma
TFO
Scleroderma – bilateral bone loss at angle of mandible also seen
NARROWING OF PDL SPACE
Ankylosis
Hypofunction of tooth
Hypercementosis – seen in Paget’s disease
NB: feature that distinguish periodontits from gingivitis – presence of clinically
detachable attachement loss in periodontits
TRAUMA FROM OCCLUSION
Trauma from occlusion
C/F – mobility of tooth (most common)
No pocket formation – differentiating from periodontitis
TOP +VE ,erythema gingiva
R/F – widening of PDL – most important diagnosis
Type of bone loss seen in 2° TFO is – vertical /angular bone loss
RX
o 1° TFO coronoplasty
o 2° TFO coronoplasty + splinting
PRIMARY TFO
o Excessive occlusive forces that exceeds the adaptive capacity of normal periodontitis
SECONDARY TFO
o Normal occlusive forces that excedes the adaptive capacity of diseased
periodontium
