Evaluation of the degree of significance of occlusal disorders in periodontal diseases based on clinical and functional research

Abstract

The main etiologic factor of periodontitis according to modern concepts is bacterial action followed by the immune response of the body and the production of proinflammatory cytokines. Genetic predisposition, lifestyle, and concomitant pathology complicate the course of the disease. Other risk factors include occlusal disorders leading to traumatic overload of the periodontium. However, to date, there are no convincing studies revealing the role and nature of occlusal factors influencing the development of periodontitis. The aim of the study is to assess the significance of occlusal disorders in the development of chronic generalized periodontitis of mild severity.
Materials and methods.
An observational study was conducted involving 45 people aged 25 to 45 years with identified occlusal disorders of the supercontact type in static and dynamic occlusions. The main group included 25 individuals with occlusal interferences against the background of chronic generalized periodontitis of mild severity, the comparison group consisted of 20 individuals with identified occlusal interferences without established periodontal pathology. To assess the condition of the periodontium, hygienic and periodontal indices were used, occlusal analysis was performed, the bioelectrical activity of the masticatory muscles was assessed using surface electromyography, and microcirculation in the periodontal tissues was studied using the rheoparodontography method.
Results.
According to the results of the study, the hygienic indices of individuals in the main group reflected an unsatisfactory level of oral hygiene, periodontal indices had significantly higher values in the main group. Rheographic characteristics of the microcirculatory bed showed statistically highly significant differences between the groups: the rheographic index was lower in the main group and amounted to 51.2±20.8 mΩ, in the comparison group — 82.5±14.8 mΩ (p<0.001). The vascular tone index and the peripheral resistance index were higher in the main group and amounted to 19.31% and 96.11%, respectively, in the comparison group — 14.48% and 76.62% (p<0.001), respectively. According to the results of the functional test with maximum compression in habitual occlusion, highly significant differences in the symmetry coefficients of opposite muscles on each side were established in the main group and the comparison group: for the right side, Td/Md was 0.64 and 0.75 (p=0.009), respectively, for the left, Ts/Ms was 0.68 and 0.79 (p=0.008), respectively.
Conclusion.
According to the data obtained, occlusal interferences in some cases cause changes in the microhemodynamics of the intact periodontium, but are compensated in most cases by its reserve forces. In the presence of an inflammatory process in the periodontium, occlusal disorders can be considered as a potential aggravating risk factor.