Trauma from occlusion (TFO) is defined as an injury resulting in tissue changes within the attachment apparatus as a result of occlusal forces (Glossary of Periodontic TermsAmerican Academy of Periodontology, 2001) This clinical condition is frequently associated with jiggling forces and results in progressive tooth mobility.Experiments performed in animals like the beagle dog showed some periodontal tissue reactions to increasing tooth mobility. Such as (i) Increase in the width of the periodontal ligament area (ii)Increase in the vascularity,vascular permeability and the migration of leukocytes from the vascular plexus and (iii) the increase in number of osteoclasts lining the marginal alveolar bone of the zone of codestruction . Also, the teeth showing increasing mobility exhibit an enhanced rate of periodontal tissue destruction when exposed to experimentally induced periodontitis When trauma from occlusion is the result of alterations in occlusal forces, it is called as primary trauma from occlusion. When it results from the reduced ability of the Periodontal tissues to resist the occlusal forces ,it is known as secondary trauma from occlusion.One of the clinical sign of TFO include presence of Fremitus which means functional tooth mobility. A tooth with fremitus has excess contact, possibly related to a premature contact during habitual centric closure and excursive mandibular movements.The role of trauma from occlusion in periodontal disease relies on the belief that excessive occlusal forces do not initiate destructive chronic periodontitis .Though these forces are capable of causing periodontal injury and To establish relation between trauma from occlusion and periodontitis both should be present in destructive stages otherwise combined lesion can't be reproduced.Primary trauma from occlusion without periodontal inflammation results in no loss of attachment, with preservation of a bone matrix that is able to regenerate in the absence of traumatogenic forces. However, when periodontal inflammation is superimposed with trauma from occlusion, alterations in alveolar bone height and volume are not reverted by elimination of traumatogenic forces, with persistence of clinical mobility and gingival inflammation .Aggravation of plaque- related inflammatory periodontal disease by trauma from occlusion is still under question, and further investigations are necessary to elucidate such an association.It is unclear whether TFO occurs primarily in periodontitis patients, or bone loss due to periodontitis leads to TFO in later stages. Review of Literature has further revealed that there is no study conducted on anterior teeth with Fremitus and its relation with periodontal parameters.
So, it may be hypothesized that TFO may have impact on Periodontal tissue in different age groups as periodontitis is chronic in nature and time of initiation of the disease could not be identified. Recently age dependent distribution of periodontitis was studied and findings reported mean clinical attachment loss increased linearly with age and recession contributed increasinginly to CAL with age specially after 45-49years.Therefore reduced periodontium in later stages it may lead to TFO, as compared to early stages of life
