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Occlusion: Definition, Causes and Treatment

Occlusion refers to the complete blockage of a blood vessel or body duct, or to the contact between upper and lower teeth when biting. Learn about causes and treatment.

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Things worth knowing about "Occlusion"

Occlusion refers to the complete blockage of a blood vessel or body duct, or to the contact between upper and lower teeth when biting. Learn about causes and treatment.

What Is Occlusion?

The term occlusion (from Latin occlusio, meaning closure or blockage) is used in medicine in two distinct contexts. In vascular medicine and general medicine, it describes the complete blockage or obstruction of a blood vessel, duct, or hollow organ. In dentistry and orthodontics, occlusion refers to the way the upper and lower teeth come together when the mouth is closed or during chewing movements.

Occlusion in Vascular Medicine

In angiology (vascular medicine) and cardiology, occlusion describes the complete closure of a blood vessel – typically an artery or vein. This can have life-threatening consequences, as affected tissues and organs are deprived of oxygen and nutrients.

Causes of Vascular Occlusion

Thrombosis: Formation of a blood clot (thrombus) within a vessel that partially or fully blocks blood flow.
Embolism: Migration of a clot, air bubble, or other particle that lodges in and occludes a vessel.
Atherosclerosis: Build-up of plaques on vessel walls that progressively narrow and may eventually completely occlude the lumen.
Vasospasm: Sudden constriction of the vessel wall muscle leading to a functional blockage.
External compression: Pressure from adjacent structures such as tumors compressing a vessel.

Symptoms of Vascular Occlusion

Symptoms vary depending on which vessel is affected and how quickly the occlusion develops:

Arterial occlusion of the limbs: Sudden pain, pallor or cyanosis (bluish discoloration), coldness, tingling, numbness, and loss of movement (the classic 6 Ps: Pain, Pallor, Paresthesia, Paralysis, Pulselessness, Prostration).
Coronary occlusion (heart attack): Severe chest pain, radiation to the arm, shoulder, or jaw, sweating, nausea.
Cerebral occlusion (stroke): Sudden paralysis, speech disturbances, visual loss, dizziness.
Mesenteric arterial occlusion: Severe abdominal pain, nausea, vomiting, intestinal bleeding.

Diagnosis

Several imaging and functional tests are used to diagnose vascular occlusion:

Doppler and Duplex Ultrasound: Non-invasive assessment of blood flow characteristics in vessels.
Angiography (CT or MR angiography): Contrast-enhanced imaging of blood vessels.
ECG and cardiac enzymes: Used when a heart attack is suspected.
Laboratory tests: Coagulation parameters, D-dimers, and complete blood count.

Treatment of Vascular Occlusion

Treatment depends on the location, extent, and onset of the occlusion:

Thrombolysis: Medication to dissolve the blood clot (e.g., rtPA, recombinant tissue plasminogen activator).
Anticoagulation: Preventing further clot formation with heparin or direct oral anticoagulants (DOACs).
Thrombectomy: Surgical or interventional removal of the clot.
Angioplasty and stenting: Widening of the narrowed vessel and placement of a stent to keep it open.
Bypass surgery: Surgical rerouting of blood flow around the blocked vessel.

Occlusion in Dentistry

In dentistry and orthodontics, occlusion describes the alignment and contact between the upper (maxillary) and lower (mandibular) teeth when the jaw is closed or in motion. A normal (physiological) occlusion exists when the teeth meet harmoniously and function correctly. Deviations from this are referred to as malocclusion.

Types of Dental Occlusion

Static occlusion: Tooth contact when the mouth is closed and the jaw is at rest (maximum intercuspation).
Dynamic occlusion: Tooth contact during jaw movements, such as chewing or lateral excursion.
Malocclusion: Misalignment of teeth or jaws, classified into Class I, II, and III according to the Angle classification system.

Causes and Consequences of Malocclusion

Malocclusions can be genetically determined or caused by habits such as thumb sucking, early loss of primary teeth, or injuries. Untreated malocclusions can lead to temporomandibular joint disorders (TMD), excessive tooth wear, dental pain, and even digestive difficulties.

Treatment of Dental Occlusion Disorders

Orthodontics: Use of fixed or removable braces to correct dental and jaw misalignment.
Prosthodontics: Adjustment of crowns, bridges, or dentures to restore correct occlusion.
Occlusal adjustment (selective grinding): Careful reshaping of interfering tooth contacts.
Occlusal splint: A custom-made plastic device worn over the teeth to protect them and relieve the temporomandibular joint.

References

Pschyrembel Clinical Dictionary, 268th edition, De Gruyter, Berlin 2020.
Kumar, V., Abbas, A. K., & Aster, J. C.: Robbins & Cotran Pathologic Basis of Disease, 10th edition, Elsevier, Philadelphia 2021.
Proffit, W. R., Fields, H. W., & Sarver, D. M.: Contemporary Orthodontics, 6th edition, Elsevier Mosby, St. Louis 2019.

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