Which negative outcome is NOT associated with failing to remove or smooth an overhanging restoration?

The option indicating occlusal trauma is not typically associated with failing to remove or smooth an overhanging restoration. Overhanging restorations primarily create issues such as food entrapment, tissue irritation, and bony defects due to the accumulation of plaque and debris in the areas that are difficult to clean.

When a restoration is overhanging, it can lead to localized inflammation and irritation of the surrounding gingival tissue because normal plaque control measures may be inadequate. This can result in periodontal disease if left untreated. Additionally, food entrapment occurs more frequently in these areas, which further exacerbates periodontal problems as it fosters an environment conducive to bacterial growth.

While bony defects can arise from the chronic inflammation caused by these conditions, occlusal trauma specifically refers to damage that occurs as a result of abnormal bite forces, which is not directly related to the poor adaptation of a restoration to the tooth surface. Therefore, the choice indicating occlusal trauma correctly reflects an outcome that is not linked to the complications arising from an overhanging restoration.