Title Protetska rehabilitacija pacijenata s bruksizmom
Title (english) Prosthetic rehabilitation of patients with bruxism
Author Maja Golik
Mentor Renata Gržić (mentor)
Committee member Renata Gržić (predsjednik povjerenstva)
Committee member Vlatka Lajnert (član povjerenstva)
Committee member Davor Kuiš (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Prosthodontics) Rijeka
Defense date and country 2017-07-18, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Dental Medicine Prosthetic Dentistry
Abstract Bruksizam je parafunkcijska aktivnost koja se javlja noću u obliku cikličkih lateralnih
brusnih pokreta, karakteristično je škripanje zubima i povišen mišićni tonus. Pritom na
stomatognati sustav djeluju sile puno veće od normalnih (kod funkcijskih aktivnosti).
Aktualno je stajalište da je uzrok bruksizma poremećaj sna vezan za psihičko stanje, a postoje
i mnogi provocirajući uzročnici (određeni lijekovi, životni stil, poremećaji središnjeg
živčanog sustava). Ova parafunkcija ostavlja mnoge posljedice na žvačni sustav, od kojih je
najprepoznatljivija pretjerana istrošenost zubi. Tu su još i glavobolje, hipertrofija i bolovi
žvačnih mišića, promjene na temporomandibularnom zglobu, moguća povećana pomičnost
zuba, zastoj u salivarnim žlijezdama zbog promjena na mišićima. Pacijenti su funkcijski i
estetski oštećeni. Bruksizam se ne može izliječiti, no postoje terapijske mogućnosti pomoću
kojih se ova parafunkcija može kontrolirati: kontrola stresa, farmakoterapija (u težim
slučajevima), botulinski toksin, a najčešća je terapija okluzijskim udlagama.
Protetska terapija ovakvih pacijenata vrlo je zahtjevna. Protetskim radovima saniraju
se posljedice bruksizma. Potrebna je dobra anamneza, klinički pregled i plan terapije. kod
fiksne terapije, suočavamo se s problemom malih bataljaka s lošim mehaničkim svojstvima,
potrebom za povećanjem vertikalne dimenzije okluzije, ključan je odabir materijala. Da bi
terapija bila uspješna i imala što veću trajnost, važno je procijeniti kakva bi vrsta protetskog
nadomjestka bila najbolja u smislu restauriranja izgubljenog tkiva, funkcijske i estetske
rehabilitacije, a da su istovremeno ispunjena pacijentova očekivanja, želje i mogućnosti. Uz
bilo kakvu protetsku terapiju mora se izraditi okluzijska udlaga jer je pacijent s tim novim
protetskim radom i dalje bruksist. Udlaga štiti protetski rad i preostale zube od novih
oštećenja uslijed parafunkcijske aktivnosti. Važno je spomenuti da je održavanje dobre oralne
higijene ključan čimbenik za uspjeh svake terapije koja se provodi u usnoj šupljini.
Abstract (english) Bruxism is a parafunctional activity. It occurs at night in the form of cyclic lateral
abrupt movements, characterized by grinding and clenching of teeth and elevated muscular
tone. The forces created during these movements are much larger than the normal ones
(during functional activities). The current view is that the cause of bruxism is a sleep disorder
influenced by the psychological condition. There are many provocative agents, such as certain
drugs, lifestyle or CNS disorders. This parafunction leaves many consequences on the
masticatory system, the most noticeable of which is excessive wear of teeth. There are also
headaches, hypertrophy and pain of chewing muscles, changes in the temporomandibular
joint, possible enlarged tooth mobility, stagnation in salivary glands due to changes in the
muscles. Patients are functionally and aesthetically damaged. Bruxism cannot be cured, but
there are therapeutic possibilities for controlling this parafunction: stress control,
pharmacotherapy (in severe cases), botulinum toxin, and most commonly, occlusal splint
therapy.
Prosthetic treatment of such patients is very demanding. It is used to treat the
consequences of bruxism. Good anamnesis, clinical review and therapy plan are needed. With
fixed prosthetics, we are facing the problem of small prepared teeth with poor mechanical
properties, the need for lifting the bite, and also, the choice of material is crucial. In order for
the therapy to be successful, it is important to evaluate what kind of prosthetic treatment
would be the best in terms of restoring lost tissue, functional and aesthetic rehabilitation,
while at the same time meeting patient expectations, wishes and opportunities.
In addition to any prosthetic therapy, the occlusal splint should be made because the patient
with this new prosthetic work continues to be a bruxist. The occlusal splint protects the
prosthetic work and the remaining teeth from the new damage due to the parafunctional activity. It is important to note that maintaining a good oral hygiene is a key factor for the
success of any therapy performed in the oral cavity
Keywords
Bruksizam
Protetska terapija
Keywords (english)
Bruxism
Prosthetic treatment
Language croatian
URN:NBN urn:nbn:hr:184:821366
Study programme Title: Dental Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
Type of resource Text
File origin Born digital
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Created on 2017-08-07 06:49:27