master's thesis
Bruxism diagnosis and therapy

Monika Keča (2012)
Sveučilište u Rijeci
Medicinski fakultet
Katedra za stomatološku protetiku
Metadata
TitleDijagnostika i terapija bruksizma
AuthorMonika Keča
Mentor(s)Renata Gržić (thesis advisor)
Abstract
Bruksizam je parafunkcija koja se odvija pri spavanju i u budnom stanju. Bruksizam pri spavanju se svrstava u poremećaje pokreta pri spavanju. Bruksizam u budnom stanju se povezuje s psihosocijalnim faktorima te se više smatra naučenim ili adaptivnim mehanizmom koji osoba razvija kako bi se lakše nosila sa stresnom situacijom, anksioznošću i socijalnim životom nego poremećajem. Njihova je međusobna povezanost još uvijek predmet rasprave te se za sada klasificiraju kao dva zasebna klinička entiteta. Bruksizam pri spavanju se opisuje ritmičkim aktivnostima mastikatornih mišića (RMMA) koje se ciklički pojavljuju u najvećem postotku tijekom NREM spavanja, u isto vrijeme kad i kratkotrajna buđenja koja su dio cikličkog alterirajućeg obrasca (CAP-a). Bruksizam u budnom stanju se uglavnom odnosi na stiskanje zuba. Klinički simptomi su se pokazali kao nesigurni dijagnostički faktori te se ulažu mnogi napori kako bi se proizveo elektromiografski uređaj koji bi bio u širokoj kliničkoj praksi, a dijagnostička vrijednost bi mu bila jednaka polisomnografiji, zlatnom standardu u dijagnostici bruksizma pri spavanju. U kliničkom radu bitno je razlikovati kada je parafunkcijska aktivnost uzrok pacijentovih simptoma, a kada samo popratno stanje. Bitna je rana dijagnostika zbog preventivnog djelovanja, iscrpna anamneza i interdisciplinarni pristup u liječenju koegzistentnih patoloških stanja (poput poremećaja temporomandibularnog zgloba i gastroezofagealnog refluksa). Time bi se destruktivni efekt parafunkcijske aktivnosti sveo na minimalu mjeru. Terapija bruksizma pri spavanju još je uvijek ograničena na izradu okluzijske udlage, a pacijentima s bruksizmom u budnom stanju treba predložiti psihoterapiju i/ili primijeniti „Biofeedback“ tehniku. Prilikom protetskog zbrinjavanja potrošene denticije trebalo bi umjesto fokusiranja na dugotrajnost opstanka restauracije obratiti više pozornosti biološkim tehnikama.
Keywordssleep bruxism awake bruxism diagnosis treatment prosthetic treatment
Parallel title (English)Bruxism diagnosis and therapy
Committee MembersRenata Gržić
Vlatka Lajnert
Danko Bakarčić
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za stomatološku protetiku
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Dental Medicine
Prosthetic Dentistry
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeDental Medicine
Academic title abbreviationdr. med. dent.
Genremaster's thesis
Language Croatian
Defense date2012-12-20
Parallel abstract (English)
Bruxism is a parafunctional activity, occurring both during sleep and wakefulness. Sleep bruxism is one of the sleep-related motor disorders. Awake bruxism is associated with psychosocial factors and considered to be an adaptive mechanism or the reactive learning behavior, developed by a person in order to cope with stress, anxiety and social life, rather than a specific disorder. Their mutual relationship is still a matter of debate so these two have been classified as two different clinical entities so far. Sleep bruxism is described by the rhythmic muscular masticator activity (RMMA), which appears cyclically mostly during non-REM sleep at the same time as the micro arousals that belong to cyclic alternating pattern (CAP).Awake bruxism mainly refers to tooth clenching. It has been shown that the diagnosis of bruxism based solely on clinical symptoms is not reliable. Further efforts should be made to create a device with the same accuracy as gold standard in diagnosis of bruxism, polysomnografy recording. In clinical work is crucial to differentiate between the case when parafunctional activity is the cause of patient’s symptoms and the case when it is simply the side effect. Early diagnosis for the preventive action, detailed anamnesis and interdisciplinary approach in the treatment of coexistent pathological conditions (such as temporomandibular joint dysfunction and gastroesophageal reflux) are of great importance. Thus the destructive effect of parafunctional activity would be reduced to a minimum. Sleep bruxism treatment is still limited to the manufacture of occlusal splint, while psychotherapy and/or the Biofeedback technique are suggested to wake bruxism patients. When planning the prosthetic treatment of worn dentition, the emphasis should be put on the biological technique rather than on the survival of the restoration.
Parallel keywords (Croatian)bruksizam pri spavanju bruksizam u budnom stanju dijagnostika terapija protetska rehabilitacija
Resource typetext
Access conditionAccess restricted to students and staff of home institution
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:470057
CommitterBosa Licul