Dijagnostički, pripremni i rekonstruktivni postupci u fiksnoprotetskoj terapiji pacijenata s bruksizmom

master's thesis

• Title (english): Diagnostic, preparatory and reconstructive treatment protocols in fixed prosthodontic therapy of patients with bruxism
• Author: Natko Klancir
• Mentor: Amir Ćatić (mentor)
• Committee member: Amir Ćatić (predsjednik povjerenstva)
• Committee member: Joško Viskić (član povjerenstva)
• Committee member: Domagoj Vražić (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Fixed Prosthodontics); Zagreb
• Defense date and country: 2020-09-24, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Prosthetic Dentistry

Abstract

Bruksizam se smatra oblikom parafunkcije stomatognatnog sustava kod koje dolazi do ponavljajuće aktivnosti žvačnih mišića. Očituje se kao stiskanje ili škripanje zubima koje kao posljedicu ima oštećenje i patološko trošenje zuba, temporomandibularne poremećaje te oštećenje parodonta. Etiologija bruksizma nije sa sigurnošću utvrđena, no danas se smatra da su primarni uzroci bruksizma stres i emocionalni faktori. Dijagnostika se temelji na kvalitetnoj anamnezi, kliničkom pregledu i laboratorijskim dijagnostičkim postupcima poput polisomnografije. Bruksizam nije izlječivo stanje, već se terapijom pokušavaju smanjiti simptomi bolesti i nadoknaditi gubitak zubnog tkiva. Sami simptomi su najčešće bol zuba ili žvačnih mišića, glavobolja, te trošenje okluzalnih površina zuba i posljedično smanjenje vertikalne dimenzije okluzije. Bruksizam se pokušava liječiti redukcijom psihičkog stresa, fizikalnom terapijom ili lijekovima. Uz to se kao uspješno terapijsko sredstvo pokazala i stabilizacijska udlaga koja pomaže uspostaviti harmonijski odnos čeljusti i struktura u temporomandibularnom zglobu. Osim smanjenja intenziteta simptoma bruksizma, važan dio terapije su i rekonstruktivni postupci kojima se nadoknađuje izgubljeno tvrdo zubno tkivo. Oni uključuju izradu ispuna i različitih vrsta protetskih nadomjestaka. Krunice su se pokazale kao uspješno sredstvo za nadoknadu zubnog tkiva i podizanje izgubljene vertikalne dimenzije okluzije. Budući da se kod pacijenata s bruksizmom razvijaju jake patološke žvačne sile, potrebno je procijeniti postoji li mogućnost za fiksnoprotetsku terapiju, kao i pomno izvršiti pretprotetsku pripremu pacijenta. Važno je i odabrati adekvatan materijal za rekonstrukciju te nakon protetske opskrbe izraditi udlagu kako bi se smanjio utjecaj patoloških sila i osigurala dugotrajnost nadomjeska.

Abstract (english)

Bruxism is considered a parafunctional activity of the stomatognathic system in which there is an excessive activity of the masticatory muscles present. Associated symptoms of bruxism are clenching of the jaw and teeth grinding, which may result in tooth damage and wear, as well as temporomandibular disorders and the damaging of the periodontal ligament. Causes of this condition have not yet been uncovered with certainty, although the widely accepted view is that emotional factors and stress play a role. Diagnostics rely mostly on a precise anamnesis, a general health examination, as well as diagnostic methods carried out at a laboratory, such as polysomnography. Bruxism is incurable, however, therapy can be prescribed to better manage the symptoms and rebuild lost tissue. The symptoms most commonly include painful teeth and masticatory muscles, migraines, as well as a gradual decrease of the vertical dimension of occlusion. Strategies for making symptoms manageable are a reduction in psychological stress, physical therapy, or medication. A splint designed to function as a stabilizer has proved to be an efficient way of maintaining a harmonious link between the jaw and the structures in the temporomandibular joint. Other than the reduction of direct symptoms, an important part of therapy are also the reconstructive procedures of rebuilding the lost dental tissue, such as providing fillings and various prosthetics. Crowns have proven to be a good tool for rehabilitation, as well as increasing the vertical dimension of occlusion. Since patients suffering from bruxism develop strong pathological impulses pertaining to their masticatory muscles, it is important to ascertain if there is a way to apply the fixed-prosthetic treatment, as well as to conduct the pre-prosthetic preparation for the patient. It is crucial to choose the right material to be used during reconstruction and then provide them with a splint that can lessen the impact of the condition.

• Keywords: krunice; bruksizam; udlage
• Keywords (english): crowns; bruxism; splints
• Language: croatian
• URN:NBN: urn:nbn:hr:127:488427
• 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
• Access conditions: Open access
• Repository: University of Zagreb School of Dental Medicine Repository
• Created on: 2021-01-05 11:14:49