RESUMEN
BACKGROUND: Bruxism is a condition that results from hyperactivity in the central nervous system, and factors such as stress or other anxious conditions increase the frequency of episodes. When bruxism occurs at a young age, tooth wear can occur. The extent of wear can lead to the need for restorative dentistry and prosthetic treatments to restore the morphological and functional integrity of the teeth, with high costs associated with such treatments. CASE REPORT: A healthy 15-year-old boy presented to the orthodontist observation. His incisal ridges appeared thin, without mamelons, and with increased translucency. For treatment, the authors used only the Functional Plane of Monaco (FPM), a device which he had to wear 16 hours during the day. CONCLUSION: The orthodontist successfully treated an orthopaedic/orthodontic case with the FPM device.
Asunto(s)
Bruxismo/prevención & control , Aparatos Ortodóncicos Funcionales , Trastornos de la Articulación Temporomandibular/prevención & control , Adolescente , Humanos , MasculinoRESUMEN
The aim of the present study was to summarize the risk factors for bruxism that were identified by a systematic search of the literature published between 2007 and 2016. Depending on the size of the odds ratios (ORs) and the lower limit of the 95% confidence intervals indicated by the reports, four risk categories were differentiated. Among others, emotional stress, consumption of tobacco, alcohol, or coffee, sleep apnea syndrome, and anxiety disorders were recognized as important factors among adults. In children and adolescents, apart from distress, behavioral abnormalities and sleep disturbances predominated. Knowledge of the identified risk factors may be useful when taking the medical history of bruxing patients. Although many of the described variables cannot be influenced by prophylactic or therapeutic means, we recommend the following patient-centered approach ("SMS therapy"): self-observation, muscle relaxation, stabilization (Michigan) splint.
Asunto(s)
Bruxismo/etiología , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Trastornos de Ansiedad/complicaciones , Trastornos de Ansiedad/epidemiología , Bruxismo/epidemiología , Bruxismo/prevención & control , Café/efectos adversos , Intervalos de Confianza , Humanos , Oportunidad Relativa , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/epidemiología , Estrés Psicológico/complicaciones , Estrés Psicológico/epidemiología , Tabaquismo/complicaciones , Tabaquismo/epidemiologíaRESUMEN
Cerebral palsy (CP) is a common chronic motor disorder with associated cognitive, communicative, and seizure disorders. Children with CP have a higher risk of dental problems creating significant morbidity that can further affect their wellbeing and negatively impact their quality of life. Screening for dental disease should be part of the initial assessment of any child with CP. The objective of this article is to present an updated overview of dental health issues in children with CP and outline important preventative and practical strategies to the management of this common comorbidity. Providing adequate oral care requires adaptation of special dental skills to help families manage the ongoing health issues that may arise. As oral health is increasingly recognized as a foundation for general wellbeing, caregivers for CP patients should be considered an important component of the oral health team and must become knowledgeable and competent in home oral health practices.
Asunto(s)
Parálisis Cerebral , Atención Odontológica , Higiene Bucal , Enfermedades Estomatognáticas/prevención & control , Bruxismo/prevención & control , Bruxismo/terapia , Cuidadores/educación , Niño , Caries Dental/prevención & control , Caries Dental/terapia , Humanos , Maloclusión/terapia , Tamizaje Masivo , Enfermedades Periodontales/prevención & control , Enfermedades Periodontales/terapia , Calidad de Vida , Sialorrea/terapia , Enfermedades Estomatognáticas/terapia , Trastornos de la Articulación Temporomandibular/prevención & control , Trastornos de la Articulación Temporomandibular/terapia , Erosión de los Dientes/prevención & control , Erosión de los Dientes/terapiaRESUMEN
Tooth wear is a multifactorial condition and the term is used to describe all types of non-carious tooth substance loss: abrasion (produced by interaction between the teeth and other substances), attrition (produced during tooth-to-tooth contact), erosion (produced by a chemical process) and abfraction (produced through abnormal occlusal loading that predisposes tooth substance to mechanical and chemical wear). Dental technology has an important role in preventing, managing and monitoring tooth wear in a variety of ways. Hard poly(methyl methacrylate) or soft ethylene-vinyl acetate splints can be prescribed to alleviate bruxism, the most common cause of attrition. Thermoformed appliances can be used for the application of products that reduce dental erosion such as fluoride gel. Patients with significant tooth surface loss may require laboratory-made restorations, as well as removable appliances with bite planes that generate inter-occlusal space to facilitate restorations, or surgical templates to provide guidance in preparing restorations for those requiring surgical crown lengthening. Dental study models and digitised models can also prove valuable in terms of monitoring the condition. This paper presents a review of the role that dental technology plays in tooth wear prevention, management and monitoring.
Asunto(s)
Tecnología Odontológica , Desgaste de los Dientes/prevención & control , Desgaste de los Dientes/terapia , Bruxismo/prevención & control , Bruxismo/terapia , Humanos , Ferulas Oclusales , Polimetil Metacrilato , Polivinilos , Factores de Riesgo , Erosión de los Dientes/etiología , Erosión de los Dientes/prevención & control , Erosión de los Dientes/terapia , Técnicas de Movimiento Dental , Desgaste de los Dientes/etiologíaAsunto(s)
Estética Dental , Rehabilitación Bucal/métodos , Resinas Acrílicas/química , Bruxismo/complicaciones , Bruxismo/prevención & control , Cementación/métodos , Diseño Asistido por Computadora , Coronas , Porcelana Dental/química , Fracaso de la Restauración Dental , Alisadura de la Restauración Dental , Restauración Dental Provisional/métodos , Humanos , Registro de la Relación Maxilomandibular/métodos , Masculino , Persona de Mediana Edad , Planificación de Atención al Paciente , Técnica de Perno Muñón , Cementos de Resina/química , Preparación Protodóncica del Diente/métodos , Desgaste de los Dientes/complicaciones , Desgaste de los Dientes/terapia , Dimensión VerticalRESUMEN
OBJECTIVE: The inhibitory neurotransmitter γ-aminobutyric acid (GABA) plays an important role in the pathophysiology of anxiety behavioural disorders such as panic disorder and post-traumatic stress disorder and is also implicated in the manifestation of tooth-grinding and clenching behaviours generally known as bruxism. In order to test whether the stress-related behaviours of tooth-grinding and clenching share similar underlying mechanisms involving GABA and other metabolites as do anxiety-related behavioural disorders, we performed a Magnetic Resonance Spectroscopy (MRS) study for accurate, in vivo metabolite quantification in anxiety-related brain regions. DESIGN: MRS was performed in the right hippocampus and right thalamus involved in the hypothalamic-pituitary-adrenal axis system, together with a motor planning region (dorsal anterior cingulate cortex/pre-supplementary motor area) and right dorsolateral prefrontal cortex (DLPFC). Eight occlusal splint-wearing men (OCS) with possible tooth-grinding and clenching behaviours and nine male controls (CON) with no such behaviour were studied. RESULTS: Repeated-measures ANOVA showed significant Group×Region interaction for GABA+ (p = 0.001) and glutamate (Glu) (p = 0.031). Between-group post hoc ANOVA showed significantly lower levels of GABA+ (p = 0.003) and higher levels of Glu (p = 0.002) in DLPFC of OCS subjects. These GABA+ and Glu group differences remained significant (GABA+, p = 0.049; Glu, p = 0.039) after the inclusion of anxiety as a covariate. Additionally, GABA and Glu levels in the DLPFC of all subjects were negatively related (Pearson's r = -0.75, p = 0.003). CONCLUSIONS: These findings indicate that the oral behaviours of tooth-grinding and clenching, generally known as bruxism, may be associated with disturbances in brain GABAergic and glutamatergic systems.
Asunto(s)
Encéfalo/metabolismo , Bruxismo/metabolismo , Bruxismo/prevención & control , Ácido Glutámico/metabolismo , Espectroscopía de Resonancia Magnética , Ferulas Oclusales , Ácido gamma-Aminobutírico/metabolismo , Adulto , Química Encefálica , Estudios de Casos y Controles , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosAsunto(s)
Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/terapia , Sueño/fisiología , Adulto , Conducción de Automóvil , Bruxismo/diagnóstico , Bruxismo/prevención & control , Presión de las Vías Aéreas Positiva Contínua , Educación Médica Continua , Fatiga/etiología , Fatiga/prevención & control , Homeostasis/fisiología , Humanos , Neuronas/fisiología , Aparatos Ortodóncicos Removibles , Terapia por Inhalación de Oxígeno , Postura , Guías de Práctica Clínica como Asunto , Área Preóptica/fisiología , Factores de Riesgo , Trastornos del Sueño-Vigilia/etiología , Sueño REM/fisiología , Núcleo Supraquiasmático/fisiología , Vigilia/fisiología , Pérdida de PesoRESUMEN
Hypnosis is making a comeback in all of the medical disciplines. But in a world where everyone wants to control everything and manage everything, it's helpful to know that hypnosis is a dynamic process that cannot be forced on anyone, a psychic reality, clearly demonstrated today by brain imaging. Hypnosis does not take any power over the individual. It is just one more tool to help ease patient's discomfort. It is also useful to avoid professional burnout to provide care without depleting our energy and without wasting our valuable time. Medical hypnosis is a real asset for providing comfortable orthodontic treatment and creating a serene atmosphere. It can be done simply and rapidly to take high quality impressions, to place braces comfortably on a patient who is sitting quietly. Orthodontic treatment requires cooperation and motivation, so let's give our patients a new sense of confidence and a willingness to cooperate.
Asunto(s)
Hipnosis Dental , Ortodoncia Correctiva , Trastornos de la Articulación/prevención & control , Bruxismo/prevención & control , Comunicación , Conducta Cooperativa , Ansiedad al Tratamiento Odontológico/prevención & control , Recubrimiento Dental Adhesivo/métodos , Técnica de Impresión Dental , Relaciones Dentista-Paciente , Glosalgia/prevención & control , Humanos , Lenguaje , Motivación , Higiene Bucal , Aparatos Ortodóncicos , Dolor/prevención & control , Autoimagen , PensamientoRESUMEN
Despite the documented excellent clinical performance of dental implants, concerns linger regarding the best way to protect the restored dentition in patients with bruxism. This is because of the risk of occlusal overload that is reported to cause biological and biomechanical failures in the implant-prosthesis system. To better distribute occlusal loads to the rigid components of the prosthesis and to the interface between bone and implant during parafunctional movements, several dentists prescribe acrylic resin occlusal splints for nocturnal use by patients considered at risk. However, it is unclear whether this recommendation is based on scientific evidence or expert clinical opinion. This report reflects our effort to employ the systematic review protocol to assess whether there is scientific evidence to recommend an occlusal splint in bruxers after implant therapy.
Asunto(s)
Bruxismo/prevención & control , Implantes Dentales , Ferulas Oclusales , Prótesis Dental de Soporte Implantado , Odontología Basada en la Evidencia , Humanos , PrescripcionesRESUMEN
Bruxism and/or clenching, resulting in fatigue or dysfunction of masseter muscles (MM), may cause temporomandibular disorders. Functional support of the microcirculation is critical for prolonged muscle activity. Histamine is a regulator of the microcirculation and is supplied by release from its stores and/or by de novo production via the induction of histidine decarboxylase (HDC). Interleukin (IL)-1, a cytokine involved in temporomandibular disorders, is an inducer of HDC. In the present study, we examined the roles of histamine, HDC and IL-1 in MM activity. Experiments were conducted using our R+G+ model. A mouse restrained (R+) inside a narrow cylinder (front end blocked with a thin plastic strip) gnaws away (G+) the strip to escape, with the weight reduction in the strip serving as an index of MM activity. Fexofenadine (a peripherally acting histamine H1 receptor antagonist) reduced MM activity in normal mice. Both H1 receptor-deficient and HDC-deficient mice exhibited low MM activity. Prolonged R+G+ induced HDC activity in MM. Mast cell-deficient mice exhibited strikingly low HDC induction in MM (and also in the quadriceps femoris muscle) in response to muscle activity or IL-1ß. Mast cells were present around blood vessels and nerves in the epimysium and perimysium of MM. These results, together with others reported previously, suggest that: (i) peripheral histamine supports strenuous MM activity; (ii) strenuous MM activity stimulates mast cells to release histamine and to induce HDC (which replenishes the histamine pool in mast cells, possibly mediated by IL-1); and (iii) peripheral histamine H1 receptor antagonists may be effective in treating temporomandibular disorders or preventing prolonged clenching and/or bruxism.
Asunto(s)
Antagonistas de los Receptores Histamínicos H1/farmacología , Histamina/fisiología , Músculo Masetero/efectos de los fármacos , Actividad Motora/efectos de los fármacos , Animales , Bruxismo/metabolismo , Bruxismo/prevención & control , Histamina/metabolismo , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Histidina Descarboxilasa/genética , Histidina Descarboxilasa/metabolismo , Masculino , Músculo Masetero/irrigación sanguínea , Músculo Masetero/metabolismo , Mastocitos/efectos de los fármacos , Mastocitos/metabolismo , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Noqueados , Actividad Motora/fisiología , Receptores Histamínicos H1/genética , Receptores Histamínicos H1/metabolismo , Restricción FísicaRESUMEN
The aim of this study was to describe the treatment used in an elderly patient presenting with bruxism and dental erosion, with good gingival health and bone support, but with decreased occlusal vertical dimension (OVD). The oral rehabilitation of elderly patients presenting with bruxism in association with tooth erosion has been a great challenge for dentists. The loss of OVD, the presence of occlusal instability and the absence of an effective anterior guide due excessive dental wear, can damage stomatognathic system (SS) biology, the function and the aesthetics. In the first treatment stage, an overlay removable partial denture (ORPD) was fabricated for the immediate re-establishment of function and aesthetics. After a 2-month follow up, with the patient presenting no symptoms, a second rehabilitation stage was accomplished, with fixed and removable prostheses. Oral rehabilitation with an ORPD was able to re-establish the SS biology, but a correct diagnosis and treatment plan are essential for success. The ORPD is a non-invasive and reversible restoring modality for general dentists that allow the re-establishment of the patient's immediate aesthetics and function at low cost.