BRUXISM AND ITS TREATMENT

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BRUXISM AND ITS TREATMENT

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• DEFINITION-
• IT CAN BE DEFINED AS DIURNAL OR NOCTURNAL
  PARAFUNCTIONAL ACTIVITY THAT INCLUDES CLENCHING,
  BRACING, GNASHING AND GRINDING OF THE TEETH.

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• ETIOLOGY-
• Psychological and emotional stresses.
• e.g.- anxiety, anger, frustration .
• Occlusal interference or discrepancy.
• Pericoronitis and periodontal pain is said to
  trigger bruxism in some individuals.

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• CLINICAL FEATURES-
• Occlusal wear facets on teeth.
• Fractures of teeth and restorations.

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• CLINICAL FEATURES-
• Temporomandibular joint pain and discomfort.
• Mobility of teeth.
• Tenderness and hypertrophy of masticatory muscle.
• Muscle pain when patient wakes up in the morning.
• Muscle activity becomes abnormal also interfere
  with TMJ functions.

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• Bruxism causes disruption of the relationship or
  alignment of the condyle , disc, and articular
  surface of the temporal bone which is called an
  intracapsular disorder or internal derangement of
  the TMJ.

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• It has been estimated that during clenching or
  grinding the individual might impose a load of
  over 20 g on a tooth over period 2.5 sec at a
  time.

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• EFFECT ON IMPLANTS-
• It has been associated with increased risk of
  implant failure.
• Repeated lateral forces applied to the implants
  can be detrimental to the osseointegration
  process, especially during the early healing
  period.
• It may be due to result of their clenching or
  grinding.

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• So bruxism to be a contraindication to implant
  treatment, especially in the case of a short span
  fixed partial denture or a single tooth implant.
• If implants are planned for a patient with
  bruxism habit, protective measures should be
  employed,
• such as Creating a narrow occlusal
  table
• with flat angles,
• Protected occlusion
  and the regular use of occlusal guards.

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Diagnosis of bruxism

• There may be definitive history of bruxism but in
  an unaware patient a number of sings help in its
  detection.
• Advanced attrition
• Increased tooth mobility patterns
• The presence of widened periodontal spaces in
  radiographs
• Hypertonicity of the muscles of
  mastication-Electromyographic examination
• TMJ discomfort

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COMPLICATIONS

• If bruxism is not treated then in future life ,it
  can lead to- jaw discords,
• -damage to teeth and
• - heavy headaches.
• People get warned about their condition only
  after some complication arises and many times
  they just neglect it.

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• constant headache, sore jaws are two important
  symptoms that indicate that the person is
  suffering from bruxism.
• Once you get doubtful about your clenching of
  teeth in night, you will need to take help from
  your dentist. The dentist will examine your mouth
  and jaw and will decide whether or not you suffer
  from bruxism

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• Obstructive sleep apnea is a condition which is
  very often complicated by additional disorders or
  problems. Many patients with this common sleep
  disorder had a problem with severe teeth grinding
  (bruxism)!
• According to a recent scientific study in Israel
• obstructive sleep apnea is even the highest risk
  factor for sleep bruxism!

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Treatment of bruxism

1. The first step in the control of any
   parafunctional habit must be discussion with the
   patient.
2. If occlusal disharmonies are there ,then the
   selective grinding may help to relieve the
   parafunction.

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• Further dental treatment involves the use of
  night-guards to limit the excessive occlusal
  stress. There are basically two forms of
  night-guards, both of which are made in acrylic
• The occlusal shield which fits ovre the occlusal
  surface , incisal edges lingual tooth
  convexity.
• where attrition is sever or where there has been
  collapse of the posterior segments so that the
  freeway space is increased ,the occlusal shield
  can be usefull.

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• B. the anterior bite plate.
• where there is an obvious bruxism habit with
  symptoms of muscle spasm where the lower
  anterior teeth are well supported with bone a
  night guard with an anterior bite plate is
  extremely useful.

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• To relax your jaws, hold one warm cloth on your
  cheeks and ears.
• We can advise the patient to visit their dentist
  even if they have just hint about their clenching
  of teeth.

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THANK YOU