Current concepts of diagnosis and treatment of bruxism

Year 2019, Volume: 6 Issue: 2, 221 - 228, 01.08.2019

Melike Güleç Melek Taşsöker , Sevgi Özcan Şener

https://doi.org/10.15311/selcukdentj.440702

Cited By: 5

Abstract

Bruxism is the name of
the action of clenching and/or grinding performed on teeth without a functional
purpose such as chewing and grinding. In etiology, morphological, psychological
and parafunctional factors are generally accused. However, due to its
subjective nature, there is no universally recognized common opinion in the
diagnosis of bruxism. Bruxism can occur during sleep or while awake. Sleep
bruxism does not vary depending on sex but awake bruxism is seen mostly in
women. Bruxism can cause problems such as wear and fractures in teeth, loss of
periodontal support and mobility, pain in the masticatory system and orofacial
region, and temporomandibular joint dysfunction. There are basically five
methods for bruxism diagnosis. These are questionnaire method, clinical
observation, intraoral appliances, electromyographic analysis of masticator
muscles and polysomnographic evaluation (PSG). Although PSG evaluation is accepted
as the gold standard among these methods, it has some limitations. Clinical
observation is mainly based on tooth wear and changes in soft tissues.
Abfraction, attrition, corrosion and abrasion are named according to the
factors affecting the formation of tooth wear. Conditions where the degree of
wear is high, the tooth is unable to perform its specific function, the cause of
pain and sensitivity, and the level of loss of tooth tissue that requires
restoration is called pathological tooth wear. Differences in the etiology of
bruxism require different approaches on treatment.  Current bruxism treatment approaches are
personal approaches (cognitive-behavioral therapy), pharmacological approaches
and occlusal approaches. The aim of this study is to present current diagnosis
and treatment principles of bruxism. 

Keywords

Bruxism, etiology

Bruksizmin tanı ve tedavisinde güncel yaklaşımlar

Abstract

Bruksizm, çiğneme ve
öğütme gibi fonksiyonel bir amaç olmaksızın dişlerde gerçekleştirilen sıkma
ve/veya gıcırdatma hareketinin adıdır. Etiyolojide genel olarak morfolojik,
psikolojik ve parafonksiyonel faktörler suçlanmaktadır. Ancak subjektif olması
yönüyle bruksizm tanısında dünya genelinde kabul görmüş ortak bir görüş
bulunmamaktadır. Bruksizm uyku esnasında veya uyanıkken gerçekleşebilir. Uyku
bruksizmi cinsiyete bağlı farklılık göstermezken, uyanıkken gerçekleşen
bruksizm daha çok
kadınlarda görülmektedir. Bruksizm, dişlerde fraktür
ve aşınmalar, periodontal dokularda destek kaybı ve mobilite, çiğneme
sisteminde ve orofasial bölgede ağrı ile temporomandibular eklem disfonksiyonu
gibi problemlere yol açabilmektedir. Bruksizm tanısında temel olarak beş yöntem
uygulanmaktadır. Bunlar; anket yöntemi, klinik gözlem, ağız içi
apareyleri, çiğneme kaslarının elektromyografik analizi, polisomnografi (PSG)’dir.
Bu yöntemlerin içinde PSG ile değerlendirme gold standart olarak kabul
edilmesine rağmen belirli limitasyonları bulunmaktadır. Klinik gözlemde temel
olarak diş aşınmaları ve yumuşak dokuda görülen değişiklikler izlenmektedir. Diş
aşınmaları oluşumuna etki eden faktörlere göre abfraksiyon, atrizyon, korozyon
ve abrazyon olarak adlandırılmaktadır. Aşınma derecesi fazla olan, dişin
spesifik fonksiyonunu yapamadığı, ağrı ve hassasiyete sebep olduğu ve diş
dokusundaki kaybın restorasyon gerektirecek seviyeye geldiği durumlar patolojik
diş aşınması olarak adlandırılır. Bruksizmin etiyolojisindeki farklılıklar
tedavilerinde de farklı yaklaşımlar gerektirir. Günümüzde bruksizm tedavi
yaklaşımları; kişiye yönelik yaklaşımlar (bilişsel-davranışsal terapi),
farmakolojik yaklaşımlar ve oklüzal yaklaşımlar olarak özetlenebilir. Bu çalışmanın amacı, bruksizmin güncel tanı ve tedavi
prensiplerini sunmaktır. 

Anahtar Kelimeler: Bruksizm, etiyoloji, diş aşınmaları

Keywords

Bruksizm, etiyoloji

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