Temporomandibular Bozukluklar ve Bruksizmde Eşlik Eden Psikiyatrik Bozukluklar ve Tedavi Seçenekleri

Yıl 2020, Cilt: 12 Sayı: 2, 205 - 231, 30.06.2020

Bahadır Geniş , Çiçek Hocaoğlu

https://doi.org/10.18863/pgy.570861

Cited By: 1

Öz

Temporomandibular bozukluk (TMB) çiğneme kaslarını,
temporomandibular eklemi (TME) ve bu eklemi çevreleyen yapıların etkilendiği
klinik bir durumdur. Bruksizm, diş sıkma ve taşlamayla stomatognatik yapıların aşırı
yüklenmesinin bir sonucu olarak ortaya çıkan, TMB etiyolojisinde yer alan
parafoksiyonel bir alışkanlıktır. TMB popülasyonun yaklaşık %10'unda, bruksizm %8-20'sinde
görülür. TMB ve bruxism etiyolojisinde birçok faktör etkilidir ve bu faktörler
arasında etkileşimler vardır. Biyomekanik, nöromüsküler, biyopsikososyal ve
nörobiyolojik faktörler hastalığa katkıda bulunur. Psikiyatrik bozuklukların
prevalansı TMB ve bruxism olan bireylerde yüksektir. Birçok psikiyatrik
bozukluk, özellikle de depresyon ve anksiyete bozuklukları, TMB ve bruksizme eşlik
eder. Bu hastalıkların tedavisinde kullanılan antidepresanlar bruksizme neden
olur. Bu, TMB ve bruksizmin tedavisinde önemli zorluklardan biridir. TMB ve bruksizmin
tedavisinde ilk adım temel önleme yöntemlerine değinmektir. Amitriptilin
kullanımı TMB farmakoterapisinde belirgin olmakla birlikte, bruksizmde buspiron
ve klonazepam kullanılan iki önemli ilaçtır. Bu ilaçların küçük örneklerde incelenmesi ve mevcut
bilgilerin çoğunlukla vaka raporlarına dayanması gerçeği, ileri ki çalışmaların
gerekliliğini açıkça göstermektedir. Her iki hastalıkta da bilişsel davranışçı
terapinin yaygın kullanımı bir çözüm olacak ve ilacın yan etkilerini ortadan
kaldıracaktır. Tedavi seçeneği ne olursa olsun hem diş hekimleri hem de
psikiyatristler multidisipliner bir çalışma ortamında olmalı ve bu hastalıkları
biyopsikososyal model çerçevesinde değerlendirmelidir.

Anahtar Kelimeler

Temporomandibular Bozukluklar, bruksizm, depresyon, mental bozukluklar, tedavi

Comorbid Psychiatric Disorders and Treatment Options in Temporomandibular Disorders and Bruxism

Öz

Temporomandibular disorder (TMD) is a
clinical condition affecting the masticatory muscles, the temporomandibular
joint (TMJ) and the structures surrounding this joint.Bruxism is a
parafunctional habit that occurs as a result of overloading of stomatognathic
structures with tooth squeezing and grinding, which is included in the etiology
of TMB.TMB is seen in approximately 10% of the population and bruxism is seen
in 8-20%. Many factors are effective in the etiology of TMD and bruxism, and
there are interactions between these factors. Biomechanical, neuromuscular,
biopsychosocial and neurobiological factors contribute to the disease. The
prevalence of psychiatric disorders is high in individuals with TMB and
bruxism. Many psychiatric disorders, especially depression and anxiety disorders,
accompany TMB and Bruxism. The antidepressants used in the treatment of these
disorders cause bruxism. This is one of the important challenges in the
treatment of TMB and bruxism.The first step in the treatment of TMB and bruxism
is to address the basic prevention methods. While amitriptyline use is prominent in
TMB pharmacotherapy, in bruxism, buspirone and clonazepam are two important
drugs used.The study of these drugs in small samples and the fact that the
available information is mostly based on case reports clearly shows the
necessity of further studies. The widespread use of cognitive behavioral
therapy in both disorders will be a solution and eliminate the side effects of
medication.Regardless of the treatment option, both dentists and psychiatrists
should be in a multidisciplinary working environment and should evaluate these
diseases within the framework of the biopsychosocial model.

Anahtar Kelimeler

Temporomandibular Disorders, Bruxism, depression, mental disorders, treatment

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