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Protetična rehabilitacija bruksizma s poudarkom na dvigu vertikalne dimenzije okluzije : diplomsko delo
ID Vencelj, Nina (Author), ID Rojko, Franc (Mentor) More about this mentor... This link opens in a new window, ID Bohinc, Peter (Reviewer)

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Abstract
Uvod: Bruksizem je ponavljajoča se aktivnost mišic čeljusti, za katero sta značilna stiskanje ali škrtanje zob z zategovanjem ali potiskanjem spodnje čeljusti. Bruksizem ima dve različni obliki. Lahko se pojavi med spanjem (t. i. bruksizem v spanju) ali med budnostjo (t. i. budni bruksizem). Bruksizem, ki je krovni izraz za stiskanje zob in škrtanje z zobmi, je najpogostejši od mnogih parafunkcionalnih dejavnosti žvečnega sistema. Mnenja o vzroku bruksizma so številna in različna. Trenutni pregledi kažejo, da etiologija ni v celoti znana, vendar je verjetno večfaktorska. Čeprav sta občasno stiskanje in škrtanje izjemno pogosta, po navadi ne predstavljata resnih posledic za oralno obrabo struktur. Po drugi strani pa lahko močan bruksizem povzroči težave, ki so za pacienta enako moteče kot za načrtovalca terapevtskega zdravljenja. Posledice bruksizma vključujejo obrabo zob, znake in simptome temporomandibularne motnje (TMD), glavobole, zobobole, mobilnost zob in različne težave z restavracijo obrabljenih zobnih struktur, ki vključujejo tako fiksno kot snemno protetiko. Namen: Namen diplomskega dela je predstaviti značilnosti bruksizma in njegov vpliv na temporomandibularni sistem. Poudarek je na rehabilitaciji obrabljenega dentina in dvigu vertikalne dimenzije okluzije, ki je potreben pri večini protetičnih rehabilitacij naprednega bruksizma. Predstavljamo tudi vpliv dviga griza na žvečni sistem. Metode dela: Diplomsko delo temelji na pregledu literature, kot so znanstveni članki, znanstvene revije in strokovne knjige. Uporabili smo deskriptivno metodo. Literaturo smo iskali v knjižnicah, spletnih brskalnikih in spletnih strokovnih bazah, kot so PubMed, ScienceDirect, ProQuest, Google, Google Scholar. Zaradi pomankanja domače literature smo uporabili predvsem tujo literaturo. Na podlagi primera iz prakse smo pacientu, nagnjenemu k bruksizmu, v zobnem laboratoriju izdelali zobni nadomestek, pri katerem smo aplicirali dvig vertikalne dimenzije okluzije, pomagali smo si z izdelavo diagnostičnega navoska in uporabili sistem CAD/CAM. Rezultati: Predstavili smo postopek celostne rehabilitacije pacienta, ki ima zaradi bruksizma močno znižan griz. Opisali smo postopek izdelave bruksistične opornice, ki služi kot začasno varovalo pred nadaljnjo obrabo sklenine, sledil je celoten postopek registracije z obraznim lokom, opisali smo postopek digitalnega navoska ali »mock-upa«, tiskanja modelov in izdelavo predložk za prenos novega stanja. Razprava in zaključek: Rezultati so pokazali, da lahko pravilna protetična rehabilitacija, ki vključuje dvig vertikalne dimenzije okluzije in uporabo tehnologij CAD/CAM, znatno izboljša stanje pacientov z bruksizmom. Ugotovljeno je bilo, da pravilno izvedeno zdravljenje ne izboljša le videza, temveč tudi funkcionalnost žvečenja in zmanjša simptome, kot so bolečine v čeljusti, glavoboli in obraba zob. Ključnega pomena je tesno sodelovanje med laboratorijskim izvajalcem in terapevtom. Oba morata biti dobro seznanjena z najnovejšimi tehnologijami in metodami, da lahko svojim pacientom ponudita najsodobnejše možnosti zdravljenja.

Language:Slovenian
Keywords:diplomska dela, laboratorijska zobna protetika, bruksizem, dvig griza, vertikalna dimenzija okluzije, centralna relacija, CAD/CAM
Work type:Bachelor thesis/paper
Typology:2.11 - Undergraduate Thesis
Organization:ZF - Faculty of Health Sciences
Place of publishing:Ljubljana
Publisher:[N. Vencelj]
Year:2024
Number of pages:43 str., [1] str. pril.
PID:20.500.12556/RUL-165938 This link opens in a new window
UDC:616.31
COBISS.SI-ID:219126019 This link opens in a new window
Publication date in RUL:14.12.2024
Views:537
Downloads:534
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Secondary language

Language:English
Title:Prosthetic rehabilitation of bruxism with emphasis on raising the vertical dimension of occlusion : diploma work
Abstract:
Introduction: Bruxism is a repetitive activity of the jaw muscles, characterized by clenching or grinding of the teeth through tightening or pushing of the lower jaw. Bruxism has two different manifestations: it can occur during sleep (referred to as sleep bruxism) or while awake (referred to as awake bruxism). Bruxism, which can be considered an umbrella term for clenching and grinding of the teeth, is the most common of the many parafunctional activities of the masticatory system. Opinions on the cause of bruxism are numerous and varied. Current reviews suggest that the etiology is not entirely known but is likely multifactorial. Although occasional clenching and grinding are extremely common and usually do not result in serious consequences for the wear of oral structures, severe bruxism can cause issues that are equally troubling for the patient and the therapeutic treatment planner. The consequences of bruxism include tooth wear, signs and symptoms of temporomandibular disorder (TMD), headaches, toothaches, tooth mobility, and various challenges in restoring worn tooth structures, which involve both fixed and removable prosthetics. Purpose: The purpose of this thesis is to present the characteristics of bruxism and its impact on the temporomandibular system. The focus will be on the rehabilitation of worn dentin and the increase in vertical dimension of occlusion, which is necessary in most prosthetic rehabilitations for advanced bruxism, as well as to discuss the effects of increasing the bite on the masticatory system. Methods: The thesis will be based on a review of literature, including scientific articles, journals, and professional books. We will use a descriptive method for the research. Literature will be sourced from libraries, online search engines, and professional databases such as PubMed, ScienceDirect, ProQuest, Google, Google Scholar, etc. Due to the scarcity of domestic literature, we will primarily rely on foreign sources. Based on a case study, we will create a dental replacement in a dental laboratory for a patient prone to bruxism, incorporating an increase in the vertical dimension of occlusion. We will assist in this process by creating a diagnostic wax-up and using the CAD/CAM system. Results: In our case, we presented the process of comprehensive rehabilitation for a patient with significantly reduced bite as a consequence of bruxism. We described the procedure for creating a bruxism splint, which serves as a temporary safeguard against further enamel wear. This was followed by the complete process of registration using a facebow. Additionally, we detailed the digital wax-up or mock-up procedure, the printing of models, and the creation of templates for transferring the new occlusal state. Discussion and conclusion: The results showed that proper prosthetic rehabilitation, which includes raising the vertical dimension of occlusion and using CAD/CAM technology, can significantly improve the condition of patients with bruxism. Properly performed therapy has been found to not only improve aesthetic appearance, but also improve chewing efficiency and reduce symptoms such as jaw pain, headaches and tooth wear. Close cooperation with laboratory operators and the therapist is crucial. Both must be well-versed in the latest technologies and methods to offer their patients the most advanced treatment options.

Keywords:diploma theses, laboratory dental prosthetics, bruxism, bite elevation, vertical dimension of occlusion, central relation, CAD/CAM

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