Laboratorijska izdelava zobnega nadomestka pri pacientih z bruksizmom : diplomsko delo

Balantič, Maruša (author), Rojko, Franc (mentor), Bohinc, Peter (reviewer)

Uvod: Parafunkcijska vedenja, še posebej bruksizem, so zelo pogosta, in zobozdravniku ob pacientovi rehabilitaciji predstavljajo velik izziv. Pacientove razvade in vedenja vplivajo na način rehabilitacije in izbiro uporabljenega materiala. Bruksizem je motnja povezana s škrtanjem in stiskanjem zob, ki je pacient ne more nadzirati. Posledice bruksizma so prekomerna obraba zob, glavobol, znižana višina griza, bolečine v mišicah, predvsem v masetrskih in temporalnih, ter bolečina v čeljustnih sklepih. Pri pacientih, pri katerih se škrtanje z zobmi pojavlja več let, opazimo preoblikovanje zob. Zobne krone so krajše in odkrušene. V primeru, da ima pacient še svoje zobe, a so ti preveč obrabljeni, se jih obrusi za prevleke. Z namenom, da bi zmanjšali poškodbe keramičnih zobnih nadomestkov, se je vpeljal nov način izdelave CAD/CAM. Namen: Namen diplomskega dela je pregledati obstoječe znanje o bruksizmu in mogoče probleme, s katerimi se srečujejo zobozdravniki in laboratorijski zobni protetiki pri načrtovanju in izdelavi zobnih nadomestkov pri takšnih pacietnih; predstaviti sodobne tehnologije in materiale kompatibilne za CAD/CAM sistem. Na kliničnem primeru dveh pacientov z bruksizmom je v diplomskem delu predstavljena izdelava ustrezne zobne sanacije z materiali z ustreznimi mehanskimi lastnostmi in hkrati izpolniti pacientove želje. Metode dela: Za teoretično podlago diplomskega dela smo uporabili deskriptivno metodo dela na podlagi študij obstoječih strokovnih člankov in ostale literature. Praktični del diplomskega dela smo izvedli v zobnem laboratoriju. Izdelali smo zobne prevleke s cirkonijevim oksidnim ogrodjem na zobeh 11, 21, 22, in s kovinskim ogrodjem na zobeh 24, 25 in 26. Rezultati: Po korakih smo prikazali in opisali digitalno izdelavo, ki smo jo podprli s slikovnim gradivom. Razprava in zaključek: Uvedba CAD/CAM sistema v zobozdravstvu je prinesla razvoj novih tehnik in materialov za izdelavo zobnih nadomestkov. Cirkonijev oksidni material je trenutno zelo priljubljen material v dentalni fiksni protetiki, vendar ga je potrebno uporabljati z zadržkom, saj ne predstavlja najboljše izbire za vsakega pacienta. Včasih je kombinacija tradicionalnih in sodobnih materialov boljša izbira kot zgolj sledenje trenutnim trendom dela. Ne glede na mehanske lastnosti želenega materiala, ima večjo vlogo pri izbiri material, iz katerega so narejeni antagonisti. Po zaključeni rehabilitaciji pri bruksistih je priporočljiva izdelava zaščitne grizne opornice.

• Language: Slovenian
• Keywords: diplomska dela, laboratorijska zobna protetika, bruksizem, CAD/CAM, dentalna keramika, polnoporcelanske prevleke, kovinsko-porcelanske prevleke
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [M. Balantič]
• Year: 2022
• Number of pages: 46 str.
• PID: 20.500.12556/RUL-142454
• UDC: 616.31
• COBISS.SI-ID: 128742659
• Publication date in RUL: 10.11.2022

Secondary language

• Language: English
• Title: Laboratory production of dental replacement in patients with bruxism : diploma work

Abstract

Introduction: Parafunctional behaviours, especially bruxism, are common nowadays and present a great challenge for dentists. The patient's habits and behaviors affect the type of rehabilitation and used materials. Bruxism is an uncontrolled disorder associated with gnashing and clenching of teeth. The consequences of bruxism are excessive tooth wear, headaches, decreased bite height, muscle pain, especially in the masseter and temporal, and pain in the jaw joint. Dental crowns are shorter and chipped. If the patient still has his teeth, but they are too worn, the preparations for crown are made. In order to reduce damage to ceramic dental prostheses, a new method of manufacturing CAD/CAM was introduced. Purpose: The purpose of this thesis is to review the existing knowledge about bruxism and possible problems faced by dentists and laboratory dental technicians in the design and manufacture of dental prostheses in such patients. On top of that, it is intended to introduce modern technologies and materials compatible for CAD/CAM system. In the clinical case of two patients with bruxism, make appropriate dental restorations with materials of suitable mechanical properties and at the same time fulfill the patient's wishes. Methods: For the theoretical basis of the thesis, we used a descriptive method of work based on studies of existing professional articles and other literature. The practical part of the diploma work was performed in the dental laboratory. We made dental crowns with a zirconium oxide frame on teeth 11, 21, 22, and with a metal frame on teeth 24, 25 and 26. Results: Step by step we showed and described the steps of digital production, which we supported with graphical material. Discussion and conclusion: The introduction of the CAD/CAM system in dentistry brought the development of new techniques and materials for the production of dental replacements. Zirconium oxide is currently a very popular material in dental fixed prosthetics, but it should be used with caution as it is not the best choice for every patient. Sometimes a combination of traditional and modern materials is a better choice than following current work trends. Regardless of the mechanical properties of the desired material, the material from which antagonists are made, plays a more vital role. After a completed rehabilitation from bruxism, it is recommended to make a protective biting splint.

• Keywords: diploma theses, laboratory dental prosthetics, bruxism, CAD/CAM, dental ceramic, porcelain monolitic crowns, porcelain fused to metal crowns