Лекции SDM 2013

10:15 - 11:30, 06 окт (неделя), 2013
Стая: MIS

"Бруксизъм и възстановявания върху импланти.Оклузални съображения."

Проф. Илия Русу

According to the American Academy of Orofacial Pain bruxism is defined as a diurnal or nocturnal parafunctional activity including clenching, bracing, gnashing, and grinding of the teeth. Bruxism is an involuntary movement and patients are often not even aware of the parafunction although the tooth wear might be significant. The diagnosis of bruxism is based on the report of tooth grinding or clenching by the patient or his/her partner, in combination with at least one of the following signs: abnormal tooth wear, sounds associated with bruxism and pain - dysfunction symptoms of the masticatory muscles and/ or the TM Joints.
The literature, which is so far published about the etiology of bruxism, is often difficult to interpret. However, there is a general agreement about the multifactorial nature of the etiology of bruxism. Taken all evidence together, bruxism seems to be centrally regulated in the central nervous system and not peripherally. Since the exact etiology is not known there is no definitive treatment. The treatment options address the overload of the stomatognathic system and its various structures.
Based on clinical experience, probably every dentist would group bruxers into a high-risk category for technical and mechanical complications and failures once the implant restorations are delivered. Bruxism is a potential risk factor for implant failure. The osseointegration of the implants allows for almost no axial mobility during overloading of the masticatory surfaces of the restorations. As a consequence some changes need to be consider in the treatment plan in order for the final restoration to became a healthy part of the stomatognathic system and for its longevity. Controlling the overload of the implants restorations is a distinguished clinical consideration with different demands in order to achieve the least trauma to the surrounding tissues There are a few practical guidelines as to minimize the chance of complications. Besides the recommendation to control the forces applied by bruxism itself, these guidelines concern a different occlusion design.. The restoring dentist but also the lab technician need to understand the differences between implant and tooth supported restorations. The specific occlusal guidelines that need a different approach from the usual tooth supported restorations concern will be discussed in this presentation. The differences between tooth supported and implant restorations will be explored and through a series of clinical cases the differences in the occlusal design will be discussed