PREVALENCE OF BRUXISM AMONG ADULTS (PART II)
Keywords:
bruxism, questionnaire, palpation of muscles and TMJ, abrasion facets, occlusograms, occlusal contacts, BruxChecker®Abstract
The issue of bruxism diagnosis, treatment and prevention is one of the most relevant in modern dentistry. It is established that bruxism is an extremely common phenomenon. It is proved that the formation of the mentioned pathology is caused by many factors, both local and general. In addition, in patients with bruxism there is a number of neurological symptoms. Many researchers consider bruxism as one of the signs of frustration not only in the dental field, but also somatic and psychiatric disorders (cerebral palsy, autism, Down syndrome), parasitic infections. Therefore, the detection of such phenomena as bruxism can be regarded as an additional stage of diagnosis in general complex diagnostic procedures in many pathological conditions. The aim of the investigation. To analyze the prevalence of bruxism among adults and conduct a comparative assessment of the credibility and effectiveness of different methods for diagnosis of this pathological condition. The materials and the methods of the investigation. 377 students of the Faculty of Dentistry of Ternopil State Medical University aged from 18 to 31 years (mean age - 19.9 years) participated in the current research. The study included conducting surveys to identify signs of bruxism (survey of the presence of such bad habits like biting of lips, cheeks, tongue, fingernails, other objects, which is considered as indirect sign of masticatory muscles parafunctions), as well as answers to the 13 questions of the questionnaire (by R. Slavichek). In case of positive answer, the participants were asked to independently assess the intensity of the complaint according to 3-point scale, where 1 point is the smallest, and 3 is the greatest severity of the given disorder. As a result of this assessment occlusal index (OI) was calculated - the ratio of points to the number of positive responses, that characterizes the severity of violations in stomatognatic system. At the same time OI from 0 to 1 is considered to be low, 1-2 points - medium, and from 2 to 3 - high. Also the research procedure included muscle palpation of maxillofacial area, head, shoulders and neck, the area of the temporomandibular joint in statics and dynamics, performing wax occludograms, determination of occlusal contacts using dental carbon paper and photographing them for further analysis, printing of dental impressions using alginate impression mass, making plaster models were used to identify abrasion facets (AF) on teeth and dental manufacturing thermoformed plates BruxChecker®. These plates were used at night to diagnose bruxism and to determine occlusal contact pattern. The findings. The results of studies bruxism prevalence among adults using a variety of methods ( questionnaires, muscle and TMJ palpation, study of wax occludograms, occlusal contacts, abrasion facets, BruxChecker® ) showed rather high presence of this phenomenon. Comparative evaluation of the reliability and effectiveness of different methods for diagnosis of this pathological condition found their different diagnostic value: the survey using specially compiled questionnaires can only alert the physician to determine the patient's bruxism, and to confirm this diagnosis additional methods of examination should be necessarily used. The fact that this condition is widespread among adults, confirming the need for special attention to the diagnosis of bruxism to detect somatic, psychic and parasitic lesions, which, according to studies by many authors, is often accompanied by this phenomenon, and timely prevention of its complications in the solid tissues (abfractions, abfraction facets, enamel cracks, fractures of tooth crown and root,teeth hypersensitivity), periodontal (gum recession, alveolar bone resorption, localized and generalized gingivitis), therapeutic and orthopedic restorations (cracking and loss of fillings, chipped ceramic, implant fractures), the occurrence of temporomandibular jaw disorders. But it should be noted that there is a necessity for further large-scale epidemiological studies involving wider layers of the population in order to obtain more reliable data.
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