磨牙伴颞下颌障碍的治疗:1例报告

Marcus Vinícius Andrade Oliveira, Marco Aurélio Fonseca Porto, Paulo Cézar Simamoto Júnior, Uriel Paulo Coelho, L. C. Cabral
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引用次数: 0

摘要

研究发现磨牙症发作与颞下颌紊乱(TMD)的体征和症状之间存在关联。本研究的目的是报告磨牙症与TMD相关的诊断和姑息治疗。患者,23岁,男性,就诊于牙科诊所,主诉左侧颞下颌关节疼痛,前牙形态改变。在记忆期间,记录了这种症状是反复出现的,并报告了磨牙的习惯。临床检查发现中心关系与最大习惯性间歇不一致,突出导向不理想,存在磨损面,开口时咔嗒声和下颌偏曲。采用颞下颌疾病研究诊断标准(RDC / TMD)问卷对TMD进行诊断。通过特定的算法将这种疾病分类为肌筋膜疼痛、椎间盘复位移位和骨关节炎,均影响左侧。为此,提出将模型装配在半可调关节器中进行咬合映射和上蜡诊断,然后通过选择性磨损和材料添加进行咬合调整。手术后,安装咬合夹板作为磨牙的姑息治疗。本病例报告表明,通过咬合调整和咬合夹板的方法,在诊断为磨牙和颞下颌疾病的患者中,减少了影响口颌系统组成部分的体征和症状。
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Management of bruxism associated with temporomandibular disorder: case report
ABSTRACT Studies have found the association between episodes of bruxism and the presence of signs and symptoms of temporomandibular disorder (TMD). The aim of the present study was to report the diagnosis and palliative therapy of bruxism associated with TMD. Patient, 23 years old, male gender, presented at dental clinic, complaining of pain in the temporomandibular joint on the left side and alteration of the form of the anterior teeth. During the anamnesis it was documented that this symptom was recurrent and reported the habit of grinding teeth. The clinical examination observed discrepancy between the centric relation and the maximum habitual intercuspation, unsatisfactory protrusive guide, presence of wear facets, clicking and mandibular deviation during mouth opening. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD) questionnaire was applied to diagnose TMD. By means of specific algorithms this disorder was classified as myofascial pain, disc displacement with reduction and osteoarthritis, all affecting the left side. Thus, it was proposed the assembly of the models in semi-adjustable articulator for occlusal mapping and waxing diagnosis, then the occlusal adjustment by selective wear and material addition was executed. After this procedure, the occlusal splint was installed as a palliative therapy for bruxism. This case report suggests that the dental approach by means of occlusal adjustment and occlusal splint, in a patient diagnosed with bruxism and temporomandibular disorder, reduces the signs and symptoms that affect the components of the Stomatognathic System.
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