Bruxism and Prosthetic Treatment

1. BRUXISM AND PROSTHETIC
TREATMENT:A CRITICAL REVIEW
Presented by
Dr. AJINS CB

2. CONTENTS :
• INTRODUCTION
• DEFINITION
• CAUSES
• RISK FACTORS
• EFFECTS OF BRUXISM
• DISCUSSION
• CONCLUSION

3. INTRODUCTION
• Bruxism is the commonest parafunctional activities of
masticatory system
• Clenching and grinding of teeth

4. BRUXISM
DEFINITION:
Involuntary, non-functional, rhythmic or spasmodic
gnashing, grinding and clenching of teeth.

5. CAUSES
Repressed aggression
Emotional tension
Anger
Fear
Frustration
Occlusal distrubances

6. RISK FACTORS
Lower age
Females
Tobacco
Alcohol
Psycosocial
factors
Sleeping
disorders
Medication

7. EFFECTS OF BRUXISM
EFFECTS OF BRUXISM ON MASTICATORY SYSTEM
EFFECTS OF BRUXISM ON PROSTHETIC RESTORATION ON
NATURAL TEETH
EFFECTS OF RESTORATION ON IMPLANT RESTORATION
EFFECT OF BRUXISM ON REMOVABLE DENTURES

8. EFFECTS OF BRUSXISM ON MASTICATORY SYSTEM
• Primary effect of bruxism is TOOTH WEAR
• Others- Tooth mobility/Tooth movement,changes in soft
tissue and jaw bones
• No specific treatment for sleep bruxism
• To prevent destructive effects OCCLUSAL SPLINTS,NIGHT
GUARDS are adviced.

9. EFFECTS OF BRUXISM ON PROSTHETIC
RESTORATION ON NATURAL TEETH
• Fixed dental prosthesis are successful prosthetic restoration in
partialy dentate patients.
• The most common technical failures included loss of retention
and fracture of material.
• This occurrence of these failures commonly seen in bruxism
patients.

10. • Heavy chewing forces or unfvourable loading directions
between teeth will be difficult to achieve adequate mechanical
retention and resistance forms.
• Metal occlusal surface to the opposing natural tooth enamel are
used to minimize wear of the natural dentition.
• Unpolished ceramics could be hazardous to opposing natural
teeth.

11. METHODS TO MANAGE BRUXISM
OCCLUSAL ADJUSTMENTS – Occlusal prematurities should be
corrected by coronoplasty and brought back to their relaxed
position of jaw.
OCCLUSAL SPLINTS – Night guards,
Occlusal splints,
Removable appliances
Customized appliances

12. • Removable splint – worn at night to guide tooth movement so
that periodontal manage is minimal.
• Splint should cover occlusal surface of all teeth.
• These appliances vary in appearance and features.

13. PHYSIOTHERAPY – Physiotherepeutic approaches should be done
to foster calmness
• Patient counscelling can lead to decrease in tension also create
awareness of the habit.
• This will result in increase voluntary control and thus can
reduce parafunctional tooth movements.
RELAXATION TRAINING – The patient is trained to relax the
muscle group voluntarily.

14. DRUGS
ANTI ANXEITY
TRANQUILIZERS
SEDATIVES
MUSCLE RELAXANTS

15. BIOMECHANICAL FACTORS
• For conventional fixed prosthesis,single crowns should be
constructed and should be with minimum extension.
• To increase retention of conventionaly retained crowns on
short,worn abutments is to include boxes,grooves and pins.
• Splinting should be avoided
• Proctective occlusal splint is adviced for severe tooth wear.

16. EFFECTS OF BRUXISM ON IMPLANT RESTORATION
• Bruxism and heavy occlusal loading causes the
implant failure.
• Mandibular implant supported
prosthesis,smoking andpoor oral hygiene had a
significant influence on boneloss,while occlusal
factors such as bruxism,maximal bite force and
length cantilevers areminorimportance.

17. EFFECTS OF BRUXISM ON REMOVABLE DENTURES
• COMPLETE DENTURE
• REMOVABLE PARTIAL DENTURE

18. COMPLETE DENTURE
• Bruxism is a frequent cause of complaint of soreness of the
denturebearing mucosa.
• Parafunctional habits is a possible factor to magnitude of ridge
reduction.
REMOVABLE PARTIAL DENTURE
• Mandibular distal extension removable partial dentures in
moderately shortened dental arches remains controversial

19. DISCUSSION :
• There is no evidence that prosthetic therapy , or any other
available treatment , can eliminate bruxism.
• Equally , there is no evidence that bruxism can be caused by
prosthetic therapy.
• The review was , therefore , directed towards the effects of
bruxism on various kinds of prosthodontic restorations

20. CONCLUSION:
• Tooth wear is a natural and generally slow process , and worn
teeth seldom need prosthetic rehabilitation .
• In extensive tooth wear , the decision to treat or not should be
based on the patients perceived need , the severity of the wear
and risk of its progression with respect to the patients age
• When prosthetic intervention is indicated in a patient with
bruxism , efforts should be made to reduce the effects of heavy
occlusal loading .

21. THANK YOU