This document summarizes a case report of bruxism in a 4-year-old boy. Bruxism is defined as teeth grinding or clenching and can occur during sleep or while awake. The prevalence of bruxism is highest in children between 14-18% and decreases with age. Etiology may include psychological stress, malocclusion, and sleep disorders. The case report describes a 4-year-old boy with severe tooth wear consistent with bruxism. A functional orthodontic appliance was used for 3 years to control vertical growth and prevent further tooth wear. Regular adjustments were made to accommodate tooth eruption. Follow-ups showed improvement in tooth wear with treatment.
The document discusses the mechanics of orthodontic tooth movement. It covers topics such as the nature of orthodontic tooth movement, forces, center of resistance, moments, couples, types of tooth movement including tipping, translation, rotation, intrusion and extrusion. It also discusses force duration types including continuous, interrupted and intermittent forces. Threshold force values and moment to force ratios for different tooth movements are provided.
This document outlines various topics related to orthodontic anchorage. It defines anchorage as the resistance to unwanted tooth movement and discusses optimal force levels in orthodontics. It also assesses factors that influence anchorage demands and describes different types of anchorage including intraoral sources from teeth, soft tissues, bone and the opposing arch as well as extraoral headgear. Methods to reinforce anchorage like headgear are also covered. The document provides an overview of anchorage in orthodontic treatment planning and mechanics.
Types of tooth movement in orthodontics (4th BDS)Cing Sian Dal
There are three main types of orthodontic tooth movement: translation (bodily movement), pure rotation, and combined rotation and translation (tipping movement). Different levels of optimal force are required depending on the type of movement. Tipping requires 35-60g of force since only half the periodontal ligament area is compressed. Translation requires 70-120g since the entire area is compressed. Intrusion requires only 10-20g to avoid damage from heavy forces concentrating at the root apex. Root uprighting and torqueing also use force couples that compress within the crown, requiring 50-100g.
Bruxism refers to the involuntary, excessive grinding or clenching of teeth. It can occur during waking hours or sleep. The document discusses the various definitions, types, prevalence, etiology, diagnosis, and treatment of bruxism. Bruxism is a multifactorial condition influenced by morphological, pathophysiological, respiratory, and psychological factors. It is most common in children under 11 years of age. Treatment involves the use of occlusal splints and addressing any underlying causes like stress, sleep disorders, malocclusion, or respiratory conditions.
This document discusses various methods of mixed dentition analysis used to predict the size of unerupted permanent teeth during childhood. It describes Moyer's, Tanaka Johnston, Hixon-Oldfather, Nance, Ballard and Wylie, and Huckaba methods. Each method uses dental casts and sometimes radiographs to measure erupted teeth and predict unerupted tooth sizes using regression equations or charts. The most accurate methods are Hixon-Oldfather and refinements like Staley-Kerber, but other methods may be more practical or applicable to different populations.
Orthodontic Case History and ExaminationAhmed Gamil
The document discusses essential and supplemental diagnostic aids used in orthodontic diagnosis. Essential aids include case history, clinical examination, study models, and certain radiographs. Supplemental aids provide additional information and include specialized radiographs, electromyography, and biopsy. A thorough case history covers chief complaint, medical/dental history, and family history. Clinical examination assesses facial symmetry, profile, jaw relationships, and soft tissues. Essential radiographs aid in case evaluation and treatment planning.
The document discusses the mechanics of orthodontic tooth movement. It covers topics such as the nature of orthodontic tooth movement, forces, center of resistance, moments, couples, types of tooth movement including tipping, translation, rotation, intrusion and extrusion. It also discusses force duration types including continuous, interrupted and intermittent forces. Threshold force values and moment to force ratios for different tooth movements are provided.
This document outlines various topics related to orthodontic anchorage. It defines anchorage as the resistance to unwanted tooth movement and discusses optimal force levels in orthodontics. It also assesses factors that influence anchorage demands and describes different types of anchorage including intraoral sources from teeth, soft tissues, bone and the opposing arch as well as extraoral headgear. Methods to reinforce anchorage like headgear are also covered. The document provides an overview of anchorage in orthodontic treatment planning and mechanics.
Types of tooth movement in orthodontics (4th BDS)Cing Sian Dal
There are three main types of orthodontic tooth movement: translation (bodily movement), pure rotation, and combined rotation and translation (tipping movement). Different levels of optimal force are required depending on the type of movement. Tipping requires 35-60g of force since only half the periodontal ligament area is compressed. Translation requires 70-120g since the entire area is compressed. Intrusion requires only 10-20g to avoid damage from heavy forces concentrating at the root apex. Root uprighting and torqueing also use force couples that compress within the crown, requiring 50-100g.
Bruxism refers to the involuntary, excessive grinding or clenching of teeth. It can occur during waking hours or sleep. The document discusses the various definitions, types, prevalence, etiology, diagnosis, and treatment of bruxism. Bruxism is a multifactorial condition influenced by morphological, pathophysiological, respiratory, and psychological factors. It is most common in children under 11 years of age. Treatment involves the use of occlusal splints and addressing any underlying causes like stress, sleep disorders, malocclusion, or respiratory conditions.
This document discusses various methods of mixed dentition analysis used to predict the size of unerupted permanent teeth during childhood. It describes Moyer's, Tanaka Johnston, Hixon-Oldfather, Nance, Ballard and Wylie, and Huckaba methods. Each method uses dental casts and sometimes radiographs to measure erupted teeth and predict unerupted tooth sizes using regression equations or charts. The most accurate methods are Hixon-Oldfather and refinements like Staley-Kerber, but other methods may be more practical or applicable to different populations.
Orthodontic Case History and ExaminationAhmed Gamil
The document discusses essential and supplemental diagnostic aids used in orthodontic diagnosis. Essential aids include case history, clinical examination, study models, and certain radiographs. Supplemental aids provide additional information and include specialized radiographs, electromyography, and biopsy. A thorough case history covers chief complaint, medical/dental history, and family history. Clinical examination assesses facial symmetry, profile, jaw relationships, and soft tissues. Essential radiographs aid in case evaluation and treatment planning.
This document discusses various classifications and causes of malocclusion. It begins by introducing Moyer's classification which categorizes etiology into heredity, development defects, trauma, physical agents, habits, diseases, and malnutrition. White and Gardiner's classification separates causes into dental base abnormalities, pre-eruption abnormalities, and post-eruption abnormalities. Graber's classification divides factors into general factors like heredity, environment, and local factors like anomalies in tooth number. The document then examines specific causes in greater detail such as heredity, congenital defects, environment, anomalies in tooth number including supernumerary teeth and missing teeth.
This document provides an overview and instructions for Carey's analysis and Lundstrom analysis. Carey's analysis involves measuring the arch length and comparing it to the tooth material to determine if extractions are needed. It can indicate if a premolar extraction or first molar extraction is required based on the discrepancy. Lundstrom analysis divides the dental arch into segments and measures the tooth widths to calculate the net discrepancy. Both methods help assess dental arch perimeter and tooth size to determine appropriate treatment planning.
This document provides an overview of orthodontics and orthodontic tooth movement. It defines orthodontics as the specialty concerned with treatment and management of malocclusion. Orthodontic tooth movement results from forces delivered by fixed or removable appliances and occurs through the periodontal ligament in response to these mechanical forces. Proper application of biomechanical principles can improve treatment efficiency. Different types of tooth movement like tipping, translation, and rotation are discussed along with optimal force levels and durations. Factors like wire properties, bracket size and material are also covered.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Unlike natural teeth, the artificial teeth act as a single unit. Hence there should be a minimum of three point contact (usually one anterior and two posterior) between the upper and lower teeth at any position of the mandible for even force distribution and stabilization of the denture.
All occlusal forms should have a tripod contact in centric relation. Balanced occlusion should have a tripod contact in eccentric relation.
This document discusses functional appliances used in orthodontic treatment. It describes the advantages and disadvantages of functional appliances, how they work to produce orthopedic, dentoalveolar and muscular changes, different types of functional appliances including activators and Frankel regulators, and guidelines for use and patient instruction.
Natal and neonatal teeth refer to teeth present at birth or within the first 30 days of life. Natal teeth erupt at birth while neonatal teeth erupt within the first month. The most commonly affected teeth are the mandibular incisors. The cause is unknown but may involve the superficial position of the developing tooth germ. Natal and neonatal teeth can resemble normal primary teeth but are often poorly developed with incomplete roots. Radiographs are important to determine root development and whether extraction is necessary to prevent aspiration risk. Most experts recommend leaving the teeth in place if possible to allow stabilization as the permanent arch develops.
This document provides guidelines for providing anticipatory guidance to parents at different stages of their child's development. It covers topics such as oral development, nutrition, oral hygiene, fluoride use, habits, and injury prevention. Guidelines are provided for prenatal counseling, and ages 6-12 months, 12-24 months, 2-6 years, 6-12 years, and adolescence. The document emphasizes educating parents on establishing good oral health habits and preventing dental injuries at each stage.
This document discusses non-carious tooth surface loss including erosion, abrasion, abfraction, and attrition. It defines each type of lesion, describes their causes, clinical features, diagnosis, and treatment options. Erosion is caused by chemical dissolution from acids, while abrasion results from mechanical forces from toothbrushing or habits. Abfraction is microstructural loss from occlusal stresses. Attrition is normal wear from tooth contact. Prevention focuses on diet, oral habits, and correcting occlusal issues. Treatment includes restoration, endodontics, and protecting teeth from further loss.
Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
This document provides an overview of space maintainers used in pediatric dentistry. It begins with definitions of space maintenance, space control, and space maintainers. It then discusses Nolla's classification of primary teeth and causes of premature loss of primary teeth. Key points include that space closure occurs most rapidly in the first 6 months after loss and more so in the maxilla compared to mandible. The document describes effects of premature loss of individual primary teeth and factors influencing malocclusion development. It provides a classification of space maintainers and discusses various fixed and removable appliance designs like band and loop, lingual arch, and distal shoe space maintainers. Treatment considerations and case indications for different appliances are also summarized.
This document discusses the dental management of medically compromised patients. It provides guidance for treating patients with diabetes, including deferring surgery until diabetes is controlled, scheduling early appointments to avoid fatigue, and monitoring vitals during procedures. It also outlines protocols for patients with hypertension, angina, heart disease, respiratory disorders like asthma, liver and kidney disorders, and thyroid conditions. The document emphasizes the importance of medical consultation, using anxiety-reduction techniques, having emergency medications available, and taking precautions to minimize risks for these medically complex patients.
This document provides an overview of minimally invasive dentistry (MID), including:
1. MID aims to conserve healthy tooth structure using prevention, remineralization, and minimal intervention. It focuses on performing only necessary dentistry using long-lasting materials.
2. Key principles of MID include disease control, remineralization of early lesions, avoiding removal of excess tooth structure, and using strong, long-lasting materials.
3. Techniques discussed include caries diagnosis/risk assessment, various caries removal methods like air abrasion and lasers, fissure sealants, preventive resin restorations, ART, and chemo-mechanical caries removal.
Development of dentition & occlusion /certified fixed orthodontic courses by ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
This document discusses dental diagnosis and summarizes various diagnostic methods and tests used in dentistry. It begins by defining diagnosis and differential diagnosis, and lists qualities of a good diagnostician such as knowledge, interest, intuition and patience. It then discusses the use of subjective and objective symptoms in diagnosis. Various types of dental pain are described. The document outlines steps in performing a thorough dental examination, including visual inspection, palpation, percussion, mobility testing, and thermal and electric pulp testing to evaluate the pulp and determine the nature of any dental issues.
01 occlusion in prosthodontics introduction - stomatognathic system- definiti...Amal Kaddah
The document discusses dental occlusion, including:
- The stomatognathic system which includes the teeth, jaws, muscles and joints that enable chewing.
- What occlusion is, the importance of ideal occlusion, and the differences between natural and artificial occlusion.
- Mandibular movements including centric relation, centric occlusion, and excursive movements.
- Factors that affect balanced occlusion such as simultaneous anterior and posterior tooth contacts.
- The use of articulators and facebows to record occlusion for removable prosthodontics.
Therapeutic extraction is used to relieve crowding, correct dental arch relationships, and improve facial esthetics. Key considerations for extraction include the condition and position of teeth and the degree and location of crowding. Common teeth extracted are first premolars, upper lateral incisors, and malpositioned teeth. Serial extraction involves removing specific teeth over time from ages 8-11.5 years old to relieve crowding in the mixed dentition.
Concepts of Complete denture occlusion Amal Kaddah
This document discusses concepts of complete denture occlusion. It provides an overview of the history of denture occlusion philosophies from early carvings of teeth from stone and wood to modern concepts developed in the early 20th century. Key concepts discussed include balanced occlusion, factors affecting balanced occlusion like condylar guidance and incisal guidance, and various occlusion philosophies proposed over time including those by Gysi, Hanau, Pleasure, and Boucher. The document does not conclude on a superior occlusal scheme but notes a balanced articulation appears most appropriate.
Otosclerosis or otospongiosis is a bone degeneration that occurs in the otic capsule, the bone structure that surrounds the cochlea and labyrinth. Is an aberrant process of bone resorption of the labyrinthine capsule followed by reparative deposition of new, immature sclerotic bone (Abdurehim, 2016) [1]. This disease most often starts at the base of the stapes, which is the smallest bone in the human body, receiving the name of fenestral otosclerosis. Over time, it can progress to the cochlea and even reach the internal auditory meatus. Therefore, it is far from being a simple “calcification” of a small ear bone, requiring correct diagnosis, long-term follow-up, and personalized treatment.
This document provides information on aggressive periodontitis, including its historical background, classification, clinical presentation, epidemiology, etiology, and pathogenesis. Some key points include:
- Aggressive periodontitis is a rare, severe form of periodontitis characterized by early onset and familial aggregation. It includes localized aggressive periodontitis (LAP) and generalized aggressive periodontitis (GAP).
- LAP typically affects first molars and incisors in adolescents/young adults and is associated with A. actinomycetemcomitans infection, while GAP has a more generalized pattern of attachment/bone loss.
- Screening involves measuring attachment loss via probing or radiographic assessment of alveolar bone levels
This document discusses various classifications and causes of malocclusion. It begins by introducing Moyer's classification which categorizes etiology into heredity, development defects, trauma, physical agents, habits, diseases, and malnutrition. White and Gardiner's classification separates causes into dental base abnormalities, pre-eruption abnormalities, and post-eruption abnormalities. Graber's classification divides factors into general factors like heredity, environment, and local factors like anomalies in tooth number. The document then examines specific causes in greater detail such as heredity, congenital defects, environment, anomalies in tooth number including supernumerary teeth and missing teeth.
This document provides an overview and instructions for Carey's analysis and Lundstrom analysis. Carey's analysis involves measuring the arch length and comparing it to the tooth material to determine if extractions are needed. It can indicate if a premolar extraction or first molar extraction is required based on the discrepancy. Lundstrom analysis divides the dental arch into segments and measures the tooth widths to calculate the net discrepancy. Both methods help assess dental arch perimeter and tooth size to determine appropriate treatment planning.
This document provides an overview of orthodontics and orthodontic tooth movement. It defines orthodontics as the specialty concerned with treatment and management of malocclusion. Orthodontic tooth movement results from forces delivered by fixed or removable appliances and occurs through the periodontal ligament in response to these mechanical forces. Proper application of biomechanical principles can improve treatment efficiency. Different types of tooth movement like tipping, translation, and rotation are discussed along with optimal force levels and durations. Factors like wire properties, bracket size and material are also covered.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Unlike natural teeth, the artificial teeth act as a single unit. Hence there should be a minimum of three point contact (usually one anterior and two posterior) between the upper and lower teeth at any position of the mandible for even force distribution and stabilization of the denture.
All occlusal forms should have a tripod contact in centric relation. Balanced occlusion should have a tripod contact in eccentric relation.
This document discusses functional appliances used in orthodontic treatment. It describes the advantages and disadvantages of functional appliances, how they work to produce orthopedic, dentoalveolar and muscular changes, different types of functional appliances including activators and Frankel regulators, and guidelines for use and patient instruction.
Natal and neonatal teeth refer to teeth present at birth or within the first 30 days of life. Natal teeth erupt at birth while neonatal teeth erupt within the first month. The most commonly affected teeth are the mandibular incisors. The cause is unknown but may involve the superficial position of the developing tooth germ. Natal and neonatal teeth can resemble normal primary teeth but are often poorly developed with incomplete roots. Radiographs are important to determine root development and whether extraction is necessary to prevent aspiration risk. Most experts recommend leaving the teeth in place if possible to allow stabilization as the permanent arch develops.
This document provides guidelines for providing anticipatory guidance to parents at different stages of their child's development. It covers topics such as oral development, nutrition, oral hygiene, fluoride use, habits, and injury prevention. Guidelines are provided for prenatal counseling, and ages 6-12 months, 12-24 months, 2-6 years, 6-12 years, and adolescence. The document emphasizes educating parents on establishing good oral health habits and preventing dental injuries at each stage.
This document discusses non-carious tooth surface loss including erosion, abrasion, abfraction, and attrition. It defines each type of lesion, describes their causes, clinical features, diagnosis, and treatment options. Erosion is caused by chemical dissolution from acids, while abrasion results from mechanical forces from toothbrushing or habits. Abfraction is microstructural loss from occlusal stresses. Attrition is normal wear from tooth contact. Prevention focuses on diet, oral habits, and correcting occlusal issues. Treatment includes restoration, endodontics, and protecting teeth from further loss.
Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
This document provides an overview of space maintainers used in pediatric dentistry. It begins with definitions of space maintenance, space control, and space maintainers. It then discusses Nolla's classification of primary teeth and causes of premature loss of primary teeth. Key points include that space closure occurs most rapidly in the first 6 months after loss and more so in the maxilla compared to mandible. The document describes effects of premature loss of individual primary teeth and factors influencing malocclusion development. It provides a classification of space maintainers and discusses various fixed and removable appliance designs like band and loop, lingual arch, and distal shoe space maintainers. Treatment considerations and case indications for different appliances are also summarized.
This document discusses the dental management of medically compromised patients. It provides guidance for treating patients with diabetes, including deferring surgery until diabetes is controlled, scheduling early appointments to avoid fatigue, and monitoring vitals during procedures. It also outlines protocols for patients with hypertension, angina, heart disease, respiratory disorders like asthma, liver and kidney disorders, and thyroid conditions. The document emphasizes the importance of medical consultation, using anxiety-reduction techniques, having emergency medications available, and taking precautions to minimize risks for these medically complex patients.
This document provides an overview of minimally invasive dentistry (MID), including:
1. MID aims to conserve healthy tooth structure using prevention, remineralization, and minimal intervention. It focuses on performing only necessary dentistry using long-lasting materials.
2. Key principles of MID include disease control, remineralization of early lesions, avoiding removal of excess tooth structure, and using strong, long-lasting materials.
3. Techniques discussed include caries diagnosis/risk assessment, various caries removal methods like air abrasion and lasers, fissure sealants, preventive resin restorations, ART, and chemo-mechanical caries removal.
Development of dentition & occlusion /certified fixed orthodontic courses by ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
This document discusses dental diagnosis and summarizes various diagnostic methods and tests used in dentistry. It begins by defining diagnosis and differential diagnosis, and lists qualities of a good diagnostician such as knowledge, interest, intuition and patience. It then discusses the use of subjective and objective symptoms in diagnosis. Various types of dental pain are described. The document outlines steps in performing a thorough dental examination, including visual inspection, palpation, percussion, mobility testing, and thermal and electric pulp testing to evaluate the pulp and determine the nature of any dental issues.
01 occlusion in prosthodontics introduction - stomatognathic system- definiti...Amal Kaddah
The document discusses dental occlusion, including:
- The stomatognathic system which includes the teeth, jaws, muscles and joints that enable chewing.
- What occlusion is, the importance of ideal occlusion, and the differences between natural and artificial occlusion.
- Mandibular movements including centric relation, centric occlusion, and excursive movements.
- Factors that affect balanced occlusion such as simultaneous anterior and posterior tooth contacts.
- The use of articulators and facebows to record occlusion for removable prosthodontics.
Therapeutic extraction is used to relieve crowding, correct dental arch relationships, and improve facial esthetics. Key considerations for extraction include the condition and position of teeth and the degree and location of crowding. Common teeth extracted are first premolars, upper lateral incisors, and malpositioned teeth. Serial extraction involves removing specific teeth over time from ages 8-11.5 years old to relieve crowding in the mixed dentition.
Concepts of Complete denture occlusion Amal Kaddah
This document discusses concepts of complete denture occlusion. It provides an overview of the history of denture occlusion philosophies from early carvings of teeth from stone and wood to modern concepts developed in the early 20th century. Key concepts discussed include balanced occlusion, factors affecting balanced occlusion like condylar guidance and incisal guidance, and various occlusion philosophies proposed over time including those by Gysi, Hanau, Pleasure, and Boucher. The document does not conclude on a superior occlusal scheme but notes a balanced articulation appears most appropriate.
Otosclerosis or otospongiosis is a bone degeneration that occurs in the otic capsule, the bone structure that surrounds the cochlea and labyrinth. Is an aberrant process of bone resorption of the labyrinthine capsule followed by reparative deposition of new, immature sclerotic bone (Abdurehim, 2016) [1]. This disease most often starts at the base of the stapes, which is the smallest bone in the human body, receiving the name of fenestral otosclerosis. Over time, it can progress to the cochlea and even reach the internal auditory meatus. Therefore, it is far from being a simple “calcification” of a small ear bone, requiring correct diagnosis, long-term follow-up, and personalized treatment.
This document provides information on aggressive periodontitis, including its historical background, classification, clinical presentation, epidemiology, etiology, and pathogenesis. Some key points include:
- Aggressive periodontitis is a rare, severe form of periodontitis characterized by early onset and familial aggregation. It includes localized aggressive periodontitis (LAP) and generalized aggressive periodontitis (GAP).
- LAP typically affects first molars and incisors in adolescents/young adults and is associated with A. actinomycetemcomitans infection, while GAP has a more generalized pattern of attachment/bone loss.
- Screening involves measuring attachment loss via probing or radiographic assessment of alveolar bone levels
This document describes a retrospective study conducted at a tertiary care center that analyzed data on cases of osteomyelitis from 2006 to 2016. The study found that the number of female patients was equal to male patients, and most patients were between 30-45 years old. Unlike typical presentations where the mandible is more commonly affected, this study found that the maxilla was more commonly involved than the mandible. The posterior region of the maxilla was more frequently affected than the anterior region. The study aims to help optimize local treatment protocols by assessing epidemiological data from this specific tertiary care center.
The effects of tuberculosis and hearing lossmphaliuj
1. Tuberculosis can spread to various organs in the body, including the ears. Research has shown a link between TB and decreased hearing thresholds. People with both TB and exposure to loud noises are at higher risk of hearing loss.
2. Patients being treated for multi-drug resistant TB with certain antibiotic drugs like aminoglycosides and capreomycin are at risk of permanent sensorineural hearing loss caused by the ototoxic effects of these drugs.
3. While HIV itself does not cause hearing loss, people with HIV aged 35 and older who take ototoxic antiretroviral drugs have a higher risk of developing sensorineural hearing loss. HIV can also increase the risk of middle ear disorders and
PROSTHODONTIC MANAGEMENT OF PATIENTS WITH AMELOGENESIS IMPERFECTA: A CASE REP...Abu-Hussein Muhamad
This document discusses the prosthodontic management of patients with amelogenesis imperfecta (AI), a hereditary condition affecting the structure and appearance of enamel. It provides background on AI, including classification, genetic causes, clinical implications such as sensitivity and rapid wear, and impact on growth. Treatment considerations are outlined for the primary, mixed, and permanent dentitions. The focus case describes a patient with AI who was rehabilitated using full-mouth zirconium oxide ceramic fixed bridges over 3 years, leaving the patient satisfied with function, esthetics, and speech.
This document provides an overview of bruxism, including its definition, epidemiology, etiology, characteristics, and clinical consequences. Bruxism is defined as the forcible clenching or grinding of teeth and can occur during the day or while sleeping. It affects 8-14% of the population. The cause is multifactorial but may include occlusal factors, stress, sleep disorders, medication, and alcohol consumption. Bruxism involves rhythmic grinding and prolonged clenching that generates greater forces than normal chewing and can damage teeth, muscles, and temporomandibular joints over time if left untreated.
Oral Anesthesia Usage, Allergies, and Its Effect on the Immune System (Revise...Matthew Hernandez
The document discusses the history of dentistry and the development of modern anesthesia. It begins with an overview of how dentistry has evolved from ancient times to address oral health issues and pain. It then focuses on the introduction of local anesthesia in the late 19th century, starting with cocaine and moving to safer alternatives like lidocaine and articaine. The document also reviews studies on using transcutaneous electrical nerve stimulation (TENS) and midazolam to reduce dental anxiety and pain from local anesthesia injections. It concludes by discussing safe and effective administration of local anesthesia in pediatric patients.
Prevalence of Missing Lateral Incisor Agenesis in an Or¬thodontic Arabs Popul...Abu-Hussein Muhamad
This study examined the prevalence of congenital absence (agenesis) of maxillary lateral incisors in 2,200 orthodontic patients of Arab descent in Israel. The researchers reviewed panoramic radiographs from 2006-2013 and found that 24 patients, or 1.1%, had agenesis of one or both maxillary lateral incisors. Specifically, 13 females (54.2%) and 11 males (45.8%) were missing their lateral incisors. This suggests the prevalence of maxillary lateral incisor agenesis in this population is 1.1%, providing data to compare to other studies on tooth agenesis frequencies.
Gingival recession—can orthodontics be a cure? evidence from a case presentationEdwardHAngle
A 35-year-old woman presented with severe gingival recession and a unilateral Class II malocclusion. Her treatment plan involved orthodontic correction of the malocclusion using brackets that torqued roots more onto the bone. It also involved changing her dental hygiene methods to use an oscillating toothbrush gently. After 28 months of orthodontic treatment, her malocclusion was corrected and her gingival recession improved without needing grafting. Three months later, her teeth had settled well into their new positions.
Nonsyndromic Oligodontia in Permanent Dentition: Three Rare Casesiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Nonsyndromic Oligodontia in Permanent Dentition: Three Rare CasesAbu-Hussein Muhamad
Oligodontia is the congenital absence of six or more than six teeth in either permanent or primary dentition. Because of the missing teeth in these patients esthetic, functional and psychological problems may arise. This article reports a three rare cases of non-syndromic oligodontia. Key words: oligodontia, hypodontia, severe partial anodontia
The article discusses the debate around extracting asymptomatic impacted third molars ("wisdom teeth"). While some dentists prefer to monitor asymptomatic wisdom teeth, the author argues this "wait and watch" approach is not always best. Removing wisdom teeth early in patients under 25 can help minimize risks like pain and infection. The article also summarizes a lecture debunking common myths about wisdom teeth, such as whether their path can be predicted or if they all heal the same. Overall, the author concludes that waiting for symptoms to appear before removing wisdom teeth is not necessarily good patient care.
This case report describes a 58-year-old female patient who presented with pain in her lower left back tooth. During examination, the clinicians observed involuntary, repetitive movements of the patient's mandible resembling teeth grinding. No other abnormalities were found. Based on the clinical findings, the patient was diagnosed with oromandibular dystonia. Oromandibular dystonia is a type of focal dystonia affecting the mouth, jaw, and tongue muscles, causing involuntary contractions and repetitive movements. It can be difficult to diagnose and is managed through a multidisciplinary approach.
Dystonia is the manifestation of involuntary lasting severe muscle contractions, which lead to rhythmic and atypical movements in different parts of the body. Dystonia is the most common movement disorder next to Parkinson’s disease (PD) and essential tremor (ET). Oro Mandibular Dystonia (OMD) is considered as a focal dystonia involving mouth, jaw, and tongue, manifested by involuntary muscle contractions producing repetitive, patterned movements of the involved structures. The diagnosis of OMD is purely clinical and is to be differentiated thoroughly from the conditions mimicking the signs. Since it presents in various forms and severities it further renders the management a multidisciplinary approach with variable treatment outcomes. The following is a clinical diagnostic case report of oromandibualar dystonia with presenting signs and symptoms, history and examination characteristic of the condition
Tooth agenesis is the most prevalent craniofacial congenital anomaly in humans. The term refers to an isolated disorder in the absence of non-dental phenotypes but is also used to describe the manifestation of missing teeth in syndromes. The affected individuals suffer from compromised masticatory functions and have decreased quality of life. Discerning the genetic etiology of tooth agenesis not only improves our understanding of normal tooth development but also provides a fundamental basis for developing potential therapeutic strategies for this anomaly. To date, MSX1, Pax9, Axin2, Eda, And Wnt10a have been established as candidate genes associated with non-syndromic tooth agenesis.This article reviews the recently discovered genes involved in dental agenesis , and provides an update on the aetiological factors underlying this common malformation.
A bad bite is associated with worse postural, balance control -- ScienceDailyHenry Huszar
Two new studies have found that dental occlusion, or how the teeth fit together, is related to postural control. People with malocclusions or imperfect bites had worse balance and postural stability compared to those with perfect bites. The relationship was stronger when subjects were fatigued or stability was challenged. Correcting malocclusions through orthodontic treatment improved postural control. This suggests dental health could help prevent falls and injuries from instability.
This document summarizes an article by Allen J. Moses about obstructive breathing conditions and their implications for dental treatment. It describes an appliance called a "passivator" that supports the mandible in an open bite position without causing tooth movement. The document discusses how nasal obstruction can cause mouth breathing, which can lead to issues like narrow arches and abnormal swallowing. It reviews studies on monkeys that found oral breathing altered neuromuscular activity and bone structure. The most common causes of nasal obstruction in humans are also outlined.
Impact of Glaucoma Disease 1
Impacts of Glaucoma Disease on African Americans
Lendora Ogunbode
PSY 625
Dr. N
July 27, 2019
Impacts of Glaucoma Disease on African Americans
Specific Aims
Neuroscience refers to a medical field which is widely covered in medicine. It generally
involves the study of the human brain and its association with the entire human body’s nervous
system coordination. Therefore, all the human senses are studied under this neuroscience field of
medicine. Specifically, for this assignment, blindness as a branch of neuroscience will be dealt
with. The sense of seeing is usually aided by the relay of visual information within the human
brain. Several diseases which are related to human nervous system like Glaucoma have been
- 1 -
[no notes on this page]
2
Impacts of Glaucoma Disease
analyzed both neurologically and technologically. Although it is generally a complex process as
far as medical is concern to bringing a remedy or cure to a disease which is associated with the
human nervous system more especially when some specific tasked relays and neurons within the
system have been damaged, especially during accidents, technology is recently playing a great
advancement towards finding the possible ways at achieving an effective treatment to
neuroscience related cases (Charlson et al. 2015).
Glaucoma disease has been given priority in this research since it’s the most common
blindness condition which has threatened the entire world. "Glaucoma occurs about five times
more often in African Americans. Blindness from glaucoma is about six times more common. In
addition to this higher frequency, glaucoma often occurs earlier in life in African Americans —
on average, about ten years earlier than in other ethnic populations" ("African Americans and
Glaucoma," n.d.). Many research results have indicated the technology in collaboration with
neuroscience have taken a significant step in coming out with innovative measures which are
aimed at understanding the causes, the impacts as well as the remedy actions of blindness. These
efforts of neuroscience and medical technology will be evaluated in this study as well.
The specific aim of this proposal is to access three main aspects that are related to
Glaucoma, first is the examination of ethnic variations which are closely related to Glaucoma
disease, the second examination will be on the potential causes of Glaucoma, and finally
monitoring the impacts of cognitive progress of patients that are clinically diagnosed with
Glaucoma disease (Freedman, Shen, & Ahrens, 2016).
Background of the Study
Cases of glaucoma have been reported all over the world. The number of people affected
by glaucoma to an extend of becoming blind has increased significantly in recent years. This
PSY625: Biological Bases of Behavior Ashf ...
The physical manifestations of shaken baby syndrome. journal of forensic...Vera Moreira
The physical manifestations of shaken baby syndrome can include:
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3) Common physical findings that can help diagnose shaken baby syndrome include retinal hemorrhages present in 75% of cases, hematomas which are the most common injury, and cerebral atrophy found in over 90% of suspected intentional injury cases. Accurate
This case report describes a 9-year-old boy who presented with dental abnormalities characteristic of otodental syndrome. Key findings included large bulbous crowns in both primary and permanent canine and molar teeth. Radiographs showed the abnormal molars appeared to be fused tooth buds with duplicated pulp chambers. The patient was referred for hearing evaluation, though prior testing by parents found normal hearing. Otodental syndrome is characterized by dental anomalies and sensorineural hearing loss inherited in an autosomal dominant pattern with variable expression.
Similar to Bruxism in Childhood - Etiology, Clinical Diagnosis and the Therapeutic Approach (20)
Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an
esthetic and functional restorative treatment. . Fixed prosthodontic and removable prostheses, resin bonded retainers, orthodontic movement of maxillary
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Excess of space in the dental arch is diagnosed as a
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observed in the maxillary anterior region, as a median
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Dental implants represent one of the most successful treatment modalities in dentistry.
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Orthodontic tooth movement is basically a biologic response towards a mechanical force. Osteoclast and osteoblast cells mediate bone resorption and apposition, which eventually produces tooth movement. Researches showed that the rate of orthodontic tooth movement can be altered by certain drugs locally or systemically. The Objective of this article is to discuss the current data concerning the effect of drugs on orthodontic tooth movement.
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Materials and procedures: Unilateral agenesis of the permanent
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Porcelain laminate veneers are among the most esthetic means of creating a more pleasing and beautiful smile. Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation, approximately 0.5 mm to 0.7mm of surface enamel reduction. This study describes the use of ceramic veneers without tooth wear, reinforcing the concept that minimally invasive porcelain laminate veneers could become versatile and conservative allies in the fi eld of esthetic dentistry. Keywords: Ceramics, dentin-bonding agents, esthetics
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Bruxism in Childhood - Etiology, Clinical Diagnosis and the Therapeutic Approach
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 12 Ver. VIII (Dec. 2015), PP 00-00
www.iosrjournals.org
DOI: 10.9790/0853-1412XXXX www.iosrjournals.org 1 | Page
Bruxism in Childhood - Etiology, Clinical Diagnosis and the Therapeutic
Approach
Nezar Watted *
, Edlira Zere**, Muhamad Abu-Hussein***
* Triangle R&D Center, Kafr Qara, Israel , Clinics and policlinics for Dental, Oral and Maxillofacial Diseases
of the Bavarian Julius-Maximilian-University, Wuerzburg, Germany
**Orthodontic and Craniofacial Department, School of Graduate Dentistry, Rambam Health Care Campus,
Haifa, Israel
* * *University of Naples Federico II, Naples, Italy, Department of Pediatric Dentistry, University of Athens,
Greece
Abstract: Bruxism was defined as nonfunctional movements of the mandible with or without audible sound
occurring during the day or night. The clinical indicators of diagnosing this parafunction were the presence of
dental wear/attrition and bruxofacets. The disorder appears more frequently in the younger population. The
prevalence in children is between 14 to 20%. The present case report refers to a patient who reported to the
Center For Dentistry,Research & Aesthetics, Jatt, Almothalath, Israel ,with the complain of Bruxism .A brief
review is made of the literature concerning the etiology,clinical diagnosis and the therapeutic approach of the
disease.
Keywords: Bruxism, etiology , child, Review of bruxism
I. Introduction:
The American Academy of Orofacial Pain defines bruxism as ―diurnal or nocturnal parafunctional
activity which includes clenching, gnashing, gritting and grinding of teeth. It can be clinically diagnosed based
on the presence of excessive tooth wear which could not have been caused by mastication‖.[1]
American Sleep Disorders Association talks about ―gnashing or clenching of teeth during sleep‖, but
the diagnosis is made only when at least one of the symptoms exists (tooth wear, noises and sensitivity of the
masticatory muscles which cannot be attributed to any other disorder .[2]
The prevalence of bruxism varies among studies, but generally the prevalence of awake bruxism is
thought to be about 20%, being more common among women, while the prevalence of sleep bruxism is about
8% in the adult population being same among sexes [3,4] . However, based on self-report studies, the prevalence
of bruxism is highest in children, gradually decreasing with increasing age; from 14–18% in childhood to 3% in
the elderly . The importance of factors like ethnicity on the prevalence of bruxism is uncertain .[3,4,5,6]
Bruxism is a pathological activity of the stomatognathic system that involves tooth grinding and
clenching during parafunctional jaw movements. Clinical signs of bruxism are mostly related to dental wear and
muscular and joint discomforts, but a large number of etiological factors can be listed, as local, systemic,
psychological and hereditary factors. The association between bruxism, feeding and smoking habits and
digestive disorders may lead to serious consequences to dental and related structures, involving dental
alterations (wear, fractures and cracks), periodontal signs (gingival recession and tooth mobility) and
musclejoint sensitivity, demanding a multidisciplinary treatment plan.[6,7]
In children, bruxism may be related to growth and development of the jaws and teeth. Children may
brux because their maxillary and mandibular teeth do not occlude properly and comfortably as they are erupting.
Children may also grind their teeth because of tension, anger or as a response to pain from an earache or
teething[8.9] .
The most important characteristic of bruxism is that there is non-functional contact of mandibular and
maxillary teeth resulting in clenching or grating of teeth. There are few controversies regarding theories on
bruxism[6,9].
Disorders, such as malocclusion may be the cause of clenching and gnashing. It is based on the theory
that occlusal maladjustment leads to reduction in masticatory muscle tone. In the absence of occlusal
equilibrium, motor neuron activity of masticatory muscles is triggered by periodontal receptors[3,4].
Second theory states that, a central disturbance in the area of basal ganglia plays an important role in
causing bruxism. An imbalance caused due to the processing of basal ganglia is the main reason behind muscle
hyperactivity during nocturnal dyskinesia such as bruxism. Few authors suggest that bruxism constitutes sleep-
related parafunctional activity such as parasomnia. A recent study which explains the
2. Bruxism in Childhood - Etiology, Clinical Diagnosis and the Therapeutic Approach
DOI: 10.9790/0853-1412XXXX www.iosrjournals.org 2 | Page
potential imbalance of the basal ganglia is neuroplasticity. Neural plasticity is based on the ability of
synapses to change or modify the way they work. Due to activation of neural plasticity, changes in the
relationship between inhibitory and excitatory neurons occur[3,4].
Etiology of bruxism can be divided into three categories; they are psycho-social factors, peripheral
factors and patho-physiological factors. The etiology of sleep bruxism is uncertain; the factors responsible are
occlusal discrepancies and the anatomy of bony orofacial structures[10]. Other factors include smoking, trauma,
alcohol, drugs, systemic disease, stress or peer pressure. Heredity appears to play an important role in the
occurrence of sleep bruxism. Recent studies suggest that sleep bruxism episodes of individual are part of sleep
arousal response. It is a sudden change in the depth of sleep of an individual. Besides this, sleep bruxism
appears
to be a disturbance in the dopaminergic system. Previously, morphological factors like occlusal
discrepancies and anatomy of the bony structures of orofacial region have been considered as pivotal factors for
bruxism. However, nowadays these factors are thought to play only a minor role, as recent studies focuses more
on patho-physiological factors.[7,8,9,10]
Studies on the etiology of bruxism are not concluded yet. Researchers have suggested that local factors,
such as malocclusion, are loosing importance, whereas behavioral cognitive factors such as stress, anxiety and
personality traits are gaining more space[11,12]. The current focus is directed to the fact that bruxism is part of
a wakening reaction. This parafunctional activity seems to be modulated by several neurotransmitters in the
central nervous system, however, it can not be affirmed that it has just a central control[13,14,15].
Sari and Sonmez reported a statistically significant relationship between bruxism and some occlusal
factors, whereas, in other research studies, this association can not be proved.[16]
Bruxism can be associated to craniomandibular disorders including headache, temporomandibular
disorder , muscular pain, early tooth loss due to excessive attrition and mobility and sleep interruption from both
the subject and the person with whom he shares the room. Studies have shown the close relationship between
bruxism and some pathologies such as breathing disorders and the Obstructive Sleep Apnea Syndrome
.[1,2,10,12]
II. Bruxism may be classified according to several criteria;
a.According to presence:
a. Past bruxism
b. Present bruxism
b.According to etiology:
a. Primary, essential or idiopathic bruxism: No apparent cause is known.
b. Secondary bruxism: Secondary to disease (e.g. coma, ictus, cerebral palsy), medicinal products (e.g.
antipsychotic medication, cardioactive medication), drugs (e.g. amphetamines, cocaine, ecstasy).
c.According to occurrence:
a. Awake bruxism
b. Sleep bruxism
c. Combined bruxism
According to motor activity type:
a. Tonic: Muscular contraction sustained for more 2 sec.
b. Phasic: Brief repeated contractions of masticatory musculature with three or more consecutive bursts of EMG
activity that last 0.25 - 2 sec.
c. Combined: Alternating appearance of tonic and phasic episodes. Approximately 90% of the episodes of SB
are phasic or combined, unlike in awake bruxism, where
episodes are predominantly tonic.[1,2,3,8,9,12]
Frequently, clinicians who treat children and adolescents are questioned about the etiology, the
prevalence and the effect of bruxism. It is important that clinicians are well informed on recent studies and on
the variables related to this parafunctional activity.[1,2,6,9,13]
The present case report refers to a patient who reported to the Center For Dentistry, Research &
Aesthetics, Jatt, Almothalath, Israel, with the complain of Bruxism .A brief review is made of the literature
concerning the etiology,clinical diagnosis and the therapeutic approach of the disease.
3. Bruxism in Childhood - Etiology, Clinical Diagnosis and the Therapeutic Approach
DOI: 10.9790/0853-1412XXXX www.iosrjournals.org 3 | Page
III. Case Report
A 4-year-old boy was brought to the Center For Dentistry,Research & Aesthetics, Jatt, Almothalath,
Israel, by his mother. On history, his mother revealed that he gnashed his teeth at night, but she could not tell for
how long this had been going on. During the case history taking, his mother revealed that he clicked his teeth at
night for the last two years. No previous dental treatment was reported. Ingestion of acid drinks or medication
was denied.Clinical examination revealed that the patient had late primary dentition with Flush Terminal Plane
(Class I molar relationship on both sides) (FIG 1 ).
Fig. 1;In the flush terminal plane relationship, both the maxillary and mandibular planes are at the same level
antero-posteriorly
Fig. 2a
Fig. 2b Fig. 2c
Fig. 2d Fig. 2e
Fig. 2a-d: Clinical situation of a patient with 4 years. strong abrasions
4. Bruxism in Childhood - Etiology, Clinical Diagnosis and the Therapeutic Approach
DOI: 10.9790/0853-1412XXXX www.iosrjournals.org 4 | Page
There was no midline deviation or malocclusion. No occlusal interferences, mandibular deviation,
mouth-opening limitation or any other clinical sign indicating temporo-mandibular dysfunction was noticed
during intra-oral clinical examination. Good oral hygiene was observed. No carious lesions or gingival
inflammation was present.
The occlusal surfaces of all primary molar teeth were worn but sensitivity was not present. A slightly
increased overbite (2–3 mm) was present. The child had no history of pain, even with mechanical stimulation.
Grinding of teeth, which has a characteristic sound, Pain in the masticatory and cervical muscles, Hypersensitive
teeth,and Abnormal tooth wear.
The incisal faces of all anterior maxillary primary teeth were badly worn.Worn occlusal facets in teeth
55, 65, 75, 74, 73, 72, 82, 83 and 84 were also present
There were small fractures in the palatine cusps of teeth 54 and 64 and in the distovestibular cusp of
tooth 85. The child had no history of pain, even with mechanical stimulation (FIG 2a-e )
A function orthodontic appliance has been used as prophylactic treatment procedure (FIG 3a,b, FIG 4a-c ). The
goal of this treatment step was:
1) To stop or minimize the crunching at night
2) To control the growth in the vertical Dimention, so that it is not for severely impaired.
The control was performed every 8-10 weeks. The eruption was controlled. This leads to a bite raising, the
appliance was grinded to allow the eruption of permanent teeth.
Fig. 3a: Basic bionator with palatal wire Fig. 3b Trimmed for extrusion of posterior teeth
Fig. 4a Fig. 4b Fig. 4c
Fig. 4a-c: Bionator in mouth
Follow-up visits were scheduled every 2-3month to verify tooth wear and monitor eruption of
permanent teeth and bone growth. When necessary, appliance (Bionatur Type I) were modified to allow
adequate bone growth (FIG 5a-c ).
5. Bruxism in Childhood - Etiology, Clinical Diagnosis and the Therapeutic Approach
DOI: 10.9790/0853-1412XXXX www.iosrjournals.org 5 | Page
Fig. 5a Fig. 5b Fig. 5c
Fig. 5a-c Situation after 3 years
IV. Discussion
The prevalence of bruxism in children is estimated to range from 7% to 15.1%. A few studies confirm
a higher rate in females than males. Some authors describe bruxism as a condition of multifactorial etiology,
determined by an association of psychological, local and systemic factors.[3,4,7,8,9]
Craniofacial growth involves distinct structures and follows a complex chronological pattern, peaking
in prepuberty. Thus, when removable prostheses are placed in young
children, osseous discrepancies may arise. The bite-plates are usually removable and quarterly revision
appointments are scheduled to monitor patients’ bone growth and the eruption of permanent teeth’[5,9,10,11,14]
Funch and Gale state that bruxism is correlated with psychological factors, suggesting that the kind of life the
patient leads exerts great influence on the frequency, duration and severity of the condition. Thus, based on the
presence of
the emotional problems reported by the parents, we believed that in all probability the condition presented by
these patients was bruxism[17].
Restrepo et al demonstrated that several psychological techniques have been efficacious in reducing signs of
bruxism when they were applied to 33 children aged
3–6 years.[15]
Vanderas and others have demonstrated that stress and anxiety may be directly related to bruxism, as patients
suffering from bruxism show a higher catecholamine level, generally ascribed to emotional stress .[18]
Landry and Rompre compared the effect on sleep bruxism and tooth-grinding activity of a double-arch
temporary custom-fit mandibular advancement device (MAD) and a
single maxillary occlusal splint (MOS). Short-term use of a temporary custom-fit MAD is associated with a
remarkable reduction in sleep bruxism motor activity. To a smaller extent, the MOS also reduces sleep bruxism
[19] .
Hachmann et al and McDonald et al, a bite-plate covering the occlusal surfaces of all teeth should be used by
patients suffering from bruxism to prevent continuous abrasion.[20,21]
Dawson's experience has shown that signs and symptoms of eccentric bruxism seem to disappear completely
with careful elimination of all occlusal interferences. According to Dawson, occlusal interferences can cause
parafunctional movements which had not existed before the interference and by invasion to the envelope of
function, delete mechanism is predictable[6].
Williamson's classic study and the that of Ramfjord showed the causal relationship
between eccentric occlusal interferences and muscle hyperactivity and found that a marked reduction in muscle
tones and action follows the elimination of occlusal disharmony.[22,23]
Solberg and others assert that the use of biteplates reduces muscular activity, thus giving more comfort to the
patient. A soft-based material was chosen to protect
the primary teeth, as suggested by Casamassimo. Furthermore, the thickness (3 mm) was sufficient to prevent
perforation and increase resistance to impact.[24,25]
Kato et al suggested a diagnostic criteria for recognizing patients with severe SB: recent history of tooth noise
during sleep, occurring at least 3 to 5 nights a week for a period of 6 months; presence of tooth wear; discomfort
or fatigue in the masticatory muscles in the morning; and hypertrophy of the masseter muscle in voluntary
clenching. Studies assessing the prevalence of SB in children should adopt patient’s complete history and a
rigorous physical examination for the diagnosis of SB.[26]
Mittelman described the use of biofeedback in the management of bruxism. He described an EMG technique
which provides the daytime clencher with auditory feedback from his/her muscle activity letting the individual
to know the degree of muscle activity or relaxation that is taking place.[27]
Riolo et al. reported almost no relation between individual reporting of TMJ sounds and actual clinical joint
noises that are audible when examining children. study found a significant association between
6. Bruxism in Childhood - Etiology, Clinical Diagnosis and the Therapeutic Approach
DOI: 10.9790/0853-1412XXXX www.iosrjournals.org 6 | Page
temporomandibular symptoms (anamnestic findings), as reported in questionnaires, and temporomandibular
signs, as found in a clinical examination. This may be due to the fact that our questionnaire was designed to be
filled out by the parents (in collaboration with their children) possibility indicating that initial screening of
children for TMD should be done with parental assistance.[28]
Nilner and Lassing showed that functional disturbances of the masticatory system are common in children
aged 7–14 years (with 64% experiencing pain upon muscle palpation and 39% experiencing pain on TMJ
palpation). These values are substantially higher than the prevalence found in the present study . The difference
between the two studies may be explained by the different age and ⁄ or different, ethnic ⁄ socioeconomic status of
the study populations, differences between questionnaires, difference in the content and performance of the
clinical examination, and other factors.[29]
Kampe and others, who also demonstrated the presence of a higher level of anxiety in agroup of people with
bruxism.[30]
Lobbezoo and Naeije, level of stress and personality type have been included in the etiology of bruxism for
many years. However, the exact contribution of psychological factors remains debatable. A controlled
questionnaire study demonstrated that those with bruxism generally present emotional imbalance and tend to
develop more psychosomatic disorders.[31,32]
Lindqvist conducted a study on 196 children aged 10-13 years to investigate existing differences in the
prevalence of morphologic malocclusion between children with and without bruxism. The recorded types of
morphologic malocclusion were Class I, II, and III molar relationship, overjet, and overbite. Bruxism was
diagnosed
by the presence of atypical facets on the permanent teeth. The results showed no statistically significant
differences in any type of malocclusion between children with and without recorded facets[33].
Egermark-Eriksson et al. followed up 238 of 402 children of the initial sample to investigate the relationship
between functional malocclusion and bruxism. Their second examination, performed 4 to 5 years after the first,
studied the children at 11,15, and 20 years old. The criteria to diagnose bruxism as well as to record
functional malocclusion were the same as those used in their cross-sectional study. The results showed no
statistically significant correlations between any type
of occlusal interferences and dental wear or attrition.[34]
Gunn et al.studied the relationship between functional malocclusion and bruxism on 151 migrant children aged
6-18 years. Functional shift of the mandible was the only recorded type of functional malocclusion. Bruxism
was identified as tooth grinding by an interview. No statistically significant correlation was reported between
functional shift of the mandible and tooth grinding.[35]
Statistically significant correlations were found between different types of morphologic malocclusion
such as Class II and III molar relationship, deep bite, overjet, and dental wear or grinding. The occlusal
conditions are an etiologic factor of bruxism in children and adolescents. Therefore, it seems safe to assume that
malocclusion cannot increase the probability of the occurrence of bruxism.[36]
Most authors suggest bruxism to have a multifactorial etiology. Basically, two groups of etiological
factors can be distinguished, peripheral & morphological factors and central (pathophysiological and
psychological) factors. Among the emotional features, anxiety has been the factor most often studied in
children.[36]
Dental wear can be caused by digestive problems and physiological masticatory functions. Dental wear
of natural teeth depends on variables such as structure and hardness of the dental enamel; charge applied to the
contact surfaces, saliva, and duration of the contact.[37,38]
As this article deals with isolated clinical case, its findings cannot be generalized. Therefore, we
suggest that more epidemiological investigations be made to provide a
better understanding of the etiological factors in bruxism.
V. Conclusion
Bruxism is becoming an increasingly common condition in children. In treating this parafunctional
habit, clinicians play a leading role in determining possible etiological factors. In many situations it is the
dentist’s task to warn parents and institute multidisciplinary treatment. Recently, a multifactor model showing
different etiological events had been accepted which includes genetic, neuro-physiological, psycho-emotional
and pharmacological factors. Researchers will have to evaluate other aspects as well to determine the risk and
consequences such as tooth damage and pain by bruxism.
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