RESUMEN

OBJECTIVE: The aim of this study was to evaluate changes in pain and muscle force, and the relationship between them, in patients with muscle pain and bruxism, prior to and after treatment. METHODS: Thirty women with bruxism and myofascial pain (Ia) were included in this study. Sleep bruxism diagnosis was made based on clinical diagnostic criteria, and awake bruxism diagnosis was made by patient questionnaires and the presence of tooth wear. The diagnosis of myofascial pain was established according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD). Dentulous or partially edentulous patients (rehabilitated with conventional fixed prostheses) were included in the study according to the inclusion and exclusion criteria. The pain treatment protocol included occlusal splints, patient education, and physiotherapy for 30days. Bite force was measured using a dynamometer at the central incisor and the first molar regions on both sides. The exams were performed at baseline, after 7days, and 30days after treatment. The Wilcoxon test was used to compare patient pain level response among the periods analyzed in the study. Bite force data were submitted to two-way repeated-measures ANOVA, followed by the Tukey HSD test (p<0.05). A simple regression analysis was performed to verify the relation between pain level and bite force. RESULTS: Results revealed that there was a statistical difference in pain level over time for both muscles and sides (p<0.01). In the molar region, the bite force exhibited significantly higher values after 30days of treatment, when compared with the baseline (p<0.001). There was a correlation between pain level and bite force only for the temporal muscle in all periods analyzed (p<0.05). There was no strong correlation in the response level points to support the association of pain and bite force. CONCLUSIONS: Pain level decreased and bite force increased in the molar region after treatment. No strong correlation or dispersion in the relationship between pain levels and bite force was seen in women with myofascial pain and bruxism.

Asunto(s)

RESUMEN

O bruxismo noturno é definido como o ato involuntário de apertar ou ranger os dentes durante o sono, o que tem consequências graves para o aparelho estomatognático, incluindo a abrasão dentária. Restaurações estéticas e funcionais dos dentes desgastados são fundamentais para a reabilitação orofacial. O desenvolvimento de técnicas adesivas permitiu ao clínico novas opções de tratamento para a reabilitação de dentes anteriores desgastados pelo bruxismo. Este relato de caso descreve o diagnóstico e o tratamento de um paciente com dentes anteriores severamente desgastados devido ao bruxismo noturno. Os dentes anteriores foram submetidos ao tratamento restaurador conservador, através de resina composta direta e um guia de silicone fabricados a partir de um modelo previamente encerado. Além disso, um dispositivo interoclusal foi instalada para proteger as restaurações de desgastes no futuro. As vantagens incluem um procedimento de rápida execução, com resultado imediato, boa estética e de baixo custo

Nocturnal bruxism is defined as involuntary clenching or grinding of the teeth during sleep, which has severe consequences for the stomatognathic apparatus, including tooth abrasion. Esthetic and functional restoration of worn teeth is fundamental for dentofacial rehabilitation. The development of adhesive techniques has provided the clinician with new restorative options for the rehabilitation of worn anterior teeth due to bruxism. This case report describes the diagnosis and treatment of a patient with severely worn anterior teeth due to nocturnal bruxism. The anterior teeth were submitted to conservative restorative treatment using direct resin composite and a silicone guide fabricated from a wax-up model. In addition, an interocclusal appliance was installed to protect the restorations from future wear. Advantages include a short procedure time, immediate results, good esthetics, and low cost

Asunto(s)