Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Bruksizmin Ağız İçi Restorasyonlar ve Dişler Üzerindeki Etkisi
The Effect of Bruxism on the Oral Restorations and Teeth
Makbule Tuğba TUNÇDEMİRa, Zeynep GENÇARSLANb
aNecmettin Erbakan Üniversitesi Diş Hekimliği Fakültesi, Restoratif Diş Tedavisi ABD, Konya, TÜRKİYE
bSerbest Diş Hekimi, Konya, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2020;26(3):434-42
doi: 10.5336/dentalsci.2019-70812
Article Language: TR
Full Text
ÖZET
Amaç: Bu çalışmanın amacı; Necmettin Erbakan Üniversitesi Diş Hekimliği Fakültesine başvuran bruksizm teşhisi konulmuş hastalarda, bruksizmin dişlerde ve ağız içi restorasyonlarda oluşturduğu etkiyi değerlendirmektir. Gereç ve Yöntemler: Çalışmaya, belirli tarihler arasında muayene olan ve bruksizm teşhisi konulmuş, yaşları 18-75 arasında değişen, her 2 cinsiyetten toplam 110 bruksist gönüllü hasta katıldı. Çalışma öncesinde bireyler, araştırma hakkında bilgilendirildi. Onamları alınan hastalar, bruksizm ile ilgili sorular içeren anket formunu doldurduktan sonra, tek bir hekim tarafından ağız içi muayeneleri yapıldı. Aşınmalar; Smith ve Knight'ın diş aşınmaları indeksine göre değerlendirildi. Dişlerde ve restorasyonlarda, çatlak ve kırık olupolmadığı kayıt altına alındı. İstatistik analiz için SPSS 22 programı ve ki-kare testi kullanıldı. Bulgular: Katılımcıların %88,2'sinde keser dişlerde; %71,8'inde kaninlerde; %56,4'ünde posterior dişlerde aşınma tespit edildi. Katılımcıların %90,9'unda keser dişlerde; %64,5'inde kaninlerde; %34,5'inde de posterior dişlerde çatlak gözlendi. Keser, kanin ve posterior dişlerdeki çatlak ve aşınma oranının, cinsiyete göre dağılımında istatistiksel olarak anlamlı bir farklılık gözlenmedi (p>0,05). Kompozit dolgularda aşınma, cinsiyete göre istatistiksel olarak anlamlı bir farklılık gösterdi ve kadınlarda, erkeklere göre daha fazla tespit edildi (p<0,05). Sonuç: Bruksizmin, ağızda var olan dişlere ve restorasyonlara etkisi dikkat çekmektedir. Bu etki, çatlak oluşumu ve aşınmayla başlayıp, dişte ve restorasyonda kırık oluşumuyla sonuçlanabilmektedir. Bu bakımdan, bruksizm bulunan hastalarda kullanılacak restoratif materyal seçimi önem arz etmektedir.

Anahtar Kelimeler: Bruksizm; diş aşınmaları; çatlak diş; klinik değerlendirme
ABSTRACT
Objective: The aim of this study was to determine the changes on teeth and intraoral restorations in patients diagnosed with bruxism who applied to Necmettin Erbakan University Faculty of Dentistry. Material and Methods: A total of 110 bruxist volunteer patients of both sexes aged between 18-75 years who were examined and diagnosed as bruxism participated in this study. Subjects were informed about the examination before the study. The patients filled out the questionnaire which included questions about bruxism. Then, as ingle physician performed an oral examination. Tooth wear was evaluated according to Smith and Knight's tooth wear index. It was recorded whether there were cracks or fractures in the teeth and restorations. SPSS 22 program and chi-square test were used for statistical analysis. Results: Wear was found in 88.2% of the participants'incisor teeth; 71.8% on canin teeth; in 56.4% on the posterior teeth. Fractures were observed in 90,9% of the participants' incisor teeth; 64,5% on canine teeth; 34,5% on the posterior teeth. No statistically significant difference was observed in the distribution of fracture rate and abrasion rate in incisors, canines and posterior teeth according to gender (p>0.05). In composite restorations, abrasion showed a statistically significant difference according to gender and was higher in females than males (p<0.05). Conclusion: The effect of bruxism on teeth and restorations in the mouth is remarkable. This effect can begin with crack formation and abrasion, resulting in fracture formation in the tooth and restorations. Therefore, restorative material selection is important in bruxist patients.

Keywords: Bruxism; tooth wear; cracked tooth; clinical assessment
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-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

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