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Bruksizam je parafunkcijska aktivnost škrgutanja, odnosno stiskanja i škripanja zubima. Rana dijagnoza trošenja na tvrdim zubnim tkivima bitna je kako bi se isključili etiološki faktori i prevenirao daljnji gubitak. Protetska rehabilitacija uznapredovalog gubitka tvrdog zubnog tkiva je složen i dugotrajan zahvat koja zahtijeva multidisciplinarni pristup. Bruksizam predstavlja veliku opasnost za dugovječnost protetskog nadomjestka. Neuspjesi i problemi uzrokovani bruksizmom vezani uz protetski rad mogu biti tehnički i biološki. Protetska ili implantoprotetska rehabilitacija uključuje detaljnu anamnezu i planiranje protetske terapije, artikuliranje modela i analizu međučeljusnih odnosa, navoštavanje budućeg rada, izradu privremenog rada i nakon perioda adaptacije, izradu konačnog rada. Za uspjeh protetske terapije nužno je nošenje stabilizacijske udlage i nakon predaje gotovog rada kako bi se smanjio štetan utjecaj nepovoljnih i jakih sila. Bruxism is a parafunctional activity of teeth grinding gnashing, clenching and grinding. Early diagnosis of tooth wear is essential to exclude etiologic factors and prevent further hard tissue loss. Prosthodontic rehabilitation of advanced hard tissue loss is highly complex and long lasting procedure that requires multidisciplinary approach. Bruxism is a major risk factor to the longevity of prosthodontic device. Failures and problems caused by bruxism associated with prosthodontic rehabilitation can be either technical or biological, or both complications. Both, conventional prosthodontic rehabilitation and implant- prosthodontic rehabilitation include detailed planning prior therapy, use the most convenient materials, analyze jaw relations in the articulator, wax-up how future fixed or removable denture would look like, and provide a patient with a test splint. Only after the pilot trial the final denture may be provided. We have to point out to the patient the benefit of wearing a nightsplint, need to relax and reduce stress, even the possibility to use pharmacotherapy or botulinum toxin in severe bruxism. |
