Van der Zaag J, Lobbezoo F, Van der Avoort P G G L, Wicks D J, Hamburger H L, Naeije M
Section of Oral Kinesiology, Department of Oral Function, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands.
J Oral Rehabil. 2007 May;34(5):317-22. doi: 10.1111/j.1365-2842.2006.01651.x.
In the patient described in this study, oral implants failed as a probable consequence of severe, polysomnographically confirmed sleep bruxism. As this patient had the wish to be re-implanted after this failure, we decided to try diminishing the frequency of bruxism and duration first. To that end, two management strategies were used. Their efficacy was evaluated polysomnographically, yielding a total of six overnight recordings. Of the selected management strategies, the administration of low doses of the dopamine D1/D2 receptor agonist pergolide finally resulted in a substantial and lasting reduction in the bruxism outcome measures under study. This result supports the previous suggestion that central neurochemicals like dopamine may be involved in the modulation of sleep bruxism. The case report also illustrates the importance of an extensive history taking (questionnaires as well as oral) and clinical examination of oral implant patients for the presence of severe bruxism before the implant procedure is started. In case of doubt, polysomnography may be considered to definitively confirm or rule out the presence of severe sleep bruxism.
在本研究描述的患者中，口腔种植体失败可能是严重的、经多导睡眠图证实的睡眠磨牙症的结果。由于该患者在种植失败后希望再次种植，我们决定首先尝试降低磨牙症的频率和持续时间。为此，采用了两种治疗策略。通过多导睡眠图评估它们的疗效，总共进行了六次夜间记录。在所选的治疗策略中，低剂量多巴胺D1/D2受体激动剂培高利特的给药最终导致所研究的磨牙症结果指标显著且持久地降低。这一结果支持了先前的观点，即多巴胺等中枢神经化学物质可能参与睡眠磨牙症的调节。该病例报告还说明了在开始种植手术前，对口腔种植患者进行广泛的病史采集（问卷以及口腔检查）以检查是否存在严重磨牙症的重要性。如有疑问，可考虑进行多导睡眠图检查以明确证实或排除严重睡眠磨牙症的存在。
