Thymi Magdalini, Rollman Annemiek, Visscher Corine M, Wismeijer Daniel, Lobbezoo Frank
1Section of Oral Kinesiology, Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
2Section of Oral Implantology and Prosthetic Dentistry, Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands.
BDJ Open. 2018 Nov 9;4:17040. doi: 10.1038/s41405-018-0006-4. eCollection 2018.
To explore how bruxism is dealt with by accredited oral implantologists within daily clinical practice.
Nine semi-structured interviews of oral implantologists practicing in non-academic clinical practices in the Netherlands were performed, and thematic analysis was conducted using a framework-based approach.
Oral implant treatments in bruxing patients were a generally well-accepted practice. Complications were often expected, with most being of minor impact. Contradictive attitudes emerged on the topic of bruxism being an etiologic factor for peri-implant bone loss and loss of osseointegration. Views on the ideal treatment plan varied, though the importance of the superstructure's occlusion and articulation features was repeatedly pointed at. Similarly, views on protective splints varied, regarding their necessity and material choice. Bruxism was diagnosed mainly by clinical examination, alongside with patient anamnesis and clinician's intuition. There was little attention for awake bruxism.
Bruxism was generally not considered a contraindication for implantological treatments by accredited oral implantologists. Views on the interaction between bruxism and bone loss/loss of osseointegration varied, as did views on the ideal treatment plan.
There is a need for better understanding of the extent to which, and under which circumstances, sleep and/or awake bruxism can be seen as causal factors for the occurrence of oral implant complications.
探讨在日常临床实践中，获得认证的口腔种植医生如何处理磨牙症。
对荷兰非学术临床机构中执业的口腔种植医生进行了9次半结构化访谈，并采用基于框架的方法进行主题分析。
磨牙症患者的口腔种植治疗通常是被广泛接受的做法。并发症往往是可预期的，多数影响较小。在磨牙症是否为种植体周围骨丢失和骨结合丧失的病因这一话题上出现了矛盾的态度。对于理想治疗方案的观点各不相同，不过都反复强调了上部结构的咬合和关节特征的重要性。同样，对于防护夹板的必要性和材料选择，观点也存在差异。磨牙症主要通过临床检查，结合患者病史和医生的直觉来诊断。对清醒时磨牙症关注较少。
获得认证的口腔种植医生通常不认为磨牙症是种植治疗的禁忌证。对于磨牙症与骨丢失/骨结合丧失之间的相互作用的观点各不相同，对于理想治疗方案的看法也是如此。
有必要更好地了解睡眠和/或清醒时磨牙症在何种程度以及何种情况下可被视为口腔种植并发症发生的病因。
