Ali Samer Mostafa, Alqutaibi Ahmed Yaseen, Aboalrejal Afaf, Elawady Dina Mohamed
Department of R.Prosthodontics, Faculty of Dentistry, October University for Modern Sciences and Arts, Egypt.
Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia.
Saudi Dent J. 2021 Dec;33(8):1004-1011. doi: 10.1016/j.sdentj.2021.07.001. Epub 2021 Jul 10.
The available treatment options fail to provide definitive or curative management for bruxer patients rehabilitated with implant overdentures (OD). The data regarding Botulinum toxin (BTX) injection as a management strategy for bruxism remains unclear. This randomized, single-blinded, control-group, pretest-posttest prospective trial evaluated the occlusal guard and Botox injections (BTX) effectiveness in managing sleep bruxism (SB) in subjects whose one of the edentulous arches had been restored with the implant-supported OD.
Forty-two patients diagnosed with definite bruxism were selected, all of which had implant-retained ODs opposing natural dentition. The participants were allocated randomly to three equal groups. Participants in group I (control group) were instructed to remove the OD at night; group II was managed with conventional occlusal stents. Those in group III were given BTX injections. New ODs were constructed for all groups, and all ball attachments were replaced with a new nylon cap. A baseline assessment (one month of OD insertion) of patient satisfaction and sleep quality was conducted, and then again at 3, 6, 9, and 12 months of treatment. Subjective sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI). Patients' satisfaction was evaluated using Temporomandibular disorders/numeric scales (TMD/NS). Prosthodontic (mechanical) complications were recorded during the follow-up period.
Group III showed a statistically significant improvement in patient satisfaction and sleep quality compared to the other two groups at 3, 6, 9, and 12 months follow-up period ( = 0 0.001, 0.0001, 0.0013, and 0.0001 respectively). Regarding prosthodontic (mechanical) complications, the highest number of events was revealed in the control group.
BTX and occlusal appliances effectively improve patient satisfaction and sleep quality of Bruxer patients rehabilitated with single arch implant overdentures.
对于使用种植覆盖义齿（OD）修复的磨牙症患者，现有的治疗方案无法提供确定性或根治性的治疗。关于肉毒杆菌毒素（BTX）注射作为磨牙症管理策略的数据仍不明确。这项随机、单盲、对照组、前后测试的前瞻性试验评估了咬合保护器和肉毒杆菌毒素（BTX）注射在管理无牙弓之一已通过种植体支持的OD修复的受试者的睡眠磨牙症（SB）方面的有效性。
选择42名被诊断为明确磨牙症的患者，所有患者均有种植体固位的OD与天然牙列相对。参与者被随机分为三个相等的组。第一组（对照组）的参与者被指示在夜间取下OD；第二组采用传统的咬合支架进行治疗。第三组接受BTX注射。为所有组制作新的OD，并将所有球附着体替换为新的尼龙帽。在OD插入一个月时进行患者满意度和睡眠质量的基线评估，然后在治疗的3、6、9和12个月时再次进行评估。使用匹兹堡睡眠质量指数（PSQI）评估主观睡眠质量。使用颞下颌关节紊乱/数字量表（TMD/NS）评估患者的满意度。在随访期间记录口腔修复（机械）并发症。
在3、6、9和12个月的随访期，与其他两组相比，第三组在患者满意度和睡眠质量方面有统计学显著改善（分别为P = 0.001、0.0001、0.0013和0.0001）。关于口腔修复（机械）并发症，对照组出现的事件数量最多。
BTX和咬合器具可有效提高单牙弓种植覆盖义齿修复的磨牙症患者的患者满意度和睡眠质量。
