Protetska terapija pacijenata sa sniženom verikalnom dimenzijom okluzije

master's thesis

• Title (english): Prosthetic therapy of the patients with decreased vertical dimension of occlusion
• Author: Smiljana Blažević
• Mentor: Nikola Petričević (mentor)
• Committee member: Nikola Petričević (predsjednik povjerenstva)
• Committee member: Slađana Milardović Ortolan (član povjerenstva)
• Committee member: Silvana Jukić Krmek (član povjerenstva)
• Granter: University of Zagreb; School of Dental Medicine; (Department of Removable Prosthodontics); Zagreb
• Defense date and country: 2018-09-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine; Prosthetic Dentistry

Abstract

Snižena vertikalna dimenzija okluzije često onemogućava protetsku terapiju pacijenta. Zato se nekad kombinira s kirurškom ili ortodontskom terapijom kako bi se stvorio prostor potreban za izradu nadomjestaka. Ako to nije potrebno, ovakva terapija prvo uključuje promjenu međučeljusnih odnosa koji djeluju na temporomandibularni zglob i žvačne mišiće. Protetski nadomjestci ne smiju biti izrađeni bez prethodne promjene međučeljusnih odnosa jer bi pacijent mogao osjećati bolove zbog fiziološki neprihvatljivog položaja kondila u temporomandibularnom zglobu. Zato se prilikom planiranja terapije donose odluke o međučeljusnim odnosima te o funkciji govora i žvakanja. Odlučuje se i o raspodjeli žvačnih sila. Opskrba pacijenta privremenim zubima i stabilizacijskom udlagom jedan je od ključnih koraka u tijeku ove terapije te uključuje dugotrajnu prilagodbu pacijenta na njih. Njihovom izradom u artikulatoru odabire se nova vertikalna dimenzija okluzije te ubrušavaju okluzalni kontakti da bi zubi bili rasterećeni prilikom žvačne funkcije, odnosno vođeni prednjim zubima kod kretnji donje čeljusti. Njihov izgled prenosi se mock up predloškom na zube pacijenta. Korištenjem udlage ili privremenih zubi omogućeno je praćenje dugotrajne prilagodbe na prethodno izgubljene okluzalne odnose. Također je omogućeno endodontsko liječenje zubi ako se pojave bolni simptomi te promjene u izgledu nadomjestka, koji se onda mogu provesti prije konačnog brušenja za trajne nadomjestke. Odabir materijala također je važan jer svojstva abrazivnosti i trajnosti mogu kod ovih pacijenata biti izraženiji. Složenost ovakve terapije zahtijeva izvođenje svakog koraka s preciznošću da bi se izbjegle naknadne komplikacije.

Abstract (english)

The decreased vertical dimension of occlusion often disables prosthetic treatment of the patient. This is the reason why it is sometimes combined with surgical or orthodontic therapy in order to define dental restorative space. If the surgery or orthodontic treatment is not required, this therapy first includes changes in interjew relations which then affect temporomandibular joint and masticatory muscles. Restoring the patient's teeth should not be done before changing the interjaw relations because then he could feel pain because of the physiologically unacceptable position of condyle in temporomandibular joint. A successful treatment plan should be based on planning the interjaw relations and factors such as speech and masticatory function. Distribution of chewing forces also needs to be considered. Temporary teeth and dental stabilization splints are key steps during the therapy and require a long-term adjustment period for the patient. By making temporary teeth in the articulator, a new vertical dimension of occlusion will be chosen and occlusal contacts will be adjusted, in order to relieve teeth of chewing forces during their masticatory function and to establish anterior guidance while moving the lower jaw. Their appearance is transferred by using mock-up technique on the patient's teeth. By using a splint or temporary teeth, monitoring of the long-term adjustment to the previously lost occlusal relations is enabled. Both endodontic treatment of teeth, if pain symptoms appear, and changes in the look of the restorations can be done before the final teeth preparations for the dental restorations are done. Selecting the right dental material is also important because abrasiveness and durability of restoration can also be more stressed in these patients. The complexity of this therapy demands every step to be done precisely to avoid the risks of both early and late-stage complications.

• Keywords: vertikalna dimenzija okluzije; temporomandibularni zglob; privremeni zubi; stabilizacijska udlaga; dugotrajna prilagodba
• Keywords (english): vertical dimension of occlusion; temporomandibular joint; temporary teeth; stabilization splint; long-term adjustment
• Language: croatian
• URN:NBN: urn:nbn:hr:127:129458
• Study programme: Title: Dental medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica dentalne medicine (doktor/doktorica dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-01-11 09:25:46