Lecture 4_May 9 lecture Flashcards
tooth to tooth wear
attrition
What is RMMA?
some muscle hyperactivity may represent an increase in the static tonic contraction of the muscle (RMMA)!!!
Tonic contraction. Doesn’t have to have bruxism??? This makes your muscle sore!?
most common type of bruxism?
awake bruxism- tied to emotional stress
most destructive type of bruxism
nocturnal
mainly grinding and could include clenching
Does peripheral or CNS have a dominant role in sleep bruxism?
CNS and/or autonomaic vs. peripheral sensory factors
now classified as sleep related movement disorder
3 phases of bruxism?
- phasic or eccentric- grinding of teeth during sleep (55%). Cricket sound. and where you see wear facets.
- TOnic = constatnly clench teeth with no eccentric movements. 11%
Mixed= combo of both 36%
Etiology of bruxism?
disturbance in the cranio neuromuscular causing function hyperactivity
What is the bruxism quad?
muscles, TMJ, teeth, and sleep
Prevalence of TMD?
40-60%
If you see pitting, does this mean erosion?
not always
What often cause enamel craze lines?
chewing ice!
where do you often see wear with patients that have sleep problems?
they wear towards the anterior teeth due to posterior interferences
How many minutes do teach actually touch per day?
26 mins per day
with bruxism- much longer
How long does it take to stabilize TMD when you give an occlusal splint?
approximately 4 months
what should you use instead of abfraction?
corrosion, stress, and friction
percentage of OSAS in adults?
2% increasing to 24% by age 65
most common type of bruxism?
awake bruxism
80% of the sleep period is made of REM or Non REM sleep?
non REM which is important for the PHYSICAL rest
REM is most important for ____ rest?
psychic
was wave sleep is associated with muscle hyper function?
delta wave
AKA arousal activity
T/F SLEEP bruxism Suggests that the central and/or autonomic nervous systems, rather than peripheral sensory factors, have a dominant role
TRUE!
NOT PERIPHERAL
what are the 3 types of sleep bruxism?
phasic, tonic or centric, mixed
what is the most common type of sleep bruxism?
phasic or eccentric at 52%. this is the cricket sounding one!
what is tonic sleep bruxism?
at 11.4% of the time you get clenching of the teeth with NO eccentric movement
how long per day do teeth contact when swallowing?
17 mins
how long per day do teeth contact when chewing?
9 mins
what is the approximated time per night people grind their teeth?
38 minutes with avg 5-6 seconds per event
average biting force?
756 N, during bruxism it can be 3-10 times greater
Describe category 1?
Excessive wear WITH LOSS OF OVD. VERY difficult to restore
what is category 2?
excessive wear WITHOUT loss of OVD, but iwht space available for restoration.
Best case?
what is category 3?
excessive wear WIHTOUT loss of OVD, but with LIMITED SPACE! refer cat 3 to prostH!
what is the most difficult category to restore?
cat 1, then cat 3
occlusal device can reduce muscle activity up to what percent?
upt o 25%
what happens if you violate the space of Donder?
you can get tongue retraction
this will lead to activation of the lateral pterygoid muscles = protrusion to open the airway and bruxism
does a splint unload the joint?
Remember – Splints [Occlusal device] do NOT unload the joint!
T/F
Increasing the OVD distracts the condyles down, it DOES NOT simply ROTATES them while they are still loaded.
FALSE to both
what are contraindications to using an occlusal device?
severe retrognathia/micrognathia
lingually tipped mandibular molars and pre-molars
mobile maxillary anterior teeth! (mmakes sense- you can’t wear a device is your teeth are wiggly!)
anterior open bite
OSAS
enlarge tongue/tongue dispacement
