見出し

2000　Oct.　ＡＡＰ（at Hawaii）Luncheon for learning

A New Method to Estimate and Treat Bruxism Using an Occlusal Splint

　　　　　　　　　 Masahiko Ikeda DDS (Japan)

abstract：Occlusal trauma is one of the important accelerating factors in periodontal breakdown. In the animal models ,the forces to cause occlusal trauma were generated by jiggling or insertion of rubber between teeth. However,no precise information was available to know how large forces were loaded to cause the occlusal trauma. It is generally accepted that the forces causing occlusal trauma may derive from forces generated during mastication , swallowing and unconscious action including bruxism. Especially in bruxism ,excessive forces are loaded to teeth and periodontal tissues. Therefore , it is of importance to estimate and control the traumatic force. Very few scientific analyses and objective evaluation on bruxism have been made, since the action was caused unconsciously. In a series of our sturdies, we have estimated and visualized the degree of force caused by bruxism using an ordinary occlusal splint. The method is as follows: ①An occlusal splint is made from acrylic resin and applied on maxillary teeth thrughout sleeping.②After several adjustments of the splint, we apply special black ink on the surface of the splint and instruct the patient to use the splint.③The degree of worn-out facet and the trace of ink remained on the splint is assessed at every examination by one invesstigater.④The degree of indentation of a splint is measured by a standardized microscopy. The intensity of bruxism is classified into the following 4 groups(B-0 to B-3) according to the data obtained.

B-0 no facet on a splints.

B-1 slight worn-out of ink and shiny facet.

B-2 slight indentation of a splint. (depth of facet 0.056 ~0.092mm)

B-3 marked indentation of a splint.(depth of facet 0.65~1.0mm)

In our trial of this assessment for bruxism patients, we examined the relationship between the degree of bruxism and severity of periodontal disease. Especialy in cases of severe type of bruxism, we found the necessity of controlling the bruxism and introduction of the autosuggestion therapy toward the patients. We compared the degree of facet on the same splint between pre-and post-treatments for two weeks and found the shifts of degree in bruxism including B-3 to B-2 or B-2.

From observation, this method using a splint appears to be very useful to diagnose and the effect of treatment.

2000　Oct.　ＡＡＰ（at Hawaii） poster

Treatment of furcation involvement -A long-term observation after periodontal basic treatment- Hitoshi Uchida, DDS, Masahiko Ikeda, DDS, Hiroshi Katoh,DDS, DDSc, Dental Clinic Ikeda .Dept .Perio, Hokkaido Univ,Sch,End,Sapporo,Japan

abstract： The present study aims to observe the long-term maintenance cases after basic periodontal treatment of furcation involvement. One hundred and two teeth of 50 patients under good plaque control and well control of inflammation without any deterioration were selected. Horizontal probing depth, vertical probing depth, and radiographic bone level were assessed to determine the degree of progression of periodontitis and Dr.Ikeda’s method using occlusal splint during sleep for two weeks was used to determine the degree of force of bruxism as occlusal trauma. The degree of force of bruxism was estimated by observing the wearing away of the ink and the indentation on the splints and classified into the following four groups. B-0 was categorized as the patients with no facet on the splints,B-1 with slight wearing away of ink and shiny facet, B-2 with slight indentation and B-3 with severe indentation. The result showed that all the subjects were categorized in B-1 and B-2 groups which were ranked as weak force of bruxism. In this study, the reasons of good maintenance of the examined teeth for 11years are considered as follows: 1. Subjects were under well controled inflammation and 2. Bruxism as occlusal trauma was weak. Treatment of the furcation involvement only by basic periodontal treatment under good control of inflammation and weakening of occlusal force as occlusal trauma may be effective for long-term maintenance without further deterioration.

Original article：

Ａ Study of Influence of Occlusal Factors and the Central Nervous

System on Nocturnal Bruxism

－A Study Using an Occlusal Splint－

Tetsuo Sugawara, Masahiko Ikeda and Hiroshi Kato

Abstract：

The following experimental was conducted to learn how, among peripheral factors that have been considered to cause bruxism, occlusal factors and central nervous system factors affect nocturnal bruxism.occlusal factors and central nervous system factors affect nocturnal bruxism.For the experimental subjects 85 outpatients at Ikeda Dental Clinic were selected.First ,during sleep , an occlusal splint was inserted on the upper jaw .Then resin of the facet that developed on the surface of the occlusal splint was examined with the naked eye , to see how much the resin had been scraped.The deepest part of the facet was measured using a light permeable microscope, and the strength of nocturnal bruxism was evaluated at the same time. A part that corresponds to the molar tooth the same occlusal splint was elevated by approximately 0.5mm, the size of one tooth. After creating a premature contact and giving more variety in occlusion, bruxism was evaluated and compared to that before premature cantact was made. The result showed that, out of 85 patients, 44.7% showed no changes, and 55.3%

Showed changes. This showed that the cause of bruxism depended on the central nervous system, while the remaining 55.3% of cases were possibly linked to occlusal factors. From the above results, depending on the case, the cause for bruxism is believed to be linked to both occlusal factors and the central nervous system.