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Difference between revisions of "Bruxism"
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(Created page with "== Introduction == A brief description of bruxism, in order not to waste time on data common to most colleagues and for personal culture for non-experts, is sufficient to deepen the topic on Wikipedia which, obviously, will not be exhaustive for our purposes. Let's start, therefore, by asking ourselves some specific questions: Is bruxism an oral parafunctional activity,<ref name="Wassell 20082">Wassell R, Naru A, Steele J...") |
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As usual we are faced with the same problem of vagueness of verbal language as happened with the patient Mary Poppins,the 'Bruxism' may just be a conventional term to be distinguished from a term such as 'Tremor' but essentially the machine code may not be related to the verbal meaning. Precisely by following the now acclaimed 'Masticationpedia' model, we are preparing to present a patient suffering from 'Bruxism' for 15 years and whose dental colleagues have obviously seen the significance given to the disorder, managed with an occlusal bite plane.In presenting this clinical case, of course, we will follow the same roadmap followed with our patient Mary Poppins suffering from 'Haemasticatory Spasm'. | |||
{{ArtBy| | |||
| autore = Gianni Frisardi | |||
| autore2 = Riccardo Azzali | |||
| autore3 = Flavio Frisardi | |||
}} | |||
== Introduction == | == Introduction == | ||
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It emerged from another interesting study by M C Verhoeff et al.<ref>M C Verhoeff, M Koutris, M K A van Selms, A N Brandwijk, M S Heres, H W Berendse, K D van Dijk, F Lobbezoo. Is dopaminergic medication dose associated with self-reported bruxism in Parkinson's disease? A cross-sectional, questionnaire-based study.Clin Oral Investig. 2021 May;25(5):2545-2553. doi: 10.1007/s00784-020-03566-0.Epub 2020 Sep 12. | It emerged from another interesting study by M C Verhoeff et al.<ref>M C Verhoeff, M Koutris, M K A van Selms, A N Brandwijk, M S Heres, H W Berendse, K D van Dijk, F Lobbezoo. Is dopaminergic medication dose associated with self-reported bruxism in Parkinson's disease? A cross-sectional, questionnaire-based study.Clin Oral Investig. 2021 May;25(5):2545-2553. doi: 10.1007/s00784-020-03566-0.Epub 2020 Sep 12. | ||
</ref> that although bruxism is present in subjects with Parkinson's this is not associated with the dose of the dopaminergic drug. | </ref> that although bruxism is present in subjects with Parkinson's this is not associated with the dose of the dopaminergic drug. | ||
While for Merete Bakke et al.<ref name=":0">Merete Bakke, Tove Henriksen, Heidi Bryde Biernat, Torben Dalager, Eigild Møller . Interdisciplinary recognizing and managing of drug-induced tardive oromandibular dystonia: two case reports.Clin Case Rep. 2018 Sep 26;6(11):2150-2155. doi: 10.1002/ccr3.1548.eCollection 2018 Nov. | While for Merete Bakke et al.<ref name=":0">Merete Bakke, Tove Henriksen, Heidi Bryde Biernat, Torben Dalager, Eigild Møller . Interdisciplinary recognizing and managing of drug-induced tardive oromandibular dystonia: two case reports.Clin Case Rep. 2018 Sep 26;6(11):2150-2155. doi: 10.1002/ccr3.1548.eCollection 2018 Nov. | ||
</ref> exposure to dopamine receptor blocking agents such as antipsychotics, antitussives and antiemetics can induce dystonia including bruxism making the differential diagnosis between similar and possibly related disorders such as Parkinson's disease, essential tremor, Tourette's syndrome, temporomandibular disorders, nocturnal bruxism.[[File:IMG0103.jpg|thumb|'''Figure 1''': | </ref> exposure to dopamine receptor blocking agents such as antipsychotics, antitussives and antiemetics can induce dystonia including bruxism making the differential diagnosis between similar and possibly related disorders such as Parkinson's disease, essential tremor, Tourette's syndrome, temporomandibular disorders, nocturnal bruxism.</blockquote>[[File:IMG0103.jpg|thumb|'''Figure 1''': Patient suffering from severe diurnal and nocturnal bruxism|300x300px]]The conclusion, unfortunately, remains the same and that is that the external manifestation of an organic and/or functional disturbance is a macroscopic effect which transfers a series of mesoscopic abnormalities of the system over time. Here we were able to test only some of these neurobiological mesoscopic phenomena but the clinical result must be interpreted as a whole phenomenon because current scientific knowledge does not allow us to weigh the physiopathological value of the neurotransmitters, the PIC, the basal nuclei, the ascending reticular formation, etc. . What is certain is that an abnormality in one of these sites can generate an 'encrypted code' as a message in machine language of the Central Nervous System which in itself could not be 'Bruxism' but a form of 'Neuromotor Hyperexcitability' | ||
As usual we are faced with the same problem of vagueness of verbal language as happened with the patient Mary Poppins | As usual we are faced with the same problem of vagueness of verbal language as happened with the patient Mary Poppins,the 'Bruxism' may just be a conventional term to be distinguished from a term such as 'Tremor' but essentially the machine code may not be related to the verbal meaning. | ||
Precisely by following the now acclaimed 'Masticationpedia' model, we are preparing to present a patient suffering from 'Bruxism' for 15 years and whose dental colleagues have obviously seen the significance given to the disorder, managed with an occlusal bite plane. | Precisely by following the now acclaimed 'Masticationpedia' model, we are preparing to present a patient suffering from 'Bruxism' for 15 years and whose dental colleagues have obviously seen the significance given to the disorder, managed with an occlusal bite plane. | ||
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Also in this clinical case the differential diagnosis, as reported by Merete Bakke et al.,<ref name=":0" /> remains very complex. | Also in this clinical case the differential diagnosis, as reported by Merete Bakke et al.,<ref name=":0" /> remains very complex. | ||
In presenting this clinical case (figure 1), of course, we will follow the same roadmap followed with our patient Mary Poppins suffering from 'Haemasticatory Spasm' | In presenting this clinical case (figure 1), of course, we will follow the same roadmap followed with our patient Mary Poppins suffering from 'Haemasticatory Spasm'. The subject was a 32-year-old man suffering from pronounced nocturnal and diurnal bruxism and chronic bilateral OP prevalent in the temporoparietal regions, with greater intensity and frequency on the left side. Neurological examination showed a contraction of the masseter muscles with pronounced stiffness of the jaw, diplopia and loss of visual acuity in the left eye, left gaze nystagmus with a rotary component, papillae with blurred borders and positive bilateral Babynski's, and polykinetic tendon reflexes in all four limbs. | ||