Tag: bruxismo

Bruxism and Dental Clenching: Understanding the Causes, Symptoms and Treatments According to Dr. Roberto Markarian

Bruxism and Dental Clenching, popularly known as the habit of grinding and dental clenching are dysfunctions that affects around 40% of the Brazilian population, according to data from the World Health Organization (WHO). At the ImplArt Clinic, located in São Paulo, this disorder is one of the most frequent complaints from patients seeking treatment for orofacial pain, tooth wear and temporomandibular joint (TMJ) problems.

Dr. Roberto Markarian, director of the ImplArt Clinic, stresses that it is important to emphasize that the treatment of bruxism and clenching must be individualized, taking into account the specific needs of each patient. A consultation with a dental surgeon is essential for a proper diagnosis and definition of the best therapeutic approach. Even patients with dentures and dental implants who suffer from bruxism should seek treatment.

What is bruxism and how does it manifest itself?

Bruxism can occur both during sleep(nocturnal bruxism) and while awake(daytime bruxism). In both cases, the patient performs the unconscious act of grinding or clenching their teeth with excessive force, causing consequences such as pain in the jaw, temples, etc.

According to Dr. Roberto Markarian, specialist in implant dentistry and clinical director of ImplArt,

“Bruxism is often silent and is only noticed when the symptoms become more intense. These include jaw pain, headaches, tooth wear and fractures in restorations or dentures and even dental implants.”

Main causes of Bruxism and Dental Clenching

Bruxism and dental clenching are associated with multiple factors, including:

Emotional stress and anxiety
Changes in sleep (such as apnea)
Dental malocclusion
Use of medication such as antidepressants
Neurological or muscular problems

Dental clenching, on the other hand, is a form of bruxism in which the patient keeps their teeth pressed together without lateral movements, and is equally harmful.

BRUXISM AND dental CLENCHING — *Pain caused by bruxism and dental clenching*

Most common symptoms

Tooth wear or fracture
Pain or tiredness in the chewing muscles
TMJ clicking
Headaches, especially on waking
Tooth sensitivity
Insomnia or non-restorative sleep

Personalized diagnosis at the ImplArt Clinic for Bruxism and Dental Clenching

The ImplArt Clinic carries out the diagnosis by means of a detailed clinical assessment, imaging tests (such as CT scans and intraoral scans) and functional analysis of the bite. Dr. Markarian highlights:

“In many cases, bruxism is discovered during planning for dental implants, dental contact lenses or oral rehabilitation, as signs of wear are visible on the tooth surfaces. That’s why a multidisciplinary approach is essential.”

Effective treatments for bruxism and clenching

The treatment of bruxism is very specific and often multidisciplinary, as it is usually linked to the patient’s mental state, in the vast majority of cases. Given that modern lifestyles are accompanied by a great deal of stress, it is important to find out the reasons that trigger the symptoms and try to treat them.

Major-relaxing bite plates or occlusal plates

Miorelaxing bite plates are removable intraoral devices, usually made of acrylic resin, which cover the surfaces of the teeth. Their purpose is to protect the teeth from damage caused by clenching or grinding and to reduce the associated muscle sensitivity. The use of these plates can reduce the activity of the masticatory muscles, helping to relieve the symptoms of bruxism. At the ImplArt Clinic, myorelaxing bite plates are made and designed using modern computer graphics systems to study the patient’s ideal bite.

Major-relaxing bite plates: Custom-made devices used during sleep, usually made of acrylic resin, which cover the surfaces of the teeth.
They reduce tooth wear and relieve muscle tension.

💉 Botulinum toxin (Botox)

The application of botulinum toxin type A to the masticatory muscles, such as the masseter, has been used to reduce the excessive muscle activity associated with bruxism. This approach can relieve pain and muscle discomfort, improving symptoms.

Applied to the masticatory muscles to reduce the force of clenching.
Effective results for up to 6 months.

💊 Medicines

In some cases, medication may be indicated to control bruxism. Muscle relaxants can be prescribed to reduce muscle activity during sleep. In addition, in specific situations, anxiolytics or antidepressants can be used, always under medical supervision.

Muscle relaxants or anxiolytics (when indicated by health professionals).
Relief of symptoms related to pain and tension.

🧘 Complementary therapies

Bruxism is often associated with stress and anxiety. Cognitive-behavioral therapies, relaxation techniques, meditation and other psychological approaches can be effective in reducing bruxism episodes, especially when emotional factors are involved.

Psychotherapy, relaxation techniques, mindfulness and physiotherapy.
Treatment of the emotional or postural cause of bruxism.

Occlusal rehabilitation

In cases where there is occlusal interference or bite problems, occlusal adjustment may be indicated. This procedure aims to correct inadequate dental contacts that may contribute to bruxism. In addition, dental rehabilitation, including restorations and prostheses, may be necessary to restore proper bite function.

Adjustments to the bite or replacement of missing teeth with prostheses or implants.
In advanced cases, occlusion correction is essential.

Is it possible to eliminate bruxism and dental clenching?

According to Dr. Roberto Markarian, it is important to emphasize that in order to mitigate the effects of bruxism, multidisciplinary treatment should be adopted, with a view to the patient’s well-being in a holistic way, i.e. treating the individual as a whole and not just from a dental point of view.

If we think only of a bruxism plate, what is expected is an immediate reduction in the symptoms of bruxism, but the plate itself will not cure bruxism and teeth clenching. The bite plate helps to redistribute the pressure on all the teeth, protecting the teeth from the force of the bite and easing the patient’s pain.

With this in mind, the ImplArt Clinic offers patients who need Porcelain Crowns and Protocol Prostheses, and who suffer from bruxism, the option of using Zirconia Prostheses. Zirconia is a highly resistant and biocompatible material that is very suitable for those who suffer from bruxism precisely because of its high resistance.

When Bruxism and Dental Clenching are not treated

Untreated bruxism can lead to:

Loss of tooth structure
Need for rehabilitation with dental implants or fixed prostheses
Chronic pain in the temporomandibular joint
Aesthetic impairment of the smile

Dr. Markarian adds:

“We have seen several patients who, after years of untreated bruxism, suffer from constant headaches and tooth wear. In addition, intensive clenching can lead to tooth fractures and even dental prostheses such as implant protocols.”

Schedule your evaluation at the ImplArt Clinic

If you feel pain in the jaw joint, or even notice that your teeth are wearing down, schedule an evaluation with Dr. Roberto Markarian, director of the ImplArt Clinic. Early diagnosis and proper treatment can prevent serious consequences for your oral health.

👉 S chedule your appointment now by WhatsApp (11) 3262-4750

Guide of Bruxism and dental Clenching

DR. ROBERTO MARKARIAN IMPLANTODONTISTA SITE — Bruxism and Dental Clenching: Understanding the Causes, Symptoms and Treatments According to Dr. Roberto Markarian

Text written by DR. ROBERTO MARKARIAN – CRO-SP 73.583
Founder and Director of the ImplArt Dental Clinic – Dr. Roberto’s Linkedin profile
Access Dr. Roberto Markarian‘s scientific production on Google Scholar

Dr. Roberto Markarian is a reference in dental implants and computerized dental prostheses in Brazil. As well as having more than 10,000 implants installed, he is a researcher who produces knowledge that is published worldwide in renowned scientific journals in the field of dentistry. He is responsible for promoting knowledge and high technology applied in all the treatments offered by the ImplArt Dental Clinic.

*Accessmore videos about the treatments on the ImplArt Clinic YouTube channel and see how a dental implant is made: ImplArt Dental Clinic YouTube videos

Agende sua consulta agora por WhatsApp

5 Biggest Risks for Dental Implants

Are there any risks for dental implants? We’ll find out about 5 of them in this article. Dental implants are a more up-to-date, modern and low-risk alternative for tooth replacement than a fixed prosthesis on teeth or a removable prosthesis, the old dentures.

The technique for inserting dental implants is very safe, with an estimated 92% chance of success in non-smoking patients with good health and healthy habits. There are several types of dental implants available today, the most modern of which is the metal-free ceramic implant, an excellent option for those looking for metal-free implant treatment.

The single tooth implant, or total dental implant, is used to replace the root of one or more missing teeth and will serve as a support for an artificial tooth called adental prosthesis or dental crown.

Know more about the risks and dangers of dental implants

Crucial to the success of the procedure is the thorough planning of the implant surgery and the choice of specialist professionals who are qualified to carry out the dental implant surgery. This increases the chance of success of this important treatment, and therefore the chances of any complications are minimal.

So rest assured that you can enjoy all the benefits that this rehabilitative and safe treatment offers patients. The implant-supported prosthesis is made to resemble the person’s other natural teeth and also offer similar chewing strength.

Oral rehabilitation with dental implants is usually the best option for re-establishing the patient’s aesthetic and chewing functions, a treatment called total dental implantation.

But in very few cases, there can be some risks with dental implants. Here are the 5 main risks of dental implants:

1 – Risk of implant breakage

Patients who grind or clench their teeth (bruxism) can exert a lot of force on the implants, with an increased chance of breakage or fracture of the implants or the parts that make up the implant prostheses.

Patients who bruxism also increase the risk of loosening the screws that fix the implant crown. When this happens, the patient reports that the implant is “soft”. However, we mustn’t confuse the prosthesis becoming loose with the implant pin coming loose from the bone (which is much more serious).

Most commonly, when the problem is just the loose implant tooth, the patient feels no pain, while when the implant is lost there is always pain. If the implant fractures or comes loose from the bone, it must be replaced, starting the dental implant process all over again.

Check complete PODCAST about 5 biggest risks for dental implants:

Is it the dentist’s fault that my implant fractured?

There are several factors to consider, some of which would be the material of the prosthesis, the number and positioning of the implants, correct surgical technique, material of the dental implant, type of prosthetic components chosen, type of prosthetic connection chosen.

Assuming that the professionals are working to do their best, it’s rare that there will be any negligence in this regard. What really counts is the willingness of the patient and the professional to start again, perhaps trying to improve or perfect one of the strategies.

riscos do implante dentário — Apresentação das partes do implante dentário: implante (no osso), pilar + coroa dental (dente artificial)

2 – Inflammation in implants and risks

Inflammation can occur in a dental implant, manifesting itself as pain, swelling, pain when chewing, bleeding, and even the formation of pus in the implant. Please note that in any area of medicine where an artificial part is used inside the human body, there can be an adverse reaction of rejection.

This rejection phenomenon can occur in relation to the dental implant or an associated material such as a bone graft or a protective membrane. Bacterial infection can also occur in the implants, which can even prevent bone integration.

one of the risks of dental implants is peri implantitis — The implant on the left in the image has inflammatory bone loss, while the implant on the right has a normal bone level

That’s why all treatments at ImplArt begin with a thorough oral cleaning, as well as the removal of any infectious diseases such as cavities and periodontal disease. The patient will only have implant surgery if their mouth is clean and their oral health is good.

This is possible even if the patient doesn’t have all their teeth yet. When the prostheses on implants are finished, we teach the patient how to properly clean the dental implant. This correct hygiene is very important and certainly contributes to the chances of success of the dental implant.

3 – Risk of facial nerve damage

If the surgery is not well planned, with the use of CT scans and other imaging tests for mapping, damage to the jaw nerve can occur during dental implant surgery. In the area at the back of the mouth in the lower arch, there is a nerve that can be very superficial, especially if the patient has been without teeth for many years.

In patients with advanced periodontal disease, bone loss can also put the nerve at risk due to its proximity. To reduce the risk of nerve damage and paresthesia, the implant dentist will carry out imaging tests. The most commonly requested exam is a panoramic X-ray, but a cone beam CT scan helps to measure the bone and plan the implant.

Computer-guided surgery – reducing risks

To minimize the risks even further, we can perform computer-guided partial or total implant surgery, which offers little invasiveness and allows for perfect positioning of the dental implant, with no room for error.

Crooked or poorly positioned implants can have poor bone integration or even rejection. It is not in all cases that we are able to recover the patient from oral nerve damage or poorly placed implants.

Agende sua consulta agora por WhatsApp

Depending on the severity of the problem, an injury to the jaw nerve can lead to sequelae such as numbness in the jaw or loss of sensation in the tongue or to the sensation of tastes (gustation).

At the ImplArt dental clinic, 100% of cases are operated on with a CT scan, which can be done in our own radiology center.

4 – Risks in the bone around the implants

Bone loss can occur in an implant that has suffered infection while healing in the bone. In addition, in cases where immediate loading is carried out, i.e. a temporary or permanent tooth is placed in position immediately after surgery, there is a greater risk of bone and implant loss.

This is because the newly placed dental implant does not yet have a mature attachment to the bone and needs to rely exclusively on its mechanical locking into the bone in order to fix itself. Most of the time, if the indication and technique are correct, immediate loading works well.

But in cases of immediate failure, the consequences can be serious, for example leading to major bone loss in the area. There are more advanced dental implant models that have improvements to the fit of the tooth and also in the chemistry of the surface so that healing in the bone occurs faster and more efficiently.

Today we have dental implants that allow you to have a permanent tooth in 1 month! Get to know the dental implant models with the best advances, such as Straumann implants, Neodent cone-morse implants (national), SIN implants (national).

dental implant risks — *Implant shapes and models have to do with clinical indications*

5 – Increase in risk factors – patient health and habits

There are risks to the success of implant treatment that don’t depend on the professional or the materials used, but on patient factors. Failure to clean the teeth,smoking and diabetes increase the chance of problems with the dental implant.

In this article, we only discuss the RISKS in dental implants, however the success rates of dental implants are very high, especially for current implant dentistry techniques performed by a dental implant specialist.

Dental implants are an excellent treatment if they are well indicated, planned and executed.

Come and see our work! The ImplArt Dental Clinic has been dedicated to implant dentistry and oral rehabilitation for 18 years. We are located in São Paulo, Brazil.

Text written by DR. ROBERTO MARKARIAN – CRO-SP 73.583 – updated on 26-08-2024
Founder and Director of the ImplArt Dental Clinic – Dr. Roberto’s Linkedin profile

Agende sua consulta agora por WhatsApp

Pure zirconia dental crowns – the strongest material for crowns

Zirconia crowns are dental prostheses indicated for restoration and dental rehabilitation in people who have had damage to one or more teeth. Rehabilitation with dental crowns aims to restore the aesthetics and functionality of the smile, improving not only chewing, the appearance of the teeth, but also self-esteem.

Index

Zirconia crowns: excellence for aesthetic results

However, some materials used to make dental crowns are not strong enough to be used in patients suffering from bruxism. As is well known, bruxism is a disorder of oral function movements, characterized mainly by involuntary grinding or clenching of the teeth.

translucent pure zirconia crowns — *Translucent pure zirconia crowns*

*Pure zirconia crowns. Translucent zirconia is 10 times stronger than ordinary porcelain*.

It occurs mainly during sleep. This excessive load on the teeth and musculoskeletal structures of the face can cause problems with the teeth and correct occlusion in general.

Although the cause of bruxism is not very clear, it is certain that this condition most often affects people who suffer from emotional problems, such as stress, anxiety and excessive worry.

Just as the excessive force generated by bruxism can wear down teeth, it can also damage dentures made of certain materials.

In these cases, our team has the option of recommending porcelain crowns with a pure zirconia internal structure, which are proven to be more resistant and can withstand a greater load, even in patients with bruxism.

Zirconia acquires this strength because it goes through a controlled process called sintering, which is heating it at a high temperature in a special furnace. This process modifies its particles, creating a solid and very strong prosthetic piece. Other properties of crowns with a pure zirconia structure:

Metal free crown
Translucency – even in very bright environments
Biocompatibility – no risk of rejection
No cold or heat conductivity
They can be screwed or cemented onto implants

How do I know if I can have a crown with pure zirconia even if I have bruxism?

First of all, it’s important to assess the degree of oral impairment that bruxism has caused so far. If you have untreated bruxism for many years, there may be advanced wear of the dental crowns and/or root fractures.

Therefore, before receiving prosthetic crowns to rehabilitate and restore your smile, you will probably need to undergo treatment to correct these defects (e.g. root canal treatments, vertical dimension increase, clinical crown increase). Dr. Markarian, our general manager, saysthat controlling bruxism is essential to avoid future problems and porcelain crowns with a pure zirconia structure may be indicated.

ImplArt Odontologia has its own dental laboratory with the Cerec 3D, Cerec Primemill, Trios 3Shape and Ceramill systems, which speed up the fabrication of crowns with pure zirconia and metal-free ceramics, in some cases even in just a few hours in an ImplArt Day Clinic or Dental Spa, where you can carry out the largest number of dental procedures in just one appointment or in just a few days. This way, patients can set aside a day in their schedule or a few days in a week to dedicate to dental treatment, without it taking months to complete.

If you have any questions about treatment with metal-free aesthetic crowns, please make an appointment or contact us by clicking on the button below. We will be happy to assist you.

Agende sua consulta agora por WhatsApp

More translucent and resistant cubic zirconia crowns

Translucent cubic zirconia is an evolution of conventional dental zirconia. Dental zirconia is increasingly being used as a material for making a dental crown or even for a fixed prosthesis on dental implants. Translucent Zirconia has certainly come to revolutionize the way dental prostheses are made, since it uses modern computer graphics resources to design the prostheses, and modern 3D milling machines to sculpt them. This makes treatment faster and more comfortable for the patient.

In addition, Zirconia is the most resistant material compared to other types of crowns and allows for results with a high degree of naturalness, being the most similar to the appearance of natural teeth.

Zirconia can also be used on implants, protocol prostheses and partial prostheses.

Why is dental zirconia an excellent material?

First and foremost, one of the greatest advantages of the Pure Zirconia dental crown is its strength and durability. In addition, its modern execution method, which doesn’t require the old mass moldings and only uses a 3D scanner, makes the treatment much more comfortable for the patient. It is therefore an excellent option for those who want metal-free treatment, a situation that is highly valued today with biological dentistry.

translucent cubic zirconia dental crown — *Translucent cubic zirconia crown for molar tooth (bottom), with hole for screwing into dental implant*

These zirconia structures can be used both for implant prostheses, types of crowns on implants and for crowns on natural teeth. One of the pioneering companies in the development of durable and aesthetic zirconia dental prostheses is the Austrian company AmannGirrbach. Now it is introducing a new type of dental ceramic: Zolid FX translucent cubic zirconia.

It is a fully biocompatible material used to make first-rate prosthetic crowns, not only single-unit, but also bridges of up to 3 units. The main characteristics of Zolid FX are its super-high translucency, high strength and long-term stability.

It is therefore a strong alternative to the already established lithium disilicate (glass ceramic), and can therefore be especially suitable for cases that require high porcelain crown strength. Cubic zirconia crowns can be installed both anteriorly with excellent aesthetics and posteriorly. They can also be used in dental implant treatment.

What is the manufacturing process like?

The Zolid FX cubic zirconia crown is made using computerized CAD/CAM equipment. It starts with milling the rough block on a 3D printer to the shape of the tooth. The zirconia crown is finished with the manual addition of colors and shading so that the crown has natural visual characteristics, like the neighboring teeth. The pure zirconia crown is super aesthetic and is up to 10 times stronger than ordinary (feldspatica) porcelain.

… After a dental implant, can I place the tooth on the same day ? See here…

Translucent cubic zirconia crowns are suitable for bruxism patients due to their resistance

Bruxism is an oral functional disorder characterized by involuntary grinding or clenching of the teeth. The excessive force generated by bruxism can cause not only muscle and joint pain in simpler cases, but also the destruction of part of the tissues (bone and gum), enamel or the structure of the dental crown in more advanced cases.

It is important to remember that before your permanent porcelain crown is made, you will receive a temporary crown. This is used to check the aesthetics and chewability of the permanent crown.

translucent zirconia implant crowns — More translucent and resistant cubic zirconia crowns

zirconia crowns for implants — More translucent and resistant cubic zirconia crowns

However, bruxism can be just as damaging to the structures of prosthetic crowns made from certain materials. For this reason, there has always been a need to develop prostheses with increasingly resistant and stable materials, and at the same time aesthetic (without metals in the structure).

Meet the Ceramill Motion 2 3D tooth printer

The translucency and strength characteristics of Zolid FX are fundamental to making the prosthetic crown very comparable to natural teeth. The result is extremely aesthetic crowns and restorations with high strength and long-term stability.

ImplArt Dental Clinic only works with materials of the highest quality, developed by serious companies. For example, AmannGirrbach, which only introduces materials and equipment to the market after carrying out numerous tests and research.

If you have any questions, please contact us.

Agende sua consulta agora por WhatsApp