Metal posterior teeth for the chronic bruxing patient

A study to evaluate psychological and occlusal parameters in bruxism

Purpose

To evaluate the role of anxiety/depression and occlusal factors in bruxism using Hospital Anxiety and Depression Scale and T-Scan III respectively.

Methods

The present case control study was comprising of a group of thirty patients with bruxism (Group Br) and 30 healthy individuals as control group (Group NBr). Subjects were selected from outdoor patients visiting the dental unit with the chief complaint of wearing off/sensitivity of all the teeth due to habitual grinding. The cases were selected by using the diagnostic criteria as given by the American Academy of Sleep Medicine (AASM). Further based on similarities of age and gender, controls were selected. Tooth wear index was recorded using an index given by Ekfeldt et al. Hospital Anxiety and Depression Scale (HADS) questionnaire was administered to both the groups to evaluate anxiety and depression. Recording of occlusal parameters in both the groups was done digitally by using T-Scan III. Statistical analysis was done by using student's t-test, chi square test and Mann Whitney U test.

Results

Group Br had significantly greater mean tooth wear index (22.24 ± 11.5) than group NBr (5.17 ± 3.30). Group Br had significantly higher anxiety (9.03 + 1.87/7.17 + 1.82) and depression scores (8 + 1.93/6.17 + 1.23) as compared to NBr. The disclusion time of group Br was 0.652 ± 0.749 and that of group NBr was 0.247 ± 0.289 (p = 0.008).

Conclusions

Subjects with higher level of anxiety, depression and increased disclusion time may have greater predilection towards suffering from bruxism (p < 0.05).

Fabricating a gold occlusal platform on a removable partial denture to help prevent extrusion of mandibular incisors

A clinical procedure is presented in which a maxillary removable partial denture (RPD) replacing anterior teeth was fabricated with a cast gold anterior occlusal platform. This treatment is indicated to correct abrasion caused by extruded mandibular anterior teeth on the maxillary RPD. The advantages compared with prosthetic teeth supported by an acrylic resin base or metal-backed facings are discussed. This technique allows for development of optimal esthetics, strength, and durability, while preventing further extrusion and excessive wear of the teeth occluding against prosthesis.

Repair of a removable partial denture using gold occlusals

Limited interarch space causes maintenance problems with removable partial dentures. The problem of abrasion and breakage of acrylic resin teeth, the concomitant supraeruption of opposing natural teeth, and possible decrease of vertical dimension of occlusion can be prevented or minimized with cast-gold occlusals. Use of metal occlusals has been advocated on newly constructed removable partial dentures, but not on existing prostheses with severely worn or broken denture teeth. This article describes a repair procedure for a removable partial denture where minimal interarch distance resulted in wear and breakage of denture teeth. A thin, abraded denture tooth that had been repaired numerous times was prepared and covered with a cast gold restoration. The problem of abrasion and breakage of the acrylic resin tooth was solved and the service life of the prosthesis was extended.