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Temporomandibular Bozukluklar ve Bruksizmde Eşlik Eden Psikiyatrik Bozukluklar ve Tedavi Seçenekleri

Yıl 2020, Cilt: 12 Sayı: 2, 205 - 231, 30.06.2020
https://doi.org/10.18863/pgy.570861

Öz

Temporomandibular bozukluk (TMB) çiğneme kaslarını,
temporomandibular eklemi (TME) ve bu eklemi çevreleyen yapıların etkilendiği
klinik bir durumdur. Bruksizm, diş sıkma ve taşlamayla stomatognatik yapıların aşırı
yüklenmesinin bir sonucu olarak ortaya çıkan, TMB etiyolojisinde yer alan
parafoksiyonel bir alışkanlıktır. TMB popülasyonun yaklaşık %10'unda, bruksizm %8-20'sinde
görülür. TMB ve bruxism etiyolojisinde birçok faktör etkilidir ve bu faktörler
arasında etkileşimler vardır. Biyomekanik, nöromüsküler, biyopsikososyal ve
nörobiyolojik faktörler hastalığa katkıda bulunur. Psikiyatrik bozuklukların
prevalansı TMB ve bruxism olan bireylerde yüksektir. Birçok psikiyatrik
bozukluk, özellikle de depresyon ve anksiyete bozuklukları, TMB ve bruksizme eşlik
eder. Bu hastalıkların tedavisinde kullanılan antidepresanlar bruksizme neden
olur. Bu, TMB ve bruksizmin tedavisinde önemli zorluklardan biridir. TMB ve bruksizmin
tedavisinde ilk adım temel önleme yöntemlerine değinmektir. Amitriptilin
kullanımı TMB farmakoterapisinde belirgin olmakla birlikte, bruksizmde buspiron
ve klonazepam kullanılan iki önemli ilaçtır. Bu ilaçların küçük örneklerde incelenmesi ve mevcut
bilgilerin çoğunlukla vaka raporlarına dayanması gerçeği, ileri ki çalışmaların
gerekliliğini açıkça göstermektedir. Her iki hastalıkta da bilişsel davranışçı
terapinin yaygın kullanımı bir çözüm olacak ve ilacın yan etkilerini ortadan
kaldıracaktır. Tedavi seçeneği ne olursa olsun hem diş hekimleri hem de
psikiyatristler multidisipliner bir çalışma ortamında olmalı ve bu hastalıkları
biyopsikososyal model çerçevesinde değerlendirmelidir.

Kaynakça

  • Aguilera SB, Brown L, Perico VA (2017) Aesthetic Treatment of Bruxism. J Clin Aesthet Dermatol, 10:49-55.
  • Amerikan Psikiyatri Birliği (2000) Psikiyatride Hastalıkların Tanımlanması ve Sınıflandırılması El Kitabı, Yeniden Gözden Geçirilmiş Dördüncü Baskı (DSM-IV TR) (Çeviri Ed. E Köroğlu). Ankara, Hekimler Yayın Birliği.
  • Amerikan Psikiyatri Birliği (2013) Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı, Beşinci Baskı (DSM-V) (Çeviri Ed. E Köroğlu) Ankara, Hekimler Yayın Birliği.
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  • Benoliel R, Zini A, Zakuto A, Slutzky H, Haviv Y, Sharav Y et al. (2017) Subjective Sleep Quality in Temporomandibular Disorder Patients and Association with Disease Characteristics and Oral Health-Related Quality of Life. J ORAL FACIAL PAIN H, 31:313-322.
  • Brand HS, Dun SN, Nieuw Amerongen AV (2008) Ecstasy (MDMA) and oral health. Br Dent J, 204:77-81.
  • Calderon Pdos S, Tabaquim Mde L, Oliveira LC, Camargo AP, Ramos Netto Tde C, Conti PC (2011) Effectiveness of cognitive-behavioral therapy and amitriptyline in patients with chronic temporomandibular disorders: a pilot study. Braz Dent J, 22:415-421.
  • Camparis CM, Siqueira JT (2006) Sleep bruxism: clinical aspects and characteristics in patients with and without chronic orofacial pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101:188-193.
  • Canales GDLT, Guarda-Nardini L, Rizzatti-Barbosa CM, Conti PCR and Manfredini D (2019) Distribution of depression, somatization and pain-related impairment in patients with chronic temporomandibular disorders. J Appl Oral Sci, 27:e20180210-e20180210.
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Comorbid Psychiatric Disorders and Treatment Options in Temporomandibular Disorders and Bruxism

Yıl 2020, Cilt: 12 Sayı: 2, 205 - 231, 30.06.2020
https://doi.org/10.18863/pgy.570861

Öz

Temporomandibular disorder (TMD) is a
clinical condition affecting the masticatory muscles, the temporomandibular
joint (TMJ) and the structures surrounding this joint.Bruxism is a
parafunctional habit that occurs as a result of overloading of stomatognathic
structures with tooth squeezing and grinding, which is included in the etiology
of TMB.TMB is seen in approximately 10% of the population and bruxism is seen
in 8-20%. Many factors are effective in the etiology of TMD and bruxism, and
there are interactions between these factors. Biomechanical, neuromuscular,
biopsychosocial and neurobiological factors contribute to the disease. The
prevalence of psychiatric disorders is high in individuals with TMB and
bruxism. Many psychiatric disorders, especially depression and anxiety disorders,
accompany TMB and Bruxism. The antidepressants used in the treatment of these
disorders cause bruxism. This is one of the important challenges in the
treatment of TMB and bruxism.The first step in the treatment of TMB and bruxism
is to address the basic prevention methods. While amitriptyline use is prominent in
TMB pharmacotherapy, in bruxism, buspirone and clonazepam are two important
drugs used.The study of these drugs in small samples and the fact that the
available information is mostly based on case reports clearly shows the
necessity of further studies. The widespread use of cognitive behavioral
therapy in both disorders will be a solution and eliminate the side effects of
medication.Regardless of the treatment option, both dentists and psychiatrists
should be in a multidisciplinary working environment and should evaluate these
diseases within the framework of the biopsychosocial model.

Kaynakça

  • Aguilera SB, Brown L, Perico VA (2017) Aesthetic Treatment of Bruxism. J Clin Aesthet Dermatol, 10:49-55.
  • Amerikan Psikiyatri Birliği (2000) Psikiyatride Hastalıkların Tanımlanması ve Sınıflandırılması El Kitabı, Yeniden Gözden Geçirilmiş Dördüncü Baskı (DSM-IV TR) (Çeviri Ed. E Köroğlu). Ankara, Hekimler Yayın Birliği.
  • Amerikan Psikiyatri Birliği (2013) Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı, Beşinci Baskı (DSM-V) (Çeviri Ed. E Köroğlu) Ankara, Hekimler Yayın Birliği.
  • Bayar GR, Tutuncu R, Acikel C (2012) Psychopathological profile of patients with different forms of bruxism. Clin Oral Investig, 16:305-311.
  • Benoliel R, Zini A, Zakuto A, Slutzky H, Haviv Y, Sharav Y et al. (2017) Subjective Sleep Quality in Temporomandibular Disorder Patients and Association with Disease Characteristics and Oral Health-Related Quality of Life. J ORAL FACIAL PAIN H, 31:313-322.
  • Brand HS, Dun SN, Nieuw Amerongen AV (2008) Ecstasy (MDMA) and oral health. Br Dent J, 204:77-81.
  • Calderon Pdos S, Tabaquim Mde L, Oliveira LC, Camargo AP, Ramos Netto Tde C, Conti PC (2011) Effectiveness of cognitive-behavioral therapy and amitriptyline in patients with chronic temporomandibular disorders: a pilot study. Braz Dent J, 22:415-421.
  • Camparis CM, Siqueira JT (2006) Sleep bruxism: clinical aspects and characteristics in patients with and without chronic orofacial pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101:188-193.
  • Canales GDLT, Guarda-Nardini L, Rizzatti-Barbosa CM, Conti PCR and Manfredini D (2019) Distribution of depression, somatization and pain-related impairment in patients with chronic temporomandibular disorders. J Appl Oral Sci, 27:e20180210-e20180210.
  • Chang JP, Wu CC, Su KP (2011) A case of venlafaxine-induced bruxism alleviated by duloxetine substitution. Prog Neuropsychopharmacol Biol Psychiatry, 35:307.
  • Chikhani L, Dichamp J (2003) [Bruxism, temporo-mandibular dysfunction and botulinum toxin]. Ann Readapt Med Phys, 46:333-337.
  • Clark J, Nijs J, Yeowell G, Goodwin PC (2017) What Are the Predictors of Altered Central Pain Modulation in Chronic Musculoskeletal Pain Populations? A Systematic Review. Pain Physician, 20:487-500.
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  • Yap AU, Chua EK, Tan KB, Chan YH (2004) Relationships between depression/somatization and self-reports of pain and disability. J Orofac Pain, 18:220-225.
  • Yap AU, Dworkin SF, Chua EK, List T, Tan KB, Tan HH (2003) Prevalence of temporomandibular disorder subtypes, psychologic distress, and psychosocial dysfunction in Asian patients. J Orofac Pain, 17:21-28.
  • Yap AU, Tan KB, Chua EK, Tan HH (2002) Depression and somatization in patients with temporomandibular disorders. J Prosthet Dent, 88:479-484.
  • Yener M, Aynali G (2012) The treatment choices in temporomandibular disorders. SDU Journal of Health Science Institute, 3:150-154.
  • McNeill C (1997) Management of temporomandibular disorders: concepts and controversies. J Prosthet Dent, 77:510-522.
Toplam 103 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Psikiyatri
Bölüm Derleme
Yazarlar

Bahadır Geniş 0000-0001-8541-7670

Çiçek Hocaoğlu 0000-0001-6613-4317

Yayımlanma Tarihi 30 Haziran 2020
Kabul Tarihi 9 Temmuz 2019
Yayımlandığı Sayı Yıl 2020 Cilt: 12 Sayı: 2

Kaynak Göster

AMA Geniş B, Hocaoğlu Ç. Temporomandibular Bozukluklar ve Bruksizmde Eşlik Eden Psikiyatrik Bozukluklar ve Tedavi Seçenekleri. Psikiyatride Güncel Yaklaşımlar. Haziran 2020;12(2):205-231. doi:10.18863/pgy.570861

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