Bruksizmli hastalarda okluzal temas ve TME sesleri arasındaki ilişkinin değerlendirilmesi
Evaluation of Relationship Between Occlusal Pattern and TMJ Sounds on Patients with Bruxism Although temporomandibular joint sounds are considered to be the main physical symptoms of pathological conditions, they may also exist in healthy joints. Several authors mentioned that bruxism is a causative factor for temporomandibular joint disorders, but the data is insufficient. Similarly, the connection between bruxism and occlusion remains controversial. Some studies reported that mediotrusive tooth contacts provoke bruxism and are involved in generation of joint sounds. The aim of this study is to compare joint sounds of asymptomatic and bruxist patients with different types of occlusal relationships. Ninety patients (18-46 years old) with symptoms of bruxism participated in this study as the experimental group. Another 90 patients (18-43 years old) without symptoms of bruxism served as controls. Patients in each group were further subdivided into 4 groups as canine guidance (CG), group function (GG), canine guidance with mediotrusive contact (CG+MG) and group function with mediotrusive contact (GG+MG) due to their occlusal relationships identified by BruxChecker appliance. Joint sounds were recorded with JVA. TMJ vibration data were evaluated according to five parameters. These parameters were total integral (Ti), integral ratio (IR), peak amplitude (PA), peak frequency (PF) and median frequency (MF). The significance of variance between the groups were evaluated with Mann Whitney U test, while Wilcoxon sign test were used to determine the difference between right and left sides within the groups. According to the results of this study, Ti value of the control CG group, IR value of the control CG+MG group, IR value of the experimental GG+MG group, PA value of the control CG group and MF value of control GG and experimental GG+MG groups were found to be significantly higher on the right side comparing to left. Furthermore, in the experimental groups, PA values recorded were higher in left joint of patients with CG than those of CG+MG group, and also higher in both joints of CG+MG patients than those of GG+MG group. PF values were found statistically similar between the two side joints. Results obtained by all the patients were distributed in normal limits. The results of this research showed that there was no correlation between varying occlusal relationships and bruxism. For the most of the parameters, right joint showed higher sounds when compared to the left. Patients with bruxism and CG occlusion showed increased vibration in the presence of mediotrusive contacts. Considering the evaluation method, we may conclude that JVA technique may give reliable results in evaluating TMJ's of bruxist patients when it is used in combination with other methods.