Протетички адјувантен клинички пристап на cephalea од орофацијално потекло

Abstract

Introduction׃ Cephalea from orofacial origin is manifested in patients who were diagnosed with the following etiological factors - traumatic occlusion, bruxism, and loss of occlusal support. Early diagnosis enables its milder manifestation and timely removal. Objective: Establishment of a prosthetic adjuvant clinical approach in patients with orofacial cephalea. Material and methods: In the doctoral thesis as materials were diagnosed, followed, analyzed and treated 120 patients divided into 2 groups׃ And that is: 60 patients divided by ethiological factors: – 20 patients with traumatic occlusion; – 20 patients with bruxism; – 20 patients with loss of occlusal support; and also a control group consisting of 60 patients without the presence of ethiological factors present in the subjects. The research was performed in the private polyclinic, Kavaja, Dental Rehabilitation Unit in Pristina, Kosovo and at the PHI University Dental Clinical Center “St. Panteleimon”, Dental Prosthetics Clinic, Skopje, Republic of North Macedonia. A questionnaire was prepared, with informed consent as well as Ethical committee consent was obtained, regarding subjective changes in patients. The diagnosis of traumatic occlusion based on the perception of inadequate prosthetic restorations, the causes of it, was made accurately. Bruxism was diagnosed in patients through clinical and paraclinical methods. The degree of loss of occlusal support was diagnosed. The Helkimo Index for dysfunctional changes was also applied through anamnestic questionnaires and clinical examinations. A therapeutic approach consisting of three stages was established: – first aid where patient’s education was applied, analgesics administered, solux lamp irradiation was used, injection of anesthetic into trigger points (masticatory muscles); – initial therapy consisting of pharmacotherapy, physiotherapy, psychotherapy and prosthetic therapy; – long-term therapy consisting of continuation of pharmacological therapy, preparation and use of anterior deprogrammers-butterfly deprogrammers, and if needed, preparation and application of stabilization splints. Results and Discussion: An individualized treatment plan was developed for the three groups of patients through the discovery of the etiological - consequential link for the occurrence of cephalea of orofacial origin. Patients were appropriately treated medically, followed by removal of the etiologic agent. Prosthetic restorations, butterfly deprogrammer and/or stabilization splints were made (except for the control group). This has led to overall success and rehabilitation of patients. Conclusion׃ This paper is expected to contribute with its applicative value, as it concerns a new prosthetic adjuvant clinical approach to cephalea from orofacial origin. With this the prostheticists and technicians will help the elimination of the pain of cephalea from orofacial orogin, preserving the longevity of the definitive prosthetic restorations, and improvement of the patients' quality of life.