대한치과마취과학회지 (Journal of The Korean Dental Society of Anesthesiology)

  • 제10권1호
  • /
  • Pages.13-19
  • /
  • 2010
  • /
  • 1598-4044(pISSN)
  • /
  • 2383-7039(eISSN)
대한치과마취과학회 (The Korean Dental Society of Anesthsiology)
권호 표지

뇌손상 후 발생한 이갈이증과 근육긴장이상에 대한 보튤리눔 독소 A와 교합안정장치를 이용한 치료 증례 -증례 보고-

Bruxism and Oromandibular Dystonia after Brain Injury Treated with Botulinum Toxin A and Occlusal Appliance -A Case Report-

  • 김태완 (아주대학교 의과대학 치과학교실) ;
  • 백광우 (아주대학교 의과대학 치과학교실) ;
  • 송승일 (아주대학교 의과대학 치과학교실)
  • Kim, Tae-Wan (Department of Dentistry, School of Medicine, Ajou University) ;
  • Baek, Kwang-Woo (Department of Dentistry, School of Medicine, Ajou University) ;
  • Song, Seung-Il (Department of Dentistry, School of Medicine, Ajou University)
  • 투고 : 2010.03.25
  • 심사 : 2010.06.20
  • 발행 : 2010.06.27
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.

키워드

참고문헌

  1. Attanasio R: An overview of bruxism and its management. Review: Dent Clin North Am 1997; Apr;41(2): 229-41.
  2. Capp NJ: Occlusion and splint therapy. Br Dent J 1999; 186: 217-22.
  3. Clark GT, Koyano K, Browne PA: Oral motor disorders in humans. J Calif Dent Assoc 1993; 21(1): 19-30.
  4. Clark GT: The management of oromandibular motor disorders and facial spasms with injections of botu linum toxin. Phys Med Rehabil Clin N Am 2003; 14(4): 727-48. https://doi.org/10.1016/S1047-9651(03)00044-5
  5. Dolly O, O'Sullivan GA, Mohammed N: Feature influencing botulinum toxin-induced nerve sprouting and recovery from poisoning. International Conference 1999: Basic and therapeutic aspects of botulinum and tetanus toxins. Orlando FL Nov 1999: 20: 16-8.
  6. Glenn T, Saravanan R: Oral Motor Disorders: Bruxism, Dystonia, Dyskinesia and Drug-Induced Dystonic Extrapyramidal Reactions: Dent Clin N Am 2007; 51: 225-43. https://doi.org/10.1016/j.cden.2006.09.002
  7. Gui D, XAssetta E, Anastasio G, Bentivoglio AR, Maria G, Albanese A: Botulinum toxin for chronic anal fissure. Lancet 1994; 344: 1127-8. https://doi.org/10.1016/S0140-6736(94)90633-5
  8. Ivanhoe CB, Lai JM, Francisco GE: Bruxism after brain injury: successful treatment with botulinum toxin-A. Arch Phys Med Rehabil 1997 Nov; 78(11): 1272-3.
  9. Kato T, Thie NM, Montplaisir JY, et al: Bruxism and orofacial movements during sleep. Dent Clin North Am 2001; 45(4): 657-84.
  10. Klein AW. Contraindications and complications with the use of botulinum toxin. Clin Dermatol 2004; 22(1): 66-75. https://doi.org/10.1016/j.clindermatol.2003.12.026
  11. Major PW, Nebbe B: Use and effectiveness of splint appliance therapy: Review of literature. Cranio 1997; 15: 159-66. https://doi.org/10.1080/08869634.1997.11746007
  12. Pratap-Chand R, Gourie-Devi M: Bruxism: its significance in coma. Clin Neurol Neurosurg 1985; 87(2): 113-7. https://doi.org/10.1016/0303-8467(85)90107-6
  13. Winocur E, Gavish A, Volfin G, Halachmi M, Gazit E: Oral motor parafunctions among heavy drug addicts and their effects on signs and symptoms of temporomandibular disorders. J Orofac Pain 2001; 15(1): 56-63.