ORTHOPEDIC TREATMENT PLANNING IN PATIENTS WITH BRUXISM: MATERIAL SELECTION, OCCLUSAL SPLINTS, AND LONG-TERM MAINTENANCE OF RESTORATIONS

Abstract

Bruxism is a parafunctional oral habit characterized by involuntary clenching and grinding of the teeth, which leads to excessive occlusal loading and accelerated wear or failure of dental restorations. It presents a significant challenge in prosthodontic and orthopedic treatment planning due to the increased risk of fracture, material fatigue, and occlusal instability.

Successful management requires a comprehensive approach that focuses on controlling occlusal forces, selecting high-strength restorative materials, and ensuring long-term protection of both natural teeth and prosthetic constructions. In bruxism patients, durable materials such as monolithic zirconia and high-noble metal alloys are preferred, especially in posterior regions subjected to heavy functional stress, while glass-ceramic materials should be used cautiously and mainly in low-load aesthetic zones.

Occlusal splint therapy, particularly the hard acrylic stabilization splint (Michigan splint), plays a central role in reducing parafunctional activity, redistributing occlusal forces, and protecting restorations from overload. Proper occlusal adjustment and regular monitoring of splint wear are essential for maintaining therapeutic effectiveness. Long-term success also depends on well-designed occlusal schemes that minimize interferences, provide balanced contacts, and reduce horizontal stress. Regular follow-up examinations are necessary to evaluate restoration integrity, occlusal changes, and splint condition, allowing timely adjustments or repairs.In conclusion, the long-term prognosis of orthopedic treatment in bruxism patients is determined not only by material selection but also by occlusal management, splint therapy, and continuous maintenance protocols.