Evaluación interdisciplinaria del sistema estomatognático y de la postura en un sujeto diagnosticado con bruxismo del sueño: Reporte de caso

Abstract

espanolIntroduccion: Segun la literatura cientificael bruxismo del sueno (BS) podria producir alteraciones musculares orofaciales, dentales, cefaleas temporales y alteraciones posturales. Objetivo: Evaluar interdisciplinariamente el sistema estomatognatico y la postura de un sujeto diagnosticado con bruxismo del sueno. (BS). Materiales y metodos: Estudio descriptivo de reporte de caso de un sujeto de sexo femenino con BS que se diagnostico mediante polisomnografia. Las relaciones inter-oclusales estaticas y dinamicas se analizaron mediante montaje de modelos en un articulador semi-ajustable. Se realizo evaluacion orofacial aplicando mioescanografia, dinamometria y electromiografia y, evaluacion de la alineacion postural y la estabilidad mediante el indice de Romberg y las presiones plantares con baropodometria. Resultados: En la polisomnografia se registraron 56 eventos de BS/hora, 86 micro-despertares, 11 hipopneas, una tasa cardiaca de 67 l/min y una oximetria de 95%. En la masticacion hubo actividad marcada en maseteros (Der: 330 uV Izq: 452 uV) y temporal (Der:418 uV, Izq:221uV) y asimetria en temporales de 34% y en orbiculares de 33%. Hubo disminucion de la fuerza contractil del masetero (0.3 lb) y compresiva del orbicular (2.0 lb). Se registro miositis en los musculos orofaciales y del cuello. Hubo compromiso postural del hemicuerpo izquierdo, estabilidad durante la posicion bipeda estatica con indice de Romberg de 0.99 y presion plantar mayor en el pie izquierdo de 68,5% que en el derecho de 31,5%. Conclusiones: En un caso de BS diagnosticado por polisomnografia hubo alteraciones del sistema estomatognatico a nivel dental, de ATM y muscular con alteraciones posturales y de la presion plantar. EnglishIntroduction: According to the scientific literature, sleep bruxism (SB) could produce orofacial muscle, dental, and temporary headaches as well as postural alterations. Objective: To evaluate the stomatognathic system and the posture of an individual diagnosed with sleep bruxism (SB) from an interdisciplinary approach. Materials and methods: Descriptive study of a case report of a female individual. The SB was determined by polysomnography. Static and dynamic inter-occlusal relationships were analyzed by assembling models in a semi-adjustable articulator. An orofacial evaluation was performed by applying myoscanoplasty, dynamometry, and electromyography, and an evaluation of postural alignment and stability was performed using the Romberg index and plantar pressures with baropodometry. Results: In the polysomnography, 132 minutes of MOR stage and 265 of NMOR, 56 events of SB / hour, 86 micro-awakenings, 11 hypopneas, a cardiac rate of 67 l / min, and an oximetry of 95% were recorded. In the mastication, there was activity marked in masseters (Right: 330 uV Left: 452 uV) and temporary Right: 418 uV and asymmetry of temporal (34%) and orbicular (33%). There was a decrease in the contractile force of the masseter (0.3 lb) and compressive force of the orbicular (2.0 lb). Myositis was registered in the orofacial and neck muscles. There was postural involvement of left hemibody, stability during static bipedal position with Romberg Index of 0.99, and greater plantar pressure in the left foot of 68.5% than in the right foot of 31.5.Conclusions: In a case of SB diagnosed by polysomnography, there were alterations of the stomatognathic system at the dental, TMJ, and muscular levels with postural alterations and plantar pressure.