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Esta revisão integrativa analisa o desgaste e os efeitos biológicos associados ao uso de goteiras oclusais, com ênfase na sua utilização clínica em distúrbios temporomandibulares e bruxismo. Estas goteiras, geralmente utilizadas como dispositivos de proteção, relaxamento e estabilização oclusal, são fabricadas principalmente com polimetilmetacrilato, dada a sua disponibilidade, estabilidade dimensional e propriedades físicas favoráveis. São prescritas com o objetivo de promover o alívio de sintomas articulares e musculares, proteger os dentes de desgastes patológicos e estabilizar a oclusão em pacientes com hábitos parafuncionais. O desgaste funcional das goteiras ocorre naturalmente ao longo do tempo, influenciado pela intensidade das forças mastigatórias, frequência de uso e características individuais de cada paciente. A perda de volume e a alteração da superfície oclusal afetam diretamente a sua função clínica, podendo provocar desequilíbrios na oclusão, redução da eficácia terapêutica e necessidade de substituição precoce do dispositivo. Os efeitos biológicos decorrentes do uso prolongado das goteiras estão relacionados com a interação contínua entre o dispositivo e os tecidos orais. A libertação de monómeros residuais pode induzir alterações celulares, incluindo diminuição da viabilidade celular, aumento da apoptose e geração de espécies reativas de oxigénio. Estes efeitos contribuem para o estabelecimento de um ambiente inflamatório e de stress oxidativo, com possível impacto nos tecidos gengivais e mucosos. A resposta imune associada ao uso contínuo de goteiras pode manifestar-se de forma variável, dependendo de fatores como o tempo de exposição e características individuais dos tecidos orais . Observam-se alterações celulares compatíveis com mecanismos inflamatórios, sendo possível a ativação de vias imunológicas locais. Essas respostas podem ocorrer de forma subclínica ou com manifestações visíveis nos tecidos adjacentes, refletindo a complexidade da interação entre o material e o ambiente oral.
This integrative review analyzes the wear patterns and biological effects associated with the use of occlusal splints, with an emphasis on their clinical application in temporomandibular disorders and bruxism. These oral splints, commonly used for protection and occlusal stabilization, are also designed to promote muscular relaxation and are primarily manufactured from polymethyl methacrylate due to its wide availability. dimensional stability, and favorable physical properties. They are prescribed with the aim of relieving joint and muscular symptoms, protecting teeth from pathological wear, and stabilizing occlusion in patients with parafunctional habits. Functional wear of occlusal splints occurs naturally over time, influenced by the intensity of masticatory forces, frequency of use, and the individual characteristics of each patient. The loss of volume and alteration of the occlusal surface directly affect their clinical function, potentially causing occlusal imbalances, reduced therapeutic efficacy, and the need for early replacement of the device. The biological effects resulting from prolonged use of occlusal splints are related to the continuous interaction between the device and the oral tissues. The release of residual monomers may induce cellular changes, including decreased cell viability, increased apoptosis, and generation of reactive oxygen species. These effects contribute to the establishment of an inflammatory and oxidative stress environment, with possible impact on gingival and mucosal tissues. The immune response associated with continuous use of splints may vary depending on factors such as exposure time and individual characteristics of oral tissues. Cellular changes compatible with inflammatory mechanisms are observed, and the activation of local immunological pathways may occur. These responses may occur subclinically or with visible manifestations in the adjacent tissues, reflecting the complexity of the interaction between the material and the oral environment.
This integrative review analyzes the wear patterns and biological effects associated with the use of occlusal splints, with an emphasis on their clinical application in temporomandibular disorders and bruxism. These oral splints, commonly used for protection and occlusal stabilization, are also designed to promote muscular relaxation and are primarily manufactured from polymethyl methacrylate due to its wide availability. dimensional stability, and favorable physical properties. They are prescribed with the aim of relieving joint and muscular symptoms, protecting teeth from pathological wear, and stabilizing occlusion in patients with parafunctional habits. Functional wear of occlusal splints occurs naturally over time, influenced by the intensity of masticatory forces, frequency of use, and the individual characteristics of each patient. The loss of volume and alteration of the occlusal surface directly affect their clinical function, potentially causing occlusal imbalances, reduced therapeutic efficacy, and the need for early replacement of the device. The biological effects resulting from prolonged use of occlusal splints are related to the continuous interaction between the device and the oral tissues. The release of residual monomers may induce cellular changes, including decreased cell viability, increased apoptosis, and generation of reactive oxygen species. These effects contribute to the establishment of an inflammatory and oxidative stress environment, with possible impact on gingival and mucosal tissues. The immune response associated with continuous use of splints may vary depending on factors such as exposure time and individual characteristics of oral tissues. Cellular changes compatible with inflammatory mechanisms are observed, and the activation of local immunological pathways may occur. These responses may occur subclinically or with visible manifestations in the adjacent tissues, reflecting the complexity of the interaction between the material and the oral environment.
Descrição
Palavras-chave
Goteira oclusal Biocompatibilidade Toxicidade Desgaste PMMA Oral splints Biocompatibility Toxicity Wear