{"id":63879,"date":"2024-09-04T02:22:04","date_gmt":"2024-09-04T09:22:04","guid":{"rendered":"https:\/\/www.chronobiology.com\/?p=63879"},"modified":"2024-09-04T02:22:04","modified_gmt":"2024-09-04T09:22:04","slug":"novy-vyzkum-ukazuje-ze-zubni-prohlidky-mohou-byt-prvni-obrannou-linii-proti-smrtelnym-porucham-spanku","status":"publish","type":"post","link":"https:\/\/dev.chronobiology.com\/cs\/novy-vyzkum-ukazuje-ze-zubni-prohlidky-mohou-byt-prvni-obrannou-linii-proti-smrtelnym-porucham-spanku\/","title":{"rendered":"Nov\u00fd v\u00fdzkum ukazuje, \u017ee zubn\u00ed prohl\u00eddky mohou b\u00fdt prvn\u00ed obrannou lini\u00ed proti smrteln\u00fdm poruch\u00e1m sp\u00e1nku"},"content":{"rendered":"

Pacient usne v zuba\u0159sk\u00e9m k\u0159esle navzdory strachu z nadch\u00e1zej\u00edc\u00edho z\u00e1kroku. Zd\u00e1nliv\u011b nen\u00e1padn\u00fd \u00fakon, ale pro zuba\u0159e, kte\u0159\u00ed jsou obezn\u00e1meni s nejnov\u011bj\u0161\u00edmi v\u00fdzkumy sp\u00e1nku, je to zn\u00e1mka \u017eivot ohro\u017euj\u00edc\u00edho stavu. Ve v\u00fdzkumn\u00e9 zpr\u00e1v\u011b<\/a> zve\u0159ejn\u011bn\u00e9 v \u010dasopise Journal of the American Dental Association<\/em> v\u011bdci z Rutgers Health ozna\u010dili zuba\u0159e za ne\u010dekan\u00e9 hr\u00e1\u010de v boji proti \u017eivot ohro\u017euj\u00edc\u00edm poruch\u00e1m sp\u00e1nku.<\/p>\n

Studie ukazuje, \u017ee zubn\u00ed l\u00e9ka\u0159i maj\u00ed jedine\u010dnou mo\u017enost vy\u0161et\u0159it stavy, jako je obstruk\u010dn\u00ed sp\u00e1nkov\u00e1 apnoe, kter\u00e1 postihuje miliony lid\u00ed a je spojena s v\u00e1\u017en\u00fdmi zdravotn\u00edmi riziky, v\u010detn\u011b kardiovaskul\u00e1rn\u00edch onemocn\u011bn\u00ed<\/a> a neurodegenerace. Studie tak\u00e9 nab\u00e1d\u00e1 zuba\u0159e, aby se zam\u011b\u0159ili nejen na zuby a d\u00e1sn\u011b, ale tak\u00e9 na zdrav\u00ed sv\u00fdch pacient\u016f.<\/p>\n

Jak m\u016f\u017ee zuba\u0159 pomoci rozpoznat p\u0159\u00edznaky nebezpe\u010dn\u00fdch poruch sp\u00e1nku<\/h2>\n

Podle Davise Thomase, klinick\u00e9ho docenta na Rutgers School of Dental Medicine a hlavn\u00edho autora studie, mohou b\u00fdt zuba\u0159i prvn\u00ed lini\u00ed obrany p\u0159i odhalov\u00e1n\u00ed poruch sp\u00e1nku. \u010casto rozpoznaj\u00ed p\u0159\u00edznaky mnohem d\u0159\u00edve ne\u017e l\u00e9ka\u0159i. P\u0159\u00edznaky, jako je sk\u0159\u00edp\u00e1n\u00ed zub\u016f, p\u0159evalov\u00e1n\u00ed jazyka nebo dokonce us\u00edn\u00e1n\u00ed pacienta v zuba\u0159sk\u00e9m k\u0159esle, mohou b\u00fdt v\u010dasn\u00fdmi ukazateli, \u017ee je ve h\u0159e n\u011bco v\u00edc. Mnoho p\u0159\u00edpad\u016f obstruk\u010dn\u00ed sp\u00e1nkov\u00e9 apnoe<\/a> z\u016fst\u00e1v\u00e1 nediagnostikov\u00e1no, ale zuba\u0159i mohou hr\u00e1t d\u016fle\u017eitou roli p\u0159i sni\u017eov\u00e1n\u00ed tohoto po\u010dtu. Zpr\u00e1va uv\u00e1d\u00ed n\u011bkolik kl\u00ed\u010dov\u00fdch ukazatel\u016f, na kter\u00e9 by se m\u011bli zuba\u0159i p\u0159i vy\u0161et\u0159en\u00ed zam\u011b\u0159it, v\u010detn\u011b zv\u011bt\u0161en\u00fdch \u010delistn\u00edch sval\u016f, vydut\u00fdch okraj\u016f jazyka, b\u00edl\u00fdch \u010dar na tv\u00e1\u0159\u00edch, omezen\u00e9 viditelnosti hrdla, vzor\u016f opot\u0159eben\u00ed zub\u016f a drobn\u00fdch prasklin na zubech. \"ap\"<\/a><\/p>\n

Tyto fyzick\u00e9 p\u0159\u00edznaky ve spojen\u00ed s anamn\u00e9zou pacienta a jednoduch\u00fdmi screeningov\u00fdmi n\u00e1stroji mohou zubn\u00edm l\u00e9ka\u0159\u016fm pomoci identifikovat rizikov\u00e9 pacienty a\u017e s 80procentn\u00ed p\u0159esnost\u00ed. Dal\u0161\u00edm znepokojuj\u00edc\u00edm p\u0159\u00edznakem je podle autor\u016f studie bruxismus, obecn\u011b zn\u00e1m\u00fd jako sk\u0159\u00edp\u00e1n\u00ed zuby. Na rozd\u00edl od dlouholet\u00fdch p\u0159edpoklad\u016f studie nazna\u010duj\u00ed, \u017ee sk\u0159\u00edp\u00e1n\u00ed zub\u016f je \u010dasto p\u0159\u00edznakem z\u00e1kladn\u00edch probl\u00e9m\u016f se sp\u00e1nkem, a nikoli samostatn\u00fdm probl\u00e9mem zp\u016fsoben\u00fdm \u0161patn\u011b se\u0159\u00edzen\u00fdmi zuby.<\/p>\n

Thomas \u0159\u00edk\u00e1, \u017ee d\u00edky pochopen\u00ed neurobiologick\u00e9ho z\u00e1kladu poruch sp\u00e1nku<\/a> je mo\u017en\u00e9 nab\u00eddnout komplexn\u011bj\u0161\u00ed l\u00e9\u010dbu a potenci\u00e1ln\u011b p\u0159edch\u00e1zet z\u00e1va\u017en\u00fdm zdravotn\u00edm komplikac\u00edm. Tato zm\u011bna pohledu by mohla m\u00edt dalekos\u00e1hl\u00e9 d\u016fsledky. D\u00edky identifikaci pacient\u016f ohro\u017een\u00fdch poruchami sp\u00e1nku mohou zuba\u0159i v\u010das zas\u00e1hnout a potenci\u00e1ln\u011b tak p\u0159edej\u00edt komplikac\u00edm, jako je vysok\u00fd krevn\u00ed tlak, srde\u010dn\u00ed choroby a mrtvice. Thomas a jeho t\u00fdm navrhuj\u00ed jednoduch\u00fd protokol pro zubn\u00ed ordinace: Za\u0159adit ot\u00e1zky t\u00fdkaj\u00edc\u00ed se sp\u00e1nku do formul\u00e1\u0159\u016f l\u00e9ka\u0159sk\u00e9 anamn\u00e9zy.<\/p>\n

Dal\u0161\u00ed doporu\u010den\u00ed zahrnuj\u00ed \u0161kolen\u00ed zubn\u00edho person\u00e1lu v rozpozn\u00e1v\u00e1n\u00ed fyzick\u00fdch p\u0159\u00edznak\u016f poruch sp\u00e1nku a pou\u017e\u00edv\u00e1n\u00ed validovan\u00fdch screeningov\u00fdch n\u00e1stroj\u016f, jako je dotazn\u00edk STOP-BANG (chr\u00e1p\u00e1n\u00ed<\/a>, \u00fanava, pozorovan\u00e1 apnoe, krevn\u00ed tlak, index t\u011blesn\u00e9 hmotnosti, v\u011bk, obvod krku, pohlav\u00ed)<\/a>, kter\u00fd slou\u017e\u00ed ke screeningu obstruk\u010dn\u00ed sp\u00e1nkov\u00e9 apnoe, a tak\u00e9 vytvo\u0159en\u00ed s\u00edt\u011b doporu\u010den\u00ed u sp\u00e1nkov\u00fdch l\u00e9ka\u0159\u016f. Thomas doporu\u010duje, aby zubn\u00ed l\u00e9ka\u0159i, kte\u0159\u00ed cht\u011bj\u00ed zav\u00e9st screening sp\u00e1nku do sv\u00e9 praxe, za\u010dali s dal\u0161\u00edm vzd\u011bl\u00e1v\u00e1n\u00edm.<\/p>\n

Bruxismus ve sp\u00e1nku m\u016f\u017ee po\u0161kodit \u010delistn\u00ed klouby<\/h2>\n

Ji\u017e p\u0159edchoz\u00ed v\u00fdzkumy uk\u00e1zaly, jak nebezpe\u010dn\u00e9 je no\u010dn\u00ed sk\u0159\u00edp\u00e1n\u00ed zub\u016f a zat\u00edn\u00e1n\u00ed horn\u00ed a doln\u00ed \u010delisti. Sp\u00e1nkov\u00fd bruxismus toti\u017e m\u016f\u017ee m\u00edt \u0159adu zdravotn\u00edch n\u00e1sledk\u016f. Ot\u00e1zka, zda sp\u00e1nkov\u00fd bruxismus souvis\u00ed se vznikem nebo progres\u00ed poruch temporomandibul\u00e1rn\u00edho kloubu, je ve stomatologick\u00e9 v\u011bd\u011b kontroverzn\u00ed. Studie<\/a> Univerzitn\u00ed stomatologick\u00e9 kliniky L\u00e9ka\u0159sk\u00e9 univerzity ve V\u00eddni zjistila, \u017ee ur\u010dit\u00e9 tvary a polohy zub\u016f mohou zcela jist\u011b v\u00e9st k probl\u00e9m\u016fm s TMJ v d\u016fsledku bruxismu.<\/p>\n

P\u0159ibli\u017en\u011b 15 % populace sk\u0159\u00edpe zuby b\u011bhem sp\u00e1nku. Tento probl\u00e9m je \u010dast\u00fd zejm\u00e9na u mlad\u0161\u00edch lid\u00ed. P\u0159edpokl\u00e1d\u00e1 se, \u017ee \u010dasto enormn\u00ed tlak vyv\u00edjen\u00fd na povrch zub\u016f a \u010delist zp\u016fsobuje r\u016fzn\u00e9 zdravotn\u00ed probl\u00e9my zub\u016f a m\u016f\u017ee tak\u00e9 v\u00e9st k bolestem \u010delistn\u00edch sval\u016f a bolestem hlavy. V\u011bdci pod veden\u00edm Benedikta Sagla z katedry stomatologie L\u00e9ka\u0159sk\u00e9 univerzity ve V\u00eddni zkoumali, zda bruxismus b\u011bhem sp\u00e1nku<\/a> m\u016f\u017ee m\u00edt negativn\u00ed vliv tak\u00e9 na struktury temporomandibul\u00e1rn\u00edho kloubu. Jejich v\u00fdzkum vych\u00e1z\u00ed z teorie, \u017ee ur\u010dit\u00e9 kombinace tvaru a polohy zub\u016f p\u0159i sk\u0159\u00edp\u00e1n\u00ed maj\u00ed vliv na mechanick\u00e9 nam\u00e1h\u00e1n\u00ed temporomandibul\u00e1rn\u00edho kloubu, a lze je proto pova\u017eovat za rizikov\u00fd faktor poruch \u010delistn\u00edho kloubu.<\/p>\n

\u00dahel sklonu a poloha zub\u016f<\/h2>\n

\"fer\"<\/a>Studie byly provedeny na modern\u00edm po\u010d\u00edta\u010dov\u00e9m modelu \u017ev\u00fdkac\u00ed oblasti, kter\u00fd zahrnuje kostn\u00ed<\/a>, chrupav\u010dit\u00e9 a svalov\u00e9 struktury. Takov\u00e9 po\u010d\u00edta\u010dov\u00e9 modely lze pou\u017e\u00edt ke zkoum\u00e1n\u00ed v\u00fdzkumn\u00fdch ot\u00e1zek v p\u0159\u00edpadech, kdy p\u0159\u00edm\u00e9 studie na pacientech nejsou z etick\u00fdch d\u016fvod\u016f mo\u017en\u00e9. P\u0159edm\u011btem studie byla interakce dvou faktor\u016f, kter\u00e9 se spojuj\u00ed p\u0159i fenom\u00e9nu bruxismu. Prvn\u00edm faktorem je tvar posti\u017een\u00e9ho zubu, p\u0159esn\u011bji \u00fahel sklonu zubn\u00edho t\u0159en\u011b, kter\u00fd se p\u0159i sk\u0159\u00edp\u00e1n\u00ed dost\u00e1v\u00e1 do kontaktu se sv\u00fdm prot\u011bj\u0161kem. Druh\u00fdm faktorem je m\u00edsto kontaktu zubu (tzv. wear facet) p\u0159i dynamick\u00e9m brusn\u00e9m pohybu, kter\u00e9 v\u00fdzkumn\u00fd t\u00fdm zohlednil.<\/p>\n

Studie simulovala \u00fa\u010dinky later\u00e1ln\u00edho brou\u0161en\u00ed na prvn\u00ed stoli\u010dku a \u0161pi\u010d\u00e1k se \u0161esti r\u016fzn\u00fdmi sklony opot\u0159ebov\u00e1vac\u00ed fasety, co\u017e vedlo k celkem dvan\u00e1cti simulovan\u00fdm sc\u00e9n\u00e1\u0159\u016fm. Podle v\u00fdzkumn\u00edk\u016f v\u00fdsledky ukazuj\u00ed, \u017ee sklon i poloha opot\u0159ebov\u00e1vac\u00edch faset maj\u00ed vliv na s\u00edlu mechanick\u00e9ho zat\u00ed\u017een\u00ed temporomandibul\u00e1rn\u00edho kloubu. Jako rozhoduj\u00edc\u00ed se v\u0161ak jev\u00ed strmost obrusn\u00e9 hrany. \u010c\u00edm plo\u0161\u0161\u00ed je zub, t\u00edm vy\u0161\u0161\u00ed je zat\u00ed\u017een\u00ed kloubu, a t\u00edm i riziko poruchy TMJ, zat\u00edmco pokud maj\u00ed zubn\u00ed hrany zapojen\u00e9 do bruxismu strm\u011bj\u0161\u00ed \u00fahel sklonu, bylo vypo\u010dten\u00e9 zat\u00ed\u017een\u00ed kloubu ni\u017e\u0161\u00ed i p\u0159i stejn\u00e9 „brusn\u00e9 s\u00edle“ (bruxing force). Dal\u0161\u00ed v\u00fdzkum a klinick\u00e9 studie nyn\u00ed objasn\u00ed, zda lze tyto poznatky zahrnout do v\u00fdvoje terapeutick\u00fdch opat\u0159en\u00ed proti sp\u00e1nkov\u00e9mu bruxismu.<\/p>\n","protected":false},"excerpt":{"rendered":"

Pacient usne v zuba\u0159sk\u00e9m k\u0159esle navzdory strachu z nadch\u00e1zej\u00edc\u00edho z\u00e1kroku. Zd\u00e1nliv\u011b nen\u00e1padn\u00fd \u00fakon, ale pro zuba\u0159e, kte\u0159\u00ed jsou obezn\u00e1meni s nejnov\u011bj\u0161\u00edmi v\u00fdzkumy sp\u00e1nku, je to zn\u00e1mka \u017eivot ohro\u017euj\u00edc\u00edho stavu. Ve v\u00fdzkumn\u00e9 zpr\u00e1v\u011b zve\u0159ejn\u011bn\u00e9 v \u010dasopise Journal of the American Dental Association v\u011bdci z Rutgers Health ozna\u010dili zuba\u0159e za ne\u010dekan\u00e9 hr\u00e1\u010de v boji proti \u017eivot ohro\u017euj\u00edc\u00edm […]<\/p>\n","protected":false},"author":11,"featured_media":63822,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[371],"tags":[],"class_list":{"0":"post-63879","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-spanek","8":"entry"},"acf":[],"yoast_head":"\nNov\u00fd v\u00fdzkum ukazuje, \u017ee zubn\u00ed prohl\u00eddky mohou b\u00fdt 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