{"id":63884,"date":"2024-09-04T03:01:10","date_gmt":"2024-09-04T10:01:10","guid":{"rendered":"https:\/\/www.chronobiology.com\/?p=63884"},"modified":"2024-09-04T03:01:10","modified_gmt":"2024-09-04T10:01:10","slug":"novy-vyskum-ukazuje-ze-zubne-prehliadky-by-mohli-byt-prvou-obrannou-liniou-proti-smrtelnym-porucham-spanku","status":"publish","type":"post","link":"https:\/\/dev.chronobiology.com\/sk\/novy-vyskum-ukazuje-ze-zubne-prehliadky-by-mohli-byt-prvou-obrannou-liniou-proti-smrtelnym-porucham-spanku\/","title":{"rendered":"Nov\u00fd v\u00fdskum ukazuje, \u017ee zubn\u00e9 prehliadky by mohli by\u0165 prvou obrannou l\u00edniou proti smrte\u013en\u00fdm poruch\u00e1m sp\u00e1nku"},"content":{"rendered":"

Pacient zasp\u00ed v zub\u00e1rskom kresle napriek strachu z nadch\u00e1dzaj\u00faceho z\u00e1kroku. Zdanlivo nen\u00e1padn\u00fd \u010din, ale pre zub\u00e1rov, ktor\u00ed poznaj\u00fa najnov\u0161ie v\u00fdskumy sp\u00e1nku, je to pr\u00edznak \u017eivot ohrozuj\u00faceho stavu. Vo v\u00fdskumnej spr\u00e1ve<\/a> uverejnenej v \u010dasopise Journal of the American Dental Association<\/em> vedci z Rutgers Health ozna\u010dili zub\u00e1rov za ne\u010dakan\u00fdch hr\u00e1\u010dov v boji proti \u017eivot ohrozuj\u00facim poruch\u00e1m sp\u00e1nku.<\/p>\n

Zo \u0161t\u00fadie vypl\u00fdva, \u017ee zubn\u00ed lek\u00e1ri maj\u00fa jedine\u010dn\u00e9 mo\u017enosti na vy\u0161etrenie ochoren\u00ed, ako je napr\u00edklad ob\u0161truk\u010dn\u00e9 sp\u00e1nkov\u00e9 apnoe, ktor\u00e9 postihuje mili\u00f3ny \u013eud\u00ed a je spojen\u00e9 s v\u00e1\u017enymi zdravotn\u00fdmi rizikami vr\u00e1tane kardiovaskul\u00e1rnych ochoren\u00ed<\/a> a neurodegener\u00e1cie. \u0160t\u00fadia tie\u017e vyz\u00fdva zub\u00e1rov, aby sa okrem zubov a \u010fasien zamerali aj na zdravie svojich pacientov.<\/p>\n

Ako m\u00f4\u017ee zubn\u00fd lek\u00e1r pom\u00f4c\u0165 rozpozna\u0165 pr\u00edznaky nebezpe\u010dn\u00fdch por\u00fach sp\u00e1nku<\/h2>\n

Pod\u013ea Davisa Thomasa, klinick\u00e9ho docenta na Rutgers School of Dental Medicine a hlavn\u00e9ho autora \u0161t\u00fadie, m\u00f4\u017eu by\u0165 zubn\u00ed lek\u00e1ri prvou obrannou l\u00edniou pri zis\u0165ovan\u00ed por\u00fach sp\u00e1nku. \u010casto rozpoznaj\u00fa pr\u00edznaky ove\u013ea sk\u00f4r ako lek\u00e1ri. Pr\u00edznaky, ako je \u0161kr\u00edpanie zubami, kr\u00fatenie jazykom alebo dokonca zasp\u00e1vanie pacienta v zub\u00e1rskom kresle, m\u00f4\u017eu by\u0165 v\u010dasn\u00fdmi indik\u00e1tormi, \u017ee ide o nie\u010do viac. Mnoho pr\u00edpadov ob\u0161truk\u010dn\u00e9ho sp\u00e1nkov\u00e9ho apnoe<\/a> zost\u00e1va nediagnostikovan\u00fdch, ale zubn\u00ed lek\u00e1ri m\u00f4\u017eu zohr\u00e1va\u0165 d\u00f4le\u017eit\u00fa \u00falohu pri zni\u017eovan\u00ed tohto po\u010dtu. Spr\u00e1va uv\u00e1dza nieko\u013eko k\u013e\u00fa\u010dov\u00fdch ukazovate\u013eov, na ktor\u00e9 by sa mali zub\u00e1ri po\u010das vy\u0161etrenia zamera\u0165, vr\u00e1tane zv\u00e4\u010d\u0161en\u00fdch \u010de\u013eustn\u00fdch svalov, vydut\u00fdch okrajov jazyka, bielych l\u00edni\u00ed na l\u00edcach, obmedzenej vidite\u013enosti hrdla, vzorcov opotrebovania zubov a drobn\u00fdch praskl\u00edn na zuboch. \"ap\"<\/a><\/p>\n

Tieto fyzick\u00e9 pr\u00edznaky v spojen\u00ed s anamn\u00e9zou pacienta a jednoduch\u00fdmi skr\u00edningov\u00fdmi n\u00e1strojmi m\u00f4\u017eu zubn\u00fdm lek\u00e1rom pom\u00f4c\u0165 identifikova\u0165 rizikov\u00fdch pacientov a\u017e s 80-percentnou presnos\u0165ou. \u010eal\u0161\u00edm znepokojuj\u00facim znakom je pod\u013ea autorov \u0161t\u00fadie bruxizmus, v\u0161eobecne zn\u00e1my ako \u0161kr\u00edpanie zubami. V rozpore s dlhoro\u010dn\u00fdmi predpokladmi \u0161t\u00fadie nazna\u010duj\u00fa, \u017ee \u0161kr\u00edpanie zubami je \u010dasto pr\u00edznakom z\u00e1kladn\u00fdch probl\u00e9mov so sp\u00e1nkom, a nie samostatn\u00fdm probl\u00e9mom sp\u00f4soben\u00fdm nespr\u00e1vne nastaven\u00fdmi zubami. Thomas tvrd\u00ed, \u017ee pochopen\u00edm neurovedeck\u00e9ho z\u00e1kladu por\u00fach sp\u00e1nku<\/a> je mo\u017en\u00e9 pon\u00faknu\u0165 komplexnej\u0161iu lie\u010dbu a potenci\u00e1lne pred\u00eds\u0165 v\u00e1\u017enym zdravotn\u00fdm komplik\u00e1ci\u00e1m. T\u00e1to zmena poh\u013eadu by mohla ma\u0165 \u010falekosiahle d\u00f4sledky.<\/p>\n

Identifikovan\u00edm pacientov ohrozen\u00fdch poruchami sp\u00e1nku m\u00f4\u017eu zubn\u00ed lek\u00e1ri v\u010das zasiahnu\u0165 a potenci\u00e1lne tak pred\u00eds\u0165 komplik\u00e1ci\u00e1m, ako je vysok\u00fd krvn\u00fd tlak, srdcov\u00e9 choroby a mozgov\u00e9 pr\u00edhody. Na realiz\u00e1ciu t\u00fdchto zisten\u00ed Thomas a jeho t\u00edm navrhuj\u00fa jednoduch\u00fd protokol pre zubn\u00e9 ordin\u00e1cie: Zahrn\u00fa\u0165 ot\u00e1zky t\u00fdkaj\u00face sa sp\u00e1nku do formul\u00e1rov lek\u00e1rskej anamn\u00e9zy.<\/p>\n

\u010eal\u0161ie odpor\u00fa\u010dania zah\u0155\u0148aj\u00fa \u0161kolenie zubn\u00e9ho person\u00e1lu na rozpozn\u00e1vanie fyzick\u00fdch pr\u00edznakov por\u00fach sp\u00e1nku a pou\u017e\u00edvanie validovan\u00fdch skr\u00edningov\u00fdch n\u00e1strojov, ako je dotazn\u00edk STOP BANG (chr\u00e1panie<\/a>, \u00fanava, pozorovan\u00e9 apnoe, krvn\u00fd tlak, index telesnej hmotnosti, vek, obvod krku, pohlavie), ktor\u00fd sl\u00fa\u017ei na skr\u00edning ob\u0161truk\u010dn\u00e9ho sp\u00e1nkov\u00e9ho apnoe, ako aj vytvorenie siete odpor\u00fa\u010dan\u00ed pre sp\u00e1nkov\u00fdch lek\u00e1rov. Thomas odpor\u00fa\u010da, aby zubn\u00ed lek\u00e1ri, ktor\u00ed chc\u00fa zavies\u0165 skr\u00edning sp\u00e1nku do svojej praxe, za\u010dali s \u010fal\u0161\u00edm vzdel\u00e1van\u00edm.<\/p>\n

Bruxizmus po\u010das sp\u00e1nku m\u00f4\u017ee po\u0161kodi\u0165 temporomandibul\u00e1rne k\u013aby<\/h2>\n

U\u017e predch\u00e1dzaj\u00faci v\u00fdskum uk\u00e1zal, ak\u00e9 nebezpe\u010dn\u00e9 je no\u010dn\u00e9 \u0161kr\u00edpanie zubami a zat\u00ednanie hornej a dolnej \u010de\u013euste. Sp\u00e1nkov\u00fd bruxizmus m\u00f4\u017ee ma\u0165 v skuto\u010dnosti mno\u017estvo zdravotn\u00fdch n\u00e1sledkov.
\nOt\u00e1zka, \u010di sp\u00e1nkov\u00fd bruxizmus s\u00favis\u00ed so vznikom alebo progresiou por\u00fach temporomandibul\u00e1rneho k\u013abu, je v zubnej vede kontroverzn\u00e1. \u0160t\u00fadia<\/a> na Univerzitnej klinike stomatol\u00f3gie na Lek\u00e1rskej univerzite vo Viedni zistila, \u017ee ur\u010dit\u00e9 tvary a polohy zubov m\u00f4\u017eu ur\u010dite vies\u0165 k probl\u00e9mom s TMJ v d\u00f4sledku bruxizmu.<\/p>\n

Pribli\u017ene 15 % popul\u00e1cie po\u010das sp\u00e1nku \u0161kr\u00edpe zubami. Tento probl\u00e9m je obzvl\u00e1\u0161\u0165 \u010dast\u00fd u mlad\u0161\u00edch \u013eud\u00ed. Predpoklad\u00e1 sa, \u017ee \u010dasto enormn\u00fd tlak vyv\u00edjan\u00fd na povrch zubov a \u010de\u013euste sp\u00f4sobuje r\u00f4zne zdravotn\u00e9 probl\u00e9my zubov a m\u00f4\u017ee vies\u0165 aj k bolestiam \u010de\u013eustn\u00fdch svalov a bolestiam hlavy. Vedci pod veden\u00edm Benedikta Sagla z Katedry stomatol\u00f3gie Lek\u00e1rskej univerzity vo Viedni sk\u00famali, \u010di bruxizmus po\u010das sp\u00e1nku<\/a> m\u00f4\u017ee ma\u0165 negat\u00edvny vplyv aj na \u0161trukt\u00fary temporomandibul\u00e1rneho k\u013abu. Ich v\u00fdskum je zalo\u017een\u00fd na te\u00f3rii, \u017ee ur\u010dit\u00e9 kombin\u00e1cie tvaru a polohy zubov po\u010das br\u00fasenia maj\u00fa vplyv na mechanick\u00e9 za\u0165a\u017eenie temporomandibul\u00e1rneho k\u013abu, a preto ich mo\u017eno pova\u017eova\u0165 za rizikov\u00fd faktor por\u00fach TMJ.<\/p>\n

Uhol sklonu a poloha zubov<\/h2>\n

\"fer\"<\/a>\u0160t\u00fadie sa uskuto\u010dnili s pou\u017eit\u00edm modern\u00e9ho po\u010d\u00edta\u010dov\u00e9ho modelu \u017euvacieho \u00fastrojenstva, ktor\u00fd zah\u0155\u0148a kostn\u00e9<\/a>, chrupavkov\u00e9 a svalov\u00e9 \u0161trukt\u00fary.
\nTak\u00e9to po\u010d\u00edta\u010dov\u00e9 modely sa m\u00f4\u017eu pou\u017ei\u0165 na sk\u00famanie v\u00fdskumn\u00fdch ot\u00e1zok, ke\u010f priame \u0161t\u00fadie na pacientoch nie s\u00fa z etick\u00fdch d\u00f4vodov mo\u017en\u00e9.
\nPredmetom \u0161t\u00fadie bola interakcia dvoch faktorov, ktor\u00e9 sa sp\u00e1jaj\u00fa pri fenom\u00e9ne bruxizmu. Prv\u00fdm faktorom je tvar postihnut\u00e9ho zuba, presnej\u0161ie uhol sklonu zubn\u00e9ho k\u00fdp\u0165a, ktor\u00fd prich\u00e1dza do kontaktu so svoj\u00edm n\u00e1protivkom po\u010das br\u00fasenia. Druh\u00fdm faktorom je miesto kontaktu zubu (takzvan\u00e1 opotrebov\u00e1van\u00e1 hrana) po\u010das dynamick\u00e9ho pohybu br\u00fasenia, ktor\u00e9 v\u00fdskumn\u00fd t\u00edm zoh\u013eadnil.<\/p>\n

V \u0161t\u00fadii sa simulovali \u00fa\u010dinky bo\u010dn\u00e9ho br\u00fasenia na prv\u00fd mol\u00e1r a \u0161pi\u010d\u00e1k so \u0161iestimi r\u00f4znymi sklonmi opotrebovanej fasety, \u010do viedlo k celkovo dvan\u00e1stim simulovan\u00fdm scen\u00e1rom. Pod\u013ea v\u00fdskumn\u00edkov v\u00fdsledky ukazuj\u00fa, \u017ee sklon aj poloha opotrebovan\u00fdch faziet maj\u00fa vplyv na silu mechanick\u00e9ho za\u0165a\u017eenia temporomandibul\u00e1rneho k\u013abu. Ako rozhoduj\u00faca sa v\u0161ak jav\u00ed strmos\u0165 br\u00fasnej hrany. \u010c\u00edm je zub plochej\u0161\u00ed, t\u00fdm je za\u0165a\u017eenie k\u013abu v\u00e4\u010d\u0161ie, a t\u00fdm aj riziko poruchy TMJ, zatia\u013e \u010do ak maj\u00fa zubn\u00e9 hrany zapojen\u00e9 do bruxizmu strm\u0161\u00ed uhol sklonu, vypo\u010d\u00edtan\u00e9 za\u0165a\u017eenie k\u013abu bolo ni\u017e\u0161ie aj pri rovnakej „sile br\u00fasenia“ (bruxing force). \u010eal\u0161\u00ed v\u00fdskum a klinick\u00e9 \u0161t\u00fadie teraz objasnia, \u010di sa tieto zistenia m\u00f4\u017eu zahrn\u00fa\u0165 do v\u00fdvoja terapeutick\u00fdch opatren\u00ed proti sp\u00e1nkov\u00e9mu bruxizmu.<\/p>\n","protected":false},"excerpt":{"rendered":"

Pacient zasp\u00ed v zub\u00e1rskom kresle napriek strachu z nadch\u00e1dzaj\u00faceho z\u00e1kroku. Zdanlivo nen\u00e1padn\u00fd \u010din, ale pre zub\u00e1rov, ktor\u00ed poznaj\u00fa najnov\u0161ie v\u00fdskumy sp\u00e1nku, je to pr\u00edznak \u017eivot ohrozuj\u00faceho stavu. Vo v\u00fdskumnej spr\u00e1ve uverejnenej v \u010dasopise Journal of the American Dental Association vedci z Rutgers Health ozna\u010dili zub\u00e1rov za ne\u010dakan\u00fdch hr\u00e1\u010dov v boji proti \u017eivot ohrozuj\u00facim poruch\u00e1m sp\u00e1nku. […]<\/p>\n","protected":false},"author":11,"featured_media":63833,"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":[517],"tags":[],"class_list":{"0":"post-63884","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-spanok","8":"entry"},"acf":[],"yoast_head":"\nNov\u00fd v\u00fdskum ukazuje, \u017ee zubn\u00e9 prehliadky by mohli by\u0165 prvou obrannou l\u00edniou proti smrte\u013en\u00fdm poruch\u00e1m sp\u00e1nku – Chronobiology.com<\/title>\n<meta name=\"description\" content=\"Vo v\u00fdskumnej spr\u00e1ve uverejnenej v \u010dasopise Journal of the American Dental Association v\u00fdskumn\u00edci z 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