Tinnitus after placing Bruxzir bridge.

I could use some quick help here as I've exhausted my resources here at home to no avail. I have a patient who came to me a year ago with a 3 unit PFM bridge 29-31 which had most of it's porcelain fractured off. I replaced the bridge with the same material, checked the occlusion and she was on her way. About 3-4 months later, I must have missed an interference since she sheared off some of the porcelain on the pontic.

I explained to her that she needed to help me protect her occlusion with an equilibration and night splint. She declined and told me if it breaks again, she won't hold me accountable. Because I didn't want to even be faced with that prospect, I decided to try a Brux-zir bridge, my first and only one. She returned a week later claiming that her bite felt off a bit and I adjusted it almost out of occlusion.

A couple weeks later, she returned complaining of moderate tinnitus preventing her from sleeping and generally just aggravating for her throughout the day. She states it's constant and not improving. It's been just over a month now since giving her a course of corticosteroids. She saw her GP and ENT who didn't find anything wrong and referred her back to me.

I don't know what else to do but to take the bridge off and put her back to the condition she was in when she didn't have the ringing. My concern is that she may have damaged her TMJ those first couple nights clenching on an unforgiving prosthesis. Can't believe it wouldn't have healed though by now.

Does anyone have any suggestions or comments? I'm concerned that taking the bridge off will do nothing.

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Permalink Reply by Jeff M. Roy on June 4, 2012 at 9:11pm

I never saw this, but I would think that taking the bridge off would've done nothing. It sounds like bruxism and the need for splint therapy. How does the story end? :-)