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Bipolar Hastalarda Bruksizmin Ağız Sağlığı ve Temporomandibular Eklem Disfonksiyonuna Etkisi

Year 2024, Volume: 6 Issue: 1, 140 - 149, 25.04.2024
https://doi.org/10.46413/boneyusbad.1411557

Abstract

Amaç: Bu çalışmanın amacı bipolar hastalarda ağız sağlığı problemlerini ve temporomandibular eklem disfonksiyonunu (TMD) araştırmak ve bruksizm varlığının TMD üzerine etkisini incelemektir.
Gereç ve Yöntem: Kesitsel tipte olan çalışmamız Eylül-Aralık 2023 tarihleri arasında İstanbul’da bir eğitim araştırma hastanesinin ayaktan tedavi ünitelerinde yürütüldü. Katılımcıların ağız ve diş sağlığına ilişkin yaşam kalitesi Ağız Sağlığı Etki Profili-14 (OHIP-14) ile, TMD şiddeti Fonseca Anamnestik Anketi (FAA) ile ve çiğneme fonksiyonelliği Çenenin Fonksiyon Kısıtlanma Skalası-8 (ÇFKS-8) ile değerlendirildi.
Bulgular: Çalışmamıza 40 bipolar hasta dahil edildi. Katılımcılar olası bruksizm varlığına göre bruksizmi olan (Grup 1=25) ve bruksizmi olmayan (Grup 2=15) şeklinde iki gruba ayırıldı. Çalışmaya alınan bireylerin %57.5’inde TMD olduğu görüldü. İki grup arasında ölçek puanları karşılaştırıldığında OHIP-14 (p=0.001), ÇFKS-8 (p=0.000) ve FAA (p=0.000) puanları ile TMD varlığı (p=0.003) bruksizmli bireylerin oluşturduğu grupta anlamlı derecede yüksekti. TMD’ye sahip olma olasılığının bruksizm varlığında istatistiksel olarak anlamlı şekilde 9.669 kat arttığı görüldü (p=0.005).
Sonuç: Çalışmamızın sonuçları bipolar hastalarda ağız sağlığının olumsuz etkilendiğini, TMD görülme durumunun yüksek olduğunu ve bruksizm varlığının TMD üzerinde etkili olduğunu göstermiştir. Bu nedenle bipolar hastalarda ağız sağlığı değerlendirilirken, TMD ve eşlik edebilecek bruksizm varlığının da değerlendirilmesi yaşam kalitesini artırma açısından önemli olabilir.

References

  • American Society of Temporomandibular Joint Surgeons (2003). Guidelines for diagnosis and management of disorders involving the temporomandibular joint and related musculoskeletal structures. Cranio: The Journal of Craniomandibular Practice, 21(1), 68–76.
  • Beddis, H. P., Davies, S. J. (2023). Relationships between tooth wear, bruxism and temporomandibular disorders. British dental journal, 234(6), 422–426. doi: 10.1038/s41415-023-5584-4
  • Blanco Aguilera, A., Gonzalez Lopez, L., Blanco Aguilera, E., De la Hoz Aizpurua, J. L., Rodriguez Torronteras, A., Segura Saint-Gerons, R., Blanco Hungría, A. (2014). Relationship between self-reported sleep bruxism and pain in patients with temporomandibular disorders. Journal of Oral Rehabilitation, 41(8), 564–572. doi: 10.1111/joor.12172
  • Câmara-Souza, M. B., Bracci, A., Colonna, A., Ferrari, M., Rodrigues Garcia, R. C. M., Manfredini, D. (2023). Ecological Momentary Assessment of Awake Bruxism Frequency in Patients with Different Temporomandibular Disorders. Journal of Clinical Medicine, 12(2), 501. doi: 10.3390/jcm12020501
  • Collins, P. Y., Patel, V., Joestl, S. S., March, D., Insel, T. R., Daar, A. S., …, Stein, D. J. (2011). Grand challenges in global mental health. Nature, 475(7354), 27–30. doi: 10.1038/475027a
  • Ekman, A., Rousu, J., Näpänkangas, R., Kuoppala, R., Raustia, A., & Sipilä, K. (2023). Association of self-reported bruxism with temporomandibular disorders- Northern Finland Birth Cohort (NFBC) 1966 study. Cranio: The Journal of Craniomandibular Practice, 41(3), 212–217. doi: 10.1080/08869634.2020.1853306
  • Fernandes, G., Franco, A. L., Siqueira, J. T., Gonçalves, D. A., Camparis, C. M. (2012). Sleep bruxism increases the risk for painful temporomandibular disorder, depression and non-specific physical symptoms. Journal of Oral Rehabilitation, 39(7), 538–544. doi: 10.1111/j.1365-2842.2012.02308.x
  • Friedlander, A. H., & Birch, N. J. (1990). Dental conditions in patients with bipolar disorder on long-term lithium maintenance therapy. Special care in dentistry: official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 10(5), 148–151. doi: 10.1111/j.1754-4505.1990.tb00782.x
  • Friedlander, A. H., Friedlander, I. K., Marder, S. R. (2002). Bipolar I disorder: psychopathology, medical management and dental implications. Journal of the American Dental Association (1939), 133(9), 1209–1217. doi: 10.14219/jada.archive.2002.0362
  • Grunze, H., Vieta, E., Goodwin, G. M., Bowden, C., Licht, R. W., Möller, H. J., …, WFSBP Task Force on Treatment Guidelines for Bipolar Disorders (2013). The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder. The world journal of biological psychiatry: the official journal of the World Federation of Societies of Biological Psychiatry, 14(3), 154–219. doi: 10.3109/15622975.2013.770551
  • Gurbuz Oflezer, O., Altinbas, K., Delice, M., Oflezer, C., Kurt, E. (2018). Oral Health among Patients with Bipolar Disorder. Oral Health & Preventive Dentistry, 16(6), 509–516. doi: 10.3290/j.ohpd.a41662
  • Hamilton M. The Hamilton Rating Scale for Depression. In: Assessment of Depression [Internet]. Berlin, Heidelberg: Springer Berlin Heidelberg; 1986 [cited 2019 Jul 1]. p. 143– 52. Available from: http://www.springerlink.com/index/10.1007/978-3-642-70486-4_14.
  • Hanna, K., Nair, R., Amarasena, N., Armfield, J. M., Brennan, D. S. (2021). Temporomandibular dysfunction experience is associated with oral health-related quality of life: an Australian national study. BMC Oral Health, 21(1), 432. doi: 10.1186/s12903-021-01773-z
  • Huhtela, O. S., Näpänkangas, R., Joensuu, T., Raustia, A., Kunttu, K., Sipilä, K. (2016). Self-Reported Bruxism and Symptoms of Temporomandibular Disorders in Finnish University Students. Journal of Oral & Facial Pain and Headache, 30(4), 311–317. doi: 10.11607/ofph.1674
  • J. Griffiths, V. Jones, I. Leeman, D. Lewis, K. Patel, K. Wilson, R. Blankenstein. (2000). Oral health care for people with mental health problems guidelines and recommendations. British Society for Disability and Oral Health. Jan:2-20.
  • Jiménez-Silva, A., Peña-Durán, C., Tobar-Reyes, J., Frugone-Zambra, R. (2017). Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: A systematic review from 2003 to 2014. Acta Odontologica Scandinavica, 75(1), 36–58. doi:10.1080/00016357.2016.1247465
  • Kaynak, B. A., Taş, S, Salkın, Y. (2020). ‘The accuracy and reliability of the Turkish version of the Fonseca anamnestic index in temporomandibular disorders’, Cranio®, 1-6. doi:10.1080/08869 634.2020.1812808.
  • Leketas, M., Šaferis, V., Kubilius, R., Cervino, G., Bramanti, E., Cicciù, M. (2017). Oral Behaviors and Parafunctions: Comparison of Temporomandibular Dysfunction Patients and Controls Journal of Craniofacial Surgery, 28(8), 1933–1938. doi:10.1097/scs.0000000000003945
  • Lobbezoo, F., Ahlberg, J., Glaros, A. G., Kato, T., Koyano, K., Lavigne, G. J., …, Winocur, E. (2013). Bruxism defined and graded: an international consensus. Journal of Oral Rehabilitation, 40(1), 2–4. doi: 10.1111/joor.12011
  • Lobbezoo, F., Ahlberg, J., Raphael, K. G., Wetselaar, P., Glaros, A. G., Kato, T., Santiago, V., …, Manfredini, D. (2018). International consensus on the assessment of bruxism: Report of a work in progress. Journal of Oral Rehabilitation, 45(11), 837–844. doi: 10.1111/joor.12663
  • Manfredini, D., Lobbezoo, F. (2010). Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 109(6), e26–e50. doi: 10.1016/j.tripleo.2010.02.013
  • McEvoy, G. K. AHFS drug information 2002. Bethesda, Md.: American Society of Health-System Pharmacists. Mumcu, G., İnanç, N., Ergun, T., İkiz, K., Güneş, M., İşlek, U., …, Direskeneli H. (2006). Oral health related quality of life is affected by disease activity in Behçet’s disease. Oral Disease, 12:145-151.
  • Nykänen, L., Manfredini, D., Lobbezoo, F., Kämppi, A., Bracci, A., Ahlberg, J. (2023). Assessment of awake bruxism by a novel bruxism screener and ecological momentary assessment among patients with masticatory muscle myalgia and healthy controls. Journal of Oral Rehabilitation. Advance online publication. doi: 10.1111/joor.13462
  • Ohrbach, R., Larsson, P., List, T. (2008). The jaw functional limitation scale: Development, reliability, and validity of 8-item and 20-item versions. J Orofac Pain. (22): 219- 230.
  • Ramon, T., Grinshpoon, A., Zusman, S. P., Weizman, A. (2003). Oral health and treatment needs of institutionalized chronic psychiatric patients in Israel. European psychiatry: the journal of the Association of European Psychiatrists, 18(3), 101–105. doi: 10.1016/s0924-9338(03)00023-3
  • Rofes, L., Arreola, V., Almiral, J., Cabré, M., Campins, L., García-Peris, P., ..., Clavé, P. (2011). Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterology Research and Practice. 2011(1): 13.
  • Slade G. D. (1997). Derivation and validation of a short-form oral health impact profile. Community Dentistry and Oral Epidemiology, 25(4), 284–290. doi: 10.1111/j.1600-0528.1997.tb00941.x
  • Tritsaris, K., Gromada, J., Jørgensen, T. D., Nauntofte, B., Dissing, S. (2001). Reduction in the rate of inositol 1,4,5-trisphosphate synthesis in rat parotid acini by lithium. Archives of Oral Biology, 46(4), 365–373. doi: 10.1016/s0003-9969(00)00109-6
  • Vieta, E., Berk, M., Schulze, T. G., Carvalho, A. F., Suppes, T., Calabrese, J. R., …, Grande, I. (2018). Bipolar Disorders. Nature Reviews. Disease Primers, 4, 18008. doi: 10.1038/nrdp.2018.8
  • Wınkler, S. Dalkowskı, K. Maır, J. Klebe, S. Paulsen, F. Böckers, T. M. Waschke, J. (2015). Sobotta Lehrbuch Anatomie, Berlin, Elsevier, 1.Baskı
  • Yap, A. U., Zhang, M. J., Lei, J., Fu, K. Y. (2021). Accuracy of the Fonseca Anamnestic Index for identifying pain-related and/or intra-articular Temporomandibular Disorders. Cranio: The Journal of Craniomandibular Practice, 1–8. Advance online publication. doi: 10.1080/08869634.2021.1954375
  • Young, R. C., Biggs, J. T., Ziegler, V. E., Meyer, D. A. (1978). A rating scale for mania: reliability, validity and sensitivity. The British Journal of Psychiatry: The Journal of Mental Science, 133, 429–435. doi: 10.1192/bjp.133.5.429

The Effect of Bruxism on Oral Health and Temporomandibular Joint Dysfunction in Bipolar Patients

Year 2024, Volume: 6 Issue: 1, 140 - 149, 25.04.2024
https://doi.org/10.46413/boneyusbad.1411557

Abstract

Aim: This study aimed to investigate oral health problems and temporomandibular joint dysfunction (TMD) in bipolar patients and to examine the effect of the presence of bruxism on TMD.
Material and Method: This cross-sectional study was conducted between September and December 2023 at the outpatient clinics of a training and research hospital in Istanbul. Participants' oral and dental health-related quality of life was assessed using the Oral Health Impact Profile-14 (OHIP-14), TMD severity using the Fonseca Anamnestic Questionnaire (FAQ), and chewing functionality using the Jaw Functional Limitation Scale-8 (JFLS-8).
Results: Forty bipolar patients were included in our study. According to the possible presence of bruxism, participants were divided into two groups: bruxism (Group 1=25) and non-bruxism (Group 2=15). 57.5% of the participants had TMD. The OHIP-14 (p=0.001), JFLS-8 (p=0.000), and FAQ (p=0.000) scores and the presence of TMD (p=0.003) were significantly higher in the group with bruxism. It was found that the odds of having TMD increased by 9.669 times with bruxism (p=0.005).
Conclusion: This study showed that oral health was affected in bipolar patients, the incidence of TMD was high, and the presence of bruxism had an impact on TMD. Therefore, when assessing oral health in bipolar patients, it may be essential to determine the presence of TMD and associated bruxism to improve quality of life.

References

  • American Society of Temporomandibular Joint Surgeons (2003). Guidelines for diagnosis and management of disorders involving the temporomandibular joint and related musculoskeletal structures. Cranio: The Journal of Craniomandibular Practice, 21(1), 68–76.
  • Beddis, H. P., Davies, S. J. (2023). Relationships between tooth wear, bruxism and temporomandibular disorders. British dental journal, 234(6), 422–426. doi: 10.1038/s41415-023-5584-4
  • Blanco Aguilera, A., Gonzalez Lopez, L., Blanco Aguilera, E., De la Hoz Aizpurua, J. L., Rodriguez Torronteras, A., Segura Saint-Gerons, R., Blanco Hungría, A. (2014). Relationship between self-reported sleep bruxism and pain in patients with temporomandibular disorders. Journal of Oral Rehabilitation, 41(8), 564–572. doi: 10.1111/joor.12172
  • Câmara-Souza, M. B., Bracci, A., Colonna, A., Ferrari, M., Rodrigues Garcia, R. C. M., Manfredini, D. (2023). Ecological Momentary Assessment of Awake Bruxism Frequency in Patients with Different Temporomandibular Disorders. Journal of Clinical Medicine, 12(2), 501. doi: 10.3390/jcm12020501
  • Collins, P. Y., Patel, V., Joestl, S. S., March, D., Insel, T. R., Daar, A. S., …, Stein, D. J. (2011). Grand challenges in global mental health. Nature, 475(7354), 27–30. doi: 10.1038/475027a
  • Ekman, A., Rousu, J., Näpänkangas, R., Kuoppala, R., Raustia, A., & Sipilä, K. (2023). Association of self-reported bruxism with temporomandibular disorders- Northern Finland Birth Cohort (NFBC) 1966 study. Cranio: The Journal of Craniomandibular Practice, 41(3), 212–217. doi: 10.1080/08869634.2020.1853306
  • Fernandes, G., Franco, A. L., Siqueira, J. T., Gonçalves, D. A., Camparis, C. M. (2012). Sleep bruxism increases the risk for painful temporomandibular disorder, depression and non-specific physical symptoms. Journal of Oral Rehabilitation, 39(7), 538–544. doi: 10.1111/j.1365-2842.2012.02308.x
  • Friedlander, A. H., & Birch, N. J. (1990). Dental conditions in patients with bipolar disorder on long-term lithium maintenance therapy. Special care in dentistry: official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 10(5), 148–151. doi: 10.1111/j.1754-4505.1990.tb00782.x
  • Friedlander, A. H., Friedlander, I. K., Marder, S. R. (2002). Bipolar I disorder: psychopathology, medical management and dental implications. Journal of the American Dental Association (1939), 133(9), 1209–1217. doi: 10.14219/jada.archive.2002.0362
  • Grunze, H., Vieta, E., Goodwin, G. M., Bowden, C., Licht, R. W., Möller, H. J., …, WFSBP Task Force on Treatment Guidelines for Bipolar Disorders (2013). The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder. The world journal of biological psychiatry: the official journal of the World Federation of Societies of Biological Psychiatry, 14(3), 154–219. doi: 10.3109/15622975.2013.770551
  • Gurbuz Oflezer, O., Altinbas, K., Delice, M., Oflezer, C., Kurt, E. (2018). Oral Health among Patients with Bipolar Disorder. Oral Health & Preventive Dentistry, 16(6), 509–516. doi: 10.3290/j.ohpd.a41662
  • Hamilton M. The Hamilton Rating Scale for Depression. In: Assessment of Depression [Internet]. Berlin, Heidelberg: Springer Berlin Heidelberg; 1986 [cited 2019 Jul 1]. p. 143– 52. Available from: http://www.springerlink.com/index/10.1007/978-3-642-70486-4_14.
  • Hanna, K., Nair, R., Amarasena, N., Armfield, J. M., Brennan, D. S. (2021). Temporomandibular dysfunction experience is associated with oral health-related quality of life: an Australian national study. BMC Oral Health, 21(1), 432. doi: 10.1186/s12903-021-01773-z
  • Huhtela, O. S., Näpänkangas, R., Joensuu, T., Raustia, A., Kunttu, K., Sipilä, K. (2016). Self-Reported Bruxism and Symptoms of Temporomandibular Disorders in Finnish University Students. Journal of Oral & Facial Pain and Headache, 30(4), 311–317. doi: 10.11607/ofph.1674
  • J. Griffiths, V. Jones, I. Leeman, D. Lewis, K. Patel, K. Wilson, R. Blankenstein. (2000). Oral health care for people with mental health problems guidelines and recommendations. British Society for Disability and Oral Health. Jan:2-20.
  • Jiménez-Silva, A., Peña-Durán, C., Tobar-Reyes, J., Frugone-Zambra, R. (2017). Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: A systematic review from 2003 to 2014. Acta Odontologica Scandinavica, 75(1), 36–58. doi:10.1080/00016357.2016.1247465
  • Kaynak, B. A., Taş, S, Salkın, Y. (2020). ‘The accuracy and reliability of the Turkish version of the Fonseca anamnestic index in temporomandibular disorders’, Cranio®, 1-6. doi:10.1080/08869 634.2020.1812808.
  • Leketas, M., Šaferis, V., Kubilius, R., Cervino, G., Bramanti, E., Cicciù, M. (2017). Oral Behaviors and Parafunctions: Comparison of Temporomandibular Dysfunction Patients and Controls Journal of Craniofacial Surgery, 28(8), 1933–1938. doi:10.1097/scs.0000000000003945
  • Lobbezoo, F., Ahlberg, J., Glaros, A. G., Kato, T., Koyano, K., Lavigne, G. J., …, Winocur, E. (2013). Bruxism defined and graded: an international consensus. Journal of Oral Rehabilitation, 40(1), 2–4. doi: 10.1111/joor.12011
  • Lobbezoo, F., Ahlberg, J., Raphael, K. G., Wetselaar, P., Glaros, A. G., Kato, T., Santiago, V., …, Manfredini, D. (2018). International consensus on the assessment of bruxism: Report of a work in progress. Journal of Oral Rehabilitation, 45(11), 837–844. doi: 10.1111/joor.12663
  • Manfredini, D., Lobbezoo, F. (2010). Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 109(6), e26–e50. doi: 10.1016/j.tripleo.2010.02.013
  • McEvoy, G. K. AHFS drug information 2002. Bethesda, Md.: American Society of Health-System Pharmacists. Mumcu, G., İnanç, N., Ergun, T., İkiz, K., Güneş, M., İşlek, U., …, Direskeneli H. (2006). Oral health related quality of life is affected by disease activity in Behçet’s disease. Oral Disease, 12:145-151.
  • Nykänen, L., Manfredini, D., Lobbezoo, F., Kämppi, A., Bracci, A., Ahlberg, J. (2023). Assessment of awake bruxism by a novel bruxism screener and ecological momentary assessment among patients with masticatory muscle myalgia and healthy controls. Journal of Oral Rehabilitation. Advance online publication. doi: 10.1111/joor.13462
  • Ohrbach, R., Larsson, P., List, T. (2008). The jaw functional limitation scale: Development, reliability, and validity of 8-item and 20-item versions. J Orofac Pain. (22): 219- 230.
  • Ramon, T., Grinshpoon, A., Zusman, S. P., Weizman, A. (2003). Oral health and treatment needs of institutionalized chronic psychiatric patients in Israel. European psychiatry: the journal of the Association of European Psychiatrists, 18(3), 101–105. doi: 10.1016/s0924-9338(03)00023-3
  • Rofes, L., Arreola, V., Almiral, J., Cabré, M., Campins, L., García-Peris, P., ..., Clavé, P. (2011). Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterology Research and Practice. 2011(1): 13.
  • Slade G. D. (1997). Derivation and validation of a short-form oral health impact profile. Community Dentistry and Oral Epidemiology, 25(4), 284–290. doi: 10.1111/j.1600-0528.1997.tb00941.x
  • Tritsaris, K., Gromada, J., Jørgensen, T. D., Nauntofte, B., Dissing, S. (2001). Reduction in the rate of inositol 1,4,5-trisphosphate synthesis in rat parotid acini by lithium. Archives of Oral Biology, 46(4), 365–373. doi: 10.1016/s0003-9969(00)00109-6
  • Vieta, E., Berk, M., Schulze, T. G., Carvalho, A. F., Suppes, T., Calabrese, J. R., …, Grande, I. (2018). Bipolar Disorders. Nature Reviews. Disease Primers, 4, 18008. doi: 10.1038/nrdp.2018.8
  • Wınkler, S. Dalkowskı, K. Maır, J. Klebe, S. Paulsen, F. Böckers, T. M. Waschke, J. (2015). Sobotta Lehrbuch Anatomie, Berlin, Elsevier, 1.Baskı
  • Yap, A. U., Zhang, M. J., Lei, J., Fu, K. Y. (2021). Accuracy of the Fonseca Anamnestic Index for identifying pain-related and/or intra-articular Temporomandibular Disorders. Cranio: The Journal of Craniomandibular Practice, 1–8. Advance online publication. doi: 10.1080/08869634.2021.1954375
  • Young, R. C., Biggs, J. T., Ziegler, V. E., Meyer, D. A. (1978). A rating scale for mania: reliability, validity and sensitivity. The British Journal of Psychiatry: The Journal of Mental Science, 133, 429–435. doi: 10.1192/bjp.133.5.429
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Physiotherapy
Journal Section RESEARCH ARTICLES
Authors

Hazel Çelik Güzel 0000-0001-6510-5012

Berdel Çelik 0009-0006-6607-8056

Early Pub Date April 25, 2024
Publication Date April 25, 2024
Submission Date December 29, 2023
Acceptance Date February 11, 2024
Published in Issue Year 2024 Volume: 6 Issue: 1

Cite

APA Çelik Güzel, H., & Çelik, B. (2024). Bipolar Hastalarda Bruksizmin Ağız Sağlığı ve Temporomandibular Eklem Disfonksiyonuna Etkisi. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Ve Araştırmaları Dergisi, 6(1), 140-149. https://doi.org/10.46413/boneyusbad.1411557
AMA Çelik Güzel H, Çelik B. Bipolar Hastalarda Bruksizmin Ağız Sağlığı ve Temporomandibular Eklem Disfonksiyonuna Etkisi. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi. April 2024;6(1):140-149. doi:10.46413/boneyusbad.1411557
Chicago Çelik Güzel, Hazel, and Berdel Çelik. “Bipolar Hastalarda Bruksizmin Ağız Sağlığı Ve Temporomandibular Eklem Disfonksiyonuna Etkisi”. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Ve Araştırmaları Dergisi 6, no. 1 (April 2024): 140-49. https://doi.org/10.46413/boneyusbad.1411557.
EndNote Çelik Güzel H, Çelik B (April 1, 2024) Bipolar Hastalarda Bruksizmin Ağız Sağlığı ve Temporomandibular Eklem Disfonksiyonuna Etkisi. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi 6 1 140–149.
IEEE H. Çelik Güzel and B. Çelik, “Bipolar Hastalarda Bruksizmin Ağız Sağlığı ve Temporomandibular Eklem Disfonksiyonuna Etkisi”, Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi, vol. 6, no. 1, pp. 140–149, 2024, doi: 10.46413/boneyusbad.1411557.
ISNAD Çelik Güzel, Hazel - Çelik, Berdel. “Bipolar Hastalarda Bruksizmin Ağız Sağlığı Ve Temporomandibular Eklem Disfonksiyonuna Etkisi”. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi 6/1 (April 2024), 140-149. https://doi.org/10.46413/boneyusbad.1411557.
JAMA Çelik Güzel H, Çelik B. Bipolar Hastalarda Bruksizmin Ağız Sağlığı ve Temporomandibular Eklem Disfonksiyonuna Etkisi. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi. 2024;6:140–149.
MLA Çelik Güzel, Hazel and Berdel Çelik. “Bipolar Hastalarda Bruksizmin Ağız Sağlığı Ve Temporomandibular Eklem Disfonksiyonuna Etkisi”. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri Ve Araştırmaları Dergisi, vol. 6, no. 1, 2024, pp. 140-9, doi:10.46413/boneyusbad.1411557.
Vancouver Çelik Güzel H, Çelik B. Bipolar Hastalarda Bruksizmin Ağız Sağlığı ve Temporomandibular Eklem Disfonksiyonuna Etkisi. Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi. 2024;6(1):140-9.

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