Sleep hygiene measures combined with mindfulness meditation in the management of sleep bruxism in children: A randomized controlled clinical trial.

BACKGROUND: Sleep hygiene measures and meditation may reduce stress and improve sleep quality, but their effect on the occurrence of sleep bruxism in children has not yet been investigated. AIM: To explore the effects of sleep hygiene measures combined with mindfulness meditation (relaxation audio) in the management of probable sleep bruxism (SB) in children. DESIGN: This clinical trial (no. NCT04501237) randomized 36 children with 3-8 years of age. Probable SB detection was performed according to the criteria established by the International Consensus on The Assessment of Bruxism-2018. Intervention group was instructed to practice sleep hygiene measures and mindfulness meditation (i.e., the use of a digital app to broadcast audio relaxation) each night before bedtime for 5 weeks; control group did not receive guidance for therapies. Parents completed a bruxism diary for 5 weeks, and the outcome was the number of SB episodes-day reported in the week (ranging from 0 to 7) in each period. A multilevel mixed-effects Poisson regression model was performed. RESULTS: A total of 32 children (mean age: 6.1 years) completed the study. The children who received the therapies related to sleep hygiene measures and mindfulness meditation had a reduction in the SB incidence rate ratio (IRR) of 46% (IRR = 0.54 [Confidence Interval 95%, 0.45-0.65]) during a 5-week observation period. The sensitivity analyses did not show relevant changes in the measure of the effect. CONCLUSION: Sleep hygiene measures combined with mindfulness meditation reduced the SB in children.

Daily screen time, sleep pattern, and probable sleep bruxism in children: A cross-sectional study.

OBJECTIVE: This study aimed to evaluate the prevalence of probable sleep bruxism (SB) in children aged 7-8 years and its association with sleep pattern and the time spent using devices with a screen. MATERIAL AND METHODS: A cross-sectional study was conducted with children from Pelotas, Brazil (n = 556). Parents/caregivers were interviewed and provided demographic/socioeconomic information, children's daily screen time, nighttime tooth grinding or clenching, sleep duration and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-sleep domain). Probable SB was determined based on a positive clinical inspection with/without a positive parental/caregiver's reports of tooth clenching or grinding. Hierarchical Poisson regression was performed. RESULTS: The prevalence of probable SB was 15.83% (n = 88). There was no difference in the probable SB prevalence according to the daily screen time (p = 0.744), and low family socioeconomic status was associated with higher SB prevalence (Prevalence Ratio [PR] = 1.95; 95% Confidence Interval [95% CI]: 1.21-3.17; p = 0.006). Higher scores in the sleep domain of the BRIAN-K scale were associated with probable SB [PR = 1.07; 95% CI: 1.01-1.30; p = 0.013]. CONCLUSIONS: Difficulties in maintaining sleep and low family socioeconomic status were associated with probable SB in schoolchildren, while screen time spent using devices with a screen was not associated.

Perinatal health and malocclusions in preschool children: Findings from a cohort of adolescent mothers in Southern Brazil.

INTRODUCTION: Pregnancy in adolescence has long-term consequences that can negatively influence oral conditions. In this study, we aimed to assess malocclusion in deciduous dentition and its association with prolonged breastfeeding, pacifier use, and perinatal health indicators pertaining to the periods immediately before and after birth. METHODS: This cross-sectional study was nested in a cohort of adolescent mothers who became pregnant from 13 to 19 years of age (mean age, 17.3 ± 1.6 years). A total of 509 mother-child dyads were included. Information on perinatal indicators, including Apgar score (0-10), which is a standardized assessment of the condition of the infant at birth (heart rate, breath rate, muscle tone, reflex irritability, and skin color), head circumference, birth weight, and need for intensive care unit admission were collected after delivery through interviews with the mothers. By the time the children were 24 to 36 months of age, malocclusion was assessed, and information on the use of pacifiers and breastfeeding was collected. Multivariate Poisson regression was used to assess the effect of independent variables on the outcome (malocclusion). RESULTS: The prevalence of malocclusion was 62.33%, and open bite was the most frequent one (47.45%). After adjustments, children with no need for intensive care unit admission had a lower risk of malocclusion (prevalence ratio [PR] = 0.75; 95% CI, 0.56-0.99), whereas those with an Apgar score less than 7 had a higher risk (PR = 1.32; 95% CI, 1.06-1.64). Children who had used a pacifier (PR = 1.82; 95% CI, 1.02-3.24) or were still using it (PR = 3.88; 95% CI, 2.65-5.68) had a higher chance of malocclusion compared with children who never used a pacifier. Children breastfeeding for 24 months or longer were less likely to have malocclusion (PR = 0.46; 95% CI, 0.34-0.73). CONCLUSIONS: Poor perinatal health and pacifier use may be risk factors for malocclusion development in deciduous teeth. Long duration of breastfeeding is associated with better occlusal conditions in children of adolescent mothers. Further studies are needed with other age groups.

A Modified Photoactivation Protocol Using Two Simultaneous Light-Curing Units for Bonding Brackets to Enamel.

UNLABELLED: This study investigated the effect of a modified photoactivation protocol using two simultaneous light-curing units on the shear bond strength (SBS) of brackets to enamel. Metal brackets were bonded to bovine incisors using the resin-based orthodontic cement Transbond XT (3M Unitek). Four photoactivation protocols of the orthodontic cement were tested (n = 15): CONTROL: photoactivation for 10 s on each proximal face of the bracket at a time; Simultaneous: photoactivation for 10 s on both proximal faces of the bracket at the same time; One side-20s: photoactivation for 20 s at one proximal face of the bracket only; and One side-10s: photoactivation for 10 s only at one proximal face of the bracket. SBS was tested immediately or after 1000 thermal cycles. Adhesive remnant index (ARI) was classified. Data were subjected to two-way ANOVA and Student-Newman-Keuls' test (α = 0.05). Pooled means ± standard deviations for SBS to enamel (MPa) were: 10.2 ± 4.2 (CONTROL), 9.7 ± 4.5 (Simultaneous), 5.6 ± 3.1 (One side-20s), and 4.6 ± 1.9 (One side-10s). Pooled SBS data for immediate and thermal cycled groups were 6.3 ± 2.6 and 8.8 ± 5.2. A predominance of ARI scores 1-2 and 0-1 was observed for the immediate and thermally cycled groups, respectively. In conclusion, simultaneous photoactivation of the orthodontic cement using two light-curing units, one positioned at each proximal face of the bracket, yielded similar bonding ability compared to the conventional light-curing method. Photoactivation of the orthodontic cement at one proximal face of the bracket only is not recommended, irrespective of the light-curing time used.

A Modified Photoactivation Protocol Using Two Simultaneous Light-Curing Units for Bonding Brackets to Enamel

This study investigated the effect of a modified photoactivation protocol using two simultaneous light-curing units on the shear bond strength (SBS) of brackets to enamel. Metal brackets were bonded to bovine incisors using the resin-based orthodontic cement Transbond XT (3M Unitek). Four photoactivation protocols of the orthodontic cement were tested (n=15): Control: photoactivation for 10 s on each proximal face of the bracket at a time; Simultaneous: photoactivation for 10 s on both proximal faces of the bracket at the same time; One side-20s: photoactivation for 20 s at one proximal face of the bracket only; and One side-10s: photoactivation for 10 s only at one proximal face of the bracket. SBS was tested immediately or after 1000 thermal cycles. Adhesive remnant index (ARI) was classified. Data were subjected to two-way ANOVA and Student-Newman-Keuls' test (α=0.05). Pooled means ± standard deviations for SBS to enamel (MPa) were: 10.2±4.2 (Control), 9.7±4.5 (Simultaneous), 5.6±3.1 (One side-20s), and 4.6±1.9 (One side-10s). Pooled SBS data for immediate and thermal cycled groups were 6.3±2.6 and 8.8±5.2. A predominance of ARI scores 1-2 and 0-1 was observed for the immediate and thermally cycled groups, respectively. In conclusion, simultaneous photoactivation of the orthodontic cement using two light-curing units, one positioned at each proximal face of the bracket, yielded similar bonding ability compared to the conventional light-curing method. Photoactivation of the orthodontic cement at one proximal face of the bracket only is not recommended, irrespective of the light-curing time used.

Este estudo investigou o efeito de um protocolo modificado de fotoativação utilizando duas unidades de fotopolimerização simultâneas na resistência de união ao cisalhamento (RUC) de braquetes ao esmalte. Braquetes metálicos foram fixados a incisivos bovinos utilizando o cimento ortodôntico resinoso Transbond XT (3M Unitek). Quatro protocolos de fotoativação do cimento ortodôntico foram testados (n=15): Controle: fotoativação por 10 s em cada face proximal do braquete de cada vez; Simultâneo: fotoativação por 10 s em ambas as faces proximais do braquete ao mesmo tempo; Um lado-20s: fotoativação por 20 s em uma face proximal do braquete apenas; e Um lado-10s: fotoativação por 10 s apenas em uma face proximal do braquete. A RUC foi testada imediatamente ou após 1000 ciclos térmicos. O Índice de Remanescente de Adesivo (IRA) foi classificado. Os dados foram submetidos a ANOVA de duas vias e teste de Student-Newman-Keuls (α=0,05). As médias agrupadas ± desvios-padrão de RUC ao esmalte (MPa) foram: 10,2±4,2 (Controle), 9,7±4,5 (Simultâneo), 5,6±3,1 (Um lado-20s), e 4,6±1,9 (Um lado-10s). Os dados agrupados de RUC para os grupos imediatos e termociclados foram 6,3±2,6 e 8,8±5,2. Predominância de escores IRA 1-2 e 0-1 foi observada para os grupos imediatos e termociclados, respectivamente. Em conclusão, a fotoativação simultânea do cimento ortodôntico utilizando duas fontes de luz, uma posicionada em cada face proximal do braquete, gerou similar capacidade de união ao método convencional de fotopolimerização. Fotoativação do cimento ortodôntico em apenas uma face proximal do braquete não é recomendada, independente do tempo de fotoativação utilizado.