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Sleep bruxism (SB) has been associated with biological and psychosocial factors. The assessment of SB includes self-report, clinical evaluation, and polysomnography. This study aimed to investigate the associations of self-reported SB with other sleep disorders and demographic, psychological, and lifestyle factors in the adult general population, and to investigate whether self-reported SB and polysomnographically (PSG) confirmed SB provide similar outcomes in terms of their associated factors. We recruited 915 adults from the general population in Sao Paulo, Brazil. All participants underwent a one-night PSG recording and answered questions about sex, age, BMI, insomnia, OSA risk, anxiety, depression, average caffeine consumption, smoking frequency, and alcohol consumption frequency. We investigated the link between SB and the other variables in univariate, multivariate, and network models, and we repeated each model once with self-reported SB and once with PSG-confirmed SB. Self-reported SB was only significantly associated with sex (p = 0.042), anxiety (p = 0.002), and depression (p = 0.03) in the univariate analysis, and was associated with insomnia in the univariate (p < 0.001) and multivariate (ß = 1.054, 95%CI 1.018-1.092, p = 0.003) analyses. Network analysis showed that self-reported SB had a direct positive edge to insomnia, while PSG-confirmed SB was not significantly associated with any of the other variables. Thus, sleep bruxism was positively associated with insomnia only when self-reported, while PSG-confirmed SB was not associated with any of the included factors.
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Bruxismo do Sono , Distúrbios do Início e da Manutenção do Sono , Adulto , Humanos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/complicações , Bruxismo do Sono/epidemiologia , Brasil/epidemiologia , Polissonografia , Autorrelato , SonoRESUMO
The objective of the current study was to evaluate the clinical utility of bruxism episode index in predicting the level of masticatory muscle pain intensity. The study involved adults (n = 220) recruited from the Outpatient Clinic of Temporomandibular Disorders at the Department of Experimental Dentistry, Wroclaw Medical University, during the period 2017-2022. Participants underwent medical interview and dental examination, focusing on signs and symptoms of sleep bruxism. The intensity of masticatory muscle pain was gauged using the Numeric Rating Scale. Patients identified with probable sleep bruxism underwent further evaluation through video-polysomnography. Statistical analyses included the Shapiro-Wilk test, Spearman's rank correlation test, association rules, receiver operating characteristic curves, linear regression, multivariate regression and prediction accuracy analyses. The analysis of correlation and one-factor linear regression revealed no statistically significant relationships between bruxism episode index and Numeric Rating Scale (p > 0.05 for all analyses). Examination of receiver operating characteristic curves and prediction accuracy indicated a lack of predictive utility for bruxism episode index in relation to masticatory muscle pain intensity. Multivariate regression analysis demonstrated no discernible relationship between bruxism episode index and Numeric Rating Scale across all examined masticatory muscles. In conclusion, bruxism episode index and masticatory muscle pain intensity exhibit no correlation, and bruxism episode index lacks predictive value for masticatory muscle pain. Clinicians are advised to refrain from employing the frequency of masticatory muscle activity as a method for assessing the association between masticatory muscle pain and sleep bruxism.
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BACKGROUND: Visualizing (micro)vascular structures remains challenging for researchers and clinicians due to limitations in traditional radiological imaging methods. Exploring the role of vascular development in craniofacial malformations in experimental settings can enhance understanding of these processes, with the effectiveness of high-resolution imaging techniques being crucial for successful research in this field. Micro-CT imaging offers 3D microstructural insights, but requires contrast-enhancing staining agents (CESAs) for visualizing (micro)-vascular tissues, known as contrast-enhanced micro-CT (CECT). As effective contrast agents are crucial for optimal visualization, this review focuses on comparative studies investigating such agents for micro-vascular tissue imaging using micro-CT. Furthermore, we demonstrate the utilization of B-Lugol solution as a promising contrast agent for acquiring high-quality micro-CT images of (micro)vascular structures in human embryonic samples. METHOD: This scoping review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols. PubMed database provided relevant articles, screened initially by title and abstract. Inclusion and exclusion criteria defined outcomes of interest. RESULTS: From an initial search, 273 records were identified, narrowed down to 9 articles after applying our criteria. Additionally, two articles were added through citation searching. This, a total of 11 articles were incorporated in this study. CONCLUSION: This micro-CT contrast agent review underscores the need for tailored choices based on research goals. Both Barium sulfate and Iodine-based agents showing excellent results, providing high resolution (micro) vascular content, especially in ex-vivo specimens. However, careful consideration of protocols and tissue characteristics remains imperative for optimizing the effectiveness of micro-CT imaging for the study of cranio-facial vascular development.
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Meios de Contraste , Microtomografia por Raio-X , Humanos , Microtomografia por Raio-X/métodos , Imageamento Tridimensional/métodosRESUMO
PURPOSE: The existence of a bidirectional relationship between poor sleep and pain intensity has been studied, and good sleep quality has been found to be a key factor underlying pain control. The purpose of this prospective cohort study was to observe if OSA treatment provides a reduction in temporo-mandibular disorder (TMD) pain and headache attributed to TMD in patients with obstructive sleep apnea (OSA) after 18 months of OSA treatment. METHODS: A prospective cohort study was conducted on consecutive patients suffering from OSA. Patients underwent polysomnography and TMD examination according to the DC/TMD protocol at baseline and after 18 months. Intensity of TMD pain and headache attributed to TMD were analyzed. RESULTS: Of 40 patients (31 men, mean age 51.3 ± 10.3 years), 33 underwent OSA treatment. At the follow-up examination after 18 months, significant improvements in the intensity of pain-related TMD and headache attributed to TMD were observed (p < 0.05). Seven patients did not start treatment for OSA or discontinued treatment. These patients did not show any significant difference in intensity of TMD-pain or headache attributed to TMD after 18 months (p > 0.05). CONCLUSIONS: Significant reductions in intensity of pain-related TMD and headache attributed to TMD were observed in patients with OSA after 18 months of OSA treatment onset, while no difference was observed in subjects not undergoing or discontinuing OSA treatment. TRIAL REGISTRATION: The protocol was registered on ClinicalTrials.gov database with number NCT04948541.
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Apneia Obstrutiva do Sono , Transtornos da Articulação Temporomandibular , Masculino , Humanos , Adulto , Pessoa de Meia-Idade , Estudos Prospectivos , Transtornos da Articulação Temporomandibular/terapia , Dor , Apneia Obstrutiva do Sono/terapia , CefaleiaRESUMO
PURPOSE: To compare the anatomical balance and shape of the upper airway in the supine position between adults with positional obstructive sleep apnea (POSA) and adults with non-positional OSA (NPOSA). METHODS: Adults diagnosed with OSA (apnea-hypopnea index (AHI) > 10 events/h) were assessed for eligibility. POSA was defined as the supine AHI more than twice the AHI in non-supine positions; otherwise, patients were classified as NPOSA. Cone beam computed tomography (CBCT) imaging was performed for every participant while awake in the supine position. The anatomical balance was calculated as the ratio of the tongue size to the maxillomandibular enclosure size. The upper airway shape was calculated as the ratio of the anteroposterior dimension to the lateral dimension at the location of the minimal cross-sectional area of the upper airway (CSAmin-shape). RESULTS: Of 47 participants (28 males, median age [interquartile range] 56 [46 to 63] years, median AHI 27.8 [15.0 to 33.8]), 34 participants were classified as having POSA (72%). The POSA group tended to have a higher proportion of males and a lower AHI than the NPOSA group (P = 0.07 and 0.07, respectively). After controlling for both sex and AHI, the anatomical balance and CSAmin-shape were not significantly different between both groups (P = 0.18 and 0.73, respectively). CONCLUSION: Adults with POSA and adults with NPOSA have similar anatomical balance and shape of their upper airway in the supine position. TRIAL REGISTRATION: This study was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR Trial ACTRN12611000409976).
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Apneia Obstrutiva do Sono , Masculino , Adulto , Humanos , Pessoa de Meia-Idade , Decúbito Dorsal , Polissonografia , Austrália , Tomografia Computadorizada de Feixe CônicoRESUMO
BACKGROUND: It is assumed that other factors than masticatory muscle activity awareness could drive the self-report of awake bruxism. OBJECTIVES: To investigate the extent to which the report of awake bruxism is associated with psychological distress, and with the belief that oral behaviours put a strain on the masticatory system among TMD-pain patients. MATERIALS AND METHODS: The study sample consisted of 1830 adult patients with reported function-dependent TMD pain. Awake bruxism was assessed through six items of the Oral Behaviors Checklist. Psychological distress was assessed by means of somatic symptoms, depression and anxiety. Causal attribution belief was measured with the question 'Do you think these behaviours put a strain on your jaws, jaw muscles, and/or teeth?' RESULTS: Mean age of all participants was 42.8 (±15.2) years, 78.2% being female. Controlled for sex, positive, yet weak, correlations were found between awake bruxism and somatic symptom severity (rs = 0.258; p < .001), depression (rs = 0.272; p < .001) and anxiety (rs = 0.314; p < .001): patients with the highest scores reported approximately twice as much awake bruxism compared to those with minimal scores. Controlled for age and sex, a positive, moderate correlation was found between awake bruxism and causal attribution belief (rs = 0.538; p < .001). Patients who believed that performing awake oral behaviours put 'very much' a strain on the masticatory system reported four times more awake bruxism than patients who did not believe that these behaviours are harmful. CONCLUSIONS: Based on the results and relevant scientific literature, the theoretical background mechanisms of our findings are discussed in four scenarios that are either in favour of the use of self-report of awake bruxism being a representation of masticatory muscle activity awareness, or against it.
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Bruxismo , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Bruxismo/diagnóstico , Autorrelato , Vigília , Músculos da Mastigação , DorRESUMO
BACKGROUND: The importance of incorporating patient and medical professional perspectives in medical research is increasingly recognized. However, formal platforms for these voices are limited. OBJECTIVE: To address this gap, this study proposes a novel manuscript type, the Personal Scoping Review, within the Journal of Oral Rehabilitation. MATERIALS AND METHODS: Personal Scoping Reviews utilize a qualitative design with semi-structured interviews to gather patient and professional perspectives. This approach offers flexibility and depth, allowing authors to explore diverse insights. The reviews focus on care, education and research agendas related to the topic, using the voices of individuals as primary evidence. RESULTS & CONCLUSION: Personal Scoping Reviews highlight concerns in patient care, educational needs and research gaps, offering a comprehensive view. By integrating diverse perspectives, these reviews provide valuable insights for improving medical research and practice. They facilitate the formulation of agendas to address key issues in care, education and research. By amplifying individual perspectives, these reviews aim to enhance the relevance and impact of research, ultimately benefiting patients and healthcare providers alike.
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Pesquisa Qualitativa , Humanos , Pesquisa BiomédicaRESUMO
BACKGROUND AND OBJECTIVE: Parkinson's disease (PD) poses a range of challenges, including oral health issues, that significantly impact the patient's quality of life. Despite growing awareness of PD, oral health receives limited attention. To shed light on this matter, this personal scoping review explores the perspectives of Professor K.G. Raphael, who is both a professional and a PD patient, on various aspects of oral health in PD. METHODS: Through semi-structured interviews, Prof. Raphael shares her insights on the complexities of oral health as a PD patient to compose an agenda for oral health care, research, and education, for PD patients. RESULTS: She emphasises the importance of interdisciplinary collaboration and education. Additionally, Prof. Raphael identifies crucial research areas, such as exploring the role of the oral microbiome and assessing the impact of exercise on oral health in PD. CONCLUSION: This study resulted in agendas to improve oral health care, research and education, advocating for a holistic approach to enhance PD patients' well-being. Despite its limitations, this study highlights the imperative of integrating oral health into the broader management of PD, emphasising interdisciplinary collaboration and patient empowerment.
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Saúde Bucal , Doença de Parkinson , Qualidade de Vida , Humanos , Doença de Parkinson/psicologia , Doença de Parkinson/complicações , FemininoRESUMO
BACKGROUND: The association of sleep bruxism with mortality has not been studied. OBJECTIVES: Altogether 12 040 subjects from the nationwide Finnish twin cohort were included in the analyses. We examined whether self-reported sleep bruxism is associated with increased risk of mortality, and if so, whether the effect is independent of known common risk factors. The time span of the follow-up was 30 years. METHODS: Cox proportional hazards regression models (Hazard Ratios and their 95% Confidence Intervals) adjusted by age, sex and covariates were used to assess the effect of baseline bruxism status in 1990 on future mortality in 1990-2020. RESULTS: The risk of mortality among all participants (n = 12 040), independent of missing covariates and adjusted by age and sex, was 40% higher in weekly bruxers than in never bruxers (HR 1.40, 95% CI 1.16-1.68, p < .001). However, when adjusted by all studied covariates, (n = 11 427) the risk was no longer observed (HR 1.04, 95% CI 0.86-1.25, p = .717). Despite the overall lack of between bruxism and mortality after adjustment for covariates, we examined the cause-specific risks for major cause-of-death groups. There were no substantial associations of weekly bruxism with major disease outcomes by the fully adjusted hazard ratios for them. CONCLUSION: Bruxism does not kill-in line with its definition of being rather a behaviour (with all its phenotypes) than a disease.
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Bruxismo , Bruxismo do Sono , Humanos , Bruxismo/epidemiologia , Finlândia/epidemiologia , Fatores de Risco , Autorrelato , Sono , Bruxismo do Sono/epidemiologiaRESUMO
BACKGROUND: Sleep bruxism (SB) occurring during No-REM (nREM) sleep and increase in microarousals per hour have been described in adults, but not in children. OBJECTIVE: To assess the correlation between sleep architecture and masseter muscle activity related to sleep bruxism (SB/MMA) in children. MATERIALS AND METHODS: Forty-three children aged 7-12 years (mean age: 9.4 ± 1.3) with confirmed SB underwent a two-night polysomnographic (PSG) study in a sleep laboratory, for accommodation (first night) and data collection (second night). Data on sleep architecture (total sleep duration (TSD), sleep efficiency (SE), sleep onset latency (SOL), REM and nREM sleep duration and proportion and microarousals/hour during REM and nREM sleep) and episodes/hour of SB/MMA were recorded. Single and multiple-variable linear regression analyses were performed to assess the correlation between data on sleep architecture (predictors) and SB/MMA (dependent variable). RESULTS: Shorter TSD, REM and nREM stage 1 sleep duration, longer SOL and more microarousals/hour during REM and nREM sleep were found to be positive predictors of SB/MMA in children in the multiple-variable regression analysis (R2 = 0.511). CONCLUSION: Within the limitations of this study, it can be concluded that SB/MMA is correlated with altered sleep architecture in children (shorter total sleep duration (TSD), shorter nREM and REM sleep and higher microarousals during REM and nREM sleep). Nevertheless, the clinical significance of these findings need to be demonstrated in future studies.
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Bruxismo do Sono , Adulto , Criança , Humanos , Músculo Masseter/fisiologia , Polissonografia , Sono/fisiologiaRESUMO
BACKGROUND: Bruxism is defined as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism can occur during sleep (sleep bruxism, SB) or during wakefulness (awake bruxism, AB). To date, the effect of AB on the purported negative consequences of bruxism has remained unclear. OBJECTIVES: The assessment of AB, its relation to temporomandibular disorders (TMD) treatment modalities, and their possible outcomes were investigated among TMD patients resistant to treatment in primary care and referred to a tertiary care clinic. METHODS: The records of 115 patients were studied. Patients were referred to the Head and Neck Centre, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, for TMD treatment between 2017 and 2020. The data derived from the eligible patients' records included the following: background data (age and sex), referral data (reason and previous treatment), medical background (somatic and psychiatric), clinical and possible radiological diagnoses at a tertiary care clinic, treatment modalities for masticatory muscle myalgia, bruxism assessment, its possible treatment modalities and their outcomes, and overall management outcome. We analysed the outcomes of single treatment modalities and combined groups of modalities. For the demographic data, the Chi-squared test and Fischer's Exact test were used to determine the associations between the categorical variables. A Sankey-diagram was used to describe the flow of treatment. RESULTS: Temporomandibular joint-pain-dysfunction syndrome (K07.60) was the most frequent single reason to refer a patient to tertiary care (17.4%). At referral, men had myalgia (M79.1) significantly more often (p = .034) than women. Similarly, men had depression (p = .002) more often and other psychiatric diagnoses (p = .034). At tertiary care, the presence of AB was assessed in 53.9%, and self-reported AB was recorded in 48.7%. In patients with possible AB, those who were prescribed neuropathic pain medication showed significantly less improvement in symptoms (p = .021) than those who underwent splint therapy (p = .009). Overall, half of the patients showed overall improvement in their TMD symptoms from the treatment combinations. CONCLUSION: Despite several treatment modalities, only half of the patients showed improvement in their symptoms in the present study. A standardised assessment method encompassing all factors contributing to bruxism behaviours and their consequences is suggested.
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Bruxismo , Bruxismo do Sono , Transtornos da Articulação Temporomandibular , Masculino , Humanos , Feminino , Bruxismo/complicações , Bruxismo/terapia , Bruxismo/diagnóstico , Vigília , Estudos Retrospectivos , Atenção Terciária à Saúde , Mialgia , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/terapia , Transtornos da Articulação Temporomandibular/diagnóstico , Bruxismo do Sono/complicações , Bruxismo do Sono/terapia , Bruxismo do Sono/diagnósticoRESUMO
BACKGROUND: Recently, the Standardized Tool for the Assessment of Bruxism (STAB) and the bruxism screener (BruxScreen) have been developed for use in research and clinical settings. OBJECTIVE: As to ascertain high-quality use of both instruments worldwide, it was our aim to develop a guideline for the translation and cultural adaptation of the STAB and the BruxScreen. METHODS AND RESULTS: This paper describes a 12-step guideline for the translation and cultural adaptation of the STAB and the BruxScreen. A format of a translation log is provided as well. Besides, a website has been created for the guidance of translation teams. CONCLUSION: Following the 12 steps, new language versions of the STAB and the BruxScreen will be ready for further testing (reliability, validity, responsiveness and interpretability) and, ultimately, application in research and clinics around the world.
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Bruxismo , Humanos , Bruxismo/diagnóstico , Reprodutibilidade dos Testes , Idioma , Inquéritos e Questionários , Comparação Transcultural , Traduções , PsicometriaRESUMO
BACKGROUND: Obstructive sleep apnoea (OSA) is a highly prevalent problem with significant consequences. Continuous positive airway pressure (CPAP) and oral mandibular advancement device (MAD) are considered the standard treatments for OSA. Patients may experience self-reported oral moistening disorders (OMDs) (i.e. xerostomia or drooling) at the beginning, throughout and after treatment. This affects oral health, quality of life and treatment effectiveness. The exact nature of the associations between OSA and self-reported OMD is still unknown. We aimed to provide an overview of the associations between self-reported OMD on the one hand and OSA and its treatment (namely CPAP and MAD) on the other hand. In addition, we sought to determine whether OMD affects treatment adherence. MATERIALS AND METHODS: A literature search in PubMed was performed up to 27 September 2022. Two researchers independently assessed studies for eligibility. RESULTS: In total, 48 studies were included. Thirteen papers investigated the association between OSA and self-reported OMD. They all suggested an association between OSA and xerostomia but not between OSA and drooling. The association between CPAP and OMD was addressed in 20 articles. The majority of studies have indicated xerostomia as a CPAP side effect; however, some have observed that xerostomia diminishes with CPAP therapy. In 15 papers, the association between MAD and OMD was investigated. In most publications, both xerostomia and drooling have been described as common side effects of MADs. These side effects are often mild and transient, and they improve as patients continue to use their appliance. Most studies found that these OMDs do not cause or are not a strong predictor of non-compliance. CONCLUSION: Xerostomia is a common side effect of CPAP and MAD, as well as a significant symptom of OSA. It may be regarded as one of the indicators of sleep apnoea. Moreover, MAD therapy can be associated with OMD. However, it seems that OMD may be mitigated by being adherent to the therapy.
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Avanço Mandibular , Sialorreia , Apneia Obstrutiva do Sono , Xerostomia , Humanos , Qualidade de Vida , Autorrelato , Sialorreia/complicações , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/terapia , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Resultado do Tratamento , Xerostomia/complicaçõesRESUMO
BACKGROUND: Bruxism is a masticatory muscle activity occurring during sleep or wakefulness, involving grinding and clenching of teeth and/or jaw bracing. As yet, the aetiology, epidemiology and consequences of awake bruxism (AB) are largely unknown. OBJECTIVES: The aims of the study were to AB behaviours using a novel bruxism screener (BruxScreen) questionnaire part and Ecological Momentary Assessment (EMA; BruxApp©) on AB behaviours, and to investigate AB's prevalence among masticatory muscle myalgia patients and non-patients. METHODS: Altogether, 115 participants (masticatory myalgia patients referred to a specialist clinic (n = 67) and non-patients (n = 46)) filled in a bruxism screener questionnaire to report bruxism behaviours and jaw symptoms. A selection of both groups did a week-long EMA (patients n = 12, non-patients n = 11) to report AB behaviours. The chi-squared test was used to determine group differences in categorical variables. A logistic regression model was fitted to study the probability of AB. RESULTS: According to BruxScreen, bruxism behaviours and jaw symptoms were more frequent in patients than in non-patients (p < .001). Based on EMA, 14.6% of the behaviour in patients was tooth clenching; for non-patients, this was 0.5% (p < .000). Relaxed muscles were reported by patients and non-patients at 20.6% and 56.4%, respectively (p < .021). Logistic regression, adjusted by age and sex, revealed that patients reported AB 5 times more often than non-patients (OR 4.8, 95% CI 2.1-11.2). CONCLUSION: Awake bruxism behaviours are significantly more frequent in masticatory muscle myalgia patients than non-patients and associate with frequent bruxism-related symptoms. Self-reported teeth clenching seems to be the most significant sign of AB behaviour.
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Bruxismo , Bruxismo do Sono , Humanos , Bruxismo/diagnóstico , Bruxismo/etiologia , Vigília , Mialgia , Avaliação Momentânea Ecológica , Músculos da Mastigação , Bruxismo do Sono/diagnóstico , Bruxismo do Sono/complicaçõesRESUMO
BACKGROUND: Most of the respiratory events in adults with obstructive sleep apnea (OSA) occurs in supine position. It has been reported that the contraction of masseter muscles is dependent on the occurrence of arousals rather than on the occurrence of respiratory events. OBJECTIVES: This study had two aims: (1) to compare the rhythmic masticatory muscle activity (RMMA) index in supine position (RMMA_sup) and in non-supine positions (RMMA_nsup) in adults with OSA; and (2) to determine the associations between RMMA index in both supine position and non-supine positions on the one hand, and several demographic and polysomnographic variables on the other hand. METHODS: One hundred OSA participants (36 females and 64 males; mean age = 50.3 years (SD = 10.5)) were selected randomly from among patients with a full-night polysomnographic recording. RMMA_sup index and RMMA_nsup index were compared using Mann-Whitney U-test. Multivariate linear regression analyses were used to predict RMMA index both in supine and non-supine positions based on several demographic and polysomnographic variables. RESULTS: In patients with OSA, the RMMA_sup index was significantly higher than the RMMA_nsup index (p < .001). RMMA_sup index was significantly associated with the arousal index (p = .002) and arousal index in supine position (p < .001). RMMA_nsup index was only significantly associated with the arousal index in non-supine positions (p = .004). CONCLUSION: Within the limitations of this study, RMMAs occur more frequently in supine position than in non-supine positions in patients with OSA. In both sleep positions, RMMAs are associated with arousals.
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Polissonografia , Apneia Obstrutiva do Sono , Bruxismo do Sono , Humanos , Masculino , Feminino , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/complicações , Pessoa de Meia-Idade , Bruxismo do Sono/fisiopatologia , Bruxismo do Sono/complicações , Decúbito Dorsal/fisiologia , Adulto , Músculo Masseter/fisiopatologia , EletromiografiaRESUMO
BACKGROUND: To assess awake and sleep bruxism, the Standardised Tool for the Assessment of Bruxism (STAB) is currently being developed. The STAB will be a comprehensive tool for the detailed assessment of bruxism behaviour itself as well as of its possible consequences, causes, and comorbid conditions. OBJECTIVE: Since the STAB cannot fully meet the 'A4 principle' for a bruxism assessment tool, i.e., being Accurate (reliable and valid), Applicable (feasible), Affordable (cost-effective), and Accessible (suitable for everyday clinical use), the Bruxism Screener (BruxScreen) has been developed to be used in large-scale epidemiological research projects and, especially, in general, dental practices. METHODS: The BruxScreen consists of two parts: a questionnaire (BruxScreen-Q) to be completed by patients, and a clinical assessment form (BruxScreen-C) to be completed by dentists. RESULTS: This paper describes the development of the BruxScreen and provides the outcomes of the pilot testing phase and the face validity assessment (i.e. that the first impressions of the tool indicate that it adequately reflects the construct to be measured). CONCLUSION: The resulting BruxScreen is considered ready for more profound psychometric testing in the general dental setting.
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Bruxismo , Bruxismo do Sono , Humanos , Bruxismo/diagnóstico , Bruxismo do Sono/diagnóstico , Inquéritos e Questionários , Reprodutibilidade dos TestesRESUMO
BACKGROUND: The occurrence of cognitive impairment (CI) is expected to increase within an ageing population. CI is associated with tooth loss, which influences masticatory performance. A decrease in masticatory performance may cause functional and morphological changes in the brain. However, whether CI is associated with masticatory performance, demographics, and structural brain signatures has not been studied yet. OBJECTIVES: To assess the associations between CI on the one hand, and masticatory performance, demographic factors, and structural brain signatures (i.e. cortical volume and thickness) on the other hand. METHODS: In total, 18 older adults with CI (mean ± SD age = 72.2 ± 9.5 years) and 68 older adults without CI (65.7 ± 7.5 years) were included in this study. Masticatory performance was quantified using a colour-changeable chewing gum. A Magnetic Resonance Imaging (MRI) scan was used to map structural brain signatures. To study our aim, a multivariate binary logistic regression analysis with backward selection was performed. RESULTS: The cortical volume of the right entorhinal cortex was negatively associated with CI (p < .01). However, demographic factors, masticatory performance, and the other structural brain signatures under investigation were not associated with CI. CONCLUSION: A decrease in the volume of the right entorhinal cortex is associated with CI in older people.
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Encéfalo , Disfunção Cognitiva , Humanos , Idoso , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Projetos Piloto , Estudos Transversais , Encéfalo/diagnóstico por imagem , Neuroimagem , Disfunção Cognitiva/diagnóstico por imagem , Demografia , MastigaçãoRESUMO
BACKGROUND: With time, due to the poor knowledge on it epidemiology, the need to focus on awake bruxism as a complement of sleep studies emerged. OBJECTIVE: In line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, that is better assessment and more efficient management. METHODS: We summarised current strategies for AB assessment and proposed a research route for improving its metrics. RESULTS: Most of the literature focuses on bruxism in general or SB in particular, whilst knowledge on AB is generally fragmental. Assessment can be based on non-instrumental or instrumental approaches. The former include self-report (questionnaires, oral history) and clinical examination, whilst the latter include electromyography (EMG) of jaw muscles during wakefulness as well as the technology-enhanced ecological momentary assesment (EMA). Phenotyping of different AB activities should be the target of a research task force. In the absence of available data on the frequency and intensity of wake-time bruxism-type masticatory muscle activity, any speculation about the identification of thresholds and criteria to identify bruxers is premature. Research routes in the field must focus on the improvement of data reliability and validity. CONCLUSIONS: Probing deeper into the study of AB metrics is a fundamental step to assist clinicians in preventing and managing the putative consequences at the individual level. The present manuscript proposes some possible research routes to advance current knowledge. At different levels, instrumentally based and subject-based information must be gathered in a universally accepted standardised approach.
Assuntos
Bruxismo , Bruxismo do Sono , Humanos , Bruxismo/diagnóstico , Bruxismo/terapia , Vigília/fisiologia , Reprodutibilidade dos Testes , Bruxismo do Sono/diagnóstico , Bruxismo do Sono/terapia , Polissonografia , Músculos da MastigaçãoRESUMO
OBJECTIVE: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. METHODS: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications. RESULTS: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration. CONCLUSIONS: The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields.
Assuntos
Bruxismo , Bruxismo do Sono , Transtornos do Sono-Vigília , Humanos , Bruxismo/diagnóstico , Bruxismo/etiologia , Bruxismo do Sono/diagnóstico , Bruxismo do Sono/complicações , Sono , Autorrelato , Transtornos do Sono-Vigília/complicaçõesRESUMO
BACKGROUND: Despite advances in temporomandibular disorders' (TMDs) diagnosis, the diagnostic process continues to be problematic in non-specialist settings. OBJECTIVE: To complete a Delphi process to shorten the Diagnostic Criteria for TMD (DC/TMD) to a brief DC/TMD (bDC/TMD) for expedient clinical diagnosis and initial management. METHODS: An international Delphi panel was created with 23 clinicians representing major specialities, general dentistry and related fields. The process comprised a full day workshop, seven virtual meetings, six rounds of electronic discussion and finally an open consultation at a virtual international symposium. RESULTS: Within the physical axis (Axis 1), the self-report Symptom Questionnaire of the DC/TMD did not require shortening from 14 items for the bDC/TMD. The compulsory use of the TMD pain screener was removed reducing the total number of Axis 1 items by 18%. The DC/TMD Axis 1 10-section examination protocol (25 movements, up to 12 sets of bilateral palpations) was reduced to four sections in the bDC/TMD protocol involving three movements and three sets of palpations. Axis I then resulted in two groups of diagnoses: painful TMD (inclusive of secondary headache), and common joint-related TMD with functional implications. The psychosocial axis (Axis 2) was shortened to an ultra-brief 11 item assessment. CONCLUSION: The bDC/TMD represents a substantially reduced and likely expedited method to establish (grouping) diagnoses in TMDs. This may provide greater utility for settings requiring less granular diagnoses for the implementation of initial treatment, for example non-specialist general dental practice.