Bibliometric Analysis of Botulinum Toxin and Bruxism: Impact, Visualization, and Collaborative Networks.

AIM: To analyze the scientific production related to the use of botulinum toxin (BTX-A) in the management of bruxism and evaluate its scope, impact, networks, and new research trends. MATERIALS AND METHODS: A descriptive and retrospective study of publications indexed in Scopus from January 2018 to May 2024 was conducted. The bibliometric indicators evaluated were a number of publications, citations, h-index, SCImago Journal Rank 2022, CiteScore 2022, Lotka's Law, Bradford's Law, and keyword co-occurrence analysis. Data were processed using SciVal and VOSviewer. RESULTS: We obtained 98 publications, including original articles, reviews, and other types of documents. Among the most productive authors, most were from South Korea and Turkey. Wonkwang University (South Korea) had the highest number of publications, while Baylor College of Medicine (USA) had the highest impact with 66.5 citations per publication. Toxins had the highest number of publications and the best Cite Score in 2022. Six main topics related to BTX-A in bruxism were identified, highlighting "reviews," "electromyography" and "controlled clinical trials". CONCLUSIONS: The use of BTX-A for the treatment of bruxism has generated increasing interest and scientific output in recent years, especially in South Korea and Brazil. However, there is a disparity in the productivity of authors, with most authors presenting only one publication. CLINICAL SIGNIFICANCE: This study highlights the need for further research and collaborations to optimize clinical practice and better understand the efficacy and management of BTX-A for treating bruxism. How to cite this article: Villanueva-García M, Ruck-Sanchez N, Tinedo-López PL, et al. Bibliometric Analysis of Botulinum Toxin and Bruxism: Impact, Visualization, and Collaborative Networks. J Contemp Dent Pract 2024;25(6):599-604.

Temporomandibular disorders: INfORM/IADR key points for good clinical practice based on standard of care.

OBJECTIVE: To present a list of key points for good Temporomandibular Disorders (TMDs) clinical practice on behalf of the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) group of the International Association for Dental, Oral and Craniofacial Research (IADR). METHODS: An open working group discussion was held at the IADR General Session in New Orleans (March 2024), where members of the INfORM group finalized the proposal of a list of 10 key points. RESULTS: The key points covered knowledge on the etiology, diagnosis, and treatment. They represent a summary of the current standard of care for management of TMD patients. They are in line with the current need to assist general dental practitioners advance their understanding and prevent inappropriate treatment. CONCLUSIONS: The key points can be viewed as a guiding template for other national and international associations to prepare guidelines and recommendations on management of TMDs adapted to the different cultural, social, educational, and healthcare requirements.

Impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults : A cross-sectional study.

PURPOSE: The aim of this study was to investigate the impact of malocclusion and oral habits on oral health-related quality of life and sleep disturbance in young adults. METHODS: A cross-sectional study was conducted with a sample of 213 young adults aged 18-30 years. Dental occlusion data were assessed through clinical examination. A questionnaire was used to collect data on oral habits. Outcomes were collected using the Oral Health Impact Profile (OHIP-14) and Mini Sleep Questionnaire. RESULTS: Anterior open bite (adjusted odds ratio [OR] = 2.41, 95% confidence interval [CI] = 1.02-5.67, p = 0.044), swallowing disorders (adjusted OR = 2.39, 95% CI = 1.13-5.05, p = 0.022), and sleeping on hands were associated with a negative impact on oral health-related quality of life. Females (adjusted OR = 2.61, 95% CI = 1.10-6.17, p = 0.029), teeth grinding (adjusted OR = 2.78, 95% CI = 1.08-7.14, p = 0.034), biting lips or cheeks (adjusted OR = 4.28, 95% CI = 1.49-12.29, p = 0.007), and self-perception of need for orthodontic treatment (adjusted OR = 7.88, 95% CI = 2.12-29.30, p = 0.002) were associated as a risk for sleep disturbances. CONCLUSION: The findings suggest that oral habits and some types of malocclusions can impact oral health-related quality of life. In addition, sleep disturbances were associated with a greater need for orthodontic treatment and a habit of grinding teeth in young adults.

Establishing a CAD-CAM workflow for stabilization appliances (Michigan splints).

Stabilization appliances (Michigan splints) are considered well-studied and widely adopted for managing bruxism and temporomandibular disorders (TMDs). Traditionally, these appliances have been fabricated by wax modeling and pressing resin onto casts made from irreversible hydrocolloid or silicone impressions. This article provides a detailed description of an all-digital workflow that uses intraoral scanning and computer-aided design (CAD) software to design a stabilization splint on a digital cast that can be manufactured autonomously by a computer-aided manufacturing (CAM) grinding machine in a subtractive procedure. The workflow is applicable to both dentists and technicians. Special attention is given to aspects and procedures that are important for the successful fabrication of the splint. Working without a cast can save time and money, and the use of CAD-CAM technology provides a homogeneous splint material quality.

Comparative evaluation of salivary melatonin levels in patients with bruxism: a case-control study.

Aim: To examine whether there is any difference in the levels of salivary melatonin between bruxism and nonbruxism groups and to compare the stress and anxiety levels between the two groups.Materials & methods: Patients meeting the probable bruxism criteria according to the International Consensus on the Assessment of Bruxism Criteria were included in the bruxism group. The salivary melatonin concentrations of both groups were measured using an ELISA kit. To determine the relationship between stress and bruxism, the State-Trait Anxiety Inventory (STAI) test was used.Results: The bruxism group had a significantly lower night-time salivary melatonin level than the control group (p < 0.05). No significant difference was determined between the bruxism group and the control group in respect of the STAI-T scores (p > 0.05).Conclusion: The study findings revealed a strong relationship between a low melatonin level and bruxism.

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Association between Estrogen Levels and Temporomandibular Disorders: An Updated Systematic Review.

The aim of this systematic review is to evaluate the impact of estrogen levels on the occurrence of temporomandibular disorders (TMDs) in humans. Searches were conducted in the same databases as follows: PubMed, the Cochrane Collaboration database, and the Scopus database. In accordance with the MeSH database and previous work, the following keywords were used: 'estrogens' and 'temporomandibular joint disorders'. Twelve studies were included in the review and were assessed for the quality of evidence. Estrogen levels are associated with pain modulation in the temporomandibular joint and the entire orofacial region. There is insufficient evidence to either confirm or refute the influence of estrogen on the occurrence of TMDs. The study was registered under the identifier: 10.17605/OSF.IO/BC7QF.

Stress is simultaneously related to sleep and temporomandibular disorders.

PURPOSE: This study aimed to clarify the relationship between the oral environment and psychological factors as predictor variables of sleep quality, in addition to inferring the relevant mechanisms of sleep and temporomandibular disorders (TMDs) by analyzing the relationship between TMDs and stress. METHODS: This cross-sectional study analyzed data from 1,032 participants, comprising 420 men and 612 women, from the 2017 Iwaki Health Promotion Project using multiple regression analysis. The primary endpoints were the scores of each item in the Pittsburgh Sleep Quality Index (PSQI) and its sum. Predictor variables included the number of teeth; TMDs; stress, assessed using the World Health Organization-5 (WHO-5); sleep bruxism; and oral health-related quality of life, assessed using the oral health impact profile-14 (OHIP14). The confounding factors included age, body mass index, and alcohol intake. RESULTS: Multiple regression analysis revealed that TMDs (ß value = 0.293, p = 0.034) and stress (ß value = 1.3, p < 0.001) were significantly correlated with the PSQI total score. In addition, TMDs were significantly correlated with stress (ß value = 0.076, p = 0.007). CONCLUSION: The significant relationship between sleep and TMDs suggests that mental stress contributes to the development sleep disorders and consequently is associated with the development of TMD symptoms.

Association between sleep bruxism and snoring in adults: An observational study.

OBJECTIVE: This study evaluated the association between sleep bruxism and snoring. Additionally, the associations between sleep bruxism and age, sex, body mass index, sleep structure, sleep quality, and sleepiness were evaluated. METHODS: Adults suspected of having sleep disorders (n = 61) underwent single-night video polysomnography according to the American Academy of Sleep Medicine criteria. Validated questionnaires were used to assess sleepiness and sleep quality, and clinical examinations were performed to document weight and height. Jamovi software was used for statistical analysis. Logistic regression analyses of the different sleep stages-REM sleep, NREM sleep, and total sleep time-were conducted. RESULTS: No association was found between sleep bruxism and snoring (P > 0.31), with a small effect size (V = 0.171). However, the snore index was found to influence the rhythmic masticatory muscle activity index during REM sleep, with an odds ratio of 1.018 (95 % CI: 1.005 to 1.03; P = 0.05). Moreover, logistic regression showed that the desaturation index presented an odds ratio of 5.01 (95 % CI: 0.96 to 26.13; p = 0.056), with a medium effect size (>3.5). Sleep bruxism was not associated with age, sex, body mass index, or other sleep variables. CONCLUSION: Snoring appears to be associated with bruxism during REM sleep. No associations were found between sleep bruxism and sex, age, or body mass index. This lack of association underscores the complexity of sleep bruxism and snoring and highlights the need for further research. Concerning sleep architecture, only desaturation episodes were associated with bruxism during REM sleep. Neither sleep quality nor sleepiness was associated with sleep bruxism.

Comparison of rhythmic jaw muscle activities induced by electrical stimulations of the corticobulbar tract during rapid eye movement sleep with those during wakefulness and non-rapid eye movement sleep in freely moving guinea pigs.

OBJECTIVE: Rhythmic jaw muscle activities (RJMAs) occur during rapid eye movement (REM) sleep in humans and animals even though motoneurons are inhibited. The present study compared the characteristics of jaw muscle activities induced by electrical microstimulations of the corticobulbar tract (CT) during REM sleep with those during wakefulness and non-REM sleep. METHODS: Eleven guinea pigs were surgically prepared for polygraphic recordings with the implantation of a stimulating electrode. Long- and short-train repetitive electrical microstimulations were applied to the CT under freely moving conditions. The response rate, latency, burst amplitude, and cycle length in the digastric muscle were calculated and cortical and cardiac activities were quantified. RESULTS: Long-train microstimulations induced RJMAs in the digastric muscle followed by masseter muscle activity during wakefulness and non-REM sleep and only induced rhythmic digastric muscle activity during REM sleep. The response rate of RJMAs and the burst amplitude of digastric muscles were significantly lower during REM sleep than during wakefulness and non-REM sleep. However, response latency did not significantly differ between REM sleep and wakefulness. Transient cortical and cardiac changes were associated with RJMAs induced during non-REM sleep, but not during REM sleep. Short-train microstimulations induced a short-latency digastric response, the amplitude of which was significantly lower during REM sleep than during non-REM sleep and wakefulness. CONCLUSIONS: These results suggest that the masticatory CPG was activated by electrical CT stimulations independently of the motoneuron inhibitory system during REM sleep.

Relationship between sleep bruxism and obstructive sleep apnoea: A population-based survey.

OBJECTIVE: Sleep bruxism (SB) and obstructive sleep apnoea (OSA) seem to be mutually associated. This study investigates the relationship between current SB and OSA-related symptoms and the difference in OSA-related symptoms between groups based on a history of SB. METHODS: An online survey was drafted to report the presence of SB and OSA in sample of 243 individuals (M = 129;F = 114;mean(SD)age = 42.4 ± 14.4 years). The Subject-Based Assessment strategy recommended in the 'Standardized Tool for the Assessment of Bruxism' (STAB) was adopted to assess SB. To evaluate OSA-related symptoms, Epworth Sleepiness Scale (ESS) and STOP-BANG questionnaires were adopted. Correlations between current SB and OSA-related symptoms were evaluated by Spearman test. ESS and STOP-BANG scores were compared by Mann-Whitney U test in individuals with and a without positive SB history. RESULTS: Current SB and SB history were reported by 45.7% and 39.1% of the sample, respectively. 73.7%, 21% and 5.3% of the responders showed a low, intermediate and high risk of OSA, respectively. Neither significant correlations between current SB and OSA nor significant differences between SB groups emerged. CONCLUSIONS: This study did neither find any significant correlation between self-report of current SB and OSA nor significant differences in ESS and STOP-BANG scores between groups based on SB history.

Movement disorders of the stomatognathic system: A blind spot between dentistry and medicine.

Movement disorders of the stomatognathic system include oromandibular dystonia (OMD), oral dyskinesia, sleep/awake bruxism, functional (psychogenic) stomatognathic movement disorders (FSMDs), tremors, and hemimasticatory spasm (HMS). Most patients first consult dentists or oral surgeons. The differential diagnoses of these involuntary movements require both neurological and dental knowledge and experience, and some of these movement disorders are likely to be diagnosed as bruxism or temporomandibular disorders (TMDs) by dental professionals. However, excepting movement disorder specialists, neurologists may find it difficult to differentially diagnose these disorders. Patients may visit numerous medical and dental specialties for several years until a diagnosis is made. Therefore, movement disorders of the oral region may represent a blind spot between dentistry and medicine.The present narrative review aimed to describe the clinical characteristics and differential diagnoses of some movement disorders, as well as the problems bridging dentistry and medicine. Movement disorders have the following characteristic clinical features: OMD - task specificity, sensory tricks and the morning benefit; FSMDs - inconsistent and incongruous symptoms, spreading to multiple sites and the lack of sensory tricks; and HMS - the paroxysmal contraction of unilateral jaw-closing muscles, the persistence of symptoms during sleep and the loss of a silent period. A careful differential diagnosis is essential for the adequate and effective treatment of each involuntary movement. Refining the latest definition of bruxism may be necessary to prevent the misdiagnosis of involuntary movements as bruxism.Both dental and medical professionals should take an interest in the movement disorders of the stomatognathic system, and these disorders should be diagnosed and treated by a multidisciplinary team.

Is There an Increase in Possible Sleep Bruxism in Children Over Time? A Longitudinal Study.

BACKGROUND: Bruxism is a behaviour that has several consequences in an individual's life, especially when it starts in childhood. However, bruxism can be a potential protective factor, which is an attribute that reduces the chance of a negative health outcome. OBJECTIVES: To evaluate the incidence of sleep bruxism (SB) and dental wear in children and adolescents. MATERIALS AND METHODS: This longitudinal study began in 2014 and 2016 (baseline) with initial 1816 children followed for 5 and 3 years, respectively. The follow-up data collection started in 2019. The diagnosis of SB was parents report (baseline) and self-report (follow-up) due to age groups of each phase, and questions related to symptoms of SB were collected. Five calibrated examiners (kappa >0.7) collected the clinical data. The clinical variables were dental erosion and dental wear. Contextual, individual, behaviour and clinical characteristics were collected. A multilevel logistic regression model was used to investigate the association of contextual, individual, behaviour and clinical characteristics with SB. Poisson regression for repeated measures was performed to evaluate the incidence of SB and dental wear (incidence rate ratio-IRR and confidence interval-95% CI). RESULTS: Two hundred and fifty-three children and adolescents answered questionnaires and were clinically examined. The mean age of the follow-up in 2019 was 11.25 years old (±2.19). There was no increase in the incidence of SB (95% CI: 0.74-1.35). Children/adolescents had a 2.2 higher risk to present dental wear (95% CI: 1.89-2.60). SB at the follow-up was associated with the contextual variable, earache, erosion and awake bruxism. CONCLUSIONS: In this population, children with SB remained with this behaviour and showed higher dental wear over the years.

Sleep Disorders Affecting Prognosis of Dental Treatment.

This study provided an overview of the knowledge on the main sleep-related disorders and conditions affecting the prognosis of dental treatment: sleep bruxism (SB), obstructive sleep apnea (OSA), and gastroesophageal reflux disease (GERD). Current scientific evidence seems to suggest that these phenomena (ie, SB, OSA, GERD) belong to a circle of mutually relating sleep disorders and conditions where dental practitioners can play a key role in diagnosis and treatment.

3D printed versus milled stabilization splints for the management of bruxism and temporomandibular disorders: study protocol for a randomized prospective single-blinded crossover trial.

BACKGROUND: Nowadays, stabilization splints for the management of bruxism and temporomandibular disorders (TMD) can be produced utilizing a digital workflow comprising a digital impression of the teeth, digital splint design, and computer-aided manufacturing of the splints. The latter is usually a milling process, however, more recently 3D printing gained popularity due to its better cost and time efficiency. It remains unknown whether 3D printed stabilization splints are inferior to milled splints regarding clinical outcomes. METHODS: This clinical trial assesses the non-inferiority of 3D printed occlusal splints compared to milled occlusal splints in a monocentric prospective randomized single-blinded crossover trial with two cohorts. One cohort includes 20 participants with bruxism, the other 20 participants with pain-related TMD, i.e., myalgia, myofascial pain, or arthralgia of the jaw muscles/the temporomandibular joint(s) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Michigan-type stabilization splints are fabricated in a digital workflow by milling or 3D printing using CE-marked materials within their intended purpose. The participants wear a milled and a 3D printed splint in a randomized order for 3 months each, with follow-up visits after 2 weeks and 3 months. Investigated outcome parameters are oral health-related quality of life (OHRQoL) evaluated by the Oral Health Impact Profile (OHIP-G14), participant satisfaction as rated on a visual analog scale, therapeutic efficacy, and technical result of the splints. In this context, therapeutic efficacy means antagonist wear and-in the TMD group-reduction of pain/disability assessed by the Graded Chronic Pain Scale (GCPS v2.0) and clinical assessment following the DC/TMD standard, while technical outcome measures splint fit, wear and fracture rate. DISCUSSION: The trial will provide important information on the clinical outcome of 3D printed stabilization splints in comparison to milled splints and will, therefore, enable an evidence-based decision in favor of or against a manufacturing process. This, in turn, will guarantee for a maximum of the patient's OHRQoL during splint therapy, therapeutic efficacy, and longevity of the splints. TRIAL REGISTRATION: German Clinical Trials Register (DRKS) DRKS00033904. Registered on March 15, 2024.

Sleep bruxism in children main methods of treatment: a systematic review with meta-analysis.

Sleep bruxism is both masticatory muscle activities characterized by repeated or prolonged tooth contact as well as bracing or thrusting of the jaw. This meta-analysis evaluates the differences between sexes and which therapy is most effective in treating bruxism. A literature search was performed on PubMed, Lilacs, Web of Science and Scopus, and articles published from 2000 to 2022 were considered according to the keywords entered. The term "Bruxism" has been combined with "Children" using the boolean connector AND. At the end of the research, 1462 studies were identified from the search conducted on the three engines. Only four were chosen to draw up the present systematic study. The Forrest plot found that photo biomodulation therapy has a higher efficacy (Odds Ratio (OR) 0.10; 95% Confidence Interval (CI) from 0.03 to 0.43), followed by treatment with hydroxyzine (OR 0.19; 95% CI from 0.03 to 1.04). The average between girls and boys with bruxism is 18.5 for boys and 19.5 for girls. This meta-analysis showed that treatment by photobiomodulation has more significant effects on bruxism, followed by treatment with hydroxyisalazine. However, this meta-analysis has limitations due to the diversity of treatment evaluation methods.

Botulinum toxin for bruxism treatment: a nationwide study among oral and maxillofacial surgeons in Germany.

INTRODUCTION: This study aimed to evaluate the use of botulinum toxin (BTX) for the treatment of bruxism in oral and maxillofacial surgery in Germany. MATERIAL AND METHODS: A dynamic online questionnaire comprising 7 to 25 questions was formulated to gather general and specific information regarding using BTX to treat bruxism. The questionnaire underwent internal and external assessments for validation. Subsequently, it was distributed to 906 oral and maxillofacial surgeons (OMFS) affiliated with the German Association for Oral and Maxillofacial Surgery (DGMKG). Weekly reminders were dispatched over four weeks to enhance response rates. Participation in the study was voluntary and anonymized. Descriptive methods were employed for data analysis. RESULTS: 107 OMFS participated in the study, yielding a response rate of 11.81%. On average, 17 patients with bruxism were per month, with 4 of these patients receiving BTX therapy. BTX administration was frequently accompanied by splints and physiotherapy (35.51% of participants). Botox® (Allergan) was the preferred BTX preparation, utilized by 40.79% and reconstituted with saline by 92.11% of participants. The masseter muscles were primarily targeted for BTX treatment (67.57% of participants), averaging 29 BTX (Allergan-) units per side. Injection points for each masseter muscle typically amounted to six per side, preferred by 30.67% of participants. Follow-up assessments post-BTX treatment were conducted regularly, predominantly after four weeks, by 36% of participants. In 8% of cases, additional BTX injections were necessary due to inadequate outcomes. Side effects were reported in 4% of cases, commonly manifesting as a non-disturbing reduction in bite force. Most participating OMFS (61.84%) using BTX for bruxism therapy regarded bruxism treatment with BTX as evidence-based. Notably, 97.37% of respondents expressed their willingness to recommend BTX-based bruxism treatment to their colleagues. Overall, the efficacy of BTX therapy for bruxism was rated as good (53.95%) and very good (40.79%). CONCLUSION: The use of BTX for the management of bruxism among OMFS in Germany has demonstrated efficacy. Substantial variances in certain facets of bruxism treatment employing BTX have been observed. CLINICAL RELEVANCE: Additional research endeavors are warranted to comprehensively investigate distinct elements of BTX therapy for bruxism, including the optimal dosage of BTX units and the precise localization of injection sites across various muscles.

What do Brazilian paediatric dentists know about bruxism in children? Cross-sectional study.

PURPOSE: Little is known about the knowledge of paediatric dentists on bruxism in children. The aim of this cross-sectional study was to assess the knowledge of paediatric dentists on the concept, associated factors of bruxism and management of sleep bruxism (SB) in children'. METHODS: An electronic questionnaire was sent to paediatric dentists in the state of Goiás, Brazil. Information was collected on (1) characteristics of the participants; (2) the concept of bruxism; (3) diagnosis; (4) associated factors; (5) strategies for the management of SB; and (6) updated knowledge on bruxism in children. The data were analysed descriptively. RESULTS: Fifty-seven paediatric dentists participated (10.7% of the total number of professionals). A high level of agreement was found with statements on the concepts of SB (94.7%) and awake bruxism (96.5%). The main strategy for the diagnosis was the combination of a parental report and a clinical examination (79.0%). Most participants indicated that bruxism is associated with anxiety/stress (96.5%), screen use (93%), airway obstruction (91.2%), and sleep apnoea (91.2%). In suspected cases of bruxism, the dentists would send the child for assessment by other health care providers (87.7%). The management options frequently indicated were the use of an occlusal splint, aromatherapy, and homeopathy. More than 70% of them considered themselves to be updated on the issue and sought information through scientific articles and discussions with colleagues. CONCLUSION: Paediatric dentists have knowledge on the concept of bruxism and associated factors. However, further information is needed on the management of this condition in children.

Advanced Sensing System for Sleep Bruxism across Multiple Postures via EMG and Machine Learning.

Diagnosis of bruxism is challenging because not all contractions of the masticatory muscles can be classified as bruxism. Conventional methods for sleep bruxism detection vary in effectiveness. Some provide objective data through EMG, ECG, or EEG; others, such as dental implants, are less accessible for daily practice. These methods have targeted the masseter as the key muscle for bruxism detection. However, it is important to consider that the temporalis muscle is also active during bruxism among masticatory muscles. Moreover, studies have predominantly examined sleep bruxism in the supine position, but other anatomical positions are also associated with sleep. In this research, we have collected EMG data to detect the maximum voluntary contraction of the temporalis and masseter muscles in three primary anatomical positions associated with sleep, i.e., supine and left and right lateral recumbent positions. A total of 10 time domain features were extracted, and six machine learning classifiers were compared, with random forest outperforming others. The models achieved better accuracies in the detection of sleep bruxism with the temporalis muscle. An accuracy of 93.33% was specifically found for the left lateral recumbent position among the specified anatomical positions. These results indicate a promising direction of machine learning in clinical applications, facilitating enhanced diagnosis and management of sleep bruxism.

Moving beyond bruxism episode index: Discarding misuse of the number of sleep bruxism episodes as masticatory muscle pain biomarker.

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.