Instrumental assessment of sleep bruxism: A systematic review and meta-analysis.

This systematic review and meta-analysis (MA) aimed to evaluate the diagnostic validity of portable electromyography (EMG) diagnostic devices compared to the reference standard method polysomnography (PSG) in assessing sleep bruxism. This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and was registered with PROSPERO prior to the accomplishment of the main search. Ten clinical studies on humans, assessing the diagnostic accuracy of portable instrumental approaches with respect to PSG, were included in the review. Methodological shortcomings were identified by QUADAS-2 quality assessment. The certainty of the evidence analysis was established by different levels of evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. A meta-analysis of diagnostic test accuracy was performed with multiple thresholds per study applying a two-stage random effects model, using the thresholds offered by the studies and based on the number of EMG bruxism events per hour presented by the participants. Five studies were included. The MA indicated that portable EMG diagnostic devices showed a very good diagnostic capacity, although a high variability is evident in the studies with some outliers. Very low quality of evidence due to high risk of bias and high heterogeneity among included studies suggests that portable devices have shown high sensitivity and specificity when diagnosing sleep bruxism (SB) compared to polysomnography. The tests performed in the MA found an estimated optimal cut-off point of 7 events/hour of SB with acceptably high sensitivity and specificity for the EMG portable devices.

Is there an association between sleep bruxism and obstructive sleep apnea? A case-control polysomnographic investigation.

OBJECTIVES: To estimate the statistical and epidemiological association between Sleep bruxism (SB) and Obstructive sleep apnea (OSA) based on OSA severity, and to describe sleep data findings within the analyzed population. METHODS: A case-control study (N = 37) was conducted on subjects with and without OSA. All subjects underwent a full-night polysomnographic recording at the Sleep Unit (Clinical Neurophysiology Department) of San Carlos University Hospital. The diagnosis and severity of OSA were determined using ICSD-3 and AASM-2.6 scoring. The definitive SB diagnosis was obtained through a self-report test, physical examination, and PSG recordings. Variables used to study the association between both conditions included the apnea and hypopnea episodes, the Apnea-hypopnea index (AHI), the number of SB episodes per night, and the bruxism index. Chi2, correlations, and ANOVA were calculated. The epidemiological association was calculated using the OR. RESULTS: SB showed an epidemiological association with OSA, with an OR of 0.15 (0.036-0.68), suggesting it could be considered a protective factor (p < 0.05). OSA patients presented fewer average SB episodes (6.8 ± 12.31) than non-OSA patients (25.08 ± 31.68). SB episodes correlated negatively (p < 0.05) with the AHI and the number of hypopneas (p < 0.05). The average number of SB episodes was significantly higher in patients with mild OSA compared to those with severe OSA. CONCLUSIONS: In this sample of patients with subclinical and mild OSA, SB may act as a protective factor. However, confirmation of these results with a larger sample size is necessary.

¿Tiene mi paciente bruxismo de vigilia? ¿Cómo puedo tratarlo? / Does my patient have awake bruxism? How can i treat it?

En la actualidad, el bruxismo se ha convertido en un tema de gran interés para los profesionales de la salud, ya que nuestros estilos de vida se han vuelto agitados y estresantes. Estos factores estre santes, a veces, son la principal causa de apretamiento o contacto repetitivo y sostenido de los dientes o simplemente man tenimiento de una posición forzada de la mandíbula, sin contacto dentario durante las horas de vigilia, que definimos como bruxismo de vigilia. El diagnóstico se basa principalmente en la propia capacidad del paciente para identificarlo, además de un examen clínico intraoral en busca de daños en las estructuras dentales. Para manejar estas situaciones se recomienda seguir una estrategia terapéutica que incluya: educación y recomendaciones, férulas, fármacos, terapia psicológica y fisioterapia (AU)

Bruxism has currently become a topic of great interest for health professionals as our lifestyles have become hectic and stressful. These stress factors are sometimes the main cause of repetitive and sustained clenching or contact of the teeth or simply maintaining a forced jaw position without tooth contact while awake, which we define as awake bruxism. The diagnosis is mainly based on the patient’s own ability to identify it, in addition to an intraoral clinical examination to look for damage to dental structures. To manage these situations, it is recommended that a therapeutic strategy be followed including: education and recommendations, splints, medication, psychological therapy, and physiotherapy (AU)