RESUMEN
PURPOSE: This cross-sectional longitudinal observational study aimed to clarify the question of whether painful temporomandibular disorders (TMD) in psychiatrically confirmed patients hospitalised for post-traumatic stress disorder (PTSD) therapy after using splint therapy (ST) show long-term therapeutic effects in the case of functional disorders. MATERIALS AND METHODS: One hundred fifty-three (153) inpatients (123 male and 20 female soldiers, age 35.8 ± 9.2 years, 26.6 ± 2.2 teeth) with confirmed PTSD (Impact of Event Scale - Revised ≥33), grade 3 to 4 chronic pain according to von Korff's Chronic Pain Scale and the research diagnostic criteria of painful TMD (RDC-TMD) were recorded. All participants received a maxillary occlusal splint that was worn at night. Control check-ups of the therapeutic effect of the splint were conducted for up to 9 years during psychiatric follow-ups. RESULTS: TMD pain worsened in 22 (14.4%) patients within the first 6 weeks and led to the removal of the splint. The pain intensity (PI) at BL was reported to be a mean of VAS 7.7 ± 1.1. Six weeks after ST (n = 131), the average PI was recorded as VAS 2.6 ± 1.3. Based on the last examination date of all subjects, the average PI was recorded as 0.7 ± 0.9. Seventy-two (72) patients used a second stabilisation splint in the maxilla after 14.4 ± 15.7 months, and 38 patients used between 3 and 8 splints during their psychiatric and dental treatment time (33.7 ± 29.8 months). CONCLUSION: The presented data shows that therapeutic pain reduction remained valid in the long term despite continued PTSD. The lifespan of a splint seems to be dependent on individual factors. Long-term splint therapy appears to be accepted by the majority of patients with PTSD and painful TMD.
Asunto(s)
Personal Militar , Ferulas Oclusales , Bruxismo del Sueño , Trastornos por Estrés Postraumático , Trastornos de la Articulación Temporomandibular , Humanos , Masculino , Femenino , Adulto , Trastornos de la Articulación Temporomandibular/terapia , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/psicología , Estudios Transversales , Bruxismo del Sueño/terapia , Bruxismo del Sueño/complicaciones , Trastornos por Estrés Postraumático/terapia , Estudios Longitudinales , Alemania , Hospitalización , Dimensión del DolorRESUMEN
BACKGROUND: Although biofeedback with contingent electrical stimulation (CES) has demonstrated the reduction effect on sleep bruxism (SB), the relationship between the actual applied CES intensity and efficacy remains uncertain. OBJECTIVE: This study aimed to investigate whether the reduction of bruxism events and jaw muscle symptoms could vary according to the intensity of CES and in probable sleep bruxers. METHODS: Twenty probable sleep bruxers were initially screened for bruxer confirmation based on a 2-week recording of SB events with a portable electromyography recorder (BUTLER®GrindCare®, GC4). A 3-week recording was conducted without CES using a GC4, followed by another 3-week recording with CES. At baseline and before and after the CES (+) session, clinical muscle symptoms were assessed using a 0-10 numerical rating scale (NRS). The relationships between the actual applied CES intensity and the number of SB events/hour, as well as the NRS of clinical muscle symptoms, were analysed. RESULTS: The actual applied CES intensity was positively correlated with the reduction rate of the number of SB events/hour (R = .643, p = .002), as well as with the reduction rate of NRS for pain, unpleasantness, fatigue, tension and stiffness (R > .500, p < .011). CONCLUSION: Higher CES elicited a more robust reduction in SB events and clinical muscle symptoms, in probable bruxers. Prior to selecting CES biofeedback as a management option for SB, it would be beneficial to assess the tolerance threshold of CES in each bruxer in order to predict the effectiveness of CES in probable sleep bruxers.
Asunto(s)
Terapia por Estimulación Eléctrica , Electromiografía , Bruxismo del Sueño , Humanos , Bruxismo del Sueño/terapia , Bruxismo del Sueño/fisiopatología , Bruxismo del Sueño/complicaciones , Masculino , Femenino , Adulto , Terapia por Estimulación Eléctrica/métodos , Resultado del Tratamiento , Adulto Joven , Biorretroalimentación Psicológica/métodosRESUMEN
BACKGROUND: Polysomnography (PSG) is the gold standard for sleep bruxism (SB) assessment, it is expensive, not widely accessible, and time-consuming. OBJECTIVE: Given the increasing prevalence of SB, there is a growing need for an alternative, readily available, reliable and cost-effective diagnostic method. This study aimed to evaluate the diagnostic validity of portable respiratory polygraphy (PRPG) compared with PSG for SB diagnosis. METHODS: One hundred and three subjects underwent simultaneous examinations using PRPG (NOX T3, NOX Medical) and PSG (NOX A1, NOX Medical) in a sleep laboratory. RESULTS: The mean Bruxism Episodes Index (BEI) measured by PRPG was 4.70 ± 3.98, whereas PSG yielded a mean BEI of 3.79 ± 3.08. The sensitivity for detecting sleep bruxism (BEI >2) by PRPG was 48.3%, with a specificity of 81.2%. The positive predictive value was estimated at 51.9%, and the negative predictive value at 78.9%. However, when distinguishing between mild bruxism (BEI >2 < 4) and severe bruxism (BEI >4), PRPG demonstrated a sensitivity of 77.8% and 68.3% and a specificity of 48.6% and 71.4%, respectively. CONCLUSION: Polysomnography continues to be the SB diagnostic gold standard tool, as the sensitivity and specificity of PRPG are significantly lower when compared with PSG. Nevertheless, PRPG could serve as an alternative tool for SB screening or diagnosis, despite its limitations. Furthermore, our data indicate that comorbidities such as sleep apnea and sleep quality do not influence the diagnostic accuracy of PSG, suggesting its potential as a screening instrument in individuals with other sleep disorders.
Asunto(s)
Polisomnografía , Sensibilidad y Especificidad , Bruxismo del Sueño , Humanos , Bruxismo del Sueño/diagnóstico , Polisomnografía/métodos , Femenino , Masculino , Adulto , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto Joven , Valor Predictivo de las PruebasRESUMEN
BACKGROUND: The etiology of sleep bruxism in obstructive sleep apnea (OSA) patients is not yet fully clarified. This prospective clinical study aimed to investigate the connection between probable sleep bruxism, electromyographic muscle tone, and respiratory sleep patterns recorded during polysomnography. METHODS: 106 patients with OSA (74 males, 31 females, mean age: 56.1 ± 11.4 years) were divided into two groups (sleep bruxism: SB; no sleep bruxism: NSB). Probable SB were based on the AASM criteria: self-report of clenching/grinding, orofacial symptoms upon awakening, abnormal tooth wear and hypertrophy of the masseter muscle. Both groups underwent clinical examination for painful muscle symptoms aligned with Temporomandibular Disorders Diagnostic Criteria (DC/TMD), such as myalgia, myofascial pain, and headache attributed to temporomandibular disorder. Additionally, non-complaint positive muscle palpation and orofacial-related limitations (Jaw Functional Limited Scale-20: JFLS-20) were assessed. A one-night polysomnography with electromyographic masseter muscle tone (EMG) measurement was performed. Descriptive data, inter-group comparisons and multivariate logistic regression were calculated. RESULTS: OSA patients had a 37.1% prevalence of SB. EMG muscle tone (N1-N3, REM; P = 0.001) and the number of hypopneas (P = 0.042) were significantly higher in the sleep bruxism group. While measures like apnea-hypopnea-index (AHI), respiratory-disturbance-index (RDI), apnea index (AI), hypopnea-index (HI), number of arousals, and heart rate (1/min) were elevated in sleep bruxers, the differences were not statistically significant. There was no difference in sleep efficiency (SE; P = 0.403). Non-complaint masseter muscle palpation (61.5%; P = 0.015) and myalgia (41%; P = 0.010) were significant higher in SB patients. Multivariate logistic regression showed a significant contribution of EMG muscle tone and JFLS-20 to bruxism risk. CONCLUSION: Increased EMG muscle tone and orofacial limitations can predict sleep bruxism in OSA patients. Besides, SB patients suffer more from sleep disorder breathing. Thus, sleep bruxism seems to be not only an oral health related problem in obstructive apnea. Consequently, interdisciplinary interventions are crucial for effectively treating these patients. TRIAL REGISTRATION: The study was approved by the Ethics Committee of Philipps-University Marburg (reg. no. 13/22-2022) and registered at the "German Clinical Trial Register, DRKS" (DRKS0002959).
Asunto(s)
Electromiografía , Polisomnografía , Apnea Obstructiva del Sueño , Bruxismo del Sueño , Humanos , Masculino , Femenino , Apnea Obstructiva del Sueño/fisiopatología , Apnea Obstructiva del Sueño/complicaciones , Bruxismo del Sueño/complicaciones , Bruxismo del Sueño/fisiopatología , Persona de Mediana Edad , Estudios Prospectivos , Músculo Masetero/fisiopatología , Salud Bucal , Adulto , Tono Muscular/fisiologíaRESUMEN
Sleep bruxism (SB) can be determined with different diagnostic procedures. The relationship between psychometric variables and SB varies depending on the diagnostic method. The aim of the study was to compare the association between SB and oral health-related quality of life (OHRQoL; measured by the Oral Health Impact Profile, OHIP), anxiety (measured by the State-Trait anxiety inventory, STAI), and stress (single scale variable) depending on the diagnostic method in the same sample. N = 45 participants were examined by non-instrumental (possible/probable SB) and instrumental methods (definite SB). The OHIP differed significantly between possible SB (median = 4) and non-SB (median = 0) with W = 115, p = 0.01, and probable SB (median = 6) and non-SB (median = 0) with W = 101, p = 0.01). There was no significant difference in the OHIP score between definite SB and non-SB. For the other psychometric variables, the analyses revealed no significant differences between SB and non-SB in all diagnostic procedures. The results suggest that there is a difference between possible/probable and definite SB with respect to the association with OHRQoL. Certain aspects of possible/probable SB might be responsible for the poor OHRQoL, which are not measured in definite SB.
Asunto(s)
Psicometría , Calidad de Vida , Bruxismo del Sueño , Humanos , Bruxismo del Sueño/psicología , Femenino , Masculino , Adulto , Adulto Joven , Ansiedad , Persona de Mediana Edad , Estrés Psicológico , Salud Bucal , Encuestas y CuestionariosRESUMEN
PURPOSE: The aim of this study is to assess the effects of respiratory exercises (inspiratory and expiratory) in individuals with sleep bruxism (SB) and associated obstructive sleep apnea (OSA). METHODS: This is a double-blind, placebo-controlled randomized clinical trial including individuals with SB and associated respiratory events in OSA. Respiratory physical therapy was performed using inspiratory (Threshold® IMT), expiratory (Threshold® PEP) muscle training, and compared with a placebo group. A total of 30 daily respiratory cycles (inspiration and expiration) were performed five times a week for 12 weeks. Individuals were reassessed at two times, at baseline (T1) and after 12 weeks of training (T2) by means of the Pittsburgh Sleep Quality Index and Polysomnography. RESULTS: Awakening was significantly different (p ≤ 0.05) between the inspiratory group and placebo 12 weeks after respiratory physical therapy. The number of contractions of the masseter muscle differed between the inspiratory, expiratory, and placebo groups (p ≤ 0.05). CONCLUSION: Respiratory physical therapy for OSA improved awaking levels in 80 and 67% of the number of masseter muscle contractions, when compared to placebo. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (No. RBR-9F6JKM).
Asunto(s)
Apnea Obstructiva del Sueño , Bruxismo del Sueño , Humanos , Brasil , Ejercicios Respiratorios , Método Doble Ciego , Polisomnografía , Sueño , Apnea Obstructiva del Sueño/terapia , Bruxismo del Sueño/terapiaRESUMEN
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.
Asunto(s)
Polisomnografía , Apnea Obstructiva del Sueño , Bruxismo del Sueño , Humanos , Masculino , Femenino , Apnea Obstructiva del Sueño/fisiopatología , Apnea Obstructiva del Sueño/complicaciones , Persona de Mediana Edad , Bruxismo del Sueño/fisiopatología , Bruxismo del Sueño/complicaciones , Posición Supina/fisiología , Adulto , Músculo Masetero/fisiopatología , ElectromiografíaRESUMEN
STUDY OBJECTIVES: To determine the prevalence and risk factors of sleep bruxism (SB) in adults with primary snoring (PS). METHODS: This study included 292 adults with PS (140 males, 152 females; mean age ± standard deviation = 42.8 ± 12.2 years; mean body mass index ± standard deviation = 26.7 ± 4.7 kg/m2) without previous treatment for snoring. SB was diagnosed based on the frequency of the biomarker of SB: rhythmic masticatory muscle activity (SB when rhythmic masticatory muscle activity ≥ 2 episodes/h). Logistic regression was performed, with SB as the dependent variable and with age, sex, body mass index, and sleep- and respiratory-related polysomnographic parameters as the independent variables to identify the risk factors for SB. RESULTS: The prevalence of SB was 44.6% in adults with PS. Younger age (odds ratio = 0.965 [0.944, 0.987]) and shorter total sleep time (odds ratio = 0.760 [0.609, 0.948]) significantly increased the risk of SB (P < .05). CONCLUSIONS: SB is highly prevalent in adults with PS. Younger age and shorter sleep time are significant risk factors for SB in adults with PS. CLINICAL TRIAL REGISTRATION: Registry: onderzoekmetmensen.nl; Name: A Large Sample Polysomnographic Study on Sleep Bruxism; URL: https://trialsearch.who.int/Trial2.aspx?TrialID=NL-OMON19947; Identifier: NL8516. CITATION: Li D, Lobbezoo F, Hilgevoord AAJ, de Vries N, Aarab G. Prevalence and risk factors of sleep bruxism in adults with primary snoring: a large-scale polysomnographic study. J Clin Sleep Med. 2024;20(8):1331-1337.
Asunto(s)
Polisomnografía , Bruxismo del Sueño , Ronquido , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía/métodos , Prevalencia , Factores de Riesgo , Bruxismo del Sueño/epidemiología , Bruxismo del Sueño/complicaciones , Bruxismo del Sueño/fisiopatología , Ronquido/epidemiología , Ronquido/complicaciones , Ronquido/fisiopatología , Estudios Transversales , Estudios RetrospectivosRESUMEN
What is the prevalence of temporomandibular dysfunction in patients with early rheumatoid arthritis and individuals at risk of rheumatoid arthritis? 3 groups (of 50 participants each) were examined for a possible TMD diagnosis: 1. patients with early rheumatoid arthritis, 2. at-risk individuals, and 3. healthy controls. A possible association with bruxism, determined on the basis of self-reporting and clinical features, was also examined. At-risk patients had a higher prevalence of TMD pain diagnoses compared to healthy controls (p = 0.046). Within the early rheumatoid arthritis group, seronegative patients had a higher prevalence of TMD pain diagnoses than seropositive patients (p = 0.048). No further differences in the prevalence of TMD diagnoses were found between the groups. Participants with a TMD pain diagnosis were more often diagnosed with probable sleep bruxism than those without a TMD pain diagnosis. The prevalence of TMD pain is increased in individuals at risk of rheumatoid arthritis and seronegative early rheumatoid arthritis patients, and is associated with signs of bruxism.
Asunto(s)
Artritis Reumatoide , Bruxismo , Bruxismo del Sueño , Trastornos de la Articulación Temporomandibular , Humanos , Bruxismo/epidemiología , Bruxismo/complicaciones , Trastornos de la Articulación Temporomandibular/epidemiología , Estudios Transversales , Bruxismo del Sueño/epidemiología , Dolor Facial/epidemiología , Dolor Facial/etiología , Artritis Reumatoide/complicaciones , Artritis Reumatoide/epidemiologíaRESUMEN
Objetivo: Caracterizar la arquitectura del sueño en un grupo poblacional de adultos con bruxismo del sueño, en forma general y según sexo.Materiales y método: Estudio descriptivo retrospectivo, con un muestreo por intención de 33 polisomnografías que identificaban sujetos con bruxismo del sueño, según el cut off sugerido por Lavigne et al (25 eventos /hora), entre los años 2011-2019. Se consideraron las variables sexo, edad, peso, talla e índice de masa corporal (IMC). Se determinó la arquitectura del sueño en cuanto a duración de las etapas del sueño, micro despertares y eventos de bruxismo. Se realizó un análisis descriptivo de las variables y se compraron los resultados entre los sexos.Resultados: En el grupo poblacional 64% eran mujeres y 36% hombres. El promedio de edad fue de 32.5 años, de talla 1.65, de peso 68 kg, con un IMC promedio de 24.89 (peso normal). Los sujetos tuvieron un promedio de 387.6 horas de sueño, 270 minutos en NMOR y 10.8 en MOR, con un promedio de 50 micro despertares durante la noche y de 48.64 eventos de bruxismo por hora. Según sexo los valores en minutos fueron (p>0.05): NMOR (H: 316.2 M:256.8); MOR (H: 105 M:104.4); microdespertares (H :58.9 M: 45.1); Eventos de BS/hora: (H:48.6 M: 46.6) Los sujetos con BS durmieron, en promedio, un mayor número de minutos en decúbito lateral (196,59).Conclusión: Los sujetos con BS registran determinadas características en la arquitectura del sueño que deben considerarse. No hubo diferencia en la arquitectura del sueño según sexo. (AU)
Objective: To characterize sleep architecture in a population group of adults with sleep bruxism, in general and by sex. Materials and method: Retrospective descriptive study, with intentional sampling of 33 polysomnographies that identified subjects with sleep bruxism,according to the cut off suggested by Lavigne et al (25 events /hour/), between the years 2011-2019. The variables sex, age, weight, height and body mass index (BMI) were considered. Sleep architecture was determined in terms of duration of sleep stages, micro-awakenings, and bruxism events. A descriptive anlysis of the variables was carried out and the results were compared between the sexes.Results: In the population group, 64% were women and 36% men. The average age was 32.5 years, height 1.65 m, weight 68 kg, with an average BMI of 24.89 (normal weight). Subjects had an average of 387.6 minutes of sleep, 270 minutes in non-rapid eye movement (NREM) and 10.8 in rapid eye movement (REM), with an average of 50 micro-awakenings during the night and 48.64 bruxism events per hour. According to sex, the values in minutes were: NMOR (H:316.2 M:256.8); MOR (H:105 M:104.4); microawakenings (H:58.9 M:45.1); BS events/hour: (H:48.6 M: 46.6), no significant differences were found between them (p>0.05). Subjects with BS slept, on average, a greater number of minutes in the lateral decubitus position (196.59). Conclusion: Subjects with BS register certain characteristics in their sleep architecture that must be considered. There was no difference in sleeparchitecture according to sex.(AU)
Asunto(s)
Humanos , Masculino , Femenino , Trastornos del Sueño-Vigilia , Bruxismo del Sueño , Fases del Sueño , Sueño , Epidemiología Descriptiva , Estudios RetrospectivosRESUMEN
This commentary on sleep medicine explores whether the potential relationship between sleep bruxism (SB), masticatory muscle pain (MMP) and sleep breathing disorders (SBDs)contributes to improving the management of co-occurring conditions.The paper is divided into 2 sections: (1) reviewing the debate on SB nosology; and (2) based on the publications from the Martynowicz & Wieckiewicz research group, exploringthe role of intermittent hypoxia as a putative mechanism endotype that may link such co-occurrence among individuals for whom characteristics are not yet clear.
Asunto(s)
Bruxismo del Sueño , Humanos , Bruxismo del Sueño/complicaciones , Músculos Masticadores/fisiología , Sueño/fisiología , Dolor , Hipoxia/complicacionesRESUMEN
Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student's t-test, Mann-Whitney U test, non-parametric Friedman's analysis of variance for paired samples and pairwise multiple comparisons, Pearson's chi-square test, two-proportion z-test, non-parametric McNemar's and Cochran's Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism.
Asunto(s)
Ferulas Oclusales , Bruxismo del Sueño , Adulto , Femenino , Masculino , Humanos , Férulas (Fijadores) , Calidad de Vida , Especies Reactivas de OxígenoRESUMEN
This systematic review answers the question: "Does occlusal appliance use influence masticatory muscle function of dentate individuals with sleep bruxism?". The literature search included six databases, grey literature, and manual search for articles. Randomized and non-randomized clinical trials were included comparing muscle function of sleep bruxers before and after receiving occlusal appliances. Risk of bias was assessed with risk of bias assessment for randomized and non-randomized clinical trials tool. Twelve studies, three represent randomized clinical trials, were included. Risk of bias was considered low, moderate, or serious. Meta-analyses indicated that soft and hard appliances did not influence muscle activity and bite force of bruxers. Qualitative analysis showed that occlusal appliance use did not influence masticatory performance and muscle volume. However, it was effective in reducing tongue force. Certainty of evidence was considered very low for muscle activity when evaluated with hard appliances, and for bite force evaluated with both appliance materials. Low certainty of evidence was observed for muscle activity with soft appliances. Based on the findings of this meta-analysis, occlusal appliances do not affect masticatory muscle function of sleep bruxers. Regardless of appliance material, the activity of masseter and temporal, and bite force of sleep bruxers was not influenced.
Asunto(s)
Fuerza de la Mordida , Músculos Masticadores , Ferulas Oclusales , Bruxismo del Sueño , Humanos , Bruxismo del Sueño/fisiopatología , Bruxismo del Sueño/terapia , Músculos Masticadores/fisiopatologíaRESUMEN
BACKGROUND: Bruxism has a multifactorial etiology, including the influence of sleep characteristics and chronotypes. AIM: To identify the pathways that influence the occurrence of probable sleep bruxism (PSB) and probable awake bruxism (PAB) in adolescents. DESIGN: A total of 403 adolescents, aged 12-19 years, participated in the study. Parents/caregivers filled out a questionnaire about sociodemographic issues and the adolescent's health conditions, and the adolescents about sleep characteristics, occurrence of bruxism (based on previous study and the International Consensus of Bruxism), and chronotype (Circadian Energy Scale). Clinical examinations were performed. Statistical analysis included descriptive analysis and path analysis. RESULTS: PSB and PAB are related to each other, with moderate and positive correlation (ß = .390). Poor sleep quality and higher household income had a direct effect on both PSB (ß = -.138; ß = .123, respectively) and PAB (ß = -.155; ß = .116, respectively). Chronotype had a direct effect on PSB, in such a way that adolescents with a morningness chronotype tend to have PSB (ß = -.102). Adolescents that drool on the pillow (ß = .184) and/or have agitated sleep (ß = .104) tend to have PSB. CONCLUSION: Poor sleep quality, household income, morningness chronotype profile, drooling on the pillow, and agitated sleep influence the paths taken by PSB. PAB was influenced by the quality of sleep and family income.
Asunto(s)
Bruxismo , Bruxismo del Sueño , Humanos , Adolescente , Femenino , Bruxismo del Sueño/complicaciones , Masculino , Niño , Bruxismo/complicaciones , Encuestas y Cuestionarios , Adulto Joven , Calidad del Sueño , Ritmo Circadiano/fisiologíaRESUMEN
BACKGROUND: The concept of sleep bruxism (SB) has evolved exponentially over the past several decades. Many theories and hypotheses have been proposed as to the definition, pathophysiology, and management of SB, from the early 1960s through the present. The role of peripheral factors, such as dental occlusion, in the pathogenesis of SB has been discarded. TYPES OF STUDIES REVIEWED: The authors searched several electronic databases (ie, PubMed, Google Scholar, Web of Science, Embase, and Ovid MEDLINE) for studies on bruxism. The search was conducted from January 1961 through May 2023 and yielded 4,612 articles, of which 312 were selected for comprehensive review after eliminating duplicates and nonfocused articles. RESULTS: There has been an evident progressive shift from the role of peripheral factors, such as dental occlusion, to more central factors, such as the involvement of a central pattern generator as well as the autonomic nervous system, in the genesis of bruxing movements. There is continued robust interest in the dental community to elucidate the contributing factors involved in SB. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The neurophysiology of SB appears to be leaning more toward central rather than peripheral factors. There is increasing evidence of the role of the autonomic nervous system, genetics, and comorbidities in the genesis of SB. The scientific literature seems to refute the role of dental occlusion in the causation of bruxing movements. As per the literature, there has been a paradigm shift in the definition and genesis of SB and its possible dental implications and management, which also highlights the need for succinct scientific studies in this regard.
Asunto(s)
Bruxismo del Sueño , Humanos , Bruxismo del Sueño/diagnóstico , Bruxismo del Sueño/terapia , Polisomnografía/efectos adversosRESUMEN
BACKGROUND: The Journal of Oral Biosciences is dedicated to advancing and disseminating fundamental knowledge with regard to every aspect of oral biosciences. This review features review articles in the fields of "bone regeneration," "periodontitis," "periodontal diseases," "salivary glands," "sleep bruxism," and "Sjögren's syndrome." HIGHLIGHT: This review focuses on human demineralized dentin and cementum matrices for bone regeneration, oxidized low-density lipoprotein in periodontal disease and systemic conditions, the relationship between inflammatory mediators in migraine and periodontitis, phosphoinositide signaling molecules in the salivary glands, and the pathophysiologies of sleep bruxism and Sjögren's syndrome. CONCLUSION: The review articles featured in the Journal of Oral Biosciences have broadened the knowledge of readers regarding various aspects of oral biosciences. The current editorial review discusses the findings and significance of these review articles.
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Enfermedades Periodontales , Periodontitis , Síndrome de Sjögren , Bruxismo del Sueño , Humanos , Glándulas Salivales , Literatura de Revisión como AsuntoRESUMEN
OBJECTIVES: Literature presents conflicting results regarding malocclusions, Obstructive Sleep Apnea (OSA) and sleep bruxism in children with ADHD. Aim of this study was to evaluate the prevalence of these parameters. METHODS: A prospective study was conducted on 40 consecutive ADHD children referred to the Paediatric Dentistry Unit of Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome. All subjects underwent an orthodontic examination and were screened for OSA and sleep bruxism. Data were compared to a sex- and aged-matched control group. RESULTS: Prevalence of high risk of OSA in children with ADHD was 62.5% compared to 10% in the control group (p < .00001). No differences were found in any of the occlusal variables examined between children with ADHD and controls (p > .05). An increased prevalence of sleep bruxism was observed in ADHD children (40%) compared to controls (7.5%) (p < .001). CONCLUSIONS: A higher prevalence of OSA risk and probable sleep bruxism were observed in ADHD patients compared with controls. No significant differences were observed in malocclusions d.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Maloclusión , Apnea Obstructiva del Sueño , Bruxismo del Sueño , Humanos , Niño , Anciano , Estudios Prospectivos , Bruxismo del Sueño/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Apnea Obstructiva del Sueño/epidemiología , Apnea Obstructiva del Sueño/diagnóstico , Maloclusión/epidemiología , Maloclusión/diagnósticoRESUMEN
OBJECTIVES: This cross-sectional school-based study explored the influence of malocclusion on temporomandibular disorders (TMD) pain complaints, and whether this association would be mediated by sleep bruxism in a representative sample of 7- to 8-year-old children. METHODS: Path analysis estimated direct, indirect, and total effects of occlusal features on sleep bruxism and TMD pain in 7- to 8-year-old children. Occlusal features were assessed with Dental Aesthetic Index (DAI), orofacial pain complaints using the TMD pain screener, possible sleep bruxism based on self-reports, and probable sleep bruxism based on self-reports combined with clinical findings. Structural equation modeling analyzed data with confounding factors. RESULTS: From 580 participants, possible sleep bruxism was observed in 136 children (31.5%), probable sleep bruxism in 30 children (6.7%), and TMD pain complaints in 78 children (13.8%). Malocclusion had no direct effect on either possible sleep bruxism [standardized coefficient (SC) 0.000; p = 0.992], or TMD pain complaints (SC - 0.01; p = 0.740). When probable sleep bruxism was set as the mediator of interest, malocclusion did not directly affect probable sleep bruxism (SC 0.01; p = 0.766), nor TMD pain complaints (SC - 0.02; p = 0.515). A direct effect of probable sleep bruxism on TMD pain complaints was observed with an SC of 0.60 (p < 0.001). However, in neither case, malocclusion indirectly affected TMD pain complaints via bruxism. CONCLUSION: Malocclusion in 7- to 8-year-old children did not directly influence possible or probable sleep bruxism or TMD pain complaints. Instead, probable sleep bruxism was strongly associated with TMD pain complaints. CLINICAL SIGNIFICANCE: The impact of occlusal features on TMD pain complaints and bruxism has been a long-standing controversy in dentistry. However, the scientific literature linking this association may be inconsistent, mainly due to biased sample selection methods with inadequate consideration of confounders. Further research should try to identify additional risk factors for TMD pain in addition to probable sleep bruxism in children.
Asunto(s)
Bruxismo , Maloclusión , Bruxismo del Sueño , Trastornos de la Articulación Temporomandibular , Niño , Humanos , Bruxismo del Sueño/complicaciones , Bruxismo/complicaciones , Estudios Transversales , Dolor Facial/complicaciones , Autoinforme , Trastornos de la Articulación Temporomandibular/complicaciones , Maloclusión/complicacionesRESUMEN
OBJECTIVE: The present study aimed to investigate the association between self-reported awake/sleep bruxism, and orofacial pain with post-traumatic stress disorder (PTSD). METHODS: A case-control study with a convenience sample was designed. Participants were recruited from a university-based Trauma Ambulatory. The diagnosis of PTSD was established through a clinical interview and the Structured Clinical Interview (SCID-I/P). Thirty-eight PTSD patients and 38 controls completed the Research Diagnostic Criteria for Temporomandibular Disorders Axis-II to categorize awake/sleep bruxism and orofacial pain. Following this, we performed a short clinical examination of the temporomandibular joint and extraoral muscles. RESULTS: Adjusted logistic regression analysis showed that awake bruxism was associated with PTSD (OR = 3.38, 95% CI = 1.01-11.27, p = 0.047). Sleep bruxism was not associated with any covariate included in the model. In a Poisson regression model, PTSD (IRR = 3.01, 95% CI = 1.38-6.55, p = 0.005) and the muscle pain/discomfort (IRR = 5.12, 95% CI = 2.80-9.36, p < 0.001) were significant predictors for current orofacial pain. CONCLUSIONS: PTSD was associated with self-reported awake bruxism and low-intensity orofacial pain. These conditions were frequent outcomes in patients previously exposed to traumatic events. CLINICAL RELEVANCE: We suggest including a two-question screening for bruxism in psychiatry/psychology interviews to improve under-identification and to prevent harmful consequences at the orofacial level.
Asunto(s)
Bruxismo , Bruxismo del Sueño , Trastornos por Estrés Postraumático , Humanos , Bruxismo/complicaciones , Bruxismo/diagnóstico , Bruxismo del Sueño/complicaciones , Autoinforme , Trastornos por Estrés Postraumático/epidemiología , Estudios de Casos y Controles , Dolor Facial/etiología , Dolor Facial/diagnósticoRESUMEN
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.