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OBJECTIVE: The Ecological Momentary Assessment (EMA) concept was the basis for developing a smartphone application for the real-time report of awake bruxism (AB) activities. The aim of this study was to assess the effects of the EMA with a randomised controlled trial designed to compare the frequency of AB reported in two separate single observation points between a group of students monitored over time with an EMA smartphone application and a non-EMA monitored group. METHODS: Sixty-four (N = 64) dental students (22.3 YO [±2.6]; 52F; 12 M) answered the Oral Behaviour Checklist (OBC-1) and were randomised into an EMA-group (EG) and control group (CG). EG were monitored with a smartphone application for AB report during seven consecutive days and completed three EMA monitoring periods (EMA-1, 2 and 3) at one-month intervals. After the third period (EMA-3), both EG and CG answered again the OBC (OBC-2). Descriptive statistics were performed to characterise the sample. Pearson's chi-squared test, Fixer Exact test and post hoc Z test with Bonferroni correction were performed. The study hypothesis was that EMA could influence the AB reported by the participants because it implies an increase in the awareness, self-recognition, and self-control of bruxism behaviours. The level of significance was set at p < .05. RESULT: The percentage of participants who changed the report of the activity of clenching their teeth while awake between OBC-1 and OBC-2 was significantly higher among participants in EG, when compared to CG (p = .027). For all other behaviours reported the within- and between-group differences from OBC-1 to OBC-2 were not significant. Clenching and bracing were the most frequently reported, whilst grinding was the less frequent behaviour. CONCLUSION: A smartphone-based EMA approach demonstrated be useful to monitor AB over time, increasing individual's awareness, particularly to bracing and clenching behaviours.
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Bruxismo , Avaliação Momentânea Ecológica , Aplicativos Móveis , Smartphone , Estudantes de Odontologia , Humanos , Masculino , Feminino , Estudantes de Odontologia/psicologia , Adulto Jovem , Vigília/fisiologia , AdultoRESUMO
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.
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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
BACKGROUND: Obstructive sleep apnea (OSA) is the most common sleep disorder due mainly to peripheral causes, characterized by repeated episodes of obstruction of the upper airways, associated with arousals and snoring. Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or nonrhythmic (tonic) and is not a movement disorder or a sleep disorder in otherwise healthy individuals. Given the potentially severe consequences and complications of apnea, the concurrent high prevalence of SB in daily dental practice, getting deeper into the correlation between these phenomena is worthy of interest.. STUDY OBJECTIVES: The aim of this study was to investigate the correlation between SB-related masseter muscle activity (MMA) and apnea-hypopnea events as well as to assess their temporal sequence. METHODS: Thirty (N = 30) patients with sleep respiratory disorders and clinical suspicion of sleep bruxism (SB) were recruited. Ambulatory polygraphic recording was performed to detect apnea-hypopnea events (AHEs) and sleep bruxism episodes (SBEs). Pearson test was used to assess the correlation between apnea-hypopnea index (AHI) and SB index (SBI). A 5-s time window with respect to the respiratory events was considered to describe the temporal distribution of SBEs. Furthermore, SBI was compared between groups of patients with different AHI severity (i.e., mild, moderate and severe) using ANOVA. RESULTS: On average, AHI was 27.1 ± 21.8 and SBI 9.1 ± 7.5. No correlation was shown between AHI and SBI. Most of SBEs (66.8%) occurred without a temporal relationship with respiratory events. Considering OSA, 65.7% of SBEs occurred within 5 s after AHEs, while in the case of central apnea (CA) 83.8% of SBEs occurred before the respiratory event. The participants with severe apnea (N = 9) show a tendency to have higher bruxism indexes when compared to patients with mild (N = 11) and moderate apnea (N = 10). CONCLUSIONS: Findings suggest that: 1. At the study population level, there is no correlation between AHI and SBI, as well as any temporal relationship between SBEs and respiratory events. 2. Specific patterns of temporal relationship might be identified with future studies focusing on the different types of apnea-hypopnea events and bruxism activities.
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Músculo Masseter , Apneia Obstrutiva do Sono , Humanos , Projetos Piloto , Polissonografia , Sono , Apneia Obstrutiva do Sono/complicaçõesRESUMO
OBJECTIVE: A smartphone-based ecological momentary assessment (EMA) strategy to collect real time data on awake bruxism (AB) has been recently introduced. The aim of this study was to assess the compliance with its use over 1 week in a sample of healthy young adults. METHOD: Sixty (N = 60) healthy young adults (mean age 24.2 ± 4.1 years) used a dedicated smartphone application that sent 20 alerts at random times throughout the day. Upon alert receipt, the subjects had to report in real time their condition among five possible options: relaxed jaw muscles, teeth contact, teeth clenching, teeth grinding, and mandible bracing. Compliance rate with the app was assessed at the individual and group level in terms of percentage of answered alerts as well as number of days that were needed to reach the targeted observation period of 7 days with a compliance of at least 60%. RESULTS: The mean compliance recorded with the smartphone application was 67.8% of the total alerts. On average, 9.8 ± 3.2 days (range 7-19) have been necessary to achieve the targeted goal of 7 days with a minimum of 60% alerts/day. No gender differences were detected in any compliance data. Response rate was not different during weekdays or weekends. CONCLUSIONS: This investigation is the first attempt to assess individual compliance with EMA for reporting awake bruxism. Results suggest that a smartphone-based strategy can have interesting potential. The compliance rate reported in this study will serve as a comparison standpoint for future investigations. CLINICAL SIGNIFICANCE: Based on the recent multidisciplinary focus on the study of awake bruxism, EMA has emerged as a potential approach for use in the clinical and research settings. This investigation suggests that compliance with such strategy is good, thus making it worthy of adoption for the assessment of AB and its clinical implications.
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Bruxismo/diagnóstico , Avaliação Momentânea Ecológica , Aplicativos Móveis , Smartphone , Vigília , Adulto , Humanos , Adulto JovemRESUMO
Subclinical hypothyroidism and hyperthyroidism have been recognized as clinical entities with negative effects on the cardiovascular system. Moreover, the effect of treated thyroid dysfunction on parameters associated with the cardiovascular control system has been poorly investigated. In the present study we analyzed time-domain heart rate variability in coronary artery disease (CAD) patients with known thyroid diseases. Twenty-four hour ECG monitoring was performed in 344 patients with coronary artery disease (174 with thyroid dysfunction and 170 without thyroid dysfunction used as a control group), using a 3-channel tape recorder. Time domain parameters of heart rate variability (HRV) were definitely lower both in patients with subclinical hypothyroidism and subclinical hyperthyroidism than in the control group, with statistically significant differences in SDNN, RMSSD, TINN, and mean RR for both subgroups. Furthermore, patients on L-thyroxine treatment and restored euthyroidism had generally higher HRV values than patients with subclinical hypothyroidism, nevertheless SDNN, RMSSD, SDNN index, TINN, and mean RR were significantly lower when compared to those of the control group. Significant differences in HRV were also found between hyperthyroid patients under treatment and control group subjects with respect to RMSSD, TINN, and mean RR values. In conclusion, patients with cardiac disease and known thyroid disease, even when the disease is in the subclinical range or despite treatment, should be regarded as patients at additional risk conveyed by thyroid hormone disturbances.
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Doença da Artéria Coronariana/complicações , Frequência Cardíaca , Doenças da Glândula Tireoide/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Sistema Nervoso Autônomo/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Glândula Tireoide/complicaçõesRESUMO
This article describes a class II subdivision malocclusion successfully treated by an invisible lingual appliance. The combination of en-masse distalization by interradicular palatal mini-screws and inner unilateral class II auxiliaries, first by intermaxillary elastic, later by a class II coil spring, resulted in a dento-alveolar correction, allowing one to maintain the appliance completely invisible. At the same time, the inclination of buccal sectors was normalized by a correct torque expression with set-up overcorrections, resulting in a significant improvement of the buccal corridors. This case report demonstrates the possibility of successfully solving class II division 2 subdivision malocclusion in adult patients without surgery by means of a completely invisible appliance. It also demonstrates that correct levelling and torque expression, for the correction of asymmetrical Spee and Wilson curves, are achievable with an accurate set-up planning. On the other hand, it underlines the necessity of mini-screws, auxiliaries and set-up overcorrections in order to obtain the best results.
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Má Oclusão Classe II de Angle , Adulto , Humanos , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Língua , Torque , Técnicas de Movimentação Dentária/métodos , Desenho de Aparelho Ortodôntico , CefalometriaRESUMO
This case report describes a complex full-step class II case in a young adult patient treated with lingual straight-wire appliance and upper first molar extraction. As the patient refused a surgical treatment, she was offered the best possible camouflage with the double aim of obtaining an ideal occlusal relationship and maintaining the profile; appropriate biomechanical strategies, including extraction choice and anchorage control during space closure, were needed to achieve the planned results. This case report demonstrates the possibility of successfully resolving severe sagittal discrepancies in an adult patient without surgical treatment by means of a completely invisible non-compliance technique, with the extraction of the most compromised teeth. This report also underlines the need for careful planning during both diagnostic and treatment phases, in order to obtain the best results.
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Má Oclusão Classe II de Angle , Dente Molar , Extração Dentária , Humanos , Má Oclusão Classe II de Angle/terapia , Má Oclusão Classe II de Angle/diagnóstico por imagem , Feminino , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Adulto Jovem , Fios Ortodônticos , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Cefalometria , Desenho de Aparelho Ortodôntico , Planejamento de Assistência ao Paciente , Cooperação do Paciente , Fechamento de Espaço Ortodôntico/métodos , Fechamento de Espaço Ortodôntico/instrumentação , Adulto , MaxilaRESUMO
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.
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Refluxo Gastroesofágico , Apneia Obstrutiva do Sono , Bruxismo do Sono , Humanos , Apneia Obstrutiva do Sono/terapia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/complicações , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/terapia , Refluxo Gastroesofágico/diagnóstico , Prognóstico , Bruxismo do Sono/terapia , Bruxismo do Sono/diagnóstico , Bruxismo do Sono/complicações , Assistência OdontológicaRESUMO
The correlation between magnetic resonance imaging (MRI) signs and clinical findings has been highlighted in multiple studies. However, very little information is available on the correlation between the bilateral temporomandibular joints (TMJs) of the same individual. The majority of efforts in the clinical research setting have focused on the correlation between ipsilateral imaging and clinical findings, while less attention has been paid to the contralateral imaging findings of the anatomical structures.The objective of this paper was to review the existing literature that compares temporomandibular joint (TMJ) magnetic resonance imaging (MRI) findings from both sides of the same individual.In January 2024, a systematic search of the literature from major search engines (MEDLINE (PubMed), Scopus) was conducted to identify all peer-reviewed English-language studies that presented an MRI comparison of left and right TMJ data in the same patients. The articles were analyzed using a Population/ Intervention/Comparison/Outcome (PICO) format.The search terms "temporomandibular joint" AND "magnetic" AND "resonance" yielded 2,561 results. Only 2 papers met the established inclusion criteria. The results of the papers included in the systematic review were not comparable due to differences in the evaluation of the TMJs, which prevented a meta-analysis. Manfredini et al. identified a statistical correlation between disc displacement, osseous changes (OC) and joint effusion (JE) between the joints of the contralateral sides. Koca et al. observed a significant difference in TMJ MRI findings between the painful and non-painful sides of each individual in a bruxism group and a control group (p = 0.001, p < 0.001 and p = 0.004, p < 0.001, respectively).The studies on the correlation between the right and left TMJs remain scarce. A comparative analysis of the 2 sides of the TMJ in individual patients is rarely reported.The review did not identify a common result for the findings of the contralateral TMJs in the 2 articles included.
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Imageamento por Ressonância Magnética , Transtornos da Articulação Temporomandibular , Articulação Temporomandibular , Humanos , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/patologia , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/patologiaRESUMO
Rationale: Alagille syndrome is a rare genetic disorder with dental and facial abnormalities in the head-and-neck area. It is autosomal dominant and occurs in approximately 1 in 100,000 people. No cases of Alagille Syndrome (ALGS) with mandibular hypoplasia and temporomandibular joint ankyloses (TMJa) have been reported to date. Patient Concerns and Diagnosis: A 3-year-old female patient suffering from ALGS came to our hospital affected by unilateral mandibular hypoplasia and TMJa with severe limitation of mouth opening (maximal interincisal distance [MID] of 2 mm). Treatment: A two-phase surgical management approach was undertaken based on computed tomography scans and the patient's age. The first phase involved mandibular distraction, followed by arthroplasty with amniotic human membrane placement. Outcomes: After immediate post-surgery rehabilitation, the patient showed good mandibular function with no complications after 15 months. MID was 20 mm. Take-away Lessons: This is a rare and interesting case with no previous literature reports. The use of amniotic membranes in surgical management adds further significance.
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BACKGROUND: The reduction in joint load is a potential beneficial factor in managing osteoarthritis of the temporomandibular joint (TMJ). This paper aims to compare the effectiveness of the intramuscular injection of botulinum toxin (BTX-A) as an adjunct to TMJ arthrocentesis plus viscosupplementation with arthrocentesis plus viscosupplementation alone in the management of TMJ osteoarthritis. METHODS: A pilot clinical retrospective study examined TMJ osteoarthritis treatments. Patients were divided into two groups: Group A received BTX-A injections and arthrocentesis with viscosupplementation, while Group B received only arthrocentesis with viscosupplementation. The study assessed outcomes based on mouth opening (MO), pain at rest (PR), pain at mastication (PF), and masticatory efficiency (ME) at various time points (baseline (T0), 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4)) up to 2 months after treatment. RESULTS: The study included two groups, each with five patients. Group A received five weekly sessions of arthrocentesis plus viscosupplementation and a single BTX-A injection during the first arthrocentesis appointment. Group B underwent the five-session protocol of arthrocentesis plus viscosupplementation alone. MO, PF, PR, and ME improved quickly in T2 in both groups, but the improvement was of greater importance over the following weeks and lasted longer in Group A. CONCLUSIONS: Arthrocentesis with viscosupplementation associated with BTX-A was found to be more effective than arthrocentesis alone in improving clinical outcomes. This suggests that patients with TMJ osteoarthritis and myofascial pain may benefit from reduced muscle tone and joint load.
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Artrocentese , Toxinas Botulínicas Tipo A , Transtornos da Articulação Temporomandibular , Viscossuplementação , Humanos , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Transtornos da Articulação Temporomandibular/terapia , Feminino , Masculino , Injeções Intramusculares , Adulto , Toxinas Botulínicas Tipo A/administração & dosagem , Toxinas Botulínicas Tipo A/uso terapêutico , Estudos Retrospectivos , Viscossuplementação/métodos , Pessoa de Meia-Idade , Estudos de Casos e Controles , Projetos Piloto , Osteoartrite/tratamento farmacológico , Resultado do Tratamento , Terapia Combinada , Estudo de Prova de ConceitoRESUMO
OBJECTIVE: To assess the frequency of awake bruxism (AB) behaviors in a group of undergraduate dentistry students and correlate it with the status of anxiety and depression. MATERIALS AND METHODS: The frequency of five oral behaviors (i.e., relaxed jaw muscle, teeth contact, mandible bracing, teeth clenching, teeth grinding) was evaluated using a smartphone-based ecological momentary assessment (EMA) approach. The anxiety and depression status was investigated with the four-item patient health questionnaire for anxiety and depression (PHQ-4). ANOVA with Tukey post-hoc test was used to assess the difference in frequency of AB behaviors among the four PHQ-4 groups. RESULTS: Among the four groups, there was a statistically significant difference in the frequency of relaxed jaw muscle, teeth contact, mandible bracing, and teeth clenching, but not for teeth grinding. CONCLUSION: Based on this cross-sectional study's findings, psyche seems to have a determinant impact on AB behaviors, which is significantly higher in individuals with anxiety and depression traits.
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Demographic and social changes in the last decades have resulted in improvements in health and longevity. The survival of elderly people has improved significantly and thus centenarians are becoming the fastest growing population group. Environmental, genetic, and accidental factors have influenced the human life span. Researchers have gained substantial evidence that advanced glycation end products may play an important role in the processes of physiological aging. The aim of the present study was to investigate any differences in the frequencies of -374T/A polymorphism in subjects aged >90 years and in middle-aged individuals. We observed association between the A allele and genotype homozygous for this allele (AA) with a longer life expectancy in the male population. In particular, there was a prevalence of AA genotype and A allele in long-living subjects and a prevalence of the allele T in middle-aged subjects, indicating a possible protective role of the allele A to aging. In conclusion, our results support the hypothesis that longevity is the result of a good functioning of the immune system and a presumable hyper-expression of variants of anti-inflammatory genes of immunity. The differences in the genetic regulation of inflammatory processes may influence the presence of age-related disorders.
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Estudos de Associação Genética , Imunidade Inata/genética , Longevidade/genética , Receptor para Produtos Finais de Glicação Avançada/genética , Idoso , Idoso de 80 Anos ou mais , Alelos , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Receptor para Produtos Finais de Glicação Avançada/imunologiaRESUMO
This case report describes a complex class II case with important maxillo-mandibular asymmetry in an adult patient treated with lingual straight-wire appliance. With the twofold aim of obtaining dramatic aesthetic improvement, since the patient refused surgical option, and ideal occlusal relationship, accurate set-up planification and biomechanical strategies with TADS for occlusal plane cant correction are needed to achieve the planned results. This case report demonstrates the possibility of solving successfully class II malocclusion with significant asymmetry in adult patient without surgery by means of an aesthetic appliance; on the other hand, it underlines the necessity of miniscrews and auxiliaries in order to obtain the best results.
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Oclusão Dentária , Má Oclusão Classe II de Angle , Humanos , Adulto , Dente Molar , Parafusos Ósseos , Estética Dentária , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Cefalometria/métodosRESUMO
This case report describes a complex full-step class II malocclusion with unilateral upper lateral incisor agenesis in an adult patient treated with lingual straight-wire appliance and premolar extraction, with the two-fold aim of obtaining ideal occlusal relationship and smile aesthetic improvement. In view of this, it underlines how an appropriate treatment strategy, including extraction choice and anchorage control during space closure, is needed to achieve the planned results with a completely invisible lingual appliance combined with aesthetic veneers.
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Incisivo , Má Oclusão Classe II de Angle , Humanos , Adulto , Dente Pré-Molar/cirurgia , Técnicas de Movimentação Dentária/métodos , Extração Dentária/métodos , Estética Dentária , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Parafusos Ósseos , Cefalometria/métodosRESUMO
This case report describes a complex full-step class II high angle case in an adult patient treated with lingual straight-wire appliance, premolar extractions and orthognathic surgery. With the twofold aim of obtaining ideal occlusal relationship and aesthetic improvement, surgical treatment with appropriate biomechanical strategies, including extraction choice and torque control during space closure, are needed to achieve the planned results. This case report demonstrates the possibility of solving successfully severe sagittal, transverse and vertical discrepancies in an adult patient with surgical treatment by means of an invisible technique. This report also underlines the need for precise biomechanical control, including set-up overcorrections and an auxiliary spring to manage teeth inclination, in lingual orthodontics extraction cases.
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Má Oclusão Classe II de Angle , Cirurgia Ortognática , Humanos , Adulto , Dente Pré-Molar/cirurgia , Torque , Má Oclusão Classe II de Angle/cirurgia , Estética Dentária , Cefalometria/métodosRESUMO
Self-reported awake bruxism (AB) has been associated with temporomandibular disorders (TMD). However, the daily amount of AB behavior has not been quantified in pain patients. Therefore, this study aimed to assess AB frequency in patients with myofascial pain and temporomandibular joint (TMJ) pain and compare it to a group of pain-free individuals. Eighty-four individuals belonging to either a TMD group (n = 54) or a healthy control group (n = 30) were selected. AB frequency was obtained by ecological momentary assessment with a dedicated smartphone application that sent sound alerts at random intervals during the day for one week. Upon receiving the alert, the volunteer reported the current muscular condition and/or the teeth position, i.e., relaxed jaw muscle, jaw bracing, teeth contact, teeth clenching, or teeth grinding. Data were evaluated by independent t-test (α = 0.05). During the seven days, AB frequency was 62.1% ± 26.8% for TMD patients and 36.2% ± 27.3% for pain-free subjects (p < 0.001). Mandible bracing was most common in the TMD group (p < 0.001), while teeth contact, clenching, and grinding did not differ between groups. Moreover, no differences were found in AB frequency between myofascial pain and TMJ pain patients. Therefore, TMD patients have higher AB frequency characterized by jaw bracing, irrespective of pain location.
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In 1990, Gorlin et al. described four types of craniofacial duplications: (1) single mouth with duplication of the maxillary arch; (2) supernumerary mouth laterally placed with rudimentary segments; (3) single mouth with replication of the mandibular segments; and (4) true facial duplication, namely diprosopus. We describe a newborn born with wide-spaced eyes, a very broad nose, and two separate mouths. Workup revealed the absence of the corpus callosum and the presence of a brain midline lipoma, wide sutures, and a Chiari I malformation with cerebellar herniation. We conducted a systematic review of the literature and compared all the cases described as diprosopus. In 96% of these, the central nervous system is affected, with anencephaly being the most commonly associated abnormality. Other associated anomalies include cardiac malformations (86%), cleft palate (63%), diaphragmatic hernia (13%), and disorder of sex development (DSD) (13%). Although the facial features are those that first strike the eye, the almost obligate presence of cerebral malformations suggests a disruptive event in the cephalic pole of the forming embryo. No major monogenic contribution has been recognized today for this type of malformation.
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Fissura Palatina , Recém-Nascido , Humanos , Face , Encéfalo/diagnóstico por imagem , Sistema Nervoso CentralRESUMO
BACKGROUND: The recent introduction of ecological momentary assessment (EMA) smartphone-based strategies has allowed achieving some interesting data on the frequency of different awake bruxism (AB) behaviors reported by an individual in the natural environment. OBJECTIVE: The present paper aims to review the literature on the reported frequency of AB based on data gathered via smartphone EMA technology. METHODS: On September 2022, a systematic search in the Pubmed, Scopus and Google Scholar databases was performed to identify all peer-reviewed English-language studies assessing awake bruxism behaviors using a smartphone-based Ecological Momentary Assessment. The selected articles were assessed independently by two authors according to a structured reading of the articles' format (PICO). RESULTS: A literature search, for which the search terms "Awake Bruxism" and "Ecological Momentary Assessment" were used, identified 15 articles. Of them, eight fulfilled the inclusion criteria. The results of seven studies using the same smartphone-based app reported a frequency of AB behaviors in the range between 28.3 and 40% over one week, while another investigation adopted a different smartphone-based EMA approach via WhatsApp using a web-based survey program and reported an AB frequency of 58.6%. Most included studies were based on convenience samples with limited age range, highlighting the need for more studies on other population samples. CONCLUSIONS: Despite the methodological limits, the results of the reviewed studies provide a standpoint for comparison for future studies on the epidemiology of awake bruxism behaviors.