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Oppitz LR, Arantes ACM, Garanhani RR, Costa CA, Araujo CMD, Tanaka OM, Andreis PKDS, Schappo C, Ignácio SA, Johann ACBR, Rached RN, Camargo ES. Efficiency of mixed and rigid occlusal stabilization splints: Randomized clinical trial. Braz Oral Res 2024; 38:e017. [PMID: 38477803 DOI: 10.1590/1807-3107bor-2024.vol38.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 09/13/2023] [Indexed: 03/14/2024] Open
Abstract
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.
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Affiliation(s)
- Layza Rossatto Oppitz
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Ana Carolina Mastriani Arantes
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | | | - Carlos Alberto Costa
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | | | - Orlando Motohiro Tanaka
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Patricia Kern di Scala Andreis
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Undergraduate Program in Dentistry, Curitiba, PR, Brazil
| | - Claudia Schappo
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Sérgio Aparecido Ignácio
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Aline Cristina Batista Rodrigues Johann
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Rodrigo Nunes Rached
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
| | - Elisa Souza Camargo
- Pontifícia Universidade Católica do Paraná - PUCPR, School of Medicine and Life Sciences, Post-Graduate Program in Dentistry, Orthodontics, Curitiba, PR, Brazil
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Minakuchi H, Fujisawa M, Abe Y, Iida T, Oki K, Okura K, Tanabe N, Nishiyama A. Managements of sleep bruxism in adult: A systematic review. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:124-136. [PMID: 35356038 PMCID: PMC8958360 DOI: 10.1016/j.jdsr.2022.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/24/2021] [Accepted: 02/20/2022] [Indexed: 01/11/2023] Open
Abstract
This systematic review aimed to update the management of sleep bruxism (SB) in adults, as diagnosed using polysomnography (PSG) and/or electromyography (EMG). Management methods covered were oral appliance therapy (OAT) with stabilization splints, cognitive-behavioral therapy (CBT), biofeedback therapy (BFT), and pharmacological therapy. A comprehensive search was conducted on MEDLINE, Cochrane Library, and Web of Science up to October 1st, 2021. Reference list searches and hand searches were also performed by an external organization. Two reviewers for each therapy independently performed article selection, data extraction, and risk of bias assessment. The reviewers resolved any disagreements concerning the assortment of the articles by discussion. Finally, 11, 3, 14, and 22 articles were selected for each therapy. The results suggested that OAT tended to reduce the number of SB events, although there was no significant difference compared to other types of splints, that the potential benefits of CBT were not well supported, and that BFT, rabeprazole, clonazepam, clonidine, and botulinum toxin type A injection showed significant reductions in specific SB parameters, although several side effects were reported. It can be concluded that more methodologically rigorous randomized large-sample long-term follow-up clinical trials are needed to clarify the efficacy and safety of management for SB.
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Key Words
- AB, awake bruxism
- BFT, biofeedback therapy
- BTX-A, botulinum toxin type A
- Biofeedback therapy
- CCT, controlled clinical trial
- CES, contingent electrical stimulation
- CQ, clinical question
- CTB, cognitive-behavioral therapy
- Cognitive–behavioral therapy
- EMG, electromyography
- GRADE, Grading of Recommendations, Assessment, Development and Evaluations
- Management
- OA, oral appliance
- OAT, oral appliance therapy
- Oral appliances
- PICO, participant, intervention, comparison, and outcome
- PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses
- PSG, polysomnography
- Pharmacological therapy
- RCT, randomized controlled trial
- RMMA, rhythmic masticatory muscle activity
- SB, sleep bruxism
- Sleep bruxism
- Systematic review
- TMD, temporomandibular disorders
- TMJ, temporomandibular joint
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Affiliation(s)
- Hajime Minakuchi
- Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Masanori Fujisawa
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Japan
| | - Yuka Abe
- Department of Prosthodontics, School of Dentistry, Showa University, Japan
| | - Takashi Iida
- Department of Oral Function and Fixed Prosthodontics, Nihon University School of Dentistry at Matsudo, Japan
| | - Kyosuke Oki
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Japan
| | - Kazuo Okura
- Department of Stomatognathic Function and Occlusal Reconstruction, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Norimasa Tanabe
- Department of Prosthodontics and Oral Implantology, School of Dentistry, Iwate Medical University, Japan
| | - Akira Nishiyama
- General Dentistry, Comprehensive Patient Care, Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
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Gerstner G, Yao W, Siripurapu K, Aljanabi H, Decker A, Ludkin D, Sinacola R, Frimenko K, Callaghan K, Penoyer S, Tewksbury C. Over-the-counter bite splints: A randomized controlled trial of compliance and efficacy. Clin Exp Dent Res 2020; 6:626-641. [PMID: 32779386 PMCID: PMC7745066 DOI: 10.1002/cre2.315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 06/16/2020] [Accepted: 07/05/2020] [Indexed: 11/16/2022] Open
Abstract
Background Occlusal splints are often used to curb the impacts of sleep bruxism (SB) on the dentition, and over‐the‐counter (OCT) options are becoming increasingly popular. OTC splints are usually fabricated at home by patients, but not routinely evaluated by dental professionals. It is unclear how OCT splints compare with more traditional splints that receive dental oversight. Objectives The present randomized controlled study tested how an OTC splint compared with a gold standard bite splint in terms of patient compliance (primary outcome) and efficacy (secondary outcomes). Methods Sixty‐seven subjects were randomly assigned to receive either the OTC (SOVA, N = 35) splint or the gold standard “Michigan” bite splint (MI, N = 32), with 61 completing the study (SOVA, N = 30; MI, N = 31). OTC‐splint subjects were required to fabricate their splints to clinically acceptable standards. Both groups wore the splints nightly for four months. Compliance was measured via daily diary. Efficacy outcomes evaluated stability, retention, periodontal health, night‐time rhythmic masticatory muscle activity (RMMA), and material wear. Results OTC‐splint subjects had difficulty fabricating splints to clinically acceptable standards. The number of night‐time RMMA bursts was significantly greater for the OTC splint group. Compliance and all other efficacy measurements were not significantly different between‐groups. Conclusions The results support the potential use of OTC splints for curbing the impacts of SB. However, the results strongly suggest that dentists should be actively engaged in overseeing patients' use of self‐fabricated appliances. This clinical trial is registered at ClinicalTrials.gov, Identifier number NCT02340663.
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Affiliation(s)
- Geoffrey Gerstner
- Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Wei Yao
- University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Krishnapriya Siripurapu
- Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hadel Aljanabi
- Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Ann Decker
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - David Ludkin
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Rachel Sinacola
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | | | - Kathryn Callaghan
- Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Sean Penoyer
- Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Claire Tewksbury
- Department of Biologic and Materials Sciences and Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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