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Ishimaru T, Yamaguchi T, Saito T, Hattori Y, Ono T, Arai Y, Hasegawa Y, Shiga H, Tamaki K, Tanaka J, Tsuga K, Abekura H, Miyawaki S, Maeda-Iino A, Mikami S, Gotouda A, Satoh K, Shimizu K, Kato Y, Namita T. Actual state of the diurnal masseteric electromyogram: Differences between awareness and non-awareness of awake bruxism. J Prosthodont Res 2024; 68:456-465. [PMID: 38220162 DOI: 10.2186/jpr.jpr_d_23_00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
PURPOSE This study aimed to elucidate the relationship between diurnal masseter muscle activity and awareness of diurnal awake bruxism (d-AB) by conducting a comparative analysis of electromyographic (EMG) data from individuals with and without awareness of diurnal awake bruxism (d-AB), utilizing EMG data gathered from multiple subjects. METHODS Unilateral masseter electromyography (EMG) recordings were performed during the daytime using an ultraminiature wearable EMG device. A total of 119 participants (59 with awareness of diurnal tooth clenching [d-TC] and 60 without awareness of d-TC) were included. Waveforms longer than 0.25 s with the two amplitude conditions, exceeding twice the baseline and >5% of maximum voluntary clenching, were extracted. In addition, the number of bursts and episodes (groups of bursts), burst duration, and burst peak amplitude were calculated for each participant. RESULTS There were no significant differences in the EMG parameters between the groups with and without awareness of d-TC. Additionally, the frequency distribution of the number of EMG waveforms exhibited wide ranges and substantial overlap between the two groups. CONCLUSIONS The variability in the number of bursts and episodes, burst peak amplitude, and burst duration among subjects suggests the need for an objective classification of d-AB severity based on EMG values. The absence of significant differences and large overlap in frequency distributions between the groups with and without awareness of d-TC indicate difficulty in predicting muscle activity solely based on awareness of d-AB.
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Affiliation(s)
- Tomoya Ishimaru
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taishi Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Yoshiaki Arai
- Oral Implant & Temporomandibular Joint Clinic, Niigata University Medical & Dental Hospital, Niigata, Japan
| | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroshi Shiga
- Department of Partial and Complete Denture, The Nippon Dental University School of Life Dentistry, Tokyo, Japan
| | - Katsushi Tamaki
- Graduate School of Dentistry, Kanagawa Dental University Department of Oral Interdisciplinary Medicine (OIM) Division of Prosthodontic Dentistry for function of TMJ and Occlusion, Yokosuka, Japan
| | - Junko Tanaka
- Department of Fixed Prosthodontics and Occlusion Osaka Dental University, Osaka, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan
| | - Hitoshi Abekura
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shouichi Miyawaki
- Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Aya Maeda-Iino
- Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Saki Mikami
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Kaoru Satoh
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Koichi Shimizu
- School of Optoelectronic Engineering, Xidian University, Xi'an, China
| | - Yuji Kato
- Faculty of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Takeshi Namita
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Tokyo, Japan
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Maeda-Iino A, Osako Y, Nakagawa S, Takahashi K, Oga Y, Furukawa-Sainoki M, Harada M, Fukushima M, Miyawaki S. Relationship between masseter muscle activity during wakefulness and temporomandibular disorder-related symptoms. J Oral Rehabil 2024; 51:455-468. [PMID: 38030583 DOI: 10.1111/joor.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 10/20/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Masseter muscle activity during wakefulness may be associated with temporomandibular disorder (TMD)-related symptoms, psychosocial status and pain-related disability; however, this relationship is unclear. OBJECTIVES This study aimed to determine the relationship between masseter muscle electromyography (EMG) burst/duration during wakefulness and TMD-related symptoms, psychosocial status and pain-related disability. METHODS Sixty participants were assessed masseter muscle activity during wakefulness using a data-logger-type ultraminiature EMG system and TMD-related symptoms, psychosocial status and pain-related disability through Axis I and II of the diagnostic criteria for TMD (DC/TMD). EMG bursts lasting longer than 0.25 s but less than 2.0 s and those lasting longer than 2.0 s were classified as phasic and tonic bursts, respectively. RESULTS Participants with palpation-related pain in the temporalis and masseter muscles, as assessed through the DC/TMD examination form in Axis I, had more bursts (number/h) (p = .035 and p = .009, respectively) and longer duration (time/h) (p = .013 and p = .004, respectively) of tonic bursts of the masseter muscle during wakefulness. Participants with palpation-related pain in the masseter muscles had higher oral behaviour scores during wakefulness using Axis II (p = .001), which affected the number and duration of tonic bursts of the masseter muscle activity during wakefulness (p = .011 and p = .007, respectively). CONCLUSION As tonic bursts mainly reflect clenching, individuals with pain in the masseter muscles by palpation may have a high frequency and longer duration of clenching, as well as a high frequency of oral behaviours during wakefulness.
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Affiliation(s)
- Aya Maeda-Iino
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuki Osako
- Department of Orthodontics, Center of Developmental Dentistry, Kagoshima University Hospital, Kagoshima, Japan
| | - Shoko Nakagawa
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Kotaro Takahashi
- Department of Orthodontics, Center of Developmental Dentistry, Kagoshima University Hospital, Kagoshima, Japan
| | - Yasuhiko Oga
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Minami Furukawa-Sainoki
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Marina Harada
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mika Fukushima
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Shouichi Miyawaki
- Department of Orthodontics and Dentofacial Orthopedics, Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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Mikami S, Yamaguchi T, Takahashi M, Kudo A, Saito M, Nakajima T, Maeda M, Saito T, Sakuma T, Takahashi S, Ishimaru T, Gotouda A. Examination of the relationship between masseter muscle activity during sleep and wakefulness measured by using a wearable electromyographic device. J Prosthodont Res 2024; 68:92-99. [PMID: 37005256 DOI: 10.2186/jpr.jpr_d_22_00231] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Purpose This study aimed to measure masseter muscle activity throughout the day in outpatients suspected of having awake bruxism (AB) and/or sleep bruxism (SB) and examine the relationship between AB and SB by comparing muscle activity during daytime wakefulness and nighttime sleep.Methods Fifty outpatients with suspected SB and/or AB participated in this study. A single-channel wearable electromyogram (EMG) device was used for EMG recording. The selected EMG bursts were divided into bursts during sleep (S-bursts) and bursts during awake state (A-bursts). The number of bursts per hour, average burst duration, and ratio of burst peak value to maximum voluntary contraction were calculated for both the S- and A-bursts. These values of the S- and A-bursts were then compared, and the correlations between them were analyzed. Additionally, the ratios of phasic and tonic bursts in the S- and A-bursts were compared.Results The number of bursts per hour was significantly higher for A-bursts than for S-bursts. No significant correlation was found between the numbers of S- and A-bursts. The ratio of phasic bursts was large and that of tonic bursts was small in both the S- and A-bursts. A comparison of the S- and A-bursts showed that the S-bursts had a significantly lower ratio of phasic bursts and higher ratio of tonic bursts than the A-bursts.Conclusions The number of masseteric EMG bursts during wakefulness did not show any association with that during sleep. It became clear that sustained muscle activity was not dominant in AB.
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Affiliation(s)
- Saki Mikami
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Mebae Takahashi
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Ai Kudo
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Miku Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Toshinori Nakajima
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Masana Maeda
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Taishi Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Toshimitsu Sakuma
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Sota Takahashi
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Tomoya Ishimaru
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
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Kudo A, Yamaguchi T, Mikami S, Saito M, Nakajima T, Maeda M, Takahashi M, Takahashi S, Gotouda A. Frequency distribution of the number and amplitude of electromyographic waveforms of the masseter muscle during sleep in patients with a clinical diagnosis of sleep bruxism. Cranio 2023:1-13. [PMID: 37326493 DOI: 10.1080/08869634.2023.2222640] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This study aimed to clarify frequency distribution of number and peak amplitude of electromyographic (EMG) waveforms of sleep bruxism (SB) in outpatients with clinical diagnosis of SB (probable bruxer: P-bruxer). METHODS Subjects were 40 P-bruxers. Masseteric EMG during sleep was measured at home using a wearable EMG system. EMG waveforms with amplitude of more than two times the baseline and with duration of 0.25 s were extracted as SB bursts. Clusters of bursts, i.e. SB episodes, were also scored. RESULTS There were large variations among the subjects in numbers of SB bursts and episodes and in burst peak amplitude. As for burst peak amplitude within a subject, a wide right-tailed frequency distribution was shown with the highest frequency at the class of 5-10% maximum voluntary contraction. CONCLUSION The number and amplitude of SB waveforms for P-bruxers were distributed over a wide range, indicating the existence of large individual differences.
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Affiliation(s)
- Ai Kudo
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Saki Mikami
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Miku Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Toshinori Nakajima
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Masana Maeda
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Mebae Takahashi
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Sota Takahashi
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
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Prasad S, Arunachalam S, Boillat T, Ghoneima A, Gandedkar N, Diar-Bakirly S. Wearable Orofacial Technology and Orthodontics. Dent J (Basel) 2023; 11:dj11010024. [PMID: 36661561 PMCID: PMC9858298 DOI: 10.3390/dj11010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/19/2022] [Accepted: 12/30/2022] [Indexed: 01/12/2023] Open
Abstract
Wearable technology to augment traditional approaches are increasingly being added to the arsenals of treatment providers. Wearable technology generally refers to electronic systems, devices, or sensors that are usually worn on or are in close proximity to the human body. Wearables may be stand-alone or integrated into materials that are worn on the body. What sets medical wearables apart from other systems is their ability to collect, store, and relay information regarding an individual's current body status to other devices operating on compatible networks in naturalistic settings. The last decade has witnessed a steady increase in the use of wearables specific to the orofacial region. Applications range from supplementing diagnosis, tracking treatment progress, monitoring patient compliance, and better understanding the jaw's functional and parafunctional activities. Orofacial wearable devices may be unimodal or incorporate multiple sensing modalities. The objective data collected continuously, in real time, in naturalistic settings using these orofacial wearables provide opportunities to formulate accurate and personalized treatment strategies. In the not-too-distant future, it is anticipated that information about an individual's current oral health status may provide patient-centric personalized care to prevent, diagnose, and treat oral diseases, with wearables playing a key role. In this review, we examine the progress achieved, summarize applications of orthodontic relevance and examine the future potential of orofacial wearables.
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Affiliation(s)
- Sabarinath Prasad
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
- Correspondence:
| | - Sivakumar Arunachalam
- Orthodontics and Dentofacial Orthopedics, School of Dentistry, International Medical University, Kuala Lumpur 57000, Malaysia
| | - Thomas Boillat
- Design Lab, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
| | - Ahmed Ghoneima
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
| | - Narayan Gandedkar
- Discipline of Orthodontics & Paediatric Dentistry, School of Dentistry, University of Sydney, Sydney, NSW 2006, Australia
| | - Samira Diar-Bakirly
- Department of Orthodontics, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 50505, United Arab Emirates
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Yamaguchi T, Mikami S, Maeda M, Saito T, Nakajima T, Yachida W, Gotouda A. Portable and wearable electromyographic devices for the assessment of sleep bruxism and awake bruxism: A literature review. Cranio 2023; 41:69-77. [PMID: 32870753 DOI: 10.1080/08869634.2020.1815392] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The current state of portable/wearable electromyographic (EMG) devices for assessment of bruxism was reviewed. METHODS A search of full-text articles relevant to portable/wearable EMG devices capable of being used at home was performed. The data source used was MEDLINE via PubMed from January 1970 to July 2019. RESULTS There were nine kinds of wearable EMG devices capable of being used under unrestrained conditions. Ultra-miniaturized wearable EMG devices with a level of performance equivalent to that of conventional stationary EMG devices have been developed and are being used during sleep and in the daytime. The devices have a high level of diagnostic accuracy for sleep bruxism. A definite cut-off value for awake bruxism has not been established. DISCUSSION Assessment of sleep bruxism with a high level of accuracy can be performed using a portable/wearable EMG device. However, a definite cut-off value is required for assessment of awake bruxism.
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Affiliation(s)
- Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Saki Mikami
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Masana Maeda
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Taishi Saito
- Department of Crown and Bridge Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Toshinori Nakajima
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Wataru Yachida
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorders, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
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Evaluation of Rhythmic Masseter Muscle Activity during Sleep and Awake in Patients with Dentofacial Deformity. J Maxillofac Oral Surg 2022; 21:481-486. [DOI: 10.1007/s12663-020-01467-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/14/2020] [Indexed: 12/01/2022] Open
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Quinelato V, Bonato LL, Vieira AR, Granjeiro JM, Menezes K, Borojevic R, Casado PL, Calasans-Maia JA, Tesch R. PAX7 gene polymorphism in muscular temporomandibular disorders as potentially related to muscle stem cells. BMC Musculoskelet Disord 2021; 22:959. [PMID: 34789211 PMCID: PMC8600756 DOI: 10.1186/s12891-021-04846-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Temporomandibular disorders (TMD) are a group of painful and debilitating disorders, involving the masticatory muscles and/or the temporomandibular joint (TMJ). Chronic TMD pain can be associated with genetic changes in the key muscle development genes. Objective To evaluate the association between polymorphisms in the PAX7 (paired box 7) gene and masticatory myalgia in patients with temporomandibular disorders (TMD). Materials and methods This is a case-control study. Patients with TMD were divided into two groups: (a) presence of muscular TMD (n = 122) and (b) absence of muscular TMD (n = 49). Genomic DNA was obtained from saliva samples from all participants to allow for genotyping single nucleotide polymorphisms in PAX7 (rs766325 and rs6659735). Over-representation of alleles was tested using chi-square or Fisher’s exact tests. Values of p < 0.05 were considered to be statistically significant. Results Individuals without muscular TMD were less likely to have the PAX7 rs6659735 GG genotype (p = 0.03). No associations were found for PAX7 rs766325. Conclusions Alterations in PAX7 may influence muscular pathophysiology and individuals with TMD and the rs6659735 homozygous genotype (GG) are seemingly associated with muscular involvement of the disorder. No associations were found in the region rs766325.
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Affiliation(s)
- Valquiria Quinelato
- School of Dentistry, Universidade Federal Fluminense, Mario Santos Braga St, 28 - Center, Niterói, RJ, 24020-140, Brazil.
| | - Letícia Ladeira Bonato
- School of Dentistry, Universidade Federal Fluminense, Mario Santos Braga St, 28 - Center, Niterói, RJ, 24020-140, Brazil
| | | | | | - Karla Menezes
- School of Medicine of Petropolis, Petropolis, Brazil
| | | | - Priscila Ladeira Casado
- School of Dentistry, Universidade Federal Fluminense, Mario Santos Braga St, 28 - Center, Niterói, RJ, 24020-140, Brazil
| | - Jose Albuquerque Calasans-Maia
- School of Dentistry, Universidade Federal Fluminense, Mario Santos Braga St, 28 - Center, Niterói, RJ, 24020-140, Brazil
| | - Ricardo Tesch
- School of Medicine of Petropolis, Petropolis, Brazil
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Ramanan D, Palla S, Bennani H, Polonowita A, Farella M. Oral behaviours and wake-time masseter activity in patients with masticatory muscle pain. J Oral Rehabil 2021; 48:979-988. [PMID: 34185872 DOI: 10.1111/joor.13219] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/06/2021] [Accepted: 06/24/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Little is known about wake-time masseter activity of patients with masticatory muscle pain in real-life settings. OBJECTIVES The aims of this study were (1) to assess wake-time masseter activity of women with masticatory muscle pain (MMP) and compare it with that of pain-free women; and (2) to investigate the association between objectively measured masseter contractions and self-reported oral behaviours. METHODS Adult women (N = 27) diagnosed with MMP were age-matched with pain-free women (N = 26). The electromyographic (EMG) activity of the masseter muscle when awake was recorded unilaterally for two consecutive days. The number of contraction episodes and relative contraction time (%) were calculated using cut-off thresholds of 3%, 5% and 10% of maximum voluntary contraction (MVC). Self-reported daytime oral activity was assessed using the Oral Behaviours Checklist (OBC, items 3-21). Data were analysed using univariate tests and mixed-model analyses. RESULTS The number of contraction episodes was similar between groups for all detection thresholds, but the relative contraction time at the lower detection thresholds (i.e. 3% MVC and 5% MVC) was significantly longer (1.5-fold) in the MMP than in the pain-free group. The OBC scores were significantly higher in the women with MMP than in controls, but no positive association could be found between EMG variables and OBC scores. CONCLUSION Women with MMP engage in low-level masseter muscle contractions, which last longer than those of pain-free controls. There was no relationship between self-reported oral behaviours and masseter activity when awake. These findings support the notion that prolonged low-level clenching when awake may play a role in the pathophysiology of MMP.
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Affiliation(s)
- D Ramanan
- Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - S Palla
- University of Zurich, Zurich, Switzerland
| | - H Bennani
- Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - A Polonowita
- Discipline of Oral Medicine, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - M Farella
- Discipline of Orthodontics, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand.,Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
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Manfredini D, Lobbezoo F. Sleep bruxism and temporomandibular disorders: A scoping review of the literature. J Dent 2021; 111:103711. [PMID: 34090993 DOI: 10.1016/j.jdent.2021.103711] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 05/26/2021] [Accepted: 05/29/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To provide a scoping review of the literature by assessing all the English-language papers that investigated the relationship between sleep bruxism (SB) and temporomandibular disorders (TMDs). STUDY DATA AND SOURCES A search was performed in the National Library of Medicine (PubMed) and Scopus databases, in order to identify all the articles published assessing the relationship between SB and TMDs, by several different approaches. The selected articles were then structurally read and summarized in PICO tables. The articles were selected independently by the two authors. STUDY SELECTION Out of 185 references that were initially retrieved, 47 articles met the inclusion criteria and were thus included in the review. The studies were divided into four categories based on the type of SB assessment: 1. questionnaire/self-report (n = 26), 2. clinical examination (n = 7), 3. electromyography (EMG) (n = 5), and 4. polysomnography (PSG) (n = 9). CONCLUSIONS Studies based on questionnaire/self-report SB featured a low specificity for SB assessment, and in general they found a positive association with TMD pain. On the contrary, instrumental studies (i.e., electromyography, polysomnography) found a lower level of association or even a negative relationship between SB and TMD pain. Findings from this updated review confirmed the conclusions of a previous review by Manfredini & Lobbezoo, suggesting that literature findings on the relationship between SB and TMDs are dependent on the assessment strategies that are adopted for SB. Future studies should consider SB as a multifaceted motor behavior that must be evaluated in its continuum spectrum, rather than using a simplified dichotomous approach of presence/absence.
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Affiliation(s)
- Daniele Manfredini
- Professor, School of Dentistry, Department of Medical Biotechnologies, University of Siena, Italy.
| | - Frank Lobbezoo
- Professor and Chair, Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Thymi M, Lobbezoo F, Aarab G, Ahlberg J, Baba K, Carra MC, Gallo LM, De Laat A, Manfredini D, Lavigne G, Svensson P. Signal acquisition and analysis of ambulatory electromyographic recordings for the assessment of sleep bruxism: A scoping review. J Oral Rehabil 2021; 48:846-871. [PMID: 33772835 PMCID: PMC9292505 DOI: 10.1111/joor.13170] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/07/2021] [Accepted: 03/17/2021] [Indexed: 12/14/2022]
Abstract
Background Ambulatory electromyographic (EMG) devices are increasingly being used in sleep bruxism studies. EMG signal acquisition, analysis and scoring methods vary between studies. This may impact comparability of studies and the assessment of sleep bruxism in patients. Objectives (a) To provide an overview of EMG signal acquisition and analysis methods of recordings from limited‐channel ambulatory EMG devices for the assessment of sleep bruxism; and (b) to provide an overview of outcome measures used in sleep bruxism literature utilising such devices. Method A scoping review of the literature was performed. Online databases PubMed and Semantics Scholar were searched for studies published in English until 7 October 2020. Data on five categories were extracted: recording hardware, recording logistics, signal acquisition, signal analysis and sleep bruxism outcomes. Results Seventy‐eight studies were included, published between 1977 and 2020. Recording hardware was generally well described. Reports of participant instructions in device handling and of dealing with failed recordings were often lacking. Basic elements of signal acquisition, for example amplifications factors, impedance and bandpass settings, and signal analysis, for example rectification, signal processing and additional filtering, were underreported. Extensive variability was found for thresholds used to characterise sleep bruxism events. Sleep bruxism outcomes varied, but typically represented frequency, duration and/or intensity of masticatory muscle activity (MMA). Conclusion Adequate and standardised reporting of recording procedures is highly recommended. In future studies utilising ambulatory EMG devices, the focus may need to shift from the concept of scoring sleep bruxism events to that of scoring the whole spectrum of MMA.
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Affiliation(s)
- Magdalini Thymi
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Kazuyoshi Baba
- Department of Prosthodontics, Showa University School of Dentistry, Ohta-ku, Japan
| | - Maria Clotilde Carra
- UFR of Odontology Garanciere, Université de Paris and Service of Odontology, Rothschild Hospital (AP-HP), Paris, France
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Antoon De Laat
- Department of Oral Health Sciences, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dentistry, University Hospital, Leuven, Belgium
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Gilles Lavigne
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada.,CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus Universitet Tandlageskolen, Aarhus, Denmark.,Faculty of Odontology, Malmø University, Malmø, Sweden
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12
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Robin O, Claude A, Gehin C, Massot B, McAdams E. Recording of bruxism events in sleeping humans at home with a smart instrumented splint. Cranio 2020; 40:14-22. [PMID: 31914871 DOI: 10.1080/08869634.2019.1708608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The aim of this paper is to report quantitative and qualitative characteristics of bruxism events recorded in sleeping humans with a new smart ambulatory system specifically designed to measure dental clenching and grinding forces. The device is wireless and rechargeable, which enables its use over extended periods.Methods: Thirty recordings were obtained from volunteer subjects who wore the device at home during 10 consecutive nights (Clinicaltrials.gov N° NCT03363204).Results: The recordings showed that the system was able to successfully monitor bruxism during 10 consecutive nights, allowing a quantitative (number, duration, intensity, distribution during the night), as well as a qualitative characterization of the bruxism events (clenching vs. grinding).Discussion: This system could offer new perspectives in the field of bruxism, either as a research tool for clinical studies or as a medical device for the ambulatory home-based monitoring of bruxism.
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Affiliation(s)
- Olivier Robin
- Department of Orofacial Pain and Dysfunctions, Lyon Dental University Hospital, Lyon, France.,Nanotechnology Institute of Lyon, Biomedical sensors team, UMR CNRS, INSA, Lyon, France
| | - Arthur Claude
- Nanotechnology Institute of Lyon, Biomedical sensors team, UMR CNRS, INSA, Lyon, France.,Piwio SAS, Villeurbanne, France
| | - Claudine Gehin
- Nanotechnology Institute of Lyon, Biomedical sensors team, UMR CNRS, INSA, Lyon, France
| | - Bertrand Massot
- Nanotechnology Institute of Lyon, Biomedical sensors team, UMR CNRS, INSA, Lyon, France
| | - Eric McAdams
- Nanotechnology Institute of Lyon, Biomedical sensors team, UMR CNRS, INSA, Lyon, France
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13
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Exposto FG, Arima T, Svensson P. Sleep Disorders and Chronic Orofacial Pain. CURRENT SLEEP MEDICINE REPORTS 2019. [DOI: 10.1007/s40675-019-00152-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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14
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Baad‐Hansen L, Thymi M, Lobbezoo F, Svensson P. To what extent is bruxism associated with musculoskeletal signs and symptoms? A systematic review. J Oral Rehabil 2019; 46:845-861. [DOI: 10.1111/joor.12821] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 05/09/2019] [Accepted: 05/11/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Lene Baad‐Hansen
- Section of Oro‐facial Pain and Jaw Function, Department of Dentistry Aarhus University Aarhus Denmark
- Scandinavian Center for Oro‐facial Neurosciences (SCON)
| | - Magdalini Thymi
- Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam Amsterdam The Netherlands
- Vrije Uiversiteit Amsterdam Amsterdam The Netherlands
| | - Frank Lobbezoo
- Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam Amsterdam The Netherlands
- Vrije Uiversiteit Amsterdam Amsterdam The Netherlands
| | - Peter Svensson
- Section of Oro‐facial Pain and Jaw Function, Department of Dentistry Aarhus University Aarhus Denmark
- Scandinavian Center for Oro‐facial Neurosciences (SCON)
- Department of Dental Medicine Karolinska Institutet Huddinge Sweden
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15
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Smardz J, Martynowicz H, Michalek-Zrabkowska M, Wojakowska A, Mazur G, Winocur E, Wieckiewicz M. Sleep Bruxism and Occurrence of Temporomandibular Disorders-Related Pain: A Polysomnographic Study. Front Neurol 2019; 10:168. [PMID: 30915015 PMCID: PMC6421294 DOI: 10.3389/fneur.2019.00168] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 02/08/2019] [Indexed: 12/02/2022] Open
Abstract
Introduction: The diagnosis of sleep bruxism is challenging due to the difficulties involved. Sleep bruxism can lead to clinical consequences, including pain in masticatory muscles, limitation of jaw mobility, headache, and the spectrum of symptoms associated with damage to the teeth and oral mucosa. Currently, only video-polysomnography can definitely diagnose sleep bruxism. Due to the risk of painful temporomandibular disorders (TMD) in sleep bruxers, early diagnosis of pain in the temporomandibular region using questionnaires is recommended. Therefore, this study aimed to assess the relationship between the intensity of sleep bruxism and the occurrence of pain related to TMD. Materials and Methods: This study was conducted on the patients of the Clinic of Prosthetic Dentistry operating at the Department of Prosthetic Dentistry at the Wroclaw Medical University. Based on a positive medical history, a thorough examination for the diagnosis of probable sleep bruxism was carried out in the enrolled patients. Eligible patients were then subjected to a video-polysomnographic study. Each patient was asked to complete the TMD Pain Screener questionnaire to assess the occurrence of pain in jaw and temple area. Results: The results of the study showed that increased bruxism episode index (BEI) was statistically significantly correlated with increase of all types of bruxism episodes—phasic, tonic, and mixed—in all the studied patients; a significant correlation was also found with respect to division of patients into studied and control groups. The study also showed that there was no statistically significant difference between BEI values and scores of TMD Pain Screener. In all the studied patients, a higher BEI was not found to be correlated with the occurrence of TMD-related pain assessed by TMD Pain Screener; similarly, no correlation was found with respect to division of patients into studied and control groups. Conclusions: The occurrence of TMD-related pain is not related to the intensity of sleep bruxism. TMD Pain Screener may be used as an auxiliary tool in the diagnosis or risk of occurrence of TMD-related pain, whereas in the case of sleep bruxism, it has only limited diagnostic value. Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03083405
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Affiliation(s)
- Joanna Smardz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Helena Martynowicz
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Monika Michalek-Zrabkowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Wojakowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Efraim Winocur
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
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