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Zhong Z, Li Q, Zou X, Ouyang Q, Zhang L, Liu X, Luo Y, Yao D. Effects of the low Fowler's sleep position and methazolamide treatment on sleep bruxism: A randomized controlled trial. J Sleep Res 2024:e14250. [PMID: 38803083 DOI: 10.1111/jsr.14250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/29/2024] [Accepted: 05/15/2024] [Indexed: 05/29/2024]
Abstract
Intracranial pressure is one of the determinants of sympathetic activities, and sleep bruxism is associated with increased sympathetic activities. This study aimed to investigate effects of the low Fowler's sleep position and methazolamide treatment on the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes in patients with sleep bruxism in a randomized controlled trial. Polysomnographic recordings were performed on the patients with sleep bruxism sleeping in the low Fowler's (15°-30°) or supine position (n = 11), and with methazolamide or placebo treatment (100 mg, 3-4 hr before bedtime, P.O., n = 9), and changes in sleep variables and heart rate variance during sleep in the low Fowler's position or with methazolamide treatment were determined. Sleep bruxism index, number of masseter muscle electromyographic bursts per hour of sleep, ratio of rhythmic masticatory muscle activities/sleep bruxism duration to the total sleep duration, index of total limb movements, index of limb movements with rhythmic masticatory muscle activities, and number of sleep bruxism clusters per hour of sleep in the low Fowler's position and after methazolamide intake were significantly smaller (p < 0.05-0.001) than those in the supine position and after placebo intake, respectively. The low-frequency heart rate variance powers during non-rapid eye movement sleep stage 2 (N2) in the low Fowler's position and with methazolamide treatment were significantly lower (p < 0.05) than those during sleep in the supine position and with placebo treatment, respectively. In conclusion, sleep in the low Fowler's position and methazolamide treatment were associated with significant decreases in the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes, which might be due to a reduction in intracranial pressure and sympathetic activities mainly during non-rapid eye movement sleep stage 2.
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Affiliation(s)
- Zhijun Zhong
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Qi Li
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Xueliang Zou
- Jiangxi Mental Hospital, Nanchang University, Nanchang, People's Republic of China
| | - Qian Ouyang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Ling Zhang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Xinting Liu
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Yaxing Luo
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
| | - Dongyuan Yao
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, First Affiliated Hospital of Nanchang Medical College, and Xiangya Hospital of Central South University at Jiangxi, Nanchang, People's Republic of China
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Amaral CC, Fernandez MDS, Jansen K, da Silva RA, Boscato N, Goettems ML. Daily screen time, sleep pattern, and probable sleep bruxism in children: A cross-sectional study. Oral Dis 2023; 29:2888-2894. [PMID: 36203372 DOI: 10.1111/odi.14395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/12/2022] [Accepted: 10/02/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to evaluate the prevalence of probable sleep bruxism (SB) in children aged 7-8 years and its association with sleep pattern and the time spent using devices with a screen. MATERIAL AND METHODS A cross-sectional study was conducted with children from Pelotas, Brazil (n = 556). Parents/caregivers were interviewed and provided demographic/socioeconomic information, children's daily screen time, nighttime tooth grinding or clenching, sleep duration and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN-K-sleep domain). Probable SB was determined based on a positive clinical inspection with/without a positive parental/caregiver's reports of tooth clenching or grinding. Hierarchical Poisson regression was performed. RESULTS The prevalence of probable SB was 15.83% (n = 88). There was no difference in the probable SB prevalence according to the daily screen time (p = 0.744), and low family socioeconomic status was associated with higher SB prevalence (Prevalence Ratio [PR] = 1.95; 95% Confidence Interval [95% CI]: 1.21-3.17; p = 0.006). Higher scores in the sleep domain of the BRIAN-K scale were associated with probable SB [PR = 1.07; 95% CI: 1.01-1.30; p = 0.013]. CONCLUSIONS Difficulties in maintaining sleep and low family socioeconomic status were associated with probable SB in schoolchildren, while screen time spent using devices with a screen was not associated.
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Affiliation(s)
- Cássia Cardozo Amaral
- Graduate Program in Dentistry, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | | | - Karen Jansen
- Graduate Program in Health & Behavior, Catholic University of Pelotas (UCPel), Pelotas, Brazil
| | | | - Noéli Boscato
- Graduate Program in Dentistry, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | - Marília Leão Goettems
- Graduate Program in Dentistry, Federal University of Pelotas (UFPel), Pelotas, Brazil
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The Relationship between the Plasma Concentration of Electrolytes and Intensity of Sleep Bruxism and Blood Pressure Variability among Sleep Bruxers. Biomedicines 2022; 10:biomedicines10112804. [PMID: 36359324 PMCID: PMC9687451 DOI: 10.3390/biomedicines10112804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Plasma sodium plays a major role in regulating blood pressure (BP). An augmented variability of BP is considered a risk factor for the development of arterial hypertension, which is prevalent among patients with suspected sleep bruxism (SB). The aims of this study were to assess the plasma concentration of electrolytes and their effect on the intensity of SB and BP variability among sleep bruxers. A total of 51 patients were enrolled in this prospective, observational study. A single full-night polysomnographic examination was conducted in the Wroclaw Medical University Sleep Laboratory, Poland, and based on the guidelines of the American Academy of Sleep Medicine, the results were analyzed. The monitoring of ambulatory BP was performed the next day, and the plasma levels of sodium, potassium, magnesium, and calcium were measured. The mean age of the studied group was 33.9 ± 11.2 years, and the mean bruxism episode index (BEI) was 4.94 ± 3.53. The study revealed statistically significant differences in the plasma concentrations of sodium in the SB group. A decreased sodium concentration was observed in the group of mild bruxers (2 ≤ BEI < 4) (139.7 ± 1.4 vs. 142.8 ± 3.2, p = 0.002) and severe bruxers (BEI ≥ 4) (140.5 ± 2.0 vs. 142.8 ± 3.2, p = 0.016) compared to nonbruxers (BEI < 2). A statistically significant positive linear correlation was found between plasma sodium concentration and daytime systolic BP variability (r = 0.32, p < 0.05) as well as between plasma sodium concentration and nighttime diastolic BP variability (r = 0.31, p < 0.05). The preliminary results suggest the probable relationship between the lower plasma concentration of sodium and increased intensity of SB and BP variability among suspected sleep bruxers.
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Polysomnographic Evaluation of Sleep Bruxism Intensity and Sleep Architecture in Nonapneic Hypertensives: A Prospective, Observational Study. J Clin Med 2022; 11:jcm11113113. [PMID: 35683499 PMCID: PMC9181472 DOI: 10.3390/jcm11113113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/22/2022] [Accepted: 05/28/2022] [Indexed: 11/24/2022] Open
Abstract
Sleep bruxism (SB) is a repetitive jaw muscle activity characterized by clenching or grinding of the teeth, which is classified under sleep-related movement disorders in the International Classification of Sleep Disorders—Third Edition. Because the potential common pathomechanism of SB and arterial hypertension is the activation of the sympathetic system as well as an increase in inflammatory factors, we aimed to examine the intensity of SB and the sleep architecture among patients with arterial hypertension. The study included a total of 91 Caucasian adult patients, among whom 31 had arterial hypertension diagnosed according to the current European Society of Cardiology/European Society of Hypertension (ESC/EHS) hypertension guidelines. The control group consisted of 61 normotensive patients. Patients with obstructive sleep apnea were excluded. A single full-night polysomnographic examination was conducted in the Sleep Laboratory, and then the results were analyzed based on the guidelines of the American Academy of Sleep Medicine. Bruxism episode index (BEI) was higher in the hypertensive group compared to normotensives. The groups also showed statistically significant differences in polysomnographic sleep indexes. Similar to BEI, arousal index, apnea–hypopnea index, and snoring were higher in hypertensives compared to normotensives. On the other hand, the mean and minimal oxygen saturation were lower in hypertensives compared to normotensives. A statistically significant positive correlation was observed between oxygen desaturation index and BEI in the hypertensive group, whereas this correlation was not statistically significant in the case of normotensives. In summary, nonapneic hypertensives had higher SB intensity, altered sleep architecture, decreased mean oxygen saturation, and increased snoring compared to normotensives. The results suggest that dental screening is necessary for patients with arterial hypertension, especially those presenting with the symptoms of SB.
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Saczuk K, Lapinska B, Wawrzynkiewicz A, Witkowska A, Arbildo-Vega HI, Domarecka M, Lukomska-Szymanska M. Temporomandibular Disorders, Bruxism, Perceived Stress, and Coping Strategies among Medical University Students in Times of Social Isolation during Outbreak of COVID-19 Pandemic. Healthcare (Basel) 2022; 10:740. [PMID: 35455915 PMCID: PMC9028346 DOI: 10.3390/healthcare10040740] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic caught universities along with their students off-guard, enforcing online education. Fear of the unknown, disinformation, and isolation resulted in an increased stress level in the entire population. Medical university students are particularly endangered with high stress levels and developing TMD. Temporomandibular disorders (TMD) are of multifactorial etiology, and manifest with jaw dysfunction, masticatory muscle tension or pain, as well as headache. Though bruxism can act as an exacerbating factor for TMD, stress can also play crucial role in the onset. The study aimed to measure occurrence of TMD and bruxism symptoms in the medical student population, asses the stress level, and evaluate adopted stress-coping strategies during the COVID-19 pandemic outbreak. A survey study was performed among 1018 students at Medical University of Lodz during April 2020. A self-designed questionnaire for screening TMD and bruxism symptoms, Perceived Stress Scale (PSS-10), and Brief-COPE questionnaires were applied. TMD and bruxism symptoms were observed in the majority of subjects during social isolation. The perceived stress levels were significantly higher in those experiencing TMD and bruxism symptoms. Mostly maladaptive, emotion-focused coping strategies were chosen by study subjects experiencing high levels of stress. Choosing Self-Blaming as a coping strategy is the strongest predictor of perceived stress.
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Affiliation(s)
- Klara Saczuk
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (K.S.); (B.L.); (M.D.)
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (K.S.); (B.L.); (M.D.)
| | - Adam Wawrzynkiewicz
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland;
| | | | - Heber Isac Arbildo-Vega
- Department of General Dentistry, Dentistry School, Universidad San Martín de Porres, Chiclayo 14012, Peru;
- Department of Human Medicine, Human Medicine School, Universidad San Martín de Porres, Chiclayo 14012, Peru
- Department of General Dentistry, Dentistry School, Universidad Particular de Chiclayo, Chiclayo 14012, Peru
- Department of Stomatology, School of Stomatology, Universidad Alas Peruanas, Lima 15072, Peru
| | - Monika Domarecka
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (K.S.); (B.L.); (M.D.)
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (K.S.); (B.L.); (M.D.)
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6
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Polini F, Budai R. Multimodal transcutaneous auricular vagus nerve stimulation: An option in the treatment of sleep bruxism in a "polyvagal" context. Cranio 2022:1-9. [PMID: 35322755 DOI: 10.1080/08869634.2022.2055866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To consider the possible role of the vagus nerve (VN) in the pathophysiology of sleep bruxism (SB) and introduce a multimodal protocol of transcutaneous auricular stimulation of the VN in the treatment of SB patients. METHODS Ten patients with SB underwent four sessions of electric transcutaneous auricular vagus nerve stimulation (ta-VNS) in specific auricular areas. The patients were advised to manually stimulate the same areas between sessions. Masticatory muscle activity and sleep parameters were measured by a polysomnography (PSG) before and after the treatment. Heart rate variability (HRV) parameters were measured during each stimulation. RESULTS PSG analysis revealed a statistically significant reduction in tonic SB index and tonic contraction time. HRV parameters showed a statistically significant increase in mean values of the vagal tone after each session of stimulation. No side effect was reported. CONCLUSION The stimulation of the VN might have a role in the treatment of SB.
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Affiliation(s)
- Francesco Polini
- Maxillofacial Surgery Clinic, University Hospital of Udine, Udine, Italy
| | - Riccardo Budai
- Neurophysiopathology Operative Unit, University Hospital of Udine, Udine, Italy
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7
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Zhong Z, Li Q, Zou X, Ouyang Q, Zeng Q, Hu Y, Wang M, Luo Y, Yao D. Influence of Sleep Bruxism on QTc Interval and QT Variability in Patients with OSA: a pilot study. J Oral Rehabil 2022; 49:495-504. [PMID: 35158405 DOI: 10.1111/joor.13314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 01/29/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is associated with increases in QT interval corrected for heart rate (QTc interval) and QT variability index (QTVI) and sleep bruxism (SB) is prevalent in OSA patients. OBJECTIVES To examine whether QTc interval and QT variability were changed during episodes of RMMAs/SB in SB patients with and without OSA. METHODS The RR and QTc intervals, and QTVI during RMMAs with or without accompanied limb movements (RMMAs/LMs) in 10 normal controls and 10 SB patients without OSA and during apneic and recovery periods of OSA in 10 SB patients with OSA were analyzed. RESULTS In the SB patients without OSA and controls, QTc intervals and QTVI were significantly increased during RMMAs/LMs compared with those during the 10 s periods (from 10th to 20th s) before the onset and after the offset of RMMAs/LMs, and significantly increased during RMMAs/LMs with awakenings compared with those with microarousals and no arousals. Moreover, QTc interval and QTVI were positively correlated with the duration of RMMAs/LMs. Moreover, in the SB patients with OSA, QTc interval and QTVI during the recovery period of OSA events were significantly longer and higher than those during the apneic period regardless of accompanied RMMAs/LMs, and QTc interval and QTVI during the apneic and recovery periods accompanied with RMMAs/LMs were significantly longer and higher than those without accompanied RMMAs/LMs. CONCLUSION OSA and RMMAs/LMs events were associated with longer QTc intervals and higher QTVI, and RMMAs/LMs might contribute to these changes associated with OSA events accompanied with RMMAs/LMs.
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Affiliation(s)
- Zhijun Zhong
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang Medical College and Nanchang University, Jiangxi, PR China
| | - Qi Li
- Department of Neurology, the Third Affiliated Hospital, Nanchang University, Jiangxi, PR China
| | - Xueliang Zou
- Jiangxi Mental Hospital, Nanchang University, Jiangxi, PR China
| | - Qian Ouyang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang Medical College and Nanchang University, Jiangxi, PR China
| | - Qinghong Zeng
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang Medical College and Nanchang University, Jiangxi, PR China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, PR China
| | - Yinyin Hu
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang Medical College and Nanchang University, Jiangxi, PR China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, PR China
| | - Mengmeng Wang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang Medical College and Nanchang University, Jiangxi, PR China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, PR China
| | - Yaxing Luo
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang Medical College and Nanchang University, Jiangxi, PR China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, PR China
| | - Dongyuan Yao
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang Medical College and Nanchang University, Jiangxi, PR China
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Michalek-Zrabkowska M, Martynowicz H, Wieckiewicz M, Smardz J, Poreba R, Mazur G. Cardiovascular Implications of Sleep Bruxism-A Systematic Review with Narrative Summary and Future Perspectives. J Clin Med 2021; 10:2245. [PMID: 34064229 PMCID: PMC8196855 DOI: 10.3390/jcm10112245] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 01/16/2023] Open
Abstract
Sleep bruxism is a common sleep-related behavior characterized as repetitive masticatory muscle activity. Genetic vulnerability to stress and anxiety is considered a basal component in the pathogenesis of bruxism events. Dysfunction of the autonomic nervous system related with an arousal during sleep is considered an underlying cause of the cardiovascular implications of sleep bruxism. Increased cardiovascular risk was previously linked with sleep conditions: for example, obstructive sleep apnea and insomnia, and sleep bruxism. The aim of present systematic review was to evaluate the current arguments on the relationship between sleep bruxism and cardiovascular diseases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We have reviewed the Embase, PubMed (Medline) and Scopus databases to identify applicable articles (1994-2021). A total of 127 records in English language were identified, then after screening and exclusion of nonrelevant records, 19 full-text articles were evaluated. Finally, we included 12 studies for synthesis. Due to the heterogeneity of the compared studies, only a qualitative comparison and narrative summary were performed. In the majority of studies, increased sympathetic activity was successfully established to escalate heart rate variability, the inflammatory process, oxidative stress, endothelial remodeling and hormonal disturbances, leading to hypertension and other cardiovascular complications.
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Affiliation(s)
- Monika Michalek-Zrabkowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (G.M.)
| | - Helena Martynowicz
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (G.M.)
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland; (M.W.); (J.S.)
| | - Joanna Smardz
- Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland; (M.W.); (J.S.)
| | - Rafal Poreba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (G.M.)
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (R.P.); (G.M.)
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9
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Abstract
The vision of adult sleep bruxism (SB) has changed over time. Thus, among the most important concomitant factors of SB noted are the pathophysiological aspect, namely sleep arousal, obstructive sleep apnea, gastroesophageal pH/gastroesophageal reflux disease, and the use or abuse of certain substances. The aim of this article was to review the main clinically relevant pathophysiological SB-associated factors and a proposal for a diagnostic process.
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Affiliation(s)
- Thomas Bornhardt
- Department of Integral Adult Care Dentistry, Temporomandibular Disorder and Orofacial Pain Program, Sleep & Pain Research Group, Faculty of Dentistry, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco, Chile..
| | - Veronica Iturriaga
- Department of Integral Adult Care Dentistry, Temporomandibular Disorder and Orofacial Pain Program, Sleep & Pain Research Group, Faculty of Dentistry, Universidad de La Frontera, Avenida Francisco Salazar 01145, Temuco, Chile
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10
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Personalized Biomechanical Analysis of the Mandible Teeth Behavior in the Treatment of Masticatory Muscles Parafunction. J Funct Biomater 2021; 12:jfb12020023. [PMID: 33918647 PMCID: PMC8167636 DOI: 10.3390/jfb12020023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/04/2021] [Accepted: 04/06/2021] [Indexed: 01/25/2023] Open
Abstract
A 3D finite element model of the mandible dentition was developed, including 14 teeth, a periodontal ligament (PDL), and a splint made of polymethylmethacrylate (PMMA). The study considered three design options: 1—the case of splint absence; 2—the case of the splint presence installed after manufacture; and 3—the case of splint presence installed after correction (grinding) performed to ensure a uniform distribution of occlusal force between the teeth. For cases of absence and presence of splint, three measurements of the functional load were performed using the T-Scan III software and hardware complex (TekScan, Boston, MA, USA). It was found that the presence of a splint led to a decrease in the total value of the occlusive load and to a uniform distribution between all the mandible teeth. The occlusal force was considered as a static vertical force evenly distributed between the nodes belonging to the occlusive surface of the corresponding tooth for the first design option and the occlusal surface of the splint for the second and third ones, respectively. As a result of the study, it was concluded that the splint usage was effective in order to change the distribution of the functional load during the treatment of proved masticatory muscles’ parafunction; the safety of using a splint for teeth and surrounding tissues under the influence of the considered functional load was shown; the potential applicability of PMMA as a structural material of a splint that had been used for the treatment of masticatory muscles’ parafunction was established.
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Wieczorek T, Wieckiewicz M, Smardz J, Wojakowska A, Michalek‐Zrabkowska M, Mazur G, Martynowicz H. Sleep structure in sleep bruxism: A polysomnographic study including bruxism activity phenotypes across sleep stages. J Sleep Res 2020; 29:e13028. [DOI: 10.1111/jsr.13028] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/05/2020] [Accepted: 02/18/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Tomasz Wieczorek
- Department and Clinic of Psychiatry Wroclaw Medical University Wroclaw Poland
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry Wroclaw Medical University Wroclaw Poland
| | - Joanna Smardz
- Department of Experimental Dentistry Wroclaw Medical University Wroclaw Poland
| | - Anna Wojakowska
- 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
| | - Grzegorz Mazur
- Department of Internal Medicine Occupational Diseases, Hypertension and Clinical Oncology Wroclaw Medical University Wroclaw Poland
| | - Helena Martynowicz
- Department of Internal Medicine Occupational Diseases, Hypertension and Clinical Oncology Wroclaw Medical University Wroclaw Poland
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12
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Zhong Z, Xu M, Zou X, Ouyang Q, Zhang L, Yu B, Wang K, Yao D. Changes in heart rate related to rhythmic masticatory muscle activities and limb movements in patients with sleep bruxism. J Oral Rehabil 2019; 47:170-179. [PMID: 31697853 DOI: 10.1111/joor.12900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 10/05/2019] [Accepted: 10/29/2019] [Indexed: 12/19/2022]
Abstract
Most sleep bruxism (SB) episodes are accompanied by an increase in sympathetic tone and heart rate (HR). To characterise heart rate (HR) changes in relation to rhythmic masticatory muscle activities (RMMAs) in SB patients, polysomnographic recordings were performed on 10 SB patients and 11 normal controls. The duration of movement events, amplitude and duration of HR increases, and time to reach HR peak associated with RMMAs and limb movements (LMs) were determined, and the relationships of the parameters of HR increases with types of movements and RMMAs were analysed. All of the parameters of HR increases associated with three types of movements (RMMAs, RMMAs + LMs and LMs) and masseter activities (phasic, tonic and mixed) were significantly different (two-way ANOVA, P < .001 for all) in both SB patients and controls. The duration of RMMAs/LMs was positively correlated with the parameters (SB patients: R2 = .24-.85, P < .0001; controls: R2 = .23-.68, P < .0001). The amplitude of HR increases was also positively correlated with respiration changes in the SB patients (R2 = .3258, P < .0001) and controls (R2 = .09469, P < .05). The proportions of phasic RMMAs associated with awakenings, microarousals and no cortical arousals were significantly different and so were the proportions of tonic and mixed RMMAs (Friedman's tests, P < .05-.001). The HR increases associated with RMMAs may be intrinsic to the cortical arousal response and autonomic activation, and differences in HR increases associated with different types of movements and RMMAs might be related to the changes in respiration and differences in cortical arousal levels.
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Affiliation(s)
- Zhijun Zhong
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
| | - Miao Xu
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
| | - Xueliang Zou
- Jiangxi Mental Hospital, Nanchang University, Jiangxi, China
| | - Qian Ouyang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
| | - Ling Zhang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
| | - Bin Yu
- Jiangxi Mental Hospital, Nanchang University, Jiangxi, China
| | - Kelun Wang
- Department of Health Science & Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
| | - Dongyuan Yao
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital, Nanchang, China.,School of Pharmaceutical Sciences, Nanchang University, Jiangxi, China
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13
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Kawasaki Y, Kasai T, Koikawa N, Hanazato N, Suda S, Murata A, Ozaki R, Nagai S, Matsumura Y, Kaneko H, Kubo M, Osawa A, Nojiri S, Ogasawara E, Sakuraba K, Daida H, Kitade M, Itakura A. Sex differences in factors associated with poor subjective sleep quality in athletes. J Sports Med Phys Fitness 2019; 60:140-151. [PMID: 31640313 DOI: 10.23736/s0022-4707.19.09875-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Sleep is an important recovery period for athletes. In general, women are not satisfied with their sleep quality, which is also true for female soccer players, although the reasons remain to be elucidated. This study aimed to confirm sex difference in sleep quality among athletes from various fields of sport, and to investigate factors related to poor subjective sleep quality in male and female athletes. METHODS We collected data concerning subjective sleep quality, measured by Pittsburgh Sleep Quality Index (PSQI), from athletes who were 16 to 40 years of age and played various types of sports. Data concerning their sports, lifestyle, and sleep issues and sleep environments, and also menstrual issues for females, were collected. RESULTS Data from 207 male athletes and 215 female athletes were assessed. Among them, 31.4% of men and 48.8% of women had poor subjective sleep quality (i.e., PSQI≥6). In male athletes, witnessed apnea, episodes of disorientation or confusion during the time of sleep, long time gap between dinner and bedtime, and turning on the heating in the winter, were identified as factors associated with poor sleep quality by multivariate analysis, whereas in female athletes, bathing close to bedtime, habitual drinking, and being annoyed by noises at bedtime were identified. CONCLUSIONS In both populations, females had poorer subjective sleep quality than males. Sex differences exist in factors associated with poor subjective sleep quality. Thus, different approaches should be considered to improve their sleep quality.
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Affiliation(s)
- Yu Kawasaki
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan - .,Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sleep and Sleep-Disordered Breathing Center, Juntendo University Hospital, Tokyo, Japan
| | - Natsue Koikawa
- Japanese Center for Research on Women in Sports, Juntendo University, Tokyo, Japan.,Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Naoko Hanazato
- Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Shoko Suda
- Department Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Azusa Murata
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Rie Ozaki
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Saki Nagai
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuko Matsumura
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Haruka Kaneko
- Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Mayumi Kubo
- Department of Obstetrics and Gynecology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Aki Osawa
- Department of Orthopedic Surgery, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center Clinical Research and Trial Center, Juntendo University, Tokyo, Japan
| | - Etsuko Ogasawara
- Japanese Center for Research on Women in Sports, Juntendo University, Tokyo, Japan.,Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Keishoku Sakuraba
- Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mari Kitade
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Japanese Center for Research on Women in Sports, Juntendo University, Tokyo, Japan
| | - Atsuo Itakura
- Department of Obstetrics and Gynecology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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14
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Abstract
Hypertension is a major determinant of cardiovascular morbidity and mortality and is highly prevalent in the general population. While the relationship between sleep apnea and increased blood pressure has been well documented, less recognized is emerging evidence linking sleep-related movement disorders such as restless legs syndrome/periodic limb movements of sleep and sleep-related bruxism with blood pressure (BP) dysregulation and hypertension. There is also recent literature linking narcolepsy-cataplexy with elevated BP and altered pressor responses, and there are data suggesting abnormal BP control in rapid eye movement sleep behavior disorder. It is thought that neural circulatory mechanisms, sympathetic activation in particular, comprise the predominant mediator underlying elevated BP in these neurological sleep disorders. There is very limited evidence that treating these sleep disorders may be beneficial in lowering BP primarily because this question has received very little attention. In this review, we discuss the potential pathophysiologic mechanisms underlying elevated BP in restless legs syndrome/periodic limb movements of sleep, sleep-related bruxism, narcolepsy-cataplexy, and rapid eye movement sleep behavior disorder. We also examine the relationship between these sleep disorders and elevated BP and the impact of treatment of these conditions on BP control. Last, we discuss gaps in the literature evaluating the associations between these sleep disorders and elevated BP and identify areas for further research.
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Affiliation(s)
- Meghna P. Mansukhani
- Center for Sleep Medicine, Mayo Clinic; Address: 200, First Street SW, Rochester, Minnesota
| | - Naima Covassin
- Department of Cardiovascular Diseases, Mayo Clinic; Address: 200, First Street SW, Rochester, Minnesota
| | - Virend K. Somers
- Department of Cardiovascular Diseases, Mayo Clinic; Address: 200, First Street SW, Rochester, Minnesota
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15
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Relationship between Sleep Bruxism, Perceived Stress, and Coping Strategies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173193. [PMID: 31480550 PMCID: PMC6747300 DOI: 10.3390/ijerph16173193] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 08/20/2019] [Accepted: 08/26/2019] [Indexed: 01/06/2023]
Abstract
Sleep bruxism (SB) is a common phenomenon defined as a masticatory muscle activity during sleep. Untreated severe SB can have significant dental and orofacial consequences. SB has often been linked with stress and maladaptive coping strategies. Therefore, in this study, a potential correlation between SB, perceived stress and coping strategies was evaluated. A total of 60 adults were enrolled into this study. Participants underwent a detailed intra- and extraoral exam focused on detecting bruxism symptoms. Additionally, the overnight Bruxism Index was recorded using the Bruxoff device. A total of 35 participants with symptoms of bruxism were assigned to the study group, whereas 25 asymptomatic participants were assigned to the control group. The Perceived Stress Scale (PSS-10) was used for stress assessment and Brief-COPE for coping strategies. Results showed that the higher the PSS-10 score, the higher the Bruxism Index was in the study group. Positive coping strategies were chosen most frequently in the control group, while maladaptive ones were chosen in the study group. It can be concluded that there is a relationship between perceived stress and sleep bruxism. Moreover, the type of coping strategies used by participants may have an impact on sleep bruxism, but the relationship should be further investigated.
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16
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Saczuk K, Lapinska B, Wilmont P, Pawlak L, Lukomska-Szymanska M. The Bruxoff Device as a Screening Method for Sleep Bruxism in Dental Practice. J Clin Med 2019; 8:jcm8070930. [PMID: 31261634 PMCID: PMC6678144 DOI: 10.3390/jcm8070930] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 06/22/2019] [Accepted: 06/26/2019] [Indexed: 12/30/2022] Open
Abstract
Sleep bruxism (SB) is a masticatory muscle activity during sleep and a common phenomenon. Severe SB can have a serious impact on the success of dental treatment. Reliable methods of screening and diagnosing patients with SB are crucial. Therefore, in this study, a Bruxoff device as a potential screening and diagnostic method for sleep bruxism was evaluated. A total of 60 adults participated in this study: 35 patients with symptoms of bruxism (study group) and 25 asymptomatic patients (control group). Data were recorded using Bruxoff. All symptomatic patients participating in the study turned out to be bruxers, while not all asymptomatic patients turned out to be non-bruxers according to the Bruxoff device. Bruxoff is a simple screening device that can be safely used to evaluate masseter muscle activity during sleep. Since the device does not have a built-in microphone and/or video camera and, therefore, cannot record grinding sounds, the objective capabilities of Bruxoff as a single diagnostic device for sleep bruxism are limited.
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Affiliation(s)
- Klara Saczuk
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland
| | - Paulina Wilmont
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland
| | - Lukasz Pawlak
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St., 92-213 Lodz, Poland
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17
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Iwasaki LR, Gallo LM, Markova M, Erni S, Liu H, Nickel JC. Night‐time autonomic nervous system ultradian cycling and masticatory muscle activity. Orthod Craniofac Res 2019; 22 Suppl 1:107-112. [DOI: 10.1111/ocr.12267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 12/11/2018] [Indexed: 01/27/2023]
Affiliation(s)
- Laura R. Iwasaki
- Department of OrthodonticsSchool of DentistryOregon Health & Science University Portland Oregon
| | - Luigi M. Gallo
- Department of Masticatory DisordersSchool of DentistryUniversity of Zurich Zurich Switzerland
| | - Michala Markova
- Department of Masticatory DisordersSchool of DentistryUniversity of Zurich Zurich Switzerland
| | - Stefan Erni
- Department of Masticatory DisordersSchool of DentistryUniversity of Zurich Zurich Switzerland
| | - Hongzeng Liu
- Department of OrthodonticsSchool of DentistryOregon Health & Science University Portland Oregon
| | - Jeff C. Nickel
- Department of OrthodonticsSchool of DentistryOregon Health & Science University Portland Oregon
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18
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Meira e Cruz M, Guimarães AS. A window to consolidate the “functional hypothesis of bruxism” through cardiovascular autonomic link. Oral Dis 2019; 25:1237-1238. [DOI: 10.1111/odi.13077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 02/27/2019] [Indexed: 01/04/2023]
Affiliation(s)
- Miguel Meira e Cruz
- Sleep Unit Cardiovascular Center of University of LisbonSchool of Medicine Lisboa Portugal
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