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Su D, Zeng X, Tang Y, Wang W. Construction and Application of Patient-Participated Health Care Guidance Plan for Patients with Decompensated Hepatitis B Cirrhosis. Hepat Med 2024; 16:45-54. [PMID: 38859813 PMCID: PMC11162963 DOI: 10.2147/hmer.s455557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/11/2024] [Indexed: 06/12/2024] Open
Abstract
Objective The goal of this study was to develop and assess the effectiveness of a patient-engaged healthcare guidance plan for individuals with decompensated hepatitis B cirrhosis. Methods This study employed literature review, situational analysis, and expert consultations to create a healthcare guidance plan that includes patient participation for those suffering from decompensated hepatitis B cirrhosis. Between January 2022 and January 2023, 86 patients with this condition admitted to our hospital were selected through convenience sampling and randomly assigned into two groups using a random number table. The control group (n=43) received standard care, while the intervention group (n=43) received the novel patient-engaged healthcare guidance in addition to standard care. We compared both groups in terms of anxiety and depression levels, self-care capability, uncertainty about their illness, and overall quality of life. Results Upon discharge, scores for the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Mishel's Uncertainty in Illness Scale (MUIS) decreased in both groups compared to their scores at admission (P<0.05), with the intervention group showing more significant improvements than the control group (P<0.05). Additionally, scores for the Self-Care Ability Scale (ESCA) and the component threshold scores of the Health Survey Short Form (SF-36) increased for both groups from admission to discharge (P<0.05), with the intervention group showing greater improvements than the control group (P<0.05). Conclusion The patient-engaged healthcare guidance plan developed for individuals with decompensated hepatitis B cirrhosis proved to be highly effective. It significantly reduced patient anxiety and depression, enhanced self-care capabilities, diminished illness uncertainty, and improved overall quality of life.
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Affiliation(s)
- Dan Su
- Department of Gastroenterology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province, 421001, People’s Republic of China
| | - Xiange Zeng
- Department of Gastroenterology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province, 421001, People’s Republic of China
| | - Yinliang Tang
- Department of Gastroenterology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province, 421001, People’s Republic of China
| | - Wenjing Wang
- Department of Gastroenterology, The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan Province, 421001, People’s Republic of China
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2
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Gizler M, Pietrzak N, Saczuk K, Lukomska-Szymanska M, Lapinska B. Students' awareness of the bruxism causes, effects and therapies. Heliyon 2024; 10:e23708. [PMID: 38205295 PMCID: PMC10776920 DOI: 10.1016/j.heliyon.2023.e23708] [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: 07/11/2023] [Revised: 11/17/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024] Open
Abstract
Objectives Bruxism is a repetitive activity of the masticatory muscles characterized by clenching or grinding teeth and/or mandibular stiffening. Bruxism manifests itself in two forms: during sleeping and waking. The etiology of bruxism is multifactorial. The treatment of bruxism is mainly based on making the patient aware of the presence of the condition. The aim of the study was to assess knowledge on the causes and the effects of bruxism among Polish students as well as the possible management. Materials and methods The anonymous online survey was conducted among students (aged between 18 and 25 years old) of universities across Poland, using the Google Forms platform. The survey contained questions concerning bruxism causes, effects and therapies. All variants of answers in these questions contained true information about bruxism. Results The study found significant differences in awareness of bruxism among genders in favor of females. The awareness of bruxism among population residing in cities and in villages was comparable (p > 0.05). However, the results should be taken with care due to limited number of students that participated in the study and uneven gender distribution among urban and village residents. Conclusions Within the limitations of the study it can be concluded that the knowledge of bruxism among Polish students is higher in comparison with the findings from the literature, as well as the superiority of women's awareness of bruxism over men. Future studies should be conducted on greater student population, with even distribution of participants among country areas and variety of universities. Significance The findings may indicate the need for further education of male young adults, on bruxism causes, possible effects and therapies to increase their awareness of bruxism and encourage early diagnosis and treatment.
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Affiliation(s)
- Mateusz Gizler
- Faculty of Dentistry, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland
| | - Natalia Pietrzak
- Faculty of Dentistry, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland
| | - 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
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Raggi A, Mogavero MP, DelRosso LM, Ferri R. Clonazepam for the management of sleep disorders. Neurol Sci 2023; 44:115-128. [PMID: 36112279 DOI: 10.1007/s10072-022-06397-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/06/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND The objectives of this review and meta-analysis of polysomnographic data are those to focus on the clinical use of clonazepam for the management of sleep disorders by re-analyzing clinical trials and randomized clinical trials which have been published in peer-reviewed journals. METHODS A review of the literature including clinical trials and randomized controlled trials was performed in PubMed®, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol. A random effects model meta-analysis was then carried out for the four more frequently reported polysomnographic measures: total sleep time, sleep latency, sleep efficiency, and periodic leg movement during sleep (PLMS) index. RESULTS A total of 33 articles were retrieved and screened in full text, of which 18 met the criteria for review; among the latter, nine met the criteria for meta-analysis. The studies included in the review involved patients with insomnia, REM sleep behavior disorder, sleep bruxism, and restless leg syndrome or PLMS which reported, most often, an increase in total sleep time with clonazepam. A clear sleep-promoting effect of clonazepam was found also by meta-analysis. DISCUSSION AND CONCLUSIONS Our results indicate that the pharmacological treatment of sleep disorders with clonazepam must always be personalized according to the type of patient, the risk of addiction and the concomitant presence of respiratory disorders are key factors to take into account. However, in light of the clinical evidence of the few studies in the literature on the different types of disorders, more studies on the use of clonazepam (also in association with first choice treatments) are definitely needed.
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Affiliation(s)
- Alberto Raggi
- Unit of Neurology, G.B. Morgagni - L. Pierantoni Civic Hospital, 34 Via Carlo Forlanini, 47121, Forlì, Italy.
| | - Maria Paola Mogavero
- Institute of Molecular Bioimaging and Physiology, National Research Council, Milan, Italy.,Sleep Disorders Center, Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Lourdes M DelRosso
- Seattle Children's Hospital and University of Washington, Seattle, WA, USA
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute - IRCCS, Troina, Italy
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4
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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: 21] [Impact Index Per Article: 10.5] [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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Sáenz-Farret M, Tijssen MAJ, Eliashiv D, Fisher RS, Sethi K, Fasano A. Antiseizure Drugs and Movement Disorders. CNS Drugs 2022; 36:859-876. [PMID: 35861924 DOI: 10.1007/s40263-022-00937-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/03/2022]
Abstract
The relationship between antiseizure drugs and movement disorders is complex and not adequately reviewed so far. Antiseizure drugs as a treatment for tremor and other entities such as myoclonus and restless leg syndrome is the most common scenario, although the scientific evidence supporting their use is variable. However, antiseizure drugs also represent a potential cause of iatrogenic movement disorders, with parkinsonism and tremor the most common disorders. Many other antiseizure drug-induced movement disorders are possible and not always correctly identified. This review was conducted by searching for all the possible combinations between 15 movement disorders (excluding ataxia) and 24 antiseizure drugs. The main objective was to describe the movement disorders treated and worsened or induced by antiseizure drugs. We also summarized the proposed mechanisms and risk factors involved in the complex interaction between antiseizure drugs and movement disorders. Antiseizure drugs mainly used to treat movement disorders are clonazepam, gabapentin, lacosamide, levetiracetam, oxcarbazepine, perampanel, phenobarbital, pregabalin, primidone, topiramate, and zonisamide. Antiseizure drugs that worsen or induce movement disorders are cenobamate, ethosuximide, felbamate, lamotrigine, phenytoin, tiagabine, and vigabatrin. Antiseizure drugs with a variable effect on movement disorders are carbamazepine and valproate while no effect on movement disorders has been reported for brivaracetam, eslicarbazepine, lacosamide, and stiripentol. Although little information is available on the adverse effects or benefits on movement disorders of newer antiseizure drugs (such as brivaracetam, cenobamate, eslicarbazepine, lacosamide, and rufinamide), the evidence collected in this review should guide the choice of antiseizure drugs in patients with concomitant epilepsy and movement disorders. Finally, these notions can lead to a better understanding of the mechanisms involved in the pathophysiology and treatments of movement disorders.
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Affiliation(s)
- Michel Sáenz-Farret
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Division of Neurology, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada
| | - Marina A J Tijssen
- Department of Neurology, University of Groningen, Groningen, The Netherlands.,Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Dawn Eliashiv
- UCLA Seizure Disorder Center, Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Robert S Fisher
- Departments of Neurology and Neurological Sciences and Neurosurgery, Stanford University, Stanford, CA, USA
| | - Kapil Sethi
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Division of Neurology, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada. .,Krembil Brain Institute, Toronto, ON, Canada. .,Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada.
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Abstract
OBJECTIVES The objective of this study was to report the effectiveness of trazodone for treatment of bruxism in dementia. METHODS A single case study of a 66-year-old man with severe vascular dementia and awake bruxism was performed. RESULTS The patient's bruxism responded robustly to titration of trazodone. He tolerated the medication with no untoward sedation or other adverse effects. CONCLUSIONS Bruxism is occasionally encountered in patients with advanced dementia and raises concerns about nutritional compromise and about potential need for poorly tolerated dental treatment. Trazodone may potentially be effective for bruxism in some patients.
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7
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Fernández-Núñez T, Amghar-Maach S, Gay-Escoda C. Efficacy of botulinum toxin in the treatment of bruxism: Systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:e416-e424. [PMID: 31246937 PMCID: PMC6667018 DOI: 10.4317/medoral.22923] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 02/07/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Currently it has been shown that botulinum toxin is effective for a wide variety of medical conditions, and can be applied for therapeutic purposes as cosmetic. In recent years, there has been a growing trend in the use of this drug substance to control the muscular overactivity of bruxism. The objective of this study was the use of botulinum toxin type A (BTX-A) than traditional methods, by conducting a systematic review of randomized clinical trials (RCTs) published in the health sciences literature. MATERIAL AND METHODS An electronic search was made in the databases of the PubMed, Cochrane Library and Scopus data between March and October 2017, ECA, which will analyze the effect of botulinum toxin in the treatment of bruxism. We included studies of bruxist patients older than 18 years where BTX-A tests were performed on the masseter and / or temporal muscles and the control systems were injections of placebo (saline) or the use of traditional methods for the treatment of bruxism. such as occlusal splints, other medications or cognitive-behavioral therapy. RESULTS Of the 68 studies identified, 4 RCTs that fit our inclusion criteria were selected. These studies show that BTX-A injections can reduce the frequency of bruxism episodes, decrease pain levels and maximum occlusal force generated by this pathology, offer superior efficacy in the treatment of bruxism compared to control groups who were treated with placebo or with traditional methods for the treatment of bruxism. CONCLUSION Infiltrations with BTX-A are a safe and effective treatment for patients with bruxism, so its use is justified in daily clinical practice, especially in patients diagnosed with severe bruxism.
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8
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Tavares-Silva C, Holandino C, Homsani F, Luiz RR, Prodestino J, Farah A, Lima JDP, Simas RC, Castilho CVV, Leitão SG, Maia LC, Fonseca-Gonçalves A. Homeopathic medicine of Melissa officinalis combined or not with Phytolacca decandra in the treatment of possible sleep bruxism in children: A crossover randomized triple-blinded controlled clinical trial. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 58:152869. [PMID: 30831467 DOI: 10.1016/j.phymed.2019.152869] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 12/23/2018] [Accepted: 02/17/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE The present randomized controlled clinical trial evaluated the efficacy of homeopathic medicines of Melissa officinalis (MO), Phytolacca decandra (PD), and the combination of both in the treatment of possible sleep bruxism (SB) in children. STUDY DESIGN Patients (n = 52) (6.62 ± 1.79 years old) were selected based on the parents report of SB. The study comprised a crossover design that included 4 phases of 30-day treatment (Placebo; MO 12c; PD 12c; and MO 12c + PD 12c), with a wash-out period of 15 days between treatments. METHODS At baseline and after each phase, the Visual Analogic Scale (VAS) was used as the primary outcome measure to evaluate the influence of treatments on the reduction of SB. The following additional outcome measures were used: a children's sleep diary with parent's/guardian's perceptions of their children's sleep quality, the trait of anxiety scale (TAS) to identify changes in children's anxiety profile, and side effects reports. Data were analyzed by ANOVA with repeated measures followed by Post Hoc LSD test. RESULTS Significant reduction of SB was observed in VAS after the use of Placebo (-1.72 ± 0.29), MO (-2.36 ± 0.36), PD (-1.44 ± 0.28) and MO + PD (-2.21 ± 0.30) compared to baseline (4.91 ± 1.87). MO showed better results compared to PD (p = 0.018) and Placebo (p = 0.050), and similar result compared to MO+PD (p = 0.724). The sleep diary results and TAS results were not influenced by any of the treatments. No side effects were observed after treatments. CONCLUSION MO showed promising results in the treatment of possible sleep bruxism in children, while the association of PD did not improve MO results.
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Affiliation(s)
- Cláudia Tavares-Silva
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro - UFRJ, Brazil
| | - Carla Holandino
- Faculty of Pharmacy, Universidade Federal do Rio de Janeiro - UFRJ, Brazil
| | - Fortune Homsani
- Faculty of Pharmacy, Universidade Federal do Rio de Janeiro - UFRJ, Brazil
| | - Ronir Raggio Luiz
- Institute for Studies in Public Health, Universidade Federal do Rio de Janeiro - UFRJ, Brazil
| | - Jessica Prodestino
- Institute for Studies in Public Health, Universidade Federal do Rio de Janeiro - UFRJ, Brazil
| | - Adriana Farah
- Nutrition Institute, Universidade Federal do Rio de Janeiro - UFRJ, Brazil
| | | | | | | | | | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro - UFRJ, Brazil
| | - Andréa Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro - UFRJ, Brazil.
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9
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Mostafavi SN, Jafari A, Hoseini SG, Khademian M, Kelishadi R. The efficacy of low and moderate dosage of diazepam on sleep bruxism in children: A randomized placebo-controlled clinical trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2019; 24:8. [PMID: 30815021 PMCID: PMC6383339 DOI: 10.4103/jrms.jrms_131_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/04/2018] [Accepted: 10/15/2018] [Indexed: 11/04/2022]
Abstract
Background Sleep bruxism (SB) in children is commonly a self-limited problem; however, therapy of the condition may be needed to improve sleep quality of parents and children. Benzodiazepines have some success in controlling adult bruxism. The objective of this study was to evaluate the effect and the safety of a short course of diazepam on controlling SB in healthy children. Materials and Methods In this double-blind, randomized placebo-controlled clinical trial, 109 children with SB were randomly assigned to three groups, receiving low or moderate dose of diazepam or placebo for 2 weeks. For children aged 2-8 years, the dose of 2.5 and 5 mg was considered as low and moderate dose consequently. In children >8 years, the doses were doubled. The severity of SB was evaluated at the beginning and also 2, 8, and 12 weeks thereafter. Data were collected by a questionnaire completed by parents including frequency of SB per week and per night and duration of each SB, as bruxism severity score (BSS). A mixed-model ANOVA was used to assess the differences of mean BSS between different groups and measurement times. Results From 109 children recruited, 90 completed the study. After 2 weeks of intervention, the mean BSS decreased significantly in all groups (P = 0.0001), but it was not significantly different between groups in any of follow-ups (P = 0.554). Next-day sleepiness was assessed at week 2 of the study and was significantly higher in the groups using diazepam (P = 0.026). Conclusion Short course of diazepam was not more effective than placebo for long-term control of SB in children.
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Affiliation(s)
- Seyyed-Nassereddin Mostafavi
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Jafari
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Emam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shervin Ghaffari Hoseini
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Khademian
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Emam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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10
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Fan X, Qu F, Wang JJ, Du X, Liu WC. Decreased γ-aminobutyric acid levels in the brainstem in patients with possible sleep bruxism: A pilot study. J Oral Rehabil 2017; 44:934-940. [PMID: 28891592 DOI: 10.1111/joor.12572] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND An increasing number of studies have indicated that the central and autonomic nervous systems play roles in the genesis of sleep bruxism (SB). The role of specific neurochemicals in SB has been a subject of interest. OBJECTIVE In this study, we use proton magnetic resonance spectroscopy (1 H-MRS) to determine whether the levels of γ-aminobutyric acid (GABA) and glutamate (Glu) are different in the brainstem and bilateral cortical masticatory area (CMA) between possible sleep bruxism (SB) patients and controls, and discuss whether the brainstem or cortical networks which may affect the central masticatory pathways are under the genesis of SB. METHODS Twelve possible SB patients and twelve age- and gender-matched controls underwent 1 H-MRS using the "MEGA-Point Resolved Spectroscopy Sequence" (MEGA-PRESS) technique in the brainstem and bilateral CMA. Proton magnetic resonance spectroscopy data were processed using LCModel. Because the signal detected by MEGA-PRESS includes contributions from GABA, macromolecules (primarily proteins) and homocarnosine, the GABA signal is referred to as "GABA+". The glutamate complex (Glx) signal contains both glutamate (Glu) and glutamine (Gln), which mainly reflect glutamatergic metabolism. RESULTS Edited spectra were successfully obtained from the bilateral CMA in all subjects. There were no significant differences in neurochemical levels between the left and right CMA in possible SB patients and controls. In the brainstem, significantly lower GABA+ levels were found in possible SB patients than in controls (P = .011), whereas there was no significant difference (P = .307) in Glx levels between the 2 groups. CONCLUSIONS SB patients may possess abnormalities in the GABAergic system of brainstem networks.
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Affiliation(s)
- X Fan
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - F Qu
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - J-J Wang
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - X Du
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - W-C Liu
- Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
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11
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Salgueiro MDCC, Bortoletto CC, Horliana ACR, Mota ACC, Motta LJ, Motta PDB, MesquitaFerrari RA, Fernandes KPS, Bussadori SK. Evaluation of muscle activity, bite force and salivary cortisol in children with bruxism before and after low level laser applied to acupoints: study protocol for a randomised controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:391. [PMID: 28789647 PMCID: PMC5549372 DOI: 10.1186/s12906-017-1905-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/02/2017] [Indexed: 12/02/2022]
Abstract
BACKGROUND Bruxism is a repetitive activity that causes tooth wear, audible sounds, and discomfort. Preventive measures have been studied for conditions that can exert a negative influence on physiological development in children. Low-level laser therapy administered over acupoints is an effective, painless, low-cost treatment option that has achieved good results. Thus, the aim of the proposed study is to evaluate changes in muscle activity, bite force and salivary cortisol in children with bruxism after the application of low-level laser to accupoints. METHODS The children will be randomly allocated to four groups of 19 individuals: G1 - low-level laser; G2 - occlusal splint; G3 - placebo laser; and G4 - control (without bruxism). The BTS TMJOINT electromyography will be used to determine muscle activity and a digital gnathodynamometer will be used to measure bite force. Salivary cortisol will be analysed at baseline as well as one and six months after treatment. Two-way ANOVA will be employed and complemented by Tukey's test. DISCUSSION Bruxism is a repetitive activity of the masticatory muscles that can have negative consequences if not treated, such as tooth wear, noises, discomfort and anxiety. Thus, control and treatment measures should be taken. Although low-level laser therapy over acupoints has been indicated for children, the effects of this treatment modality have not yet been studied. TRIAL REGISTRATION NCT02757261 on 8 April 2016. This study protocol received a grant from the Brazilian fostering agency São Paulo Research Foundation (FAPESP: #2015/24731-0).
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Affiliation(s)
- Mônica da Consolação Canuto Salgueiro
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
| | | | - Anna Carolina RattoTempestini Horliana
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
| | - Ana Carolina Costa Mota
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
| | - Lara Jansiski Motta
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Management in Health Systems, Nove de Julho University, São Paulo, Brazil
| | | | - Raquel Agnelli MesquitaFerrari
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Postgraduate program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Kristianne Porta Santos Fernandes
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Postgraduate program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate program in Biophotonics Applied to Health Sciences, Nove de Julho University, Rua Vergueiro, 249 - Liberdade, São Paulo, SP CEP 0154001 Brazil
- Postgraduate program in Rehabilitation Sciences, Nove de Julho University, São Paulo, Brazil
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Zhang Y, Lu J, Wang Z, Zhong Z, Xu M, Zou X, Yu B, Yao D. Companion of oral movements with limb movements in patients with sleep bruxism: preliminary findings. Sleep Med 2017; 36:156-164. [DOI: 10.1016/j.sleep.2017.05.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/13/2017] [Accepted: 05/25/2017] [Indexed: 12/22/2022]
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Rener-Sitar K, John MT, Pusalavidyasagar SS, Bandyopadhyay D, Schiffman EL. Sleep quality in temporomandibular disorder cases. Sleep Med 2016; 25:105-112. [PMID: 27823702 DOI: 10.1016/j.sleep.2016.06.031] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 03/22/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to characterize self-reported sleep quality (SQ) in cases with temporomandibular disorder (TMD) and to compare their results with those of healthy controls. METHODS The Pittsburgh Sleep Quality Index (PSQI) was used to measure SQ in a convenience sample of 609 TMD cases and 88 controls. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic nomenclature was used, but Axis I diagnoses were based on the consensus of two reliable criterion examiners and not the RDC/TMD algorithms. The PSQI scores for TMD cases were calculated also for the RDC/TMD Axis II measures assessing chronic pain and disability, depression, and nonspecific physical symptoms. PSQI scores of the TMD cases were compared with those from controls. RESULTS TMD cases with one to five TMD diagnoses (n = 609) had a mean PSQI score of 7.0 [95% confidence interval (CI) = 6.7-7.4]. In comparison, the mean score was 5.2 (95% CI = 4.6-5.9) for control subjects. For the subset of TMD cases with pain-free diagnoses (n = 113), the PSQI score was similar to controls with 5.1 (95% CI = 4.5-5.6), whereas it was significantly different for cases with pain-related diagnoses 7.5 (95% CI = 6.6-8.3; n = 87). Although the number of TMD diagnoses and participant age had some influence on SQ, psychosocial status, and pain-related impairment assessed with RDC/TMD Axis II measures had the strongest association with SQ, in particular, dysfunctional chronic pain. CONCLUSION SQ is impaired in TMD patients with pain-related diagnoses, and even more in those with dysfunctional pain. This relationship between sleep and pain suggests that SQ should be assessed in TMD pain patients, especially in those with significant Axis II involvement.
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Affiliation(s)
- Ksenija Rener-Sitar
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA; Department of Prosthodontics, Dental Division, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; University Dental Clinics, University Medical Centre of Ljubljana, Ljubljana, Slovenia.
| | - Mike T John
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - Snigdha S Pusalavidyasagar
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, School of Medicine, University of Minnesota, Minneapolis, MN, USA
| | | | - Eric L Schiffman
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
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Sakai T, Kato T, Yoshizawa S, Suganuma T, Takaba M, Ono Y, Yoshizawa A, Yoshida Y, Kurihara T, Ishii M, Kawana F, Kiuchi Y, Baba K. Effect of clonazepam and clonidine on primary sleep bruxism: a double-blind, crossover, placebo-controlled trial. J Sleep Res 2016; 26:73-83. [DOI: 10.1111/jsr.12442] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 05/25/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Takuro Sakai
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Takafumi Kato
- Department of Oral Anatomy and Neurobiology; Graduate School of Dentistry; Osaka University; Suita Osaka Japan
- Sleep Medicine Center; Osaka University Hospital; Suita Osaka Japan
| | - Shuichiro Yoshizawa
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Takeshi Suganuma
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Masayuki Takaba
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Yasuhiro Ono
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Ayako Yoshizawa
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Yuya Yoshida
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
| | - Tatsuya Kurihara
- Department of Hospital Pharmaceutics; School of Pharmacy; Showa University; Tokyo Japan
| | - Masakazu Ishii
- Department of Pathophysiology; School of Pharmacy; Showa University; Tokyo Japan
| | | | - Yuji Kiuchi
- Department of Pharmacology; School of Medicine; Showa University; Tokyo Japan
| | - Kazuyoshi Baba
- Department of Prosthodontics; School of Dentistry; Showa University; Tokyo Japan
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Abstract
Despite numerous case reports, the evidence for treatment of bruxism is still low. Different treatment modalities (behavioral techniques, intraoral devices, medications, and contingent electrical stimulation) have been applied. A clinical evaluation is needed to differentiate between awake bruxism and sleep bruxism and rule out any medical disorder or medication that could be behind its appearance (secondary bruxism). A polysomnography is required only in a few cases of sleep bruxism, mostly when sleep comorbidities are present. Counselling with regard to sleep hygiene, sleep habit modification, and relaxation techniques has been suggested as the first step in the therapeutic intervention, and is generally considered not harmful, despite low evidence of any efficacy. Occlusal splints are successful in the prevention of dental damage and grinding sounds associated with sleep bruxism, but their effects on reducing bruxism electromyographic (EMG) events are transient. In patients with psychiatric and sleep comorbidities, the acute use of clonazepam at night has been reported to improve sleep bruxism, but in the absence of double-blind randomized trials, its use in general clinical practice cannot be recommended. Severe secondary bruxism interfering with speaking, chewing, or swallowing has been reported in patients with neurological disorders such as in cranial dystonia; in these patients, injections of botulinum toxin in the masticatory muscles may decrease bruxism for up to 1–5 months and improve pain and mandibular functions. Long-term studies in larger and better specified samples of patients with bruxism, comparing the effects of different therapeutic modalities on bruxism EMG activity, progression of dental wear, and orofacial pain are current gaps of knowledge and preclude the development of severity-based treatment guidelines.
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Affiliation(s)
- Marc Guaita
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
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Odontoiatria e disturbi del sonno. DENTAL CADMOS 2015. [DOI: 10.1016/s0011-8524(15)30092-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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18
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The effects of nocturnal electromyographic biofeedback on sleep quality and psychological stress. INTERNATIONAL JOURNAL OF STOMATOLOGY & OCCLUSION MEDICINE 2015. [DOI: 10.1007/s12548-015-0131-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lapointe E, Frenette É. Periodic or Rhythmic Movements During Sleep. Sleep Med Clin 2014. [DOI: 10.1016/j.jsmc.2014.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Affiliation(s)
- Hyeyun Kim
- Department of Neurology; International St. Mary Hospital; Catholic Kwandong University; Incheon Republic of Korea
| | - Hyun Jeong Han
- Department of Neurology; Myongji Hospital; Goyang Republic of Korea
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Abstract
BACKGROUND Sleep bruxism is an oral activity characterized by involuntary teeth grinding or clenching during sleep. Several forms of treatment have been proposed for this disorder, including behavioural, dental and pharmacological strategies. OBJECTIVES To evaluate the effectiveness and safety of pharmacological therapy for the treatment of sleep bruxism compared with other drugs, no treatment or placebo. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 8, 2014), MEDLINE (1966 to August 2014), EMBASE (1980 to August 2013) and LILACS (1982 to August 2014). We identified additional reports from the reference lists of retrieved reports and from reviews on treatment of sleep bruxism. We applied no language restrictions. SELECTION CRITERIA We selected randomized controlled trials (RCTs) or quasi-RCTs that compared drugs with other drugs, no treatment or placebo in people with sleep bruxism. DATA COLLECTION AND ANALYSIS Review authors carried out data extraction and quality assessment of the included trials independently and in duplicate. We discussed discrepancies until we reached consensus. We consulted a third review author in cases of persistent disagreement. We contacted authors of primary studies when necessary. MAIN RESULTS We identified 18 potentially relevant RCTs, but only seven met the inclusion criteria. All studies had a small number of participants, ranging from seven to 16 people per study and had a cross-over design. Three studies were of low risk of bias, while four were of uncertain risk. Amitriptyline (three studies), bromocriptine (one study), clonidine (one study), propranolol (one study), levodopa (Prolopa®) (one study) and tryptophan (one study) were compared with placebo. Studies evaluating bromocriptine, clonidine, propranolol and levodopa reported our primary outcome of indices of bruxism motor activity.Results were imprecise and consistent with benefit, no difference or harm. These were the specific findings for each of the drugs according to specific outcomes: 1. Amitriptyline versus placebo for masseteric electromyography (EMG) activity per minute: standardized mean difference (SMD) -0.28 (95% confidence interval (CI) -0.91 to 0.34; P value = 0.37), 2. bromocriptine versus placebo for bruxism episodes per hour: mean difference (MD) 0.60 (95% CI -2.93 to 4.13), bruxism bursts per hour: MD -2.00 (95% CI -53.47 to 49.47), bruxism bursts per episode: MD 0.50 (95% CI -1.85 to 2.85) or number of episodes with grinding noise: MD 2.40 (95% CI -24.00 to 28.80), 3. clonidine versus placebo for number of bruxism episodes per hour: MD -2.41 (95% CI -4.84 to 0.02), 4. propranolol versus placebo for the number of bruxism episodes per hour: MD 1.16 (95% CI -1.89 to 4.21), 5. L-tryptophan versus placebo for masseteric EMG activity per second: SMD 0.08 (95% CI -0.90 to 1.06) and 6. levodopa versus placebo for bruxism episodes per hour of sleep: MD -1.47 (95% CI -3.64 to 0.70), for bruxism bursts per episode: MD 0.06 (95% CI -2.47 to 2.59).We combined several secondary outcomes (sleep duration, masseteric EMG activity per minute and pain intensity) in a meta-analysis for comparison of amitriptyline with placebo. The results for most comparisons were uncertain because of statistical imprecision. One study reported that clonidine reduced rapid eye movement (REM) sleep stage and increased the second stage of sleep. However, results for other sleep-related outcomes with clonidine were uncertain. Adverse effects were frequent in people who took amitriptyline (5/10 had drowsiness, difficulty awakening in the morning, insomnia or xerostomia compared with 0/10 in the placebo group), as well as in people who received propranolol (7/16 had moderate-to-severe xerostomia compare with 2/16 in the placebo group). Clonidine was associated with prolonged morning hypotension in three of 16 participants. The use of preventive medication avoided any adverse effects in people treated with levodopa and bromocriptine. AUTHORS' CONCLUSIONS There was insufficient evidence on the effectiveness of pharmacotherapy for the treatment of sleep bruxism. This systematic review points to the need for more, well-designed, RCTs with larger sample sizes and adequate methods of allocation, outcome assessment and duration of follow-up. Ideally, parallel RCTs should be used in future studies to avoid the bias associated with cross-over studies. There is a need to standardize the outcomes of RCTs on treatments for sleep bruxism.
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Affiliation(s)
- Cristiane R Macedo
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em SaúdeBrazilian Cochrane CentreRua Borges Lagoa, 564 cj 63São PauloSPBrazilCEP 04038‐000
| | - Elizeu C Macedo
- Mackenzie Presbyterian UniversityCognitive Neuroscience Laboratory and Developmental Disorders ProgramSão PauloBrazil
| | - Maria R Torloni
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em SaúdeBrazilian Cochrane CentreRua Borges Lagoa, 564 cj 63São PauloSPBrazilCEP 04038‐000
| | - Ademir B Silva
- Universidade Federal de São PauloNeurology, Neurosurgery and NeuroscienceRua Pedro de Toledo980 conj. 82São PauloSão PauloBrazil04039‐002
| | - Gilmar F Prado
- Escola Paulista de Medicina, Universidade Federal de São PauloDepartment of NeurologySão PauloSão PauloBrazil
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Murakami T, Masaki C, Takahashi H, Makino M, Mukaibo T, Kondo Y, Nakamoto T, Hosokawa R. Sleep bruxism is affected by peripheral benzodiazepine receptor gene polymorphisms. INTERNATIONAL JOURNAL OF STOMATOLOGY & OCCLUSION MEDICINE 2014. [DOI: 10.1007/s12548-013-0101-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Takahashi H, Masaki C, Makino M, Yoshida M, Mukaibo T, Kondo Y, Nakamoto T, Hosokawa R. Management of sleep-time masticatory muscle activity using stabilisation splints affects psychological stress. J Oral Rehabil 2013; 40:892-9. [PMID: 24237357 DOI: 10.1111/joor.12110] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2013] [Indexed: 11/28/2022]
Abstract
To treat sleep bruxism (SB), symptomatic therapy using stabilisation splints (SS) is frequently used. However, their effects on psychological stress and sleep quality have not yet been examined fully. The objective of this study was to clarify the effects of SS use on psychological stress and sleep quality. The subjects (11 men, 12 women) were healthy volunteers. A crossover design was used. Sleep measurements were performed for three consecutive days or longer without (baseline) or with an SS or palatal splint (PS), and data for the final day were evaluated. We measured masseter muscle activity during sleep using portable electromyography to evaluate SB. Furthermore, to compare psychological stress before and after sleep, assessments were made based on STAI-JYZ and the measurement of salivary chromogranin A. To compare each parameter among the three groups (baseline, SS and PS), Friedman's and Dunn's tests were used. From the results of the baseline measurements, eight subjects were identified as high group and 15 as low group. Among the high group, a marked decrease in the number of bruxism events per hour and an increase in the difference in the total STAI Y-1 scores were observed in the SS group compared with those at baseline (P < 0·05). No significant difference was observed in sleep stages. SS use may be effective in reducing the number of SB events, while it may increase psychological stress levels, and SS use did not apparently influence sleep stages.
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Affiliation(s)
- H Takahashi
- Department of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Fukuoka, Japan
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Time-linked concurrence of sleep bruxism, periodic limb movements, and EEG arousals in sleep bruxers and healthy controls. Clin Oral Investig 2013; 18:507-13. [DOI: 10.1007/s00784-013-0994-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 04/23/2013] [Indexed: 10/26/2022]
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26
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Ferri R, Zucconi M, Marelli S, Plazzi G, Schenck CH, Ferini-Strambi L. Effects of long-term use of clonazepam on nonrapid eye movement sleep patterns in rapid eye movement sleep behavior disorder. Sleep Med 2013; 14:399-406. [DOI: 10.1016/j.sleep.2013.01.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/17/2013] [Accepted: 01/25/2013] [Indexed: 11/24/2022]
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27
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An observational clinical and video-polysomnographic study of the effects of clonazepam in REM sleep behavior disorder. Sleep Med 2013; 14:24-9. [DOI: 10.1016/j.sleep.2012.09.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 09/10/2012] [Accepted: 09/14/2012] [Indexed: 11/20/2022]
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Carra MC, Huynh N, Lavigne G. Sleep bruxism: a comprehensive overview for the dental clinician interested in sleep medicine. Dent Clin North Am 2012; 56:387-413. [PMID: 22480810 DOI: 10.1016/j.cden.2012.01.003] [Citation(s) in RCA: 155] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sleep bruxism (SB) is a common sleep-related motor disorder characterized by tooth grinding and clenching. SB diagnosis is made on history of tooth grinding and confirmed by polysomnographic recording of electromyographic (EMG) episodes in the masseter and temporalis muscles. The typical EMG activity pattern in patients with SB is known as rhythmic masticatory muscle activity (RMMA). The authors observed that most RMMA episodes occur in association with sleep arousal and are preceded by physiologic activation of the central nervous and sympathetic cardiac systems. This article provides a comprehensive review of the cause, pathophysiology, assessment, and management of SB.
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Affiliation(s)
- Maria Clotilde Carra
- Faculty of Dental Medicine, Univeristé de Montréal, CP 6128 Succursale Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.
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Long H, Liao Z, Wang Y, Liao L, Lai W. Efficacy of botulinum toxins on bruxism: an evidence-based review. Int Dent J 2012; 62:1-5. [DOI: 10.1111/j.1875-595x.2011.00085.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Simmons MS, Pullinger A. Education in sleep disorders in US dental schools DDS programs. Sleep Breath 2011; 16:383-92. [PMID: 21523492 PMCID: PMC3306848 DOI: 10.1007/s11325-011-0507-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2010] [Revised: 03/05/2011] [Accepted: 03/08/2011] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Medical school surveys of pre-doctoral curriculum hours in the somnology, the study of sleep, and its application in sleep medicine/sleep disorders (SM) show slow progress. Limited information is available regarding dentist training. This study assessed current pre-doctoral dental education in the field of somnology with the hypothesis that increased curriculum hours are being devoted to SM but that competencies are still lacking. MATERIALS AND METHODS The 58 US dental schools were surveyed for curriculum offered in SM in the 2008/2009 academic year using an eight-topic, 52-item questionnaire mailed to the deans. Two new dental schools with interim accreditation had not graduated a class and were not included. Responses were received from 49 of 56 (87.5%) of the remaining schools. RESULTS AND CONCLUSIONS Results showed 75.5% of responding US dental schools reported some teaching time in SM in their pre-doctoral dental program with curriculum hours ranging from 0 to 15 h: 12 schools spent 0 h (24.5%), 26 schools 1-3 h, 5 schools 4-6 h, 3 schools 7-10 h, and 3 schools >10 h. The average number of educational hours was 3.92 h for the schools with curriculum time in SM, (2.96 across all 49 responding schools). The most frequently covered topics included sleep-related breathing disorders (32 schools) and sleep bruxism (31 schools). Although 3.92 h is an improvement from the mean 2.5 h last reported, the absolute number of curriculum hours given the epidemic scope of sleep problems still appears insufficient in most schools to achieve any competency in screening for SRBD, or sufficient foundation for future involvement in treatment.
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Affiliation(s)
- Michael Scott Simmons
- Department of Oral Medicine and Orofacial Pain, University of California Los Angeles School of Dentistry, 10833 Le Conte Ave., Los Angeles, CA 90024, USA.
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Machado E, Machado P, Cunali PA, Dal Fabbro C. Bruxismo do sono: possibilidades terapêuticas baseadas em evidências. Dental Press J Orthod 2011. [DOI: 10.1590/s2176-94512011000200008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: o bruxismo do sono (BS) é uma desordem de movimentos estereotipados e periódicos, associados ao ranger e/ou apertar de dentes durante o sono, decorrentes da contração rítmica dos músculos mastigatórios. Essa condição não é uma doença, porém quando exacerbada pode ocasionar desequilíbrio e alteração das estruturas orofaciais. Dessa forma, surge a necessidade de se obter terapêuticas efetivas e seguras para o controle e o manejo do paciente bruxômano. As alternativas de tratamento variam desde terapêuticas orodentais e farmacológicas até técnicas comportamentais-cognitivas. OBJETIVOS: através de uma revisão sistemática da literatura, tendo como bases de pesquisa a Medline, Cochrane, Embase, Pubmed, Lilacs e BBO, no período compreendido entre 1990 e 2008, e com enfoque em estudos clínicos randomizados e quasi-randomizados, revisões sistemáticas e meta-análises, esse trabalho teve como objetivo analisar e discutir métodos de tratamento para o BS. RESULTADOS: pela análise da literatura verifica-se que existe uma grande quantidade de opções terapêuticas para o BS, porém muitas das terapias não têm suporte científico que as sustente. Assim, a escolha terapêutica deve ser pautada em evidências científicas e no bom senso clínico, objetivando uma melhora na qualidade de vida do paciente bruxômano.
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Eidelman P, Talbot LS, Gruber J, Hairston I, Harvey AG. Sleep architecture as correlate and predictor of symptoms and impairment in inter-episode bipolar disorder: taking on the challenge of medication effects. J Sleep Res 2010; 19:516-24. [PMID: 20408930 PMCID: PMC2965266 DOI: 10.1111/j.1365-2869.2010.00826.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study was designed to clarify the association between inter-episode bipolar disorder (BD) and sleep architecture. Participants completed a baseline symptom and sleep assessment and, 3 months later, an assessment of symptoms and impairment. The effects of psychiatric medications on sleep architecture were also considered. Participants included 22 adults with BD I or II (inter-episode) and 22 non-psychiatric controls. The sleep assessment was conducted at the Sleep and Psychological Disorders Laboratory at the University of California, Berkeley. Follow-up assessments 3 months later were conducted over the phone. Results indicate that, at the sleep assessment, BD participants exhibited greater rapid eye movement sleep (REM) density than control participants with no other group differences in sleep architecture. Sleep architecture was not correlated with concurrent mood symptoms in either group. In the BD group, duration of the first REM period and slow-wave sleep (SWS) amount were positively correlated with manic symptoms and impairment at 3 months, while REM density was positively correlated with depressive symptoms and impairment at 3 months. The amount of Stage 2 sleep was negatively correlated with manic symptoms and impairment at 3 months. In contrast, for the control group, REM density was negatively correlated with impairment at 3 months. SWS and Stage 2 sleep were not correlated with symptoms or impairment. Study findings suggest that inter-episode REM sleep, SWS and Stage 2 sleep are correlated with future manic and depressive symptoms and impairment in BD. This is consistent with the proposition that sleep architecture may be a mechanism of illness maintenance in BD.
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Affiliation(s)
- Polina Eidelman
- Department of Psychology, University of California, Berkeley
| | - Lisa S. Talbot
- Department of Psychology, University of California, Berkeley
| | - June Gruber
- Department of Psychology, University of California, Berkeley
| | - Ilana Hairston
- Department of Psychology, University of California, Berkeley
- Psychiatry Department, Addiction Research Center, University of Michigan
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Controlled clinical, polysomnographic and psychometric studies on differences between sleep bruxers and controls and acute effects of clonazepam as compared with placebo. Eur Arch Psychiatry Clin Neurosci 2010; 260:163-74. [PMID: 19603241 DOI: 10.1007/s00406-009-0034-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 06/30/2009] [Indexed: 10/20/2022]
Abstract
The pathogenesis, pathophysiology, and pharmacotherapy of sleep bruxism (SB) are still not fully understood. We investigated symptomatology, objective and subjective sleep and awakening quality of middle-aged bruxers compared with controls and acute effects of clonazepam 1 mg compared with placebo by polysomnography and psychometry. Twenty-one drug-free bruxers spent 3 nights in the sleep lab, 21 age- and sex-matched controls 2 nights. Clinically, bruxers exhibited deteriorated PSQI, SAS, SDS and IRLSSG measures, polysomnographically impaired sleep maintenance, increased movement time, stage shift index, periodic leg movements (PLM) and arousals and psychometrically deteriorated subjective sleep and awakening quality, evening/morning well-being, drive, mood, drowsiness, attention variability, memory, and fine motor activity. As compared with placebo, clonazepam significantly decreased the SB index in all patients (mean: -42 +/- 15%). Sleep efficiency, maintenance, latency, awakenings and nocturnal wake time, the stage shift index, S1, PLM, the arousal index, subjective sleep and awakening quality, and fine motor activity improved.
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Effect of botulinum toxin injection on nocturnal bruxism: a randomized controlled trial. Am J Phys Med Rehabil 2010; 89:16-23. [PMID: 19855255 DOI: 10.1097/phm.0b013e3181bc0c78] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the effect of botulinum toxin type A on nocturnal bruxism. DESIGN Twelve subjects reporting nocturnal bruxism were recruited for a double-blind, randomized clinical trial. Six bruxers were injected with botulinum toxin in both masseters, and six with saline. Nocturnal electromyographic activity was recorded in the subject's natural sleeping environment from masseter and temporalis muscles before injection, and 4, 8, and 12 wks after injection and then used to calculate bruxism events. Bruxism symptoms were investigated using questionnaires. RESULTS Bruxism events in the masseter muscle decreased significantly in the botulinum toxin injection group (P = 0.027). In the temporalis muscle, bruxism events did not differ between groups or among times. Subjective bruxism symptoms decreased in both groups after injection (P < 0.001). CONCLUSIONS Our results suggest that botulinum toxin injection reduced the number of bruxism events, most likely mediated its effect through a decrease in muscle activity rather than the central nervous system. We controlled for placebo effects by randomizing the interventions between groups, obtaining subjective and objective outcome measures, using the temporalis muscle as a control, and collecting data at three postinjection times. Our controlled study supports the use of botulinum toxin injection as an effective treatment for nocturnal bruxism.
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Bloomfield ER, Shatkin JP. Parasomnias and movement disorders in children and adolescents. Child Adolesc Psychiatr Clin N Am 2009; 18:947-65. [PMID: 19836698 DOI: 10.1016/j.chc.2009.04.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Childhood parasomnias and movement disorders arise from a variety of etiologic factors. For some children, psychopathology plays a causal role in sleep disorders; in other cases, recurrent parasomnia episodes induce psychopathology. Current research reveals complex interconnections between sleep and mental health. As such, it is important that clinicians consider the impact psychiatric disorders have on childhood parasomnias. This article describes common parasomnias and movement disorders in children and adolescents, with emphasis on psychologic and behavioral comorbidities.
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Affiliation(s)
- Elana R Bloomfield
- Department of Psychiatry, University of Michigan Medical School, 2101 Commonwealth Drive, Suite C, Ann Arbor, MI 48105, USA.
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Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K. Bruxism physiology and pathology: an overview for clinicians. J Oral Rehabil 2009; 35:476-94. [PMID: 18557915 DOI: 10.1111/j.1365-2842.2008.01881.x] [Citation(s) in RCA: 427] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Awake bruxism is defined as the awareness of jaw clenching. Its prevalence is reported to be 20% among the adult population. Awake bruxism is mainly associated with nervous tic and reactions to stress. The physiology and pathology of awake bruxism is unknown, although stress and anxiety are considered to be risk factors. During sleep, awareness of tooth grinding (as noted by sleep partner or family members) is reported by 8% of the population. Sleep bruxism is a behaviour that was recently classified as a 'sleep-related movement disorder'. There is limited evidence to support the role of occlusal factors in the aetiology of sleep bruxism. Recent publications suggest that sleep bruxism is secondary to sleep-related micro-arousals (defined by a rise in autonomic cardiac and respiratory activity that tends to be repeated 8-14 times per hour of sleep). The putative roles of hereditary (genetic) factors and of upper airway resistance in the genesis of rhythmic masticatory muscle activity and of sleep bruxism are under investigation. Moreover, rhythmic masticatory muscle activity in sleep bruxism peaks in the minutes before rapid eye movement sleep, which suggests that some mechanism related to sleep stage transitions exerts an influence on the motor neurons that facilitate the onset of sleep bruxism. Finally, it remains to be clarified when bruxism, as a behaviour found in an otherwise healthy population, becomes a disorder, i.e. associated with consequences (e.g. tooth damage, pain and social/marital conflict) requires intervention by a clinician.
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Affiliation(s)
- G J Lavigne
- Faculty of Dentistry, Surgery Department, Pain, Sleep and Trauma Unit, Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada.
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RESTREPO CC, VSQUEZ LM, ALVAREZ M, VALENCIA I. Personality traits and temporomandibular disorders in a group of children with bruxing behaviour. J Oral Rehabil 2008; 35:585-93. [DOI: 10.1111/j.1365-2842.2007.01838.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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SVENSSON P, JADIDI F, ARIMA T, BAAD-HANSEN L, SESSLE BJ. Relationships between craniofacial pain and bruxism. J Oral Rehabil 2008; 35:524-47. [DOI: 10.1111/j.1365-2842.2008.01852.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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LOBBEZOO F, van der ZAAG J, van SELMS MKA, HAMBURGER HL, NAEIJE M. Principles for the management of bruxism. J Oral Rehabil 2008; 35:509-23. [DOI: 10.1111/j.1365-2842.2008.01853.x] [Citation(s) in RCA: 168] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ommerborn MA, Schneider C, Giraki M, Schäfer R, Handschel J, Franz M, Raab WHM. Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activity. Eur J Oral Sci 2007; 115:7-14. [PMID: 17305711 DOI: 10.1111/j.1600-0722.2007.00417.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluate the efficacy of an OS with CBT in SB patients. Following a randomized assignment, the OS group consisted of 29, and the CBT group of 28, SB patients. The CBT comprised problem-solving, progressive muscle relaxation, nocturnal biofeedback, and training of recreation and enjoyment. The treatment took place over a period of 12 wk, and the OS group received an OS over the same time period. Both groups were examined pretreatment, post-treatment, and at 6 months of follow-up for SB activity, self-assessment of SB activity and associated symptoms, psychological impairment, and individual stress-coping strategies. The analyses demonstrated a significant reduction in SB activity, self-assessment of SB activity, and psychological impairment, as well as an increase of positive stress-coping strategies in both groups. However, the effects were small and no group-specific differences were seen in any dependent variable. This is an initial attempt to compare CBT and OS in SB patients, and the data collected substantiate the need for further controlled evaluations, using a three-group randomized design with repeated measures to verify treatment effects.
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Affiliation(s)
- Michelle A Ommerborn
- Department of Operative and Preventive Dentistry and Endodontics, Faculty of Medicine Heinrich-Heine-University, Düsseldorf, Germany.
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