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Kim SB, Choi YJ, Kim ST, Kim HJ. Comparison between botulinum toxin type A injection on masseter muscle only and additional injection on anterior belly of digastric muscle in sleep bruxism patients: A clinical trial. J Oral Rehabil 2024. [PMID: 39030872 DOI: 10.1111/joor.13800] [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: 02/08/2024] [Revised: 02/24/2024] [Accepted: 07/02/2024] [Indexed: 07/22/2024]
Abstract
OBJECTIVE This study aims to evaluate the effects on bite force and muscle thickness of the botulinum toxin (BoNT) injection for patients with sleep bruxism (SB) by comparing injections into the masseter muscle only and both the masseter and the anterior belly of the digastric muscle (ABDM) in a clinical trial. METHODS Twelve SB patients received BoNT-A injections using US-guided techniques into the masseter muscle only (Group A), while the remaining 12 SB patients received injections into both the masseter and ABDM (Group B). Bite force and muscle thickness were measured before injection, as well as 1 and 2 months after injection. RESULTS The bite force and masseter muscle thickness decreased in both Group A and Group B before injection, and at 1 and 2 months after injection. However, there was no significant difference (p > .05, repeated measures analysis of variance) between the two groups, and there was also no significant difference in ABDM thickness (p > .05, repeated measures analysis of variance). CONCLUSION This study is the first to assess the short-term effects of BoNT injected into ABDM for SB control. Results show no influence on SB reduction, suggesting the need for further research on BoNT's effectiveness in controlling intense ABDM contractions during sleep and assessing suprahyoid muscle potential impact on rhythmic masticatory muscle activity occurrence.
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Affiliation(s)
- Soo-Bin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - You-Jin Choi
- Department of Anatomy, School of Medicine, Konkuk University, Chungju, South Korea
| | - Seong Taek Kim
- Department of Orofacial Pain and Oral Medicine, Yonsei University College of Dentistry, Seoul, South Korea
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, South Korea
- Department of Electric and Electronical Engineering, College of Engineering, Yonsei University, Seoul, South Korea
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Xu C, Ren X, Lin P, Jin S, Zhang Z. Exploring the causal effects of sleep characteristics on TMD-related pain: a two-sample Mendelian randomization study. Clin Oral Investig 2024; 28:384. [PMID: 38888691 DOI: 10.1007/s00784-024-05776-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVES The study was to explore the causal effects of sleep characteristics on temporomandibular disorder (TMD)-related pain using Mendelian randomization (MR) analysis. MATERIALS AND METHODS Five sleep characteristics (short sleep, insomnia, chronotype, snoring, sleep apnea) were designated as exposure factors. Data were obtained from previous publicized genome-wide association studies and single nucleotide polymorphisms (SNPs) strongly associated with them were utilized as instrumental variables (IVs). TMD-related pain was designed as outcome variable and sourced from the FinnGens database. MR analysis was employed to explore the causal effects of the five sleep characteristics on TMD-related pain. The causal effect was analyzed using the inverse variance-weighted (IVW), weighted median, and MR-Egger methods. Subsequently, sensitivity analyses were conducted using Cochran's Q tests, funnel plots, leave-one-out analyses, and MR-Egger intercept tests. RESULTS A causal effect of short sleep on TMD-related pain was revealed by IVW (OR: 1.60, 95% CI: 1.06-2.41, P = 0.026). No causal relationship was identified between other sleep characteristics (insomnia, chronotype, snoring, sleep apnea) and TMD-related pain. CONCLUSIONS Our study suggests that short sleep may increase the risk of TMD-related pain, while there was no causal relationship between other sleep characteristics and TMD-related pain. Further studies are warranted to deepen and definitively clarify their relationship. CLINICAL RELEVANCE These findings reveal that the short sleep may be a risk factor of TMD-related pain and highlight the potential therapeutical effect of extending sleep time on alleviating TMD-related pain.
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Affiliation(s)
- Chao Xu
- Department of Orthodontics, Jinan Stomatological Hospital, 82 Weier Road, Jinan, Shandong, China
| | - Xusheng Ren
- Department of Orthodontics, Jinan Stomatological Hospital, 82 Weier Road, Jinan, Shandong, China
| | - Peng Lin
- Department of Orthodontics, Jinan Stomatological Hospital, 82 Weier Road, Jinan, Shandong, China
| | - Shumei Jin
- Department of Orthodontics, Jinan Stomatological Hospital, 82 Weier Road, Jinan, Shandong, China
| | - Zhichao Zhang
- Department of Oral and Maxillofacial Surgery, the Second Hospital of Shandong University, 247 Beiyuan Street, Jinan, Shandong, China.
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Hosgor H, Altindis S, Sen E. Comparison of the efficacy of occlusal splint and botulinum toxin therapies in patients with temporomandibular disorders with sleep bruxism. J Orofac Orthop 2024; 85:102-108. [PMID: 37843582 DOI: 10.1007/s00056-023-00498-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 08/12/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE This study aims to evaluate the efficacy of occlusal splint and botulinum toxin (BTX) therapies for improving the pain scores and mouth opening in patients with temporomandibular disorders (TMD) with sleep bruxism (SB). MATERIALS AND METHODS A retrospective cohort study was conducted based on clinical record reviews of patients with TMD symptoms (e.g., temporomandibular joint [TMJ] pain, masticatory muscle pain, TMJ internal derangements, joint sounds, and limited mouth opening) and SB. The patients were divided into two groups: occlusal splint group and BTX group. Maximum unassisted mouth opening (MMO) and pain score on a visual analogue scale (VAS) before treatment and at 1‑, 3‑, and 6‑month follow-up were analyzed to evaluate the clinical outcomes. RESULTS A total of 60 patients (49 women and 11 men, mean age 34.63 ± 11.85 years) were enrolled. Each group had 30 patients. The comparisons of the groups at 1 and 3 months after treatment indicated that the BTX group had higher MMO values (P = 0.013 and 0.034, respectively) and lower VAS scores than the occlusal splint group (P = 0.000 and 0.001, respectively). No difference between the two groups was observed 6 months after treatment (P > 0.05). CONCLUSIONS Both occlusal splint and BTX treatment methods were successful in treating TMD with SB. BTX provided patients with rapid relief in the early period; therefore, BTX can be recommended as a primary treatment option in patients with greater pain.
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Affiliation(s)
- Hatice Hosgor
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Kocaeli University, 41190, Kocaeli, Turkey.
| | - Sezen Altindis
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Kocaeli University, 41190, Kocaeli, Turkey
| | - Esengul Sen
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Tokat Gaziosmanpasa University, Tokat, Turkey
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Thomas DC, Manfredini D, Patel J, George A, Chanamolu B, Pitchumani PK, Sangalli L. Sleep bruxism: The past, the present, and the future-evolution of a concept. J Am Dent Assoc 2024; 155:329-343. [PMID: 38363252 DOI: 10.1016/j.adaj.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND The concept of sleep bruxism (SB) has evolved exponentially over the past several decades. Many theories and hypotheses have been proposed as to the definition, pathophysiology, and management of SB, from the early 1960s through the present. The role of peripheral factors, such as dental occlusion, in the pathogenesis of SB has been discarded. TYPES OF STUDIES REVIEWED The authors searched several electronic databases (ie, PubMed, Google Scholar, Web of Science, Embase, and Ovid MEDLINE) for studies on bruxism. The search was conducted from January 1961 through May 2023 and yielded 4,612 articles, of which 312 were selected for comprehensive review after eliminating duplicates and nonfocused articles. RESULTS There has been an evident progressive shift from the role of peripheral factors, such as dental occlusion, to more central factors, such as the involvement of a central pattern generator as well as the autonomic nervous system, in the genesis of bruxing movements. There is continued robust interest in the dental community to elucidate the contributing factors involved in SB. CONCLUSIONS AND PRACTICAL IMPLICATIONS The neurophysiology of SB appears to be leaning more toward central rather than peripheral factors. There is increasing evidence of the role of the autonomic nervous system, genetics, and comorbidities in the genesis of SB. The scientific literature seems to refute the role of dental occlusion in the causation of bruxing movements. As per the literature, there has been a paradigm shift in the definition and genesis of SB and its possible dental implications and management, which also highlights the need for succinct scientific studies in this regard.
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Chattrattrai T, Aarab G, Blanken TF, Pires GN, Herrero Babiloni A, Dal Fabbro C, van Someren E, Lavigne G, Maluly M, Andersen ML, Tufik S, Lobbezoo F. Network analysis of sleep bruxism in the EPISONO adult general population. J Sleep Res 2024; 33:e13957. [PMID: 37246335 DOI: 10.1111/jsr.13957] [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: 03/13/2023] [Revised: 04/13/2023] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
Sleep bruxism (SB) has been associated with biological and psychosocial factors. The assessment of SB includes self-report, clinical evaluation, and polysomnography. This study aimed to investigate the associations of self-reported SB with other sleep disorders and demographic, psychological, and lifestyle factors in the adult general population, and to investigate whether self-reported SB and polysomnographically (PSG) confirmed SB provide similar outcomes in terms of their associated factors. We recruited 915 adults from the general population in Sao Paulo, Brazil. All participants underwent a one-night PSG recording and answered questions about sex, age, BMI, insomnia, OSA risk, anxiety, depression, average caffeine consumption, smoking frequency, and alcohol consumption frequency. We investigated the link between SB and the other variables in univariate, multivariate, and network models, and we repeated each model once with self-reported SB and once with PSG-confirmed SB. Self-reported SB was only significantly associated with sex (p = 0.042), anxiety (p = 0.002), and depression (p = 0.03) in the univariate analysis, and was associated with insomnia in the univariate (p < 0.001) and multivariate (β = 1.054, 95%CI 1.018-1.092, p = 0.003) analyses. Network analysis showed that self-reported SB had a direct positive edge to insomnia, while PSG-confirmed SB was not significantly associated with any of the other variables. Thus, sleep bruxism was positively associated with insomnia only when self-reported, while PSG-confirmed SB was not associated with any of the included factors.
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Affiliation(s)
- Thiprawee Chattrattrai
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Tessa F Blanken
- Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands
| | - Gabriel N Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
- Instituto do Sono, Sao Paulo, Brazil
| | - Alberto Herrero Babiloni
- Center for Advanced Research in Sleep Medicine, Research Center of CIUSSS NIM and CHUM, Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Cibele Dal Fabbro
- Instituto do Sono, Sao Paulo, Brazil
- Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - Eus van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gilles Lavigne
- Center for Advanced Research in Sleep Medicine, Research Center of CIUSSS NIM and CHUM, Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Milton Maluly
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
- Instituto do Sono, Sao Paulo, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
- Instituto do Sono, Sao Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
- Instituto do Sono, Sao Paulo, Brazil
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Cid-Verdejo R, Domínguez Gordillo AA, Hallal-Peche F, Ardizone García I, Martínez Orozco FJ. Is there an association between sleep bruxism and obstructive sleep apnea? A case-control polysomnographic investigation. Sleep Med 2024; 114:1-7. [PMID: 38141521 DOI: 10.1016/j.sleep.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/30/2023] [Accepted: 12/10/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES To estimate the statistical and epidemiological association between Sleep bruxism (SB) and Obstructive sleep apnea (OSA) based on OSA severity, and to describe sleep data findings within the analyzed population. METHODS A case-control study (N = 37) was conducted on subjects with and without OSA. All subjects underwent a full-night polysomnographic recording at the Sleep Unit (Clinical Neurophysiology Department) of San Carlos University Hospital. The diagnosis and severity of OSA were determined using ICSD-3 and AASM-2.6 scoring. The definitive SB diagnosis was obtained through a self-report test, physical examination, and PSG recordings. Variables used to study the association between both conditions included the apnea and hypopnea episodes, the Apnea-hypopnea index (AHI), the number of SB episodes per night, and the bruxism index. Chi2, correlations, and ANOVA were calculated. The epidemiological association was calculated using the OR. RESULTS SB showed an epidemiological association with OSA, with an OR of 0.15 (0.036-0.68), suggesting it could be considered a protective factor (p < 0.05). OSA patients presented fewer average SB episodes (6.8 ± 12.31) than non-OSA patients (25.08 ± 31.68). SB episodes correlated negatively (p < 0.05) with the AHI and the number of hypopneas (p < 0.05). The average number of SB episodes was significantly higher in patients with mild OSA compared to those with severe OSA. CONCLUSIONS In this sample of patients with subclinical and mild OSA, SB may act as a protective factor. However, confirmation of these results with a larger sample size is necessary.
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Affiliation(s)
- Rosana Cid-Verdejo
- Faculty of Dentistry, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040, Madrid, Spain; Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, 28005, Madrid, Spain.
| | | | - Fadi Hallal-Peche
- Clinical Neurophysiology Department, Hospital Central de la Defensa Gómez Ulla, 28028, Madrid, Spain
| | - Ignacio Ardizone García
- Faculty of Dentistry, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040, Madrid, Spain
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Debnath S, Kumar S, Sangra V, Singh S, Hawaldar C, Singh VK, Makkad RS. Investigating the Association between Obstructive Sleep Apnea and Temporomandibular Joint Disorders: A Case-Control Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S663-S665. [PMID: 38595469 PMCID: PMC11001142 DOI: 10.4103/jpbs.jpbs_924_23] [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: 09/18/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 04/11/2024] Open
Abstract
Background This study aims to explore the connection between obstructive sleep apnea (OSA) and temporomandibular joint disorders (TMD) through a case-control investigation. OSA is a sleep-related breathing disorder that affects breathing during sleep, whereas TMD involves pain and dysfunction in the jaw joint. Understanding any potential association between these two conditions could contribute to improved diagnostic and therapeutic approaches. Materials and Methods A total of 50 participants were included in both the OSA group and the control group. Participants with diagnosed OSA constituted the OSA group, whereas individuals without OSA formed the control group. TMD symptoms were assessed using standardized diagnostic criteria. Statistical analysis was performed to compare the prevalence of TMD symptoms between the two groups. Results In the OSA group, 36 out of 50 participants exhibited TMD symptoms, whereas in the control group, 18 out of 50 participants displayed such symptoms. The calculated P value was found to be 0.023, indicating a statistically significant association between OSA and TMD. Conclusion The findings of this study suggest a notable association between OSA and TMD. Individuals with OSA are more likely to experience TMD symptoms compared to those without OSA. This underscores the importance of considering TMD symptoms in individuals with OSA and vice versa for a comprehensive approach to diagnosis and management.
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Affiliation(s)
- Satarupa Debnath
- Department of Oral Medicine and Radiology, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Sachin Kumar
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Vidhi Sangra
- Department of Oral and Maxillofacial Surgery, JCD Dental College, Sirsa, Haryana, India
| | - Sandeep Singh
- Department of Orthodontics and Dentofacial Orthopedic, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Chinmaya Hawaldar
- Department of Orthodontics and Dentofacial Orthopedic, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Vinit Kumar Singh
- Department of Orthodontics and Dentofacial Orthopedic, Vananchal Dental College, Farathiya, Garwha, Jharkhand, India
| | - Ramanpal S. Makkad
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
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Zhu Y, Toyota R, Shiraishi Y, Katagiri A, Yamada M, Higashiyama M, Toyoda H, Lavigne G, Kato T. Sleep architecture as a candidate for phenotyping sleep bruxism: A narrative physiological review. J Oral Rehabil 2024; 51:87-102. [PMID: 37114936 DOI: 10.1111/joor.13482] [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: 12/23/2022] [Revised: 03/20/2023] [Accepted: 04/22/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Sleep bruxism (SB), an oral behaviour in otherwise healthy individuals, is characterised by frequent rhythmic masticatory muscle activity (RMMA) during sleep. RMMA/SB episodes occur over various sleep stages (N1-N3 and rapid eye movement (REM)), sleep cycles (non-REM to REM), and frequently with microarousals. It currently remains unclear whether these characteristics of sleep architecture are phenotype candidates for the genesis of RMMA/SB. OBJECTIVES This narrative review investigated the relationship between sleep architecture and the occurrence of RMMA as a SB phenotype candidate. METHODS PubMed research was performed using keywords related to RMMA/SB and sleep architecture. RESULTS In non-SB and SB healthy individuals, RMMA episodes were most frequent in the light non-REM sleep stages N1 and N2, particularly during the ascending phase of sleep cycles. The onset of RMMA/SB episodes in healthy individuals was preceded by a physiological arousal sequence of autonomic cardiovascular to cortical activation. It was not possible to extract a consistent sleep architecture pattern in the presence of sleep comorbidities. The lack of standardisation and variability between subject complexified the search for specific sleep architecture phenotype(s). CONCLUSION In otherwise healthy individuals, the genesis of RMMA/SB episodes is largely affected by oscillations in the sleep stage and cycle as well as the occurrence of microarousal. Furthermore, a specific sleep architecture pattern cannot be confirmed in the presence of sleep comorbidity. Further studies are needed to delineate sleep architecture phenotype candidate(s) that contribute to the more accurate diagnosis of SB and treatment approaches using standardised and innovative methodologies.
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Affiliation(s)
- Yiwen Zhu
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Risa Toyota
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University, Suita, Japan
| | - Yuki Shiraishi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Ayano Katagiri
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Masaharu Yamada
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
- Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Makoto Higashiyama
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Hiroki Toyoda
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Gilles Lavigne
- Faculte de medecine dentaire, Universite de Montreal, Montreal, Quebec, Canada
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
- United Graduate School of Child Development, Osaka University, Suita, Japan
- Sleep Medicine Center, Osaka University Hospital, Suita, Japan
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Restrepo C, Lobbezoo F, Castrillon E, Svensson P, Santamaria A, Manfredini D. Correlations between sleep architecture and sleep-related masseter muscle activity in children with sleep bruxism. J Oral Rehabil 2024; 51:110-116. [PMID: 36790219 DOI: 10.1111/joor.13430] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/29/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Sleep bruxism (SB) occurring during No-REM (nREM) sleep and increase in microarousals per hour have been described in adults, but not in children. OBJECTIVE To assess the correlation between sleep architecture and masseter muscle activity related to sleep bruxism (SB/MMA) in children. MATERIALS AND METHODS Forty-three children aged 7-12 years (mean age: 9.4 ± 1.3) with confirmed SB underwent a two-night polysomnographic (PSG) study in a sleep laboratory, for accommodation (first night) and data collection (second night). Data on sleep architecture (total sleep duration (TSD), sleep efficiency (SE), sleep onset latency (SOL), REM and nREM sleep duration and proportion and microarousals/hour during REM and nREM sleep) and episodes/hour of SB/MMA were recorded. Single and multiple-variable linear regression analyses were performed to assess the correlation between data on sleep architecture (predictors) and SB/MMA (dependent variable). RESULTS Shorter TSD, REM and nREM stage 1 sleep duration, longer SOL and more microarousals/hour during REM and nREM sleep were found to be positive predictors of SB/MMA in children in the multiple-variable regression analysis (R2 = 0.511). CONCLUSION Within the limitations of this study, it can be concluded that SB/MMA is correlated with altered sleep architecture in children (shorter total sleep duration (TSD), shorter nREM and REM sleep and higher microarousals during REM and nREM sleep). Nevertheless, the clinical significance of these findings need to be demonstrated in future studies.
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Yıldırım B, Kırarslan Karagoz O, Tekeli Simsek A, Koca C, Cicek MF. Associations between self-reported bruxism, sleep quality, and psychological status among dental students in Turkey. Cranio 2024; 42:63-68. [PMID: 33794756 DOI: 10.1080/08869634.2021.1909458] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To assess sleep quality among dental students and to identify psychological factors associated with self-reported sleep bruxism (SB). METHODS A total of 212 dentistry students from the Usak University Faculty of Dentistry participated in this study. A self-report questionnaire was administered to identify possible SB. The Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was administered to evaluate psychological factors, and the Pittsburgh Sleep Questionnaire Index (PSQI) was used to evaluate sleep quality. RESULTS Possible SB was more frequently observed in females than in males. The mean DASS-21 score in those with possible SB was significantly higher than in those without SB (p< 0.001). The mean PSQI (total) score was also significantly higher in those with possible SB than in those without SB (5.0 ± 2.4) (p= 0.007). CONCLUSION The findings revealed that psychological factors and sleep quality significantly affected the prevalence of self-reported SB among dental students.
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Affiliation(s)
- Bengisu Yıldırım
- Faculty of Dentistry, Department of Prosthodontics, Usak University, Usak, Turkey
| | | | - Aysıla Tekeli Simsek
- Faculty of Dentistry, Department of Prosthodontics, Usak University, Usak, Turkey
| | - Cansu Koca
- Faculty of Dentistry, Department of Maxillofacial Surgery, Usak University, Usak, Turkey
| | - Muhammed Fatih Cicek
- Faculty of Dentistry, Department of Maxillofacial Surgery, Usak University, Usak, Turkey
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Huynh N, Fabbro CD. Sleep bruxism in children and adolescents-A scoping review. J Oral Rehabil 2024; 51:103-109. [PMID: 37743603 DOI: 10.1111/joor.13603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 08/21/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND AND OBJECTIVE This review paper focuses on sleep bruxism (SB) in children and adolescents. It aims to assess the landscape of knowledge published in the last 20 years. METHODS A total of 144 relevant publications from 386 previously identified through Medline were included, of which 83 were on possible SB, 37 on probable SB, 20 on definite SB and 4 were non-applicable. The review places emphasis on the recent evidence on prevalence, pathophysiology, diagnosis and management of SB in children and adolescents, with special focus on probable and definitive SB. RESULTS The prevalence ranges from 5% to 50% depending on the age range and on the SB diagnosis (possible, probable or definitive). The pathophysiology is multifactorial, arousal associated and with behavioural problems and sleep disorders (obstructive sleep apnoea, snoring, nightmares) as risk factors, as well as respiratory conditions (allergies, oral breathing). Screening should include questionnaires and dental assessment. Instrumental recording is helpful to confirm diagnosis although more studies are needed to validate this approach in children. SB management includes controlling orofacial and dental consequences and assessing for any other comorbidity. Management options include occlusal splints, oral appliances (advancement mandibular), rapid maxillary expansion and some medications, although this last option is supported by limited evidences in children. CONCLUSION Suggestions of future topics in research are delivered to better understand comorbidities, diagnosis and management with improved outcomes compared to what is currently available.
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Affiliation(s)
- Nelly Huynh
- Faculty of dental medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Cibele Dal Fabbro
- CIUSSS Nord Ile Montreal, CEAMS and research centre, Montreal, Quebec, Canada
- Instituto do Sono, Sao Paulo, Brazil
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Haraki S, Tsujisaka A, Shiraishi Y, Toyota R, Katagiri A, Toyoda H, Ishigaki S, Taniike M, Kato T. Reciprocal first night effect on rhythmic and non-rhythmic oromotor episodes in moderate to severe primary sleep bruxism: A retrospective physiological study. J Oral Rehabil 2024; 51:131-142. [PMID: 37077152 DOI: 10.1111/joor.13474] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Sleep on the first night in a sleep laboratory is characterized by a lower sleep quality and frequency of rhythmic masticatory muscle activity (RMMA) than that on the second night in moderate to severe sleep bruxism (SB) patients. OBJECTIVE The aims of this study was to clarify the physiological factors contributing to the first night effect on oromotor activity during sleep and investigate whether physiological factors involved in the first night effect differed between rhythmic and non-rhythmic oromotor activities. METHODS Polysomnographic data collected on two consecutive nights from 15 moderate to severe SB subjects (F 7: M 8; age: 23.2 ± 1.3 [mean ± SD] years) were retrospectively analysed. Sleep variables, RMMA and non-specific masticatory muscle activity (NSMA) were scored in relation to episode types (i.e. phasic or tonic and cluster or isolated), sleep architecture and transient arousals. The relationships between nightly differences in oromotor and sleep variables were assessed. The distribution of oromotor events, arousals, cortical electroencephalographic power, RR intervals and heart rate variability were examined in relation to sleep cycle changes. These variables were compared between the first and second nights and between RMMA and NSMA. RESULTS Sleep variables showed a lower sleep quality on Night 1 than on Night 2. In comparisons with Night 1, the RMMA index increased by 18.8% (p < .001, the Wilcoxon signed-rank test) on Night 2, while the NSMA index decreased by 17.9% (p = .041). Changes in the RMMA index did not correlate with those in sleep variables, while changes in the NSMA index correlated with those in arousal-related variables (p < .001, Spearman's rank correlation). An increase in the RMMA index on Night 2 was found for the cluster type and stage N1 related to sleep cyclic fluctuations in cortical and cardiac activities. In contrast, the decrease in the NSMA index was associated with increases in the isolated type and the occurrence of stage N2 and wakefulness regardless of the sleep cycle. CONCLUSION Discrepancies in first night effect on the occurrence of RMMA and NSMA represent unique sleep-related processes in the genesis of oromotor phenotypes in SB subjects.
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Affiliation(s)
- Shingo Haraki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Akiko Tsujisaka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuki Shiraishi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Risa Toyota
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ayano Katagiri
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiroki Toyoda
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Shoichi Ishigaki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Masako Taniike
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Osaka University Hospital, Sleep Medicine Center, Osaka, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
- United Graduate School of Child Development, Osaka University, Osaka, Japan
- Osaka University Hospital, Sleep Medicine Center, Osaka, Japan
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Li D, Lobbezoo F, Kuang B, Hilgevoord AAJ, de Vries N, Aarab G. Effects of continuous positive airway pressure and mandibular advancement appliance therapy on sleep bruxism in adults with obstructive sleep apnea: a pilot study. Sleep Breath 2023; 27:1857-1864. [PMID: 36867294 PMCID: PMC10539441 DOI: 10.1007/s11325-023-02799-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/08/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
STUDY OBJECTIVES This study aimed to investigate the effects of continuous positive airway pressure (CPAP) and mandibular advancement appliance (MAA) therapy on rhythmic masticatory muscle activity (RMMA), a biomarker of sleep bruxism (SB), and to compare the effects of CPAP with MAA in adults with obstructive sleep apnea (OSA). METHODS This cohort study included individuals with OSA who received treatment with CPAP or MAA. Polysomnographic recordings with and without therapy were performed in each individual. Statistical analyses were performed with repeated measures ANOVA. RESULTS A total of 38 individuals with OSA were enrolled, 13 on CPAP and 25 with MAA, mean age 52.6 ± 10.6 years, 32 men, mean baseline apnea-hypopnea index (AHI) 26.5 ± 15.2 events/hour, mean RMMA index 3.5 ±events/hour. In the total group, the RMMA index decreased significantly with CPAP and MAA therapies (P < 0.05). The changes in the RMMA index with therapy did not differ significantly between CPAP and MAA (P > 0.05). The RMMA index decreased in 60% of the individuals with OSA, and the changes ranged widely, with a median of 52% and an interquartile range of 107%. CONCLUSIONS Both CPAP and MAA therapies significantly reduce SB in individuals with OSA. However, the interindividual differences in the effects of these therapies on SB are large. CLINICAL TRIAL REGISTRATION https://trialsearch.who.int (NL8516); April 08, 2020.
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Affiliation(s)
- Deshui Li
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Department of Clinical Neurophysiology, OLVG, Amsterdam, The Netherlands.
- Department of Orthodontics, School and Hospital of Stomatology, Shandong University, Jinan, China.
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Boyuan Kuang
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Neurophysiology, OLVG, Amsterdam, The Netherlands
- Taikang Bybo Dental, Shanghai, China
| | | | - Nico de Vries
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Otorhinolaryngology, OLVG, Amsterdam, The Netherlands
- Faculty of Medicine and Health Sciences, Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Kato T, Higashiyama M, Katagiri A, Toyoda H, Yamada M, Minota N, Katsura-Fuchihata S, Zhu Y. Understanding the pathophysiology of sleep bruxism based on human and animal studies: A narrative review. J Oral Biosci 2023; 65:156-162. [PMID: 37086888 DOI: 10.1016/j.job.2023.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/14/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Sleep bruxism (SB) is a common sleep disorder that affects approximately 20% of children and 10% of adults. It may cause orodental problems, such as tooth wear, jaw pain, and temporal headaches. However, the pathophysiological mechanisms underlying SB remain largely unknown, and a definitive treatment has not yet been established. HIGHLIGHT Human studies involving polysomnography have shown that rhythmic masticatory muscle activity (RMMA) is more frequent in otherwise healthy individuals with SB than in normal individuals. RMMA occurs during light non-rapid eye movement (non-REM) sleep in association with transient arousals and cyclic sleep processes. To further elucidate the neurophysiological mechanisms of SB, jaw motor activities have been investigated in naturally sleeping animals. These animals exhibit various contractions of masticatory muscles, including episodes of rhythmic and repetitive masticatory muscle bursts that occurred during non-REM sleep in association with cortical and cardiac activation, similar to those found in humans. Electrical microstimulation of corticobulbar tracts may also induce rhythmic masticatory muscle contractions during non-REM sleep, suggesting that the masticatory motor system is activated during non-REM sleep via excitatory inputs to the masticatory central pattern generator. CONCLUSION This review article summarizes the pathophysiology of SB and putative origin of RMMA in both human and animal studies. Physiological factors contributing to RMMA in SB have been identified in human studies and may also be present in animal models. Further research is required to integrate the findings between human and animal studies to better understand the mechanisms underlying SB.
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Affiliation(s)
- Takafumi Kato
- Osaka University Graduate School of Dentistry, Department of Oral Physiology, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Makoto Higashiyama
- Osaka University Graduate School of Dentistry, Department of Oral Physiology, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Ayano Katagiri
- Osaka University Graduate School of Dentistry, Department of Oral Physiology, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Hiroki Toyoda
- Osaka University Graduate School of Dentistry, Department of Oral Physiology, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Masaharu Yamada
- Osaka University Graduate School of Dentistry, Department of Oral Physiology, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan; Osaka University Graduate School of Dentistry, Department of Dental Anesthesiology, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Noriko Minota
- Osaka University Graduate School of Dentistry, Department of Oral Physiology, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan; Osaka University Graduate School of Dentistry, Department of Oral and Maxillofacial Surgery, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Sho Katsura-Fuchihata
- Osaka University Graduate School of Dentistry, Department of Oral Physiology, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Yiwen Zhu
- Osaka University Graduate School of Dentistry, Department of Oral Physiology, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
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Ommerborn MA, Özbek A, Grunwald M, Depprich RA, Walentek NP, Franken M, Schäfer R. Effects on general pain perception and dental pulp sensibility in probable sleep bruxism subjects by experimentally induced pain in a pilot study. Sci Rep 2023; 13:5836. [PMID: 37037840 PMCID: PMC10086053 DOI: 10.1038/s41598-023-33019-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 04/05/2023] [Indexed: 04/12/2023] Open
Abstract
In this pilot study, the general pain perception and the dental pulp sensibility of probable sleep bruxism (SB) subjects were compared with that of non-SB subjects. The cold pressor test (CPT), electric pulp test (EPT), and thermal pulp test with CO2 snow were executed by one trained dentist (blind to SB diagnosis). A one-factorial multivariate analysis of variance (MANOVA) with SB diagnosis as independent variable and standardized measures regarding pain perception and evaluation was performed. One-hundred-and-five participants (53 SB and 52 non-SB subjects) were included. The one-factorial MANOVA revealed a significant difference between SB and non-SB subjects (p = 0.01) concerning pain perception variables. Post-hoc univariate analyses of variance (ANOVA) showed statistically significant lower general pain tolerance (p = 0.02), higher general subjective sensibility of the teeth (p < 0.01), and a statistical trend for higher subjective dental pain intensity (p = 0.07) in SB subjects. In most of the standardized variables, probable SB subjects seem to react and feel similar to non-SB subjects. However, as probable SB subjects subjectively perceive their teeth to be more sensitive and tend to rate their subjective dental pain intensity more intensely after CO2 testing, data might point to a somatosensory amplification.
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Affiliation(s)
- Michelle Alicia Ommerborn
- Department of Operative Dentistry, Periodontology, and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Adem Özbek
- Department of Operative Dentistry, Periodontology, and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Maike Grunwald
- Department of Operative Dentistry, Periodontology, and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Rita Antonia Depprich
- Department of Cranio- and Maxillofacial Surgery, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Nicole Pascale Walentek
- Department of Operative Dentistry, Periodontology, and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Michael Franken
- Department of Operative Dentistry, Periodontology, and Endodontology, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Ralf Schäfer
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
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16
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Yu R, Zhou Z, Wu S, Gao X, Bin G. MRASleepNet: a multi-resolution attention network for sleep stage classification using single-channel EEG. J Neural Eng 2022; 19. [PMID: 36379059 DOI: 10.1088/1741-2552/aca2de] [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: 06/09/2022] [Accepted: 11/15/2022] [Indexed: 11/16/2022]
Abstract
Objective. Computerized classification of sleep stages based on single-lead electroencephalography (EEG) signals is important, but still challenging. In this paper, we proposed a deep neural network called MRASleepNet for automatic sleep stage classification using single-channel EEG signals.Approach. The proposed MRASleepNet model consisted of a feature extraction (FE) module, a multi-resolution attention (MRA) module, and a gated multilayer perceptron (gMLP) module, as well as a direct pathway for computing statistical features. The FE, MRA, and gMLP modules were used to extract features, establish feature attention, and obtain temporal relationships between features, respectively. EEG signals were normalized and cut into 30 s segments, and enhanced by incorporating contextual information from adjacent data segments. After data enhancement, the 40 s data segments were input to the MRASleepNet model. The model was evaluated on the SleepEDF and the cyclic alternating pattern (CAP) databases, using such metrics as the accuracy, Kappa, and macro-F1 (MF1).Main results.For the SleepEDF-20 database, the proposed model had an accuracy of 84.5%, an MF1 of 0.789, and a Kappa of 0.786. For the SleepEDF-78 database, the model had an accuracy of 81.4%, an MF1 of 0.754, and a Kappa of 0.743. For the CAP database, the model had an accuracy of 74.3%, an MF1 of 0.656, and a Kappa of 0.652. The proposed model achieved satisfactory performance in automatic sleep stage classification tasks.Significance. The time- and frequency-domain features extracted by the FE module and filtered by the MRA module, together with the temporal features extracted by the gMLP module and the statistical features extracted by the statistical highway, enabled the proposed model to obtain a satisfying performance in sleep staging. The proposed MRASleepNet model may be used as a new deep learning method for automatic sleep stage classification. The code of MRASleepNet will be made available publicly onhttps://github.com/YuRui8879/.
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Affiliation(s)
- Rui Yu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, People's Republic of China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, People's Republic of China
| | - Shuicai Wu
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, People's Republic of China
| | - Xiaorong Gao
- Department of Biomedical Engineering, Tsinghua University, 100084 Beijing, People's Republic of China
| | - Guangyu Bin
- Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, People's Republic of China
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17
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Influence of MAD Application on Episodes of Obstructive Apnea and Bruxism during Sleep-A Prospective Study. J Clin Med 2022; 11:jcm11195809. [PMID: 36233677 PMCID: PMC9570562 DOI: 10.3390/jcm11195809] [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: 08/29/2022] [Revised: 09/19/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
The condition of sleep bruxism (SB) is defined by many authors as the body's response to obstructive sleep apnea (OSA). In the conservative treatment of OSA, mandibular advancement devices (MADs) have found their application. The aim of the study iso assess the impact of MADs on the occurrence of episodes and the intensity of OSA and SB. The study sample consisted of eight patients with OSA and SB diagnosed with these conditions on the basis of clinical examinations and polysomnography (PSG). The prospective study was designed to assess the use of MADs for OSA and SB. MADs were prepared for the patients who subsequently underwent control examinations after one week of wear, and another PSG (PSG II) with an MAD was performed in conditions resembling the first qualification examination (PSG I). The same parameters were assessed in both PSG examinations. Following treatment with the MAD, a favorable lowering of the mean values of the examined parameters was observed. The statistically significant differences were demonstrated only for the apnea-hypopnea index (AHI), the oxygen desaturation index (ODI), and the number of apneas and hypopneas, obstructive apneas, apneas in OSA, and phasic episodes of bruxism. The application of MADs in patients with OSA has a beneficial effect on the same manifestations of OSA and SB, even though only the number of phasic episodes of bruxism was statistically significant.
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18
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Abe S, Huynh NT, Kato T, Rompré PH, Landry-Schönbeck A, Landry ML, de Grandmont P, Kawano F, Lavigne GJ. Oral appliances reduce masticatory muscle activity-sleep bruxism metrics independently of changes in heart rate variability. Clin Oral Investig 2022; 26:5653-5662. [PMID: 35538329 DOI: 10.1007/s00784-022-04520-y] [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: 08/20/2021] [Accepted: 04/24/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Sleep bruxism (SB) is associated with physiological activities including sympathetic autonomic system dominance and sleep micro-arousal. While oral appliances (OA) are used to prevent SB harmful effects, the influence of OAs physiological mechanisms during sleep is unknown. The aim of this study is to assess whether heart rate variability (HRV) changes, as a marker of autonomic nervous system activity, would be associated with the OA mechanism of action on SB using occlusal splint (OS) and mandibular advancement splint (MAS). MATERIALS AND METHODS A retrospective analysis, from data previously collected in 21 participants with SB (25.6 ± 4.5 years) with polysomnographic recordings, was done. HRV data were compared between a reference night (no-device) and ones during which OS or MAS was used in a crossover study design. Rhythmic masticatory muscle activity (RMMA) index was compared between nights. HRV was evaluated using autoregressive model analysis for three sections: baseline (distance from RMMA), immediately before, and after RMMA period. RESULTS A significant reduction in RMMA index, when wearing OA during sleep, was observed (P < 0.01), but was not associated with HRV parameters change. HRV significantly changed after RMMA onset for nights with OA during non-REM sleep in comparison with baseline (P < 0.02). CONCLUSIONS The usage of OAs for SB participants reduced RMMA, but most likely independently of changes in HRV linked to the mechanism associated with SB genesis. CLINICAL RELEVANCE Wearing OA seems to reduce grinding noise and protect from dental injuries but does not seem to influence SB genesis.
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Affiliation(s)
- Susumu Abe
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 boul, Gouin Ouest, Québec, H4J 1C5, Montréal, Canada. .,Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada. .,Department of Comprehensive Dentistry, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan.
| | - Nelly T Huynh
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Pierre H Rompré
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Anaïs Landry-Schönbeck
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Marie-Lou Landry
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Pierre de Grandmont
- Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
| | - Fumiaki Kawano
- Department of Comprehensive Dentistry, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan
| | - Gilles J Lavigne
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, 5400 boul, Gouin Ouest, Québec, H4J 1C5, Montréal, Canada.,Faculté de Médecine Dentaire, Université de Montréal, CP 6128, Succursale Centre- ville, Montréal, Québec, H3C 3J7, Canada
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19
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Verhoeff MC, Koutris M, Berendse HW, van Dijk KD, Lobbezoo F. Parkinson's disease, temporomandibular disorder pain and bruxism and its clinical consequences: a protocol of a single-centre observational outpatient study. BMJ Open 2022; 12:e052329. [PMID: 35437243 PMCID: PMC9016408 DOI: 10.1136/bmjopen-2021-052329] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION A recent questionnaire-based study suggested that bruxism and painful temporomandibular disorders (TMD pain) may be more prevalent in patients with Parkinson's disease (PD) compared with controls. The presence of both bruxism and TMD pain may negatively influence patients' quality of life. The present study is designed to clinically and more objectively investigate the presence of bruxism and TMD pain in patients with PD. The secondary aim of the study is to identify factors associated with bruxism and TMD pain in patients with PD, such as disease severity and dopaminergic medication usage. Furthermore, the presence of tooth wear in patients with PD will be studied as this can be a major consequence of bruxism. Finally, deviations in saliva composition that may contribute to tooth wear will be studied. METHODS AND ANALYSIS This is a single-centre observational outpatient study at the Amsterdam University Medical Centres, location VUmc. All patients with a clinical diagnosis of PD will be eligible for inclusion. Participants will fill in a set of questionnaires. Subsequently, patients will be examined clinically for, among others, TMD pain, presence and severity of tooth wear, and deviations in saliva composition. Sleep-time registrations will take place for 5 nights with the GrindCare GC4 (ie, a portable, single-channel electromyographic recorder) to assess sleep bruxism and simultaneously by the use of the BruxApp for 5 days to assess awake bruxism. We will partly use data collected during standard clinical care to minimise patient burden. ETHICS AND DISSEMINATION The scientific and ethical aspects of this study protocol have been approved by the Medical Ethics Review Committee of the Amsterdam UMC, location VUmc; NL. 2019.143. Informed consent will be obtained from all participants. The results will be published in a peer-reviewed journal, if relevant presented at conferences, and published as part of a PhD thesis. TRIAL REGISTRATION NUMBER NL8307.
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Affiliation(s)
| | - Michail Koutris
- Orofacial Pain and Dysfunction, ACTA, Amsterdam, The Netherlands
| | - Henk W Berendse
- Neurology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Karin D van Dijk
- Epilepsy Netherlands Foundation Sleep-Wake Centre, Heemstede, The Netherlands
| | - F Lobbezoo
- Orofacial Pain and Dysfunction, ACTA, Amsterdam, The Netherlands
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20
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Allaf BAW, Abdul-Hak M. Association between bruxism severity and serum concentrations of 25-hydroxyvitamin D levels. Clin Exp Dent Res 2022; 8:827-835. [PMID: 35128822 PMCID: PMC9382056 DOI: 10.1002/cre2.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/28/2021] [Accepted: 12/28/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives The aim of this study was to investigate the possible relationship between bruxism and blood levels of 25‐hydroxyvitamin D. Material and Methods One hundred male and female patients from Damascus joined the study. Their ages were in the range of 18–40 years. Two groups were considered in this study, the first group included patients who were already suffering from bruxism (76 patients) and the second group consisted of patients who were not suffering from any bruxism (24 patients). The analysis of the blood samples for 25‐hydroxyvitamin D levels of the two groups was carried out. Results The recorded results showed that there is a relationship between the levels of bruxism and 25‐hydroxyvitamin D concentration in the blood (p < .05), enhancing that the bruxism activity has been shown the associated deficiency in 25‐hydroxyvitamin D levels, which can be divided into five different categories. Conclusions Within the limitations of this study in spite of the number of patients (one hundred), according to the reported study, it appears that there is a significant relationship between bruxism and the level of 25‐hydroxyvitamin D in the blood.
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Affiliation(s)
- Bushra A W Allaf
- Department of Oral Medicine, Faculty of Dentistry, University of Damascus, Damascus, Syria.,Department of Oral Medicine, Faculty of Dentistry, Arab International University, Ghabaghib, Daraa Governorate, Damascus, Syria
| | - Mahmoud Abdul-Hak
- Department of Oral Medicine, Faculty of Dentistry, University of Damascus, Damascus, Syria
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21
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Qian X, Qiu Y, He Q, Lu Y, Lin H, Xu F, Zhu F, Liu Z, Li X, Cao Y, Shuai J. A Review of Methods for Sleep Arousal Detection Using Polysomnographic Signals. Brain Sci 2021; 11:1274. [PMID: 34679339 PMCID: PMC8533904 DOI: 10.3390/brainsci11101274] [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: 07/31/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
Multiple types of sleep arousal account for a large proportion of the causes of sleep disorders. The detection of sleep arousals is very important for diagnosing sleep disorders and reducing the risk of further complications including heart disease and cognitive impairment. Sleep arousal scoring is manually completed by sleep experts by checking the recordings of several periods of sleep polysomnography (PSG), which is a time-consuming and tedious work. Therefore, the development of efficient, fast, and reliable automatic sleep arousal detection system from PSG may provide powerful help for clinicians. This paper reviews the automatic arousal detection methods in recent years, which are based on statistical rules and deep learning methods. For statistical detection methods, three important processes are typically involved, including preprocessing, feature extraction and classifier selection. For deep learning methods, different models are discussed by now, including convolution neural network (CNN), recurrent neural network (RNN), long-term and short-term memory neural network (LSTM), residual neural network (ResNet), and the combinations of these neural networks. The prediction results of these neural network models are close to the judgments of human experts, and these methods have shown robust generalization capabilities on different data sets. Therefore, we conclude that the deep neural network will be the main research method of automatic arousal detection in the future.
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Affiliation(s)
- Xiangyu Qian
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
| | - Ye Qiu
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
| | - Qingzu He
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
| | - Yuer Lu
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
| | - Hai Lin
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
| | - Fei Xu
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
| | - Fangfang Zhu
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
| | - Zhilong Liu
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
| | - Xiang Li
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
| | - Yuping Cao
- Department of Psychiatry of Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Jianwei Shuai
- Department of Physics, and Fujian Provincial Key Laboratory for Soft Functional Materials Research, Xiamen University, Xiamen 361005, China; (X.Q.); (Y.Q.); (Q.H.); (Y.L.); (H.L.); (F.X.); (F.Z.); (Z.L.); (X.L.)
- National Institute for Data Science in Health and Medicine, and State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Signaling Network, Xiamen University, Xiamen 361102, China
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou 325001, China
- Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision and Brain Health), Wenzhou 325001, China
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22
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Imai H, Haraki S, Tsujisaka A, Okura M, Adachi H, Ohno Y, Yatani H, Kato T. A lack of specific motor patterns between rhythmic/non-rhythmic masticatory muscle activity and bodily movements in sleep bruxism. J Prosthodont Res 2021; 65:415-420. [PMID: 33281172 DOI: 10.2186/jpr.jpr_d_20_00012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose The aims of the present study were to investigate the temporal relationships between jaw and bodily movements and clarify motor processes in the genesis of rhythmic masticatory muscle activity (RMMA) in sleep bruxism (SB).Methods Video-polysomnography recordings were obtained from ten subjects with SB (mean age: 23.4 ± 1.6 years) and ten matched normal controls (CTL) (mean age: 24.4 ± 3.2 years). RMMA and nonspecific masseter activity (NSMA) were scored in association with bodily movements in the leg, arm, head, and trunk using electromyography and video recordings. The relationship between oromotor episodes and bodily movements was assessed in terms of sleep stage distributions and temporal relationships. Cardiac changes preceding oromotor episodes in stage N2 were assessed.Results Approximately 80% of RMMA and NSMA were associated with movements in one or more body sites. RMMA and NSMA were more frequently associated with movements of the leg (70-75%) and arm (40-55%) than movements of the head (17-22%) and trunk (5-25%). The relationship between oromotor episodes and bodily movements did not significantly differ among sleep stages. Oromotor episodes and bodily movements did not show a consistent temporal pattern in the SB and CTL groups. Regardless of the temporal relationship between oromotor episodes and bodily movements, the mean heart rate significantly increased by 5 beats before the onset of oromotor episodes.Conclusions No specific temporal motor patterns were found between RMMA and bodily movements. RMMA and NSMA represent a repertoire of arousal-related autonomic motor responses during sleep.
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Affiliation(s)
- Hideto Imai
- Faculty of Nursing, Setsunan University, Osaka, Japan
| | - Shingo Haraki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Akiko Tsujisaka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Mutsumi Okura
- Center for Sleep Medicine, Department of Neurology Asahi University Hospital, Gifu, Japan.,Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiroyoshi Adachi
- Health and Counseling Center, Osaka University, Osaka, Japan.,Sleep Medicine Center, Osaka University Hospital, Osaka, Japan
| | - Yuko Ohno
- Department of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan.,Sleep Medicine Center, Osaka University Hospital, Osaka, Japan
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23
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Toyota R, Fukui KI, Kamimura M, Katagiri A, Sato H, Toyoda H, Rompré P, Ikebe K, Kato T. Sleep stage-dependent changes in tonic masseter and cortical activities in young subjects with primary sleep bruxism. Sleep 2021; 45:6349091. [PMID: 34383078 DOI: 10.1093/sleep/zsab207] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/02/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES The present study investigated the hypothesis that subjects with primary sleep bruxism (SB) exhibit masseter and cortical hyperactivities during quiet sleep periods that are associated with a high frequency of rhythmic masticatory muscle activity (RMMA). METHODS Fifteen SB and ten control participants underwent polysomnographic recordings. The frequencies of oromotor events and arousals and the percentage of arousals with oromotor events were assessed. Masseter muscle tone during sleep was quantified using a cluster analysis. Electroencephalography power and heart rate variability were quantified and then compared between the two groups and among sleep stages. RESULTS The frequency of RMMA and percentage of arousals with RMMA were significantly higher in SB subjects than in controls in all stages, while these variables for non-rhythmic oromotor events did not significantly differ between the groups. In SB subjects, the frequency of RMMA was the highest in stage N1 and the lowest in stages N3 and R, while the percentage of arousals with RMMA was higher in stage N3 than stages N1 and R. The cluster analysis classified masseter activity during sleep into two clusters for masseter tone and contractions. Masseter muscle tone showed typical stage-dependent changes in both groups, but did not significantly differ between the groups. Furthermore, no significant differences were observed in electroencephalography power or heart rate variability between the groups. CONCLUSION Young SB subjects exhibited sleep stage-dependent increases in the responsiveness of RMMA to transient arousals, but did not show masseter or cortical hyperactivity during sleep.
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Affiliation(s)
- Risa Toyota
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan.,Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ken-Ichi Fukui
- SANKEN (The Institute of Scientific and Industrial Research), Osaka University, Osaka, Japan
| | - Mayo Kamimura
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ayano Katagiri
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hajime Sato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan.,Division of Pharmacology, Meikai University School of Dentistry
| | - Hiroki Toyoda
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Pierre Rompré
- Faculty of Dentistry, Université de Montréal, Montreal
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan.,Sleep Medicine Center, Osaka University Hospital, Osaka, Japan
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24
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Shiraishi Y, Tachibana M, Shirota A, Mohri I, Taniike M, Yamashiro T, Kato T. Relationships between cortical, cardiac, and arousal-motor activities in the genesis of rhythmic masticatory muscle activity across sleep cycles in primary sleep bruxism children. Sleep 2021; 44:6310842. [PMID: 34181734 DOI: 10.1093/sleep/zsab156] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES The present study aimed to clarify the physiological relationships between rhythmic masticatory muscle activity (RMMA) and cyclic changes in cortical, autonomic, and arousal-motor activities during sleep in sleep bruxism (SB) children. METHODS Polysomnographic recordings were performed on fifteen SB children (9 boys, 6 girls, 10.3 ± 2.5 years) and eighteen control children (5 boys, 13 girls, 10.7 ± 3.1 years) free from sleep and developmental disorders. Sleep and RMMA were scored by the standard rules. Sleep cycle was divided into NREM and REM sleep segments and the frequency of RMMA, transient arousal and movement, and cortical and cardiac activities were then quantitatively analyzed in relation to sleep cycles. RESULTS Neither sleep architecture nor sleep stage distribution of RMMA significantly differed between two groups. In sleep cycles, SB children showed more frequent RMMA in all segments than controls, while cyclic changes in cortical and autonomic activities did not significantly differ between two groups. In SB children, RMMA was the most frequent in the last NREM segment before REM sleep and was associated with increases in cortical beta activity and arousal; more than 70% of RMMA time-dependently occurred with cortical and motor arousals. CONCLUSIONS This is the first study to suggest that the potentiation of RMMA occurrence was associated with transient arousal under cyclic sleep processes in primary SB children.
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Affiliation(s)
- Yuki Shiraishi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.,Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Masaya Tachibana
- United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Osaka University Hospital, Sleep Medicine Center, Suita, Osaka, Japan
| | - Ai Shirota
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Ikuko Mohri
- United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Osaka University Hospital, Sleep Medicine Center, Suita, Osaka, Japan
| | - Masako Taniike
- United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.,Osaka University Hospital, Sleep Medicine Center, Suita, Osaka, Japan
| | - Takashi Yamashiro
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.,United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan.,Osaka University Hospital, Sleep Medicine Center, Suita, Osaka, Japan
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25
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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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26
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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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27
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Effect of Sleep Bruxism Intensity on Blood Pressure in Normotensives. J Clin Med 2021; 10:jcm10061304. [PMID: 33810035 PMCID: PMC8004920 DOI: 10.3390/jcm10061304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
The present research aimed to investigate the influence of sleep bruxism (SB) intensity on blood pressure parameters in normotensive subjects by using an ambulatory blood pressure device. The study group included 65 normotensive individuals suspected of having SB. All participants underwent one-night video-polysomnography, and ambulatory blood pressure monitoring was performed the next day; 86.15% of them were diagnosed with SB. Statistical analysis included correlation and regression analysis. The obtained results showed that systolic blood pressure variability during sleep significantly increased in individuals with BEI > 4 (bruxism episodes index; episodes/hour) compared to those with BEI ≤ 4 (8.81 ± 3.36 versus 10.57 ± 3.39, p = 0.05). Multivariable regression analysis showed that systolic blood pressure variability at nighttime was also associated with the following independent risk factors: higher apnea-to-bruxism index, male gender, BEI > 4 episodes/hour, body mass index (BMI) ≥ 25 kg/m2, higher arousal index, and shorter total sleep time. In summary, sleep bruxism intensity was associated with increased systolic blood pressure variability during sleep. Coincidental apnea, male gender, severe sleep bruxism (SB intensity with BEI > 4/hour), excess weight and obesity, higher arousal index, and shorter sleep time seem to be the main determinants that influence blood pressure in normotensive sleep bruxers.
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28
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Haraki S, Tsujisaka A, Toyota R, Shiraishi Y, Adachi H, Ishigaki S, Yatani H, Taniike M, Kato T. First night effect on polysomnographic sleep bruxism diagnosis varies among young subjects with different degrees of rhythmic masticatory muscle activity. Sleep Med 2020; 75:395-400. [DOI: 10.1016/j.sleep.2020.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/01/2020] [Accepted: 08/07/2020] [Indexed: 12/20/2022]
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29
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de Holanda TA, Castagno CD, Barbon FJ, Costa YM, Goettems ML, Boscato N. Sleep architecture and factors associated with sleep bruxism diagnosis scored by polysomnography recordings: A case-control study. Arch Oral Biol 2020; 112:104685. [DOI: 10.1016/j.archoralbio.2020.104685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 01/21/2020] [Accepted: 02/17/2020] [Indexed: 01/07/2023]
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30
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Shim YJ, Lee HJ, Park KJ, Kim HT, Hong IH, Kim ST. Botulinum Toxin Therapy for Managing Sleep Bruxism: A Randomized and Placebo-Controlled Trial. Toxins (Basel) 2020; 12:toxins12030168. [PMID: 32182879 PMCID: PMC7150956 DOI: 10.3390/toxins12030168] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/05/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to evaluate the effects of botulinum toxin type A (BoNT-A) for managing sleep bruxism (SB) in a randomized, placebo-controlled trial. Thirty SB subjects were randomly assigned into two groups evenly. The placebo group received saline injections into each masseter muscle, and the treatment group received BoNT-A injections into each masseter muscle. Audio-video-polysomnographic recordings in the sleep laboratory were made before, at four weeks after, and at 12 weeks after injection. Sleep and SB parameters were scored according to the diagnostic and coding manual of American Academy of Sleep Medicine. The change of sleep and SB parameters were investigated using repeated measures analysis of variance (RM-ANOVA). Twenty-three subjects completed the study (placebo group 10, treatment group 13). None of the SB episode variables showed a significant time and group interaction (p > 0.05) except for electromyography (EMG) variables. The peak amplitude of EMG bursts during SB showed a significant time and group interaction (p = 0.001). The injection decreased the peak amplitude of EMG bursts during SB only in the treatment group for 12 weeks (p < 0.0001). A single BoNT-A injection cannot reduce the genesis of SB. However, it can be an effective management option for SB by reducing the intensity of the masseter muscle.
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Affiliation(s)
- Young Joo Shim
- Department of Oral Medicine, College of Dentistry, Wonkwang University, Daejeon 35233, Korea;
| | - Hee Jin Lee
- Department of Orofacial Pain and Oral Medicine, Yonsei University Dental Hospital, Seoul 03722, Korea; (H.J.L.); (K.J.P.)
| | - Keun Jeong Park
- Department of Orofacial Pain and Oral Medicine, Yonsei University Dental Hospital, Seoul 03722, Korea; (H.J.L.); (K.J.P.)
| | - Hyung Tack Kim
- TMJ & Orofacial Pain Clinic, Los Angeles, CA 90006, USA;
| | | | - Seong Taek Kim
- Department of Orofacial Pain and Oral Medicine, College of Dentistry, Yonsei University, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-2228-3110
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31
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Miki H, Minakuchi H, Miyagi M, Hara ES, Shigemoto S, Suzuki Y, Maekawa K, Matsuka Y, Clark GT, Kuboki T. Association of masticatory muscle activity with sleep arousal and other concomitant movements during sleep. J Oral Rehabil 2019; 47:281-288. [DOI: 10.1111/joor.12913] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/23/2019] [Accepted: 11/14/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Haruna Miki
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Hajime Minakuchi
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Mayu Miyagi
- Department of Stomatgnathic Function and Occlusal Reconstruction Institute of Biomedical Sciences Clinical Dentistry Tokushima University Graduate School Tokushima Japan
| | - Emilio Satoshi Hara
- Department of Biomaterials Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Shuji Shigemoto
- Department of Fixed Prosthodontics School of Dental Medicine Tsurumi University Yokohama Japan
| | - Yoshitaka Suzuki
- Department of Stomatgnathic Function and Occlusal Reconstruction Institute of Biomedical Sciences Clinical Dentistry Tokushima University Graduate School Tokushima Japan
| | - Kenji Maekawa
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
| | - Yoshizo Matsuka
- Department of Stomatgnathic Function and Occlusal Reconstruction Institute of Biomedical Sciences Clinical Dentistry Tokushima University Graduate School Tokushima Japan
| | - Glenn T. Clark
- Advanced Program in Orofacial Pain and Oral Medicine Ostrow School of DentistryUniversity of Southern California Los Angeles CA USA
| | - Takuo Kuboki
- Department of Oral Rehabilitation and Regenerative Medicine Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
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32
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The Efficacy of Device Designs (Mono-block or Bi-block) in Oral Appliance Therapy for Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173182. [PMID: 31480465 PMCID: PMC6747445 DOI: 10.3390/ijerph16173182] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 08/24/2019] [Accepted: 08/25/2019] [Indexed: 11/17/2022]
Abstract
Oral appliance (OAm) therapy has demonstrated efficacy in treating obstructive sleep apnea (OSA). The aim of this systematic review was to clarify the efficacy of device designs (Mono-block or Bi-block) in OAm therapy for OSA patients. We performed a meta-analysis using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Two studies (Mono-block OAm versus Bi-block OAm) remained eligible after applying the exclusion criteria. When comparing Mono-block OAm and Bi-block OAm, Mono-block OAm significantly reduced the apnea-hypopnea index (2.92; 95% confidence interval (95%CI), 1.26 to 4.58; p = 0.0006), and patient preference for Mono-block OAm was significantly higher (2.06; 95%CI, 1.44 to 2.06; p < 0.0001). Lowest SpO2, arousal index, non-REM stage 3, sleep efficiency, Epworth Sleepiness Scale (ESS), Snoring Scale, and side effects were not significantly different between the two groups (lowest SpO2: -11.18; 95%CI, -26.90 to 4.54; p = 0.16, arousal index: 4.40; 95%CI, -6.00 to 14.80; p = 0.41, non-REM stage 3: -2.00; 95%CI, -6.00 to 14.80; p = 0.41, sleep efficiency: -1.42, 95%CI, -4.71 to 1.86; p = 0.40, ESS: 0.12; 95%CI, -1.55 to 1.79; p = 0.89, Snoring Scale: 0.55; 95%CI, -0.73 to 1.83, p = 0.55, side effects: 1.00, 95%CI, 0.62 to 1.61, p = 1.00). In this systematic review, the use of Mono-block OAm was more effective than Bi-block OAm for OSA patients.
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Lu J, Zhang Y, Han K, Wang C, Zhong Z, Xu M, Zou X, Yu B, Yao D. Heart rate changes associated with rhythmic masticatory muscle activities and limb movements in sleep bruxers: Preliminary findings. Cranio 2019; 39:47-57. [PMID: 30774008 DOI: 10.1080/08869634.2019.1578032] [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] [Indexed: 01/14/2023]
Abstract
Objective: To investigate the relationship of rhythmic masticatory muscle activities (RMMAs) and limb movements (LMs) with heart rate (HR) acceleration. Methods: The amplitude and duration of HR increases, the time to reach peak HR associated with RMMAs/LMs during sleep, duration of movement events, and their relationships with cortical arousal levels were determined in 9 sleep bruxers and 10 normal controls. Results: A total of 48.15% and 49.44% HR increased before the onset of RMMAs/LMs in the sleep bruxers and controls, respectively. All of the parameters of HR increases were significantly different between the sleep bruxers and the controls (p < 0.05-0.001) and between different cortical arousal levels (p < 0.01), and the duration of RMMAs/LMs was positively correlated with the parameters (Sleep bruxers: r2 = 0.18-0.88, p < 0.0001; Controls: r2 = 0.16-0.78, p < 0.0001). Discussion: These data suggest the HR increases are associated with the movement events and changes in cortical arousal levels in the sleep bruxers and controls. Abbreviations: LMs: Limb movements; HR: Heart rate; RMMAs: Rhythmic masticatory muscle activities; SB: Sleep bruxism; PSG: Polysomnographic; EEG: Electroencephalographic; PLMS: Periodic leg movements; SSRIs: Selective serotonin reuptake inhibitors; ECG: Electrocardiographic; EOG: Electrooculographic; EMG: Electromyographic; SD: Standard deviation; Fig: Figure; SEM: Standard error of mean; N1: Non-rapid eye movement sleep stage 1; N2: Non-rapid eye movement sleep stage 2; N3: Non-rapid eye movement sleep stage 3; REM: Rapid eye movement ; NA: No arousal; mAR: Microarousal; AW: Awakening.
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Affiliation(s)
- Junlan Lu
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital , Nanchang, PR China.,School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
| | - Yangping Zhang
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital , Nanchang, PR China.,School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
| | - Kangning Han
- Queen Mary College, Nanchang University , Nanchang, PR China
| | - Chuanying Wang
- Queen Mary College, Nanchang University , Nanchang, PR China
| | - Zhijun Zhong
- School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
| | - Miao Xu
- School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
| | - Xueliang Zou
- Jiangxi Mental Hospital, Nanchang University , Nanchang, PR China
| | - Bin Yu
- Jiangxi Mental Hospital, Nanchang University , Nanchang, PR China
| | - Dongyuan Yao
- Neurological Institute of Jiangxi Province and Department of Neurology, Jiangxi Provincial People's Hospital , Nanchang, PR China.,School of Pharmaceutical Sciences, Nanchang University , Nanchang, PR China
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Ommerborn MA, Depprich RA, Schneider C, Giraki M, Franz M, Raab WHM, Schäfer R. Pain perception and functional/occlusal parameters in sleep bruxism subjects following a therapeutic intervention. Head Face Med 2019; 15:4. [PMID: 30696443 PMCID: PMC6350301 DOI: 10.1186/s13005-019-0188-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 01/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background This study was conducted to assess the individual pain perception in sleep bruxism (SB) subjects. Moreover, the effects of a cognitive behavioural therapy (CBT) compared to an occlusal appliance (OA) on pain perception and a possible continuative impact on several functional parameters were investigated. Methods A total of 57 SB subjects participated in this investigation. The diagnosis of SB was based on the clinical criteria of the American Academy of Sleep Medicine (AASM). Twenty-eight SB subjects were randomly allocated to the CBT group and 29 to the OA group. The therapeutic intervention took place over a period of 12 weeks, whereby both groups were examined at baseline, immediately after termination of the intervention, and at a 6-month follow-up for pain perception and functional parameters. At each of the three measurement periods, participants completed the pain perception scale and ten functional/occlusal parameters were recorded. Results Of the 12 parameters recorded, statistically significant main effects were found for the affective pain perception (p < 0.05) and for the three functional variables. Interestingly, the values obtained for the affective pain perception were considerably below that of a reference group. Apart from the determined statistically significant results, the values recorded for all functional/occlusal variables as well as those obtained for the sensory pain perception were clearly located within normative ranges. Conclusions Within the limitations of this study, it might be concluded that the significantly reduced affective pain perception in SB subjects is the expression of an adaptation mechanism.
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Affiliation(s)
- Michelle Alicia Ommerborn
- Department of Operative Dentistry, Periodontics, and Endodontics, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Rita Antonia Depprich
- Department of Cranio- and Maxillofacial Surgery, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Christine Schneider
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Maria Giraki
- Department of Operative Dentistry, Periodontics, and Endodontics, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Matthias Franz
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | - Wolfgang Hans-Michael Raab
- Department of Operative Dentistry, Periodontics, and Endodontics, Faculty of Medicine, Heinrich-Heine-University, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Ralf Schäfer
- Clinical Institute of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
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Yamada K, Higashiyama M, Toyoda H, Masuda Y, Kogo M, Yoshida A, Kato T. Experimentally induced rhythmic jaw muscle activities during non‐rapid eye movement sleep in freely moving guinea pigs. J Sleep Res 2019; 28:e12823. [DOI: 10.1111/jsr.12823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/15/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Ken‐ichi Yamada
- Department of Oral and Maxillofacial Surgery I Osaka University Graduate School of Dentistry Osaka Japan
| | - Makoto Higashiyama
- Department of Oral Physiology Osaka University Graduate School of Dentistry Osaka Japan
| | - Hiroki Toyoda
- Department of Oral Physiology Osaka University Graduate School of Dentistry Osaka Japan
| | - Yuji Masuda
- Department of Oral and Maxillofacial NeurobiologyGraduate School of Oral MedicineMatsumoto Dental University Shiojiri Japan
| | - Mikihiko Kogo
- Department of Oral and Maxillofacial Surgery I Osaka University Graduate School of Dentistry Osaka Japan
| | - Atsushi Yoshida
- Department of Oral Anatomy and Neurobiology Osaka University Graduate School of Dentistry Osaka Japan
| | - Takafumi Kato
- Department of Oral Physiology Osaka University Graduate School of Dentistry Osaka Japan
- Sleep Medicine Center Osaka University Hospital Osaka Japan
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Han K, Wang C, Zhong Z, Xu M, Zou X, Yu B, Wang K, Yao D. Characterisation of the relationships between rhythmic masticatory muscle activities and limb movements in patients with sleep bruxism. J Oral Rehabil 2019; 46:399-408. [PMID: 30588653 DOI: 10.1111/joor.12760] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/25/2018] [Accepted: 12/18/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Kangning Han
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- Queen Mary College Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
| | - Chuanying Wang
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- Queen Mary College Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
| | - Zhijun Zhong
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
| | - Miao Xu
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
| | - Xueliang Zou
- Jiangxi Mental Hospital Nanchang University Jiangxi China
| | - Bin Yu
- Jiangxi Mental Hospital Nanchang University Jiangxi China
| | - Kelun Wang
- Center for Sensory‐Motor Interaction, Department of Health Science & Technology Aalborg University Aalborg Denmark
| | - Dongyuan Yao
- Jiangxi Mental Hospital Nanchang University Jiangxi China
- School of Pharmaceutical Sciences Nanchang University Jiangxi China
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Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, Santiago V, Winocur E, De Laat A, De Leeuw R, Koyano K, Lavigne GJ, Svensson P, Manfredini D. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil 2018; 45:837-844. [PMID: 29926505 PMCID: PMC6287494 DOI: 10.1111/joor.12663] [Citation(s) in RCA: 575] [Impact Index Per Article: 95.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2018] [Indexed: 12/23/2022]
Abstract
In 2013, consensus was obtained on a definition of bruxism as repetitive masticatory muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible and specified as either sleep bruxism or awake bruxism. In addition, a grading system was proposed to determine the likelihood that a certain assessment of bruxism actually yields a valid outcome. This study discusses the need for an updated consensus and has the following aims: (i) to further clarify the 2013 definition and to develop separate definitions for sleep and awake bruxism; (ii) to determine whether bruxism is a disorder rather than a behaviour that can be a risk factor for certain clinical conditions; (iii) to re-examine the 2013 grading system; and (iv) to develop a research agenda. It was concluded that: (i) sleep and awake bruxism are masticatory muscle activities that occur during sleep (characterised as rhythmic or non-rhythmic) and wakefulness (characterised by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible), respectively; (ii) in otherwise healthy individuals, bruxism should not be considered as a disorder, but rather as a behaviour that can be a risk (and/or protective) factor for certain clinical consequences; (iii) both non-instrumental approaches (notably self-report) and instrumental approaches (notably electromyography) can be employed to assess bruxism; and (iv) standard cut-off points for establishing the presence or absence of bruxism should not be used in otherwise healthy individuals; rather, bruxism-related masticatory muscle activities should be assessed in the behaviour's continuum.
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Affiliation(s)
- F Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - K G Raphael
- Department of Oral & Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
| | - P Wetselaar
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A G Glaros
- School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA
| | - T Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
- Sleep Medicine Center, Osaka University Hospital, Osaka, Japan
| | - V Santiago
- Department of Oral & Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
| | - E Winocur
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A De Laat
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
- Department of Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - R De Leeuw
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, Lexington, KY, USA
| | - K Koyano
- Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - G J Lavigne
- Centre d'étude du sommeil, Faculty of Dental Medicine, Université de Montréal and Hôpital du Sacré Coeur, Montréal, PQ, Canada
| | - P Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Scandinavian Center for Orofacial Neurosciences
| | - D Manfredini
- School of Dentistry, University of Siena, Siena, Italy
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Tsujisaka A, Haraki S, Nonoue S, Mikami A, Adachi H, Mizumori T, Yatani H, Yoshida A, Kato T. The occurrence of respiratory events in young subjects with a frequent rhythmic masticatory muscle activity: a pilot study. J Prosthodont Res 2018; 62:317-323. [DOI: 10.1016/j.jpor.2017.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/13/2017] [Accepted: 12/15/2017] [Indexed: 11/30/2022]
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Kato T, Toyota R, Haraki S, Yano H, Higashiyama M, Ueno Y, Yano H, Sato F, Yatani H, Yoshida A. Comparison of rhythmic masticatory muscle activity during non-rapid eye movement sleep in guinea pigs and humans. J Sleep Res 2017; 27:e12608. [DOI: 10.1111/jsr.12608] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/30/2017] [Indexed: 02/04/2023]
Affiliation(s)
- Takafumi Kato
- Department of Oral Physiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Osaka University Hospital; Sleep Medicine Center; Osaka Japan
| | - Risa Toyota
- Department of Oral Physiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Removable Prosthodontics; Osaka University Graduate School of Dentistry; Osaka Japan
| | - Shingo Haraki
- Department of Oral Physiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Fixed Prosthodontics; Osaka University Graduate School of Dentistry; Osaka Japan
| | - Hiroyuki Yano
- Department of Oral Physiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Oral Anatomy and Neurobiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Oral and Maxillofacial Surgery II; Osaka University Graduate School of Dentistry; Osaka Japan
| | - Makoto Higashiyama
- Department of Oral Physiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Fixed Prosthodontics; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Oral Anatomy and Neurobiology; Osaka University Graduate School of Dentistry; Osaka Japan
| | - Yoshio Ueno
- Department of Oral Physiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Oral Anatomy and Neurobiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Oral and Maxillofacial Surgery II; Osaka University Graduate School of Dentistry; Osaka Japan
| | - Hiroshi Yano
- Department of Oral Physiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Oral Anatomy and Neurobiology; Osaka University Graduate School of Dentistry; Osaka Japan
- Department of Oral and Maxillofacial Surgery II; Osaka University Graduate School of Dentistry; Osaka Japan
| | - Fumihiko Sato
- Department of Oral Anatomy and Neurobiology; Osaka University Graduate School of Dentistry; Osaka Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics; Osaka University Graduate School of Dentistry; Osaka Japan
| | - Atsushi Yoshida
- Department of Oral Anatomy and Neurobiology; Osaka University Graduate School of Dentistry; Osaka Japan
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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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Chowdhury T, Bindu B, Singh GP, Schaller B. Sleep Disorders: Is the Trigemino-Cardiac Reflex a Missing Link? Front Neurol 2017; 8:63. [PMID: 28289401 PMCID: PMC5326750 DOI: 10.3389/fneur.2017.00063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/13/2017] [Indexed: 12/26/2022] Open
Abstract
Trigeminal innervated areas in face, nasolacrimal, and nasal mucosa can produce a wide array of cardiorespiratory manifestations that include apnea, bradypnea, bradycardia, hypotension, and arrhythmias. This reflex is a well-known entity called "trigemino-cardiac reflex" (TCR). The role of TCR is investigated in various pathophysiological conditions especially in neurosurgical, but also skull base surgery procedures. Additionally, its significance in various sleep-related disorders has also been highlighted recently. Though, the role of diving reflex, a subtype of TCR, has been extensively investigated in sudden infant death syndrome. The data related to other sleep disorders including obstructive sleep apnea, bruxism is very limited and thus, this mini review aims to investigate the possible role and correlation of TCR in causing such sleep abnormalities.
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Affiliation(s)
- Tumul Chowdhury
- Department of Anesthesiology and Perioperative Medicine, University of Manitoba , Winnipeg, MB , Canada
| | - Barkha Bindu
- Department of Neuro-anaesthesiology and Critical Care, All India Institute of Medical Sciences , New Delhi , India
| | - Gyaninder Pal Singh
- Department of Neuro-anaesthesiology and Critical Care, All India Institute of Medical Sciences , New Delhi , India
| | - Bernhard Schaller
- Department of Research, University of Southampton , Southampton , UK
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Rompré PH, Daigle-Landry D, Guitard F, Montplaisir JY, Lavigne GJ. Identification of a Sleep Bruxism Subgroup with a Higher Risk of Pain. J Dent Res 2016; 86:837-42. [PMID: 17720851 DOI: 10.1177/154405910708600906] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sleep bruxism research diagnostic criteria (SB-RDC) have been applied since 1996. This study was performed to validate these criteria and to challenge the hypothesis that pain is associated with lower frequencies of orofacial activities. Polygraphic recordings were made of 100 individuals presenting with a clinical diagnosis of sleep bruxism and 43 control individuals. TwoStep Cluster analyses (SPSS) were performed with sleep bruxism variables to reveal groupings among sleep bruxers and control individuals. Participants completed questionnaires during screening, diagnosis, and recording sessions. Cluster analysis identified three subgroups of sleep bruxers. Interestingly, 45 of the 46 sleep bruxers with values below SB-RDC were classified in the low-frequency cluster. These individuals were more likely to complain of pain and fatigue of masticatory muscles than were the higher-frequency sleep bruxers (odds ratios > 3.9, p < 0.01). Sleep bruxers were distributed among three heterogeneous groups. Sleep bruxers with low frequencies of orofacial activities were more at risk of reporting pain.
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Affiliation(s)
- P H Rompré
- Faculty of Dental Medicine, Université de Montréal, CP 6128, succ Centre-Ville, Montréal, Canada
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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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A Study of the Association Between Sleep Bruxism, Low Quality of Sleep, and Degenerative Changes of the Temporomandibular Joint. J Craniofac Surg 2016; 26:2347-50. [PMID: 26501968 DOI: 10.1097/scs.0000000000002084] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to evaluate the presence of degenerative bone changes of the temporomandibular joint (TMJ) in individuals suffering from sleep bruxism (SB), associating these characteristics with the quality of sleep. For this, we followed the International Classification of Sleep Disorders for the diagnosis of SB, in addition to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for the classification of TMD and cone beam computed tomography. It was found that 97.7% of the individuals with bruxism had at least 1 RDC/TMD group III diagnosis, 75.6% of the subjects considered their sleep quality as poor, and the largest group (23%) had centric bruxism. There was no significant association between the pattern of sleep quality (P = 0.36), the type of SB (P = 0.277), and the presence of degenerative changes of the TMJ. Regardless of the quality of sleep and the type of bruxism presented, the prevalence of degenerative bone disorders was high (67%) among women with a mean age of 46 years and a clinical diagnosis of SB.
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Short-term effects of repetitive transcranial magnetic stimulation on sleep bruxism - a pilot study. Int J Oral Sci 2016; 8:61-5. [PMID: 27025267 PMCID: PMC4822180 DOI: 10.1038/ijos.2015.35] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2015] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on patients with sleep bruxism (SB). Twelve patients with SB were included in an open, single-intervention pilot study. rTMS at 1 Hz and an intensity of 80% of the active motor threshold was applied to the ‘hot spot' of the masseter muscle representation at the primary motor cortex bilaterally for 20 min per side each day for 5 consecutive days. The jaw-closing muscle electromyographic (EMG) activity during sleep was recorded with a portable EMG recorder at baseline, during rTMS treatment and at follow-up for 5 days. In addition, patients scored their jaw-closing muscle soreness on a 0–10 numerical rating scale (NRS). Data were analysed with analysis of variance. The intensity of the EMG activity was suppressed during and after rTMS compared to the baseline (P = 0.04; P = 0.02, respectively). The NRS score of soreness decreased significantly during and after rTMS compared with baseline (P < 0.01). These findings indicated a significant inhibition of jaw-closing muscle activity during sleep along with a decrease of muscle soreness. This pilot study raises the possibility of therapeutic benefits from rTMS in patients with bruxism and calls for further and more controlled studies.
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Emodi Perlman A, Lobbezoo F, Zar A, Friedman Rubin P, van Selms MKA, Winocur E. Self-Reported bruxism and associated factors in Israeli adolescents. J Oral Rehabil 2016; 43:443-50. [PMID: 26968152 DOI: 10.1111/joor.12391] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 11/27/2022]
Abstract
Little is known about the epidemiological characteristics of sleep and awake bruxism (SB and AB) in adolescents. The aims of the study were: to assess the prevalence rates of self-reported SB and AB in Israeli adolescents; to determine the associations between SB/AB and several demographical, exogenous and psychosocial factors in Israeli adolescents; and to investigate the possible concordance between SB and AB. The study made use of a questionnaire. The study population included 1000 students from different high schools in the centre of Israel. Prevalence of self-reported SB and AB in the Israeli adolescents studied was 9·2% and 19·2%, respectively. No gender difference was found regarding the prevalence of SB and AB. Multiple variable regression analysis revealed that the following predicting variables were related to SB: temporomandibular joint sounds (P = 0·002) and feeling stressed (P = 0·001). The following predicting variables were related to AB: age (P = 0·018), temporomandibular joint sounds (P = 0·002), oro-facial pain (P = 0·006), and feeling stressed (P = 0·002) or sad (P = 0·006). A significant association was found between SB and AB; that is, an individual reporting SB had a higher probability of reporting AB compared with an individual who did not report SB (odds ratio = 5·099). Chewing gum was the most common parafunction reported by adolescents. The results of this study demonstrate that self-reports of AB and SB are common in the Israeli adolescents population studied and are not related to gender. The significant correlation found between SB and AB may be a confounding bias that affects proper diagnosis of bruxism through self-reported questionnaires only.
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Affiliation(s)
- A Emodi Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - F Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - A Zar
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - P Friedman Rubin
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M K A van Selms
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | - E Winocur
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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