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Anna C, Frank L, Eleonora C, Alessandro B, Luca L, Matteo P, Daniele M. Effects of orthodontic aligners on the ecological report of awake bruxism. J Oral Rehabil 2024. [PMID: 39030849 DOI: 10.1111/joor.13810] [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: 01/17/2024] [Revised: 06/25/2024] [Accepted: 07/08/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND The demand for orthodontic treatment with aligners has recently increased, but their effects on awake bruxism (AB) behaviours have to be evaluated yet. OBJECTIVES This investigation assessed if aligners can affect oral behaviours (i.e. tooth contact, teeth clenching, teeth grinding and mandible bracing) that are related with the AB spectrum. METHODS The investigation was performed in a sample of 32 consecutively recruited healthy adult patients who required orthodontic treatment. The study protocol involved three different sessions of 1-week monitoring without aligners, with passive aligners and with active aligners, respectively. All patients underwent an orthodontic treatment with aligners and used a smartphone-based application for a real-time report (i.e. ecological momentary assessment [EMA]) of their AB behaviours. Recording time was set from 8.00 to 12.30 and from 14.30 to 22.00. Analysis of variance (ANOVA) was used to compare the average reported frequency for each activity within and between the different sessions. The coefficient of variation (CV) was assessed to evaluate daily fluctuations within the 7 days monitoring periods. RESULTS The average reported frequency of the relaxed condition was 64.9%, 63.0% and 60.0% during the sessions without aligners, with passive aligners and with active aligners, respectively. ANOVA showed no significant differences in any of the AB behaviours within (i.e. between 7 days of evaluation) and between the monitoring sessions (i.e. before orthodontic treatment, with passive aligners, with active aligners). No sex differences were detected, except for the 'tooth contact' report that showed a higher frequency in females. CONCLUSION The impact of our results in the orthodontic field is not negligible; clinicians can find support for the hypothesis that from a global point of view, wearing or not wearing aligners (passive and/or active) does not influence the frequency of AB behaviours at the short term.
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Affiliation(s)
- Colonna Anna
- Department of Medical Biotechnologies, School of Dentistry, University of Siena, Siena, Italy
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Lobbezoo Frank
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Capelli Eleonora
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Bracci Alessandro
- Department of Neurosciences, School of Dentistry, University of Padova, Padova, Italy
| | - Lombardo Luca
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Pollis Matteo
- Department of Medical Biotechnologies, School of Dentistry, University of Siena, Siena, Italy
| | - Manfredini Daniele
- Department of Medical Biotechnologies, School of Dentistry, University of Siena, Siena, Italy
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Ishimaru T, Yamaguchi T, Saito T, Hattori Y, Ono T, Arai Y, Hasegawa Y, Shiga H, Tamaki K, Tanaka J, Tsuga K, Abekura H, Miyawaki S, Maeda-Iino A, Mikami S, Gotouda A, Satoh K, Shimizu K, Kato Y, Namita T. Actual state of the diurnal masseteric electromyogram: Differences between awareness and non-awareness of awake bruxism. J Prosthodont Res 2024; 68:456-465. [PMID: 38220162 DOI: 10.2186/jpr.jpr_d_23_00072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
PURPOSE This study aimed to elucidate the relationship between diurnal masseter muscle activity and awareness of diurnal awake bruxism (d-AB) by conducting a comparative analysis of electromyographic (EMG) data from individuals with and without awareness of diurnal awake bruxism (d-AB), utilizing EMG data gathered from multiple subjects. METHODS Unilateral masseter electromyography (EMG) recordings were performed during the daytime using an ultraminiature wearable EMG device. A total of 119 participants (59 with awareness of diurnal tooth clenching [d-TC] and 60 without awareness of d-TC) were included. Waveforms longer than 0.25 s with the two amplitude conditions, exceeding twice the baseline and >5% of maximum voluntary clenching, were extracted. In addition, the number of bursts and episodes (groups of bursts), burst duration, and burst peak amplitude were calculated for each participant. RESULTS There were no significant differences in the EMG parameters between the groups with and without awareness of d-TC. Additionally, the frequency distribution of the number of EMG waveforms exhibited wide ranges and substantial overlap between the two groups. CONCLUSIONS The variability in the number of bursts and episodes, burst peak amplitude, and burst duration among subjects suggests the need for an objective classification of d-AB severity based on EMG values. The absence of significant differences and large overlap in frequency distributions between the groups with and without awareness of d-TC indicate difficulty in predicting muscle activity solely based on awareness of d-AB.
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Affiliation(s)
- Tomoya Ishimaru
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taihiko Yamaguchi
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Taishi Saito
- Department of Crown and Bridge Prosthodontics, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Geriatric Dentistry, Osaka Dental University, Osaka, Japan
| | - Yoshiaki Arai
- Oral Implant & Temporomandibular Joint Clinic, Niigata University Medical & Dental Hospital, Niigata, Japan
| | - Yoko Hasegawa
- Division of Comprehensive Prosthodontics, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroshi Shiga
- Department of Partial and Complete Denture, The Nippon Dental University School of Life Dentistry, Tokyo, Japan
| | - Katsushi Tamaki
- Graduate School of Dentistry, Kanagawa Dental University Department of Oral Interdisciplinary Medicine (OIM) Division of Prosthodontic Dentistry for function of TMJ and Occlusion, Yokosuka, Japan
| | - Junko Tanaka
- Department of Fixed Prosthodontics and Occlusion Osaka Dental University, Osaka, Japan
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan
| | - Hitoshi Abekura
- Department of Advanced Prosthodontics, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shouichi Miyawaki
- Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Aya Maeda-Iino
- Department of Orthodontics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Saki Mikami
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Akihito Gotouda
- Department of Temporomandibular Disorder, Center for Advanced Oral Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Kaoru Satoh
- Department of Crown and Bridge Prosthodontics, Hokkaido University Hospital, Sapporo, Japan
| | - Koichi Shimizu
- School of Optoelectronic Engineering, Xidian University, Xi'an, China
| | - Yuji Kato
- Faculty of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Takeshi Namita
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Tokyo, Japan
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Dias R, Lima R, Prado I, Colonna A, Serra-Negra JM, Bracci A, Manfredini D. Awake bruxism report in a population of dental students with and without ecological momentary assessment monitorization-A randomised trial. J Oral Rehabil 2024; 51:1213-1220. [PMID: 38606658 DOI: 10.1111/joor.13695] [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: 04/27/2022] [Revised: 07/07/2023] [Accepted: 03/23/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE The Ecological Momentary Assessment (EMA) concept was the basis for developing a smartphone application for the real-time report of awake bruxism (AB) activities. The aim of this study was to assess the effects of the EMA with a randomised controlled trial designed to compare the frequency of AB reported in two separate single observation points between a group of students monitored over time with an EMA smartphone application and a non-EMA monitored group. METHODS Sixty-four (N = 64) dental students (22.3 YO [±2.6]; 52F; 12 M) answered the Oral Behaviour Checklist (OBC-1) and were randomised into an EMA-group (EG) and control group (CG). EG were monitored with a smartphone application for AB report during seven consecutive days and completed three EMA monitoring periods (EMA-1, 2 and 3) at one-month intervals. After the third period (EMA-3), both EG and CG answered again the OBC (OBC-2). Descriptive statistics were performed to characterise the sample. Pearson's chi-squared test, Fixer Exact test and post hoc Z test with Bonferroni correction were performed. The study hypothesis was that EMA could influence the AB reported by the participants because it implies an increase in the awareness, self-recognition, and self-control of bruxism behaviours. The level of significance was set at p < .05. RESULT The percentage of participants who changed the report of the activity of clenching their teeth while awake between OBC-1 and OBC-2 was significantly higher among participants in EG, when compared to CG (p = .027). For all other behaviours reported the within- and between-group differences from OBC-1 to OBC-2 were not significant. Clenching and bracing were the most frequently reported, whilst grinding was the less frequent behaviour. CONCLUSION A smartphone-based EMA approach demonstrated be useful to monitor AB over time, increasing individual's awareness, particularly to bracing and clenching behaviours.
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Affiliation(s)
- Ricardo Dias
- Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rui Lima
- Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ivana Prado
- Departamento de Odontopediatria e Ortodontia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Anna Colonna
- School of Dentistry, University of Siena, Siena, Italy
| | - Junia Maria Serra-Negra
- Departamento de Odontopediatria e Ortodontia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Moreira-Souza L, Pelai EB, Bigaton DR, Freitas DQ, Oenning ACC, Asprino L. Is there a relationship between the presence of external root resorption in second molars adjacent to impacted mandibular third molars with awake bruxism and masticatory muscle activity? Clin Oral Investig 2024; 28:401. [PMID: 38940883 DOI: 10.1007/s00784-024-05775-3] [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: 08/23/2023] [Accepted: 06/11/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES This study aimed to assess whether awake bruxism and masticatory muscle activity could be related to external root resorption (ERR) in second molars adjacent to impacted mandibular third molars. MATERIALS AND METHODS Sixty patients, with requests for a cone-beam, computed tomography, were divided into two groups: ERR (patients with ERR in the second molar, n = 30), and control group (n = 30). Awake bruxism was assessed through the Oral Behaviors Checklist (OBC) and an ecological momentary assessment (EMA). Surface electromyography (EMG) was used to assess the masseter and anterior temporal muscle function. Normality and homogeneity of variances were demonstrated. Descriptive analysis was performed, using the T-test and Chi-square test to compare the characteristics of the groups. A multiple regression model was performed. RESULTS The ERR group presented more non-functional oral activities related to awake bruxism than the control group, according to OBC (p = 0.027) and EMA (p = 0.035). In addition, the ERR group had higher EMG activity than the control group in rest and isotonic protocols (p < 0.05). CONCLUSIONS Awake bruxism and greater masticatory muscle activity seem to be related to the presence of ERR in second molars adjacent to impacted mandibular third molars. CLINICAL RELEVANCE The results of the present study can reinforce the theory that triggering ERR in the second molars adjacent to impacted mandibular third molars may be related to mechanical forces coming from the masticatory function.
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Affiliation(s)
- Larissa Moreira-Souza
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Elisa Bizetti Pelai
- Department of Oral Diagnosis, Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil.
| | - Delaine Rodrigues Bigaton
- Department of Oral Diagnosis, Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | | | - Luciana Asprino
- Department of Oral Diagnosis, Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Piracicaba, São Paulo, 13414-903, Brazil
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Poluha RL, Macário HS, Câmara-Souza MB, De la Torre Canales G, Ernberg M, Stuginski-Barbosa J. Benefits of the combination of digital and analogic tools as a strategy to control possible awake bruxism: A randomised clinical trial. J Oral Rehabil 2024; 51:917-923. [PMID: 38348534 DOI: 10.1111/joor.13667] [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: 06/02/2023] [Revised: 11/11/2023] [Accepted: 02/06/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Awake Bruxism (AB) management includes cognitive and behavioural changes. Digital and analogic tools can be used to remind the individual to control/avoid AB behaviours. However, no study addressed both tools together. OBJECTIVE To compare the efficacy of the combination of digital (smartphone application) and analogic (adhesive reminders) tools versus digital tool alone for AB management. METHODS Seventy-two individuals diagnosed with probable AB were divided into 3 groups: Group 1 (n = 24), used both digital and analogic tools during 30 days; Group 2 (n = 24), used only a digital tool during 30 days and Group 3 (n = 24), used only a digital tool for the first 15 days and then added the analogic tool for 15 days. The AB frequency was measured in real-time with a smartphone app, which sent alerts asking the individuals if they were doing any AB behaviours (bracing, teeth contact, clenching or grinding). Groups were compared using one-way ANOVA and before-after adding an analogic tool (group 3) by paired t-test, considering α = 0.05. RESULTS All groups showed a decrease in AB behaviours at the end of the evaluation period. Group 1 (digital and analogic tools) showed the lowest average of AB behaviours among all groups; however, statistically significant differences were found only for the comparison between groups 1 and 2. In group 3, a significantly greater reduction in AB behaviours was found after combining both approaches. CONCLUSION The combination of digital and analogic tools showed the greatest reduction of AB frequency and can be recommended for AB control.
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Affiliation(s)
| | | | | | - Giancarlo De la Torre Canales
- Ingá University Center, Maringá, Brazil
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, Cooperativa de Ensino Superior, CRL, Caparica, Portugal
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
| | - Malin Ernberg
- Department of Dental Medicine, Karolinska Institutet, and the Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden
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Asami K, Fujisawa M, Saito-Murakami K, Miura S, Fujita T, Imamura Y, Koyama S. Assessment of awake bruxism-Combinational analysis of ecological momentary assessment and electromyography. J Prosthodont Res 2024; 68:166-171. [PMID: 37286504 DOI: 10.2186/jpr.jpr_d_22_00289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE No consensus exists regarding the examination methods and assessment criteria for awake bruxism (AB). In this study, masticatory muscle activity measured using electromyography (EMG) was recorded simultaneously with the ecological momentary assessment (EMA) of bruxism events. Data were collected to identify distinctive EMG parameters in AB. METHODS A total of 104 individuals were classified into the bruxism (BR) or control (CO) groups based on clinical findings. The participants recorded EMA on a tablet device under continuous EMG recording using a data log-type wireless EMG device. For EMA recording, a warning was randomly provided three times each hour for five hours. A receiver operating characteristic (ROC) curve was obtained based on EMA and EMG events. Maximum voluntary contraction (MVC) at the time of maximum bite force was set at 100%. The muscle activity was assessed as a relative value. RESULTS Based on discriminant analysis, analysis of participants who had four or more positive clenching EMA responses was appropriate. The assessed parameters for the EMG cutoff value determination procedure, which combined EMG and EMA, resulted in a cutoff value that enabled the distinction between the BR and CO groups. The area under the ROC curve was 0.77 and the cut-off value was 3.2 events/hour under the EMG of 20% MVC with a duration of ≥1 s. CONCLUSIONS This is the first study to report a combined analysis of the EMA and EMG. These results suggest its effectiveness as a cutoff value for AB screening.
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Affiliation(s)
- Kazuya Asami
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Masanori Fujisawa
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Konatsu Saito-Murakami
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Shoko Miura
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Takafumi Fujita
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Yoshiki Imamura
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
| | - Shiho Koyama
- Division of Fixed Prosthodontics, Department of Restorative and Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan
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Nykänen L, Lobbezoo F, Kämppi A, Manfredini D, Ahlberg J. Awake bruxism in temporomandibular disorders patients referred to tertiary care: A retrospective study on its assessment and TMD management. J Oral Rehabil 2024; 51:181-187. [PMID: 37423766 DOI: 10.1111/joor.13559] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/13/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Bruxism is defined as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism can occur during sleep (sleep bruxism, SB) or during wakefulness (awake bruxism, AB). To date, the effect of AB on the purported negative consequences of bruxism has remained unclear. OBJECTIVES The assessment of AB, its relation to temporomandibular disorders (TMD) treatment modalities, and their possible outcomes were investigated among TMD patients resistant to treatment in primary care and referred to a tertiary care clinic. METHODS The records of 115 patients were studied. Patients were referred to the Head and Neck Centre, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, for TMD treatment between 2017 and 2020. The data derived from the eligible patients' records included the following: background data (age and sex), referral data (reason and previous treatment), medical background (somatic and psychiatric), clinical and possible radiological diagnoses at a tertiary care clinic, treatment modalities for masticatory muscle myalgia, bruxism assessment, its possible treatment modalities and their outcomes, and overall management outcome. We analysed the outcomes of single treatment modalities and combined groups of modalities. For the demographic data, the Chi-squared test and Fischer's Exact test were used to determine the associations between the categorical variables. A Sankey-diagram was used to describe the flow of treatment. RESULTS Temporomandibular joint-pain-dysfunction syndrome (K07.60) was the most frequent single reason to refer a patient to tertiary care (17.4%). At referral, men had myalgia (M79.1) significantly more often (p = .034) than women. Similarly, men had depression (p = .002) more often and other psychiatric diagnoses (p = .034). At tertiary care, the presence of AB was assessed in 53.9%, and self-reported AB was recorded in 48.7%. In patients with possible AB, those who were prescribed neuropathic pain medication showed significantly less improvement in symptoms (p = .021) than those who underwent splint therapy (p = .009). Overall, half of the patients showed overall improvement in their TMD symptoms from the treatment combinations. CONCLUSION Despite several treatment modalities, only half of the patients showed improvement in their symptoms in the present study. A standardised assessment method encompassing all factors contributing to bruxism behaviours and their consequences is suggested.
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Affiliation(s)
- Laura Nykänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Head and Neck Center, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Antti Kämppi
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Head and Neck Center, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
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8
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Bracci A, Lobbezoo F, Colonna A, Bender S, Conti PCR, Emodi-Perlman A, Häggman-Henrikson B, Klasser GD, Michelotti A, Lavigne GJ, Svensson P, Ahlberg J, Manfredini D. Research routes on awake bruxism metrics: Implications of the updated bruxism definition and evaluation strategies. J Oral Rehabil 2024; 51:150-161. [PMID: 37191494 DOI: 10.1111/joor.13514] [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] [Received: 03/19/2023] [Accepted: 05/10/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND With time, due to the poor knowledge on it epidemiology, the need to focus on awake bruxism as a complement of sleep studies emerged. OBJECTIVE In line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, that is better assessment and more efficient management. METHODS We summarised current strategies for AB assessment and proposed a research route for improving its metrics. RESULTS Most of the literature focuses on bruxism in general or SB in particular, whilst knowledge on AB is generally fragmental. Assessment can be based on non-instrumental or instrumental approaches. The former include self-report (questionnaires, oral history) and clinical examination, whilst the latter include electromyography (EMG) of jaw muscles during wakefulness as well as the technology-enhanced ecological momentary assesment (EMA). Phenotyping of different AB activities should be the target of a research task force. In the absence of available data on the frequency and intensity of wake-time bruxism-type masticatory muscle activity, any speculation about the identification of thresholds and criteria to identify bruxers is premature. Research routes in the field must focus on the improvement of data reliability and validity. CONCLUSIONS Probing deeper into the study of AB metrics is a fundamental step to assist clinicians in preventing and managing the putative consequences at the individual level. The present manuscript proposes some possible research routes to advance current knowledge. At different levels, instrumentally based and subject-based information must be gathered in a universally accepted standardised approach.
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Affiliation(s)
- Alessandro Bracci
- Department of Neuroscience, School of Dentistry, University of Padova, Padova, Italy
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anna Colonna
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Steven Bender
- Department of Oral and Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, Texas, USA
| | - Paulo C R Conti
- Bauru School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Telaviv, Israel
| | | | - Gary D Klasser
- Department of Diagnostic Sciences, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Ambra Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Gilles J Lavigne
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, and Universite de Montreal, Montreal, Quebec, Canada
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
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Manfredini D, Ahlberg J, Aarab G, Bracci A, Durham J, Emodi-Perlman A, Ettlin D, Gallo LM, Häggman-Henrikson B, Koutris M, Peroz I, Svensson P, Wetselaar P, Lobbezoo F. The development of the Standardised Tool for the Assessment of Bruxism (STAB): An international road map. J Oral Rehabil 2024; 51:15-28. [PMID: 36261916 DOI: 10.1111/joor.13380] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 11/26/2022]
Abstract
This paper summarises the background reasoning and work that led to the selection of the items included in the Standardised Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on-field comprehension. The underlying premise is that the different motor activities included in the bruxism spectrum (e.g. clenching vs. grinding, with or without teeth contact) potentially need to be discriminated from each other, based on their purportedly different aetiology, comorbidities and potential consequences. Focus should be on a valid impression of the activities' frequency, intensity and duration. The methods that can be used for the above purposes can be grouped into strategies that collect information from the patient's history (subject-based), from the clinical assessment performed by an examiner (clinically based) or from the use of instruments to measure certain outcomes (instrumentally based). The three strategies can apply to all aspects of bruxism (i.e. status, comorbid conditions, aetiology and consequences). The STAB will help gathering information on many aspects, factors and conditions that are currently poorly investigated in the field of bruxism. To this purpose, it is divided into two axes. Axis A includes the self-reported information on bruxism status and potential consequences (subject-based report) together with the clinical (examiner report) and instrumental assessment (technology report). Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid role for bruxism. This comprehensive multidimensional assessment system will allow building predictive model for clinical and research purposes.
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Affiliation(s)
- Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Justin Durham
- Newcastle University's School of Dental Sciences, Newcastle, UK
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dominik Ettlin
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Birgitta Häggman-Henrikson
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden
- Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingrid Peroz
- Department for Prosthodontics, Charité-University Medicine of Berlin, Charité Centre for Dentistry, Gerodontology and Craniomandibular Disorders, Berlin, Germany
| | - Peter Svensson
- Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Peter Wetselaar
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - 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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10
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Nykänen L, Manfredini D, Lobbezoo F, Kämppi A, Bracci A, Ahlberg J. Assessment of awake bruxism by a novel bruxism screener and ecological momentary assessment among patients with masticatory muscle myalgia and healthy controls. J Oral Rehabil 2024; 51:162-169. [PMID: 37036436 DOI: 10.1111/joor.13462] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/20/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Bruxism is a masticatory muscle activity occurring during sleep or wakefulness, involving grinding and clenching of teeth and/or jaw bracing. As yet, the aetiology, epidemiology and consequences of awake bruxism (AB) are largely unknown. OBJECTIVES The aims of the study were to AB behaviours using a novel bruxism screener (BruxScreen) questionnaire part and Ecological Momentary Assessment (EMA; BruxApp©) on AB behaviours, and to investigate AB's prevalence among masticatory muscle myalgia patients and non-patients. METHODS Altogether, 115 participants (masticatory myalgia patients referred to a specialist clinic (n = 67) and non-patients (n = 46)) filled in a bruxism screener questionnaire to report bruxism behaviours and jaw symptoms. A selection of both groups did a week-long EMA (patients n = 12, non-patients n = 11) to report AB behaviours. The chi-squared test was used to determine group differences in categorical variables. A logistic regression model was fitted to study the probability of AB. RESULTS According to BruxScreen, bruxism behaviours and jaw symptoms were more frequent in patients than in non-patients (p < .001). Based on EMA, 14.6% of the behaviour in patients was tooth clenching; for non-patients, this was 0.5% (p < .000). Relaxed muscles were reported by patients and non-patients at 20.6% and 56.4%, respectively (p < .021). Logistic regression, adjusted by age and sex, revealed that patients reported AB 5 times more often than non-patients (OR 4.8, 95% CI 2.1-11.2). CONCLUSION Awake bruxism behaviours are significantly more frequent in masticatory muscle myalgia patients than non-patients and associate with frequent bruxism-related symptoms. Self-reported teeth clenching seems to be the most significant sign of AB behaviour.
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Affiliation(s)
- Laura Nykänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Antti Kämppi
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | | | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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11
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Archer AB, Da-Cas CD, Valesan LF, Cunha TCA, Januzzi E, Garanhani RR, de La Torre Canales G, de Souza BDM. Prevalence of awake bruxism in the adult population: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:7007-7018. [PMID: 37853263 DOI: 10.1007/s00784-023-05302-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/02/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES To evaluate the prevalence of awake bruxism (AB) in the adult population. MATERIALS AND METHODS Six main electronic databases and three sources of grey literature were searched to identify cross-sectional studies in which AB was assessed. The studies were independently selected by two reviewers in two phases, based on their eligibility criteria. The first one consisted of reading titles and abstracts, and the second one involved reading the full articles. The study quality assessment was obtained by using the "Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data", and the "R Statistics" software was used to perform meta-analyses. RESULTS Seventeen out of 3086 identified studies were included. None of the studies scored high in methodological quality across all 9 items of the JBI checklist. However, "the use of valid methods to identify pathology" and "appropriate statistical analysis" were considered to have high methodological quality in all the studies. The overall pooled prevalence of the meta-analysis was 15.44% (99% confidence interval: 10.81 to 20.72%) and there was no difference for sex, sampling method and according to consensus-based classification. CONCLUSIONS The prevalence of AB in adults was low. There was substantial methodological variability, which highlights the need for standardized guidelines. CLINICAL RELEVANCE Prevalence data are useful for raising patients' and clinicians' awareness of the AB. Moreover, since AB can lead to possible pain and overload of the stomatognathic system, this knowledge can also guide dentists to achieve an early diagnosis of AB and to provide appropriate care management.
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Affiliation(s)
- Adriana Battisti Archer
- Postgraduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, S/N - Trindade, Florianópolis, SC, 88040-900, Brazil.
| | - Cecília Doebber Da-Cas
- Postgraduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, S/N - Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Lígia Figueiredo Valesan
- Postgraduate Program in Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, S/N - Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Thays Crosara Abrahão Cunha
- Federal University of Uberlândia, Av. João Naves de Ávila, 2121 - Santa Mônica, Uberlândia, MG, 38408-100, Brazil
| | - Eduardo Januzzi
- Orofacial Pain Center, Hospital Mater Dei (HMD), Av. Gonçalves Dias, 2.700 - Santo Agostinho, Belo Horizonte, MG, 30190-094, Brazil
| | - Roberto Ramos Garanhani
- Zenith Specialization School, Av. Trompowsky, 354 - 1 - Centro, Florianópolis, SC, 88015-300, Brazil
| | - Giancarlo de La Torre Canales
- Egas Moniz Center for Interdisciplinary Research (CiiEM); Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Beatriz Dulcineia Mendes de Souza
- Department of Dentistry, Federal University of Santa Catarina (UFSC), Av. Delfino Conti, S/N - Trindade, Florianópolis, SC, 88040-900, Brazil
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12
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Vlăduțu DE, Ionescu M, Mercuț R, Noveri L, Lăzărescu G, Popescu SM, Scrieciu M, Manolea HO, Iacov Crăițoiu MM, Ionescu AG, Mercuț V. Ecological Momentary Assessment of Masseter Muscle Activity in Patients with Bruxism. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010581. [PMID: 36612902 PMCID: PMC9819829 DOI: 10.3390/ijerph20010581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 05/31/2023]
Abstract
According to the International Bruxism Consensus, bruxism refers to the activity of the masticatory muscles reflecting contraction disorders, regardless of whether it is during sleep (SB) or an awake (AB) state. The objective of the present study was to evaluate the activity of the masseter muscle by surface electromyographic (sEMG) recordings. This study was performed on 20 participants with self-reported “possible bruxism” (study group) and 20 participants with no self-reported bruxism (control group); all participants underwent an evaluation of the masseter muscle activity using the dia-BRUXO device, which provides numerical parameters regarding sEMG (the total duration and the type of bruxism specific events, the effort made by the masticatory muscles during the recording period, and the personal bruxism index of each participant). Participants from the study group presented more clenching events during AB, three times more frequent than the control group (p = 0.002, Mann−Whitney U test); for SB, the frequency of clenching and grinding events was comparable within the study group, being more frequent than for the control group; the mean value of the effort index was higher for AB (1.177%) than SB (0.470%) and the same for the duration index, with a mean value of 2.788% for AB and 1.054% for SB. All participants from the control group presented reduced values for all acquired parameters. Overall, the personal bruxism index in AB was approximately four times higher for the study group (2.251%) compared to the control group (0.585%) (p < 0.005, Mann−Whitney U test). Similar values were obtained for SB. All participants with “possible bruxism” from the study group presented a higher activity of the masseter muscle, which is specific for bruxism, thus being defined as “definite bruxism”.
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Affiliation(s)
- Diana Elena Vlăduțu
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Răzvan Mercuț
- Department of Plastic Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Grigore Lăzărescu
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Sanda Mihaela Popescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Monica Scrieciu
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Horia Octavian Manolea
- Department of Dental Materials, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Alin Gabriel Ionescu
- Department of Medical History, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Veronica Mercuț
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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13
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Comparison between Ecological Momentary Assessment and Questionnaire for Assessing the Frequency of Waking-Time Non-Functional Oral Behaviours. J Clin Med 2022; 11:jcm11195880. [PMID: 36233747 PMCID: PMC9570611 DOI: 10.3390/jcm11195880] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022] Open
Abstract
Over the years, several tools have been proposed to measure oral behaviours (OB). Recently, a smartphone-based application for ecological momentary assessment (EMA) has been introduced to collect real-time data on waking-time OB. The aim of this study was to compare the self-reported frequency of OB by means of a standardised questionnaire with that recorded with a smartphone-based application for EMA. A total of 151 participants, recruited from the general population, were invited to fill in the Oral Behaviour Checklist (OBC). Scores for four questions concerning grinding, clenching, tooth contact, and mandible bracing were computed. Afterwards, participants were provided with a smartphone application for prolonged real-time reporting of OB. One-way analysis of variance (ANOVA) and a general linear mixed model (GLMM) were used to compare the responses to each OBC question with the frequencies of the same condition recorded with the EMA. Results showed significant association between OBC responses and the EMA recordings. In particular, increased frequencies of clenching, grinding, and teeth contact were recorded by individuals who provided higher OBC scores. On the other hand, a nonlinear association was observed for “mandible bracing”, pointing out difficulties in the comprehension of this condition.
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14
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Bracci A, Lobbezoo F, Häggman-Henrikson B, Colonna A, Nykänen L, Pollis M, Ahlberg J, Manfredini D. Current Knowledge and Future Perspectives on Awake Bruxism Assessment: Expert Consensus Recommendations. J Clin Med 2022; 11:5083. [PMID: 36079013 PMCID: PMC9457508 DOI: 10.3390/jcm11175083] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 12/14/2022] Open
Abstract
Awake bruxism (AB) is differentiated from sleep bruxism (SB) by the differences in etiology, comorbidities, and consequences related to the different spectrum of muscle activities exerted in relation to the different circadian manifestations. Furthermore, less literature data are available on AB than on SB. The introduction of ecological momentary assessment (EMA) strategies has allowed for collecting valuable data on the frequency of the different activities reported by an individual in his/her natural environment. This strategy has been further improved with the recent use of smartphone technologies. Recent studies have described an average frequency of AB behaviors, within the range of 23-40% for otherwise healthy young adults. An association between AB and some psychological traits has emerged, and the findings have indicated that patients with musculoskeletal symptoms (e.g., temporomandibular joint and/or muscle pain, muscle stiffness, and fatigue) report higher AB frequencies. Preliminary data suggest that muscle bracing and teeth contact are the most commonly reported behaviors, while teeth clenching is much less frequently reported than commonly believed previously. Report of teeth grinding during wakefulness is almost absent. This paper has critically reviewed the currently available approaches for the assessment of AB. In addition, some future perspectives and suggestions for further research have been provided.
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Affiliation(s)
- Alessandro Bracci
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Birgitta Häggman-Henrikson
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, 20506 Malmö, Sweden
| | - Anna Colonna
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
| | - Laura Nykänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00100 Helsinki, Finland
| | - Matteo Pollis
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00100 Helsinki, Finland
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
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Szyszka-Sommerfeld L, Sycińska-Dziarnowska M, Budzyńska A, Woźniak K. Accuracy of Surface Electromyography in the Diagnosis of Pain-Related Temporomandibular Disorders in Children with Awake Bruxism. J Clin Med 2022; 11:1323. [PMID: 35268414 PMCID: PMC8911396 DOI: 10.3390/jcm11051323] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/20/2022] [Accepted: 02/26/2022] [Indexed: 12/27/2022] Open
Abstract
The study assessed masticatory muscle electromyographic (EMG) activity in both children diagnosed with pain-related temporomandibular disorders (TMD-P) and awake bruxism (AB) and in children without TMD, as well as the diagnostic value of surface electromyography (sEMG) in diagnosing TMD-P in subjects with AB. After evaluation based on the Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), 30 children diagnosed with myofascial pain were included in the myofascial pain group and 30 children without TMD diagnosis comprised the control group (mean age of 9.49 ± 1.34 years). The activity of the anterior temporal (TA) and masseter (MM) muscle was assessed bilaterally using a DAB-Bluetooth device (zebris Medical GmBH, Germany) at rest and during maximum voluntary clenching (MVC). The receiver operating characteristic (ROC) curve was used to determine the accuracy, sensitivity, and specificity of the normalized sEMG data. Statistically significant intergroup differences were observed in TA and MM muscle EMG activity at rest and during MVC. Moderate degree of sEMG accuracy in discriminating between TMD-P and non-TMD children was observed for TAmean, left MM, and MMmean EMG muscle activity at rest. sEMG can be a useful tool in assessing myofascial TMD pain in patients with AB.
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Affiliation(s)
- Liliana Szyszka-Sommerfeld
- Department of Orthodontics, Pomeranian Medical University in Szczecin, Al. Powst. Wlkp. 72, 70-111 Szczecin, Poland; (M.S.-D.); (A.B.); (K.W.)
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16
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Emodi-Perlman A, Manfredini D, Shalev T, Bracci A, Frideman-Rubin P, Eli I. Psychosocial and Behavioral Factors in Awake Bruxism-Self-Report versus Ecological Momentary Assessment. J Clin Med 2021; 10:jcm10194447. [PMID: 34640465 PMCID: PMC8509197 DOI: 10.3390/jcm10194447] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 12/28/2022] Open
Abstract
The issue of psychosocial factors and concurrent conditions associated with AB is a relatively new approach in the study of Awake Bruxism (AB). In the present study a population of 84 dental students were assessed for probable AB with two modes of AB assessment: Single point self-report (SR) and ecological momentary assessment through a designated smartphone application (BA). The two assessment modes were compared with regard to their ability to phenotype subjects as far as the following psychosocial and behavioral variables are concerned: Gender; depression; somatization; oral behaviors; chronic pain and associated pain symptoms in the head, neck and scapula. Two-way ANOVA showed main effect of SR for the following variables: Chronic Pain Intensity score (F(1,49) = 6.441, p < 0.02), migraine/headache (F(1,81) = 7.396, p < 0.01), pain in neck (F(1,81) = 6.726, p < 0.05), pain in scapula (F(1,81) = 8.546, p < 0.005) and the oral behaviors of pushing the tongue forcefully against the teeth (F(1,81) = 5.222, p < 0.05) and inserting the tongue between the upper and lower teeth (F(1,81) = 5.344, p < 0.03). The effect of SR on the habit of chewing gum was borderline (F(1,81) = 3.369, p = 0.07). Main effect of BA was found for depression (F(1,81) = 6.049, p < 0.05), while the effect of BA on somatization was borderline (F(1,81) = 3.657, p = 0.059). An interaction between SR and BA groups could be observed for the behavior of biting, chewing or playing with the tongue, cheeks or lips (F(1,81) = 4.117, p < 0.05). The results suggest that a combination of a single-point self-report referring to the past 30 days, and an ecological momentary assessment supplying information about the actual timing of the report, can help us to better assess AB, as well as increase our ability to define the phenotype of subjects with AB as far as psychosocial and behavioral factors are concerned.
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Affiliation(s)
- Alona Emodi-Perlman
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6139001, Israel; (T.S.); (P.F.-R.); (I.E.)
- Correspondence:
| | - Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, 53100 Siena, Italy;
| | - Tamar Shalev
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6139001, Israel; (T.S.); (P.F.-R.); (I.E.)
| | | | - Pessia Frideman-Rubin
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6139001, Israel; (T.S.); (P.F.-R.); (I.E.)
| | - Ilana Eli
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv 6139001, Israel; (T.S.); (P.F.-R.); (I.E.)
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Dias R, Vaz R, Rodrigues MJ, Serra-Negra JM, Bracci A, Manfredini D. Utility of Smartphone-based real-time report (Ecological Momentary Assessment) in the assessment and monitoring of awake bruxism: A multiple-week interval study in a Portuguese population of university students. J Oral Rehabil 2021; 48:1307-1313. [PMID: 34536309 DOI: 10.1111/joor.13259] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE The Ecological Momentary Assessment (EMA) concept was the basis for developing a smartphone application for the on-time report of awake bruxism (AB) activities. This study aims to monitor AB report over time in a population of healthy young adults. METHODS A population of young adults recruited among dental students in good general health was recruited. All answered to a questionnaire, including the Oral Behavior Checklist (OBC-1). They were then monitored with a smartphone application for AB report during seven consecutive days and completed three further observation periods (EMA-1, 2 and 3) at one-month intervals. After the third period (EMA-3), participants answered again the OBC questionnaire (OBC-2). Changes over time were described, and Pearson Correlation test was performed to assess the correlation between EMA and OBC items reports. A significance level of p = .01 was set. RESULTS Thirty-one University students completed the study protocol. Answers to the OBC showed an increase in the prevalence of self-reported bracing and teeth clenching from the first to second report (38.7%-54.8% and 77.4%-90.3%, respectively). A slight increase in the 'relaxed' condition (62.5%-69.0%) was observed with EMA-based smartphone application over time. No correlation between OBC items and EMA was detected between OBC-1 and EMA-1. A moderate positive correlation in bracing report (+0.509, p = .01) and weak positive correlation in teeth contact report (+0.380, p = .05) were found between OBC-2 and EMA-3. CONCLUSION Using a smartphone-based approach to AB report may be helpful to monitor AB over time and increase an individual's awareness to recognise actions such as bracing and teeth contact concerning the single-time report.
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Affiliation(s)
- Ricardo Dias
- Institute of Oral Implantology and Prosthodontics, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Rui Vaz
- Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Maria João Rodrigues
- Institute of Orofacial Pain, Dentistry Department, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Júnia Maria Serra-Negra
- Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Pampulha, Belo Horizonte, Minas Gerais, Brazil
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