1
|
Manfredini D. The evolution of a field: A challenge and an opportunity. Cranio 2024; 42:251-252. [PMID: 38409867 DOI: 10.1080/08869634.2024.2320624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Affiliation(s)
- Daniele Manfredini
- Editor-in-ChiefOrofacial Pain Unit, School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| |
Collapse
|
2
|
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. [PMID: 38606658 DOI: 10.1111/joor.13695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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.
Collapse
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
| | | | | |
Collapse
|
3
|
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] [What about the content of this article? (0)] [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.
Collapse
|
4
|
Ferrari-Cagidiaco E, Verniani G, Keeling A, Zarone F, Sorrentino R, Manfredini D, Ferrari M. A randomized controlled clinical trial on press and block lithium disilicate partial crowns: A 4-year recall. Am J Dent 2024; 37:85-90. [PMID: 38704851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
PURPOSE To evaluate clinical performances of two lithium disilicate systems (Initial LiSi press vs Initial LiSi Block, GC Co.) using modified United States Public Health Service (USPHS) evaluation criteria and survival rates after 4 years of clinical service. METHODS Partial adhesive crowns on natural abutment posterior teeth were made on 60 subjects who were randomly divided into two groups: Group 1: Initial LiSi press and Group 2: Initial LiSi Block. Fabrication of partial crowns was made with full analog and digital procedure in Groups 1 and 2 respectively. The restorations were followed-up for 1 and 4 years, and the modified USPHS evaluation was performed at baseline and each recall together with periodontal evaluation. Contingency tables to assess for significant differences of success over time in each group and time-dependent Cox regression to test for differences between the two groups were used and the level of significance was set at P< 0.05. RESULTS Regarding modified USPHS scores, all evaluated parameters showed Alpha or Bravo and no Charlie was recorded. No statistically significant difference emerged between the two groups in any of the assessed variables (P> 0.05). No statistically significant difference between scores recorded at the baseline and each recall. All modified USPHS scores were compatible with the outcome of clinical success and no one restoration was replaced or repaired, and the survival rate was 100% after 4 years of clinical service. No difference was found between traditional and digital procedure to fabricate the crowns. The two lithium disilicate materials showed similar results after 4 years of clinical service. CLINICAL SIGNIFICANCE The crowns made with the two tested lithium disilicate materials with analog and digital procedures showed 100% survival after 4 years of clinical service with no statistically significant difference using the modified USPHS scores.
Collapse
Affiliation(s)
| | - Giulia Verniani
- Department of Prosthodontics and Biomaterials, University of Siena, Siena, Italy
| | - Andrew Keeling
- Department of Digital Prosthodontics, University of Leeds, Leeds, United Kingdom
| | - Ferdinando Zarone
- Department of Digital Prosthodontics, University Federico II, Naples, Italy
| | - Roberto Sorrentino
- Department of Digital Prosthodontics, University Federico II, Naples, Italy
| | | | - Marco Ferrari
- Department Prosthodontics and Biomaterials, University of Siena, Siena, Italy,
| |
Collapse
|
5
|
Manfredini D, Ahlberg J, Lavigne GJ, Svensson P, Lobbezoo F. Five years after the 2018 consensus definitions of sleep and awake bruxism: An explanatory note. J Oral Rehabil 2024; 51:623-624. [PMID: 37994212 DOI: 10.1111/joor.13626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/31/2023] [Indexed: 11/24/2023]
Affiliation(s)
- Daniele Manfredini
- Department of Medical Biotechnologies, School of Dentistry, University of Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Gilles J Lavigne
- Faculty of Dental Medicine, Center for Advance Research in Sleep Medicine, Université de Montréal & CIUSSS Nord Ile de Montréal, Montréal, Québec, Canada
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
6
|
Lobbezoo F, Ahlberg J, Verhoeff MC, Bracci A, Nykänen L, Manfredini D. Translation and cultural adaptation of the Standardized Tool for the Assessment of Bruxism (STAB) and the Bruxism Screener (BruxScreen): A 12-step guideline. J Oral Rehabil 2024; 51:67-73. [PMID: 37749858 DOI: 10.1111/joor.13602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/19/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Recently, the Standardized Tool for the Assessment of Bruxism (STAB) and the bruxism screener (BruxScreen) have been developed for use in research and clinical settings. OBJECTIVE As to ascertain high-quality use of both instruments worldwide, it was our aim to develop a guideline for the translation and cultural adaptation of the STAB and the BruxScreen. METHODS AND RESULTS This paper describes a 12-step guideline for the translation and cultural adaptation of the STAB and the BruxScreen. A format of a translation log is provided as well. Besides, a website has been created for the guidance of translation teams. CONCLUSION Following the 12 steps, new language versions of the STAB and the BruxScreen will be ready for further testing (reliability, validity, responsiveness and interpretability) and, ultimately, application in research and clinics around the world.
Collapse
Affiliation(s)
- Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Merel C Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Alessandro Bracci
- Department of Neurosciences, School of Dentistry, University of Padova, Padova, Italy
| | - Laura Nykänen
- 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
| |
Collapse
|
7
|
Lobbezoo F, Ahlberg J, Verhoeff MC, Aarab G, Bracci A, Koutris M, Nykänen L, Thymi M, Wetselaar P, Manfredini D. The bruxism screener (BruxScreen): Development, pilot testing and face validity. J Oral Rehabil 2024; 51:59-66. [PMID: 36843424 DOI: 10.1111/joor.13442] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/12/2023] [Accepted: 02/20/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND To assess awake and sleep bruxism, the Standardised Tool for the Assessment of Bruxism (STAB) is currently being developed. The STAB will be a comprehensive tool for the detailed assessment of bruxism behaviour itself as well as of its possible consequences, causes, and comorbid conditions. OBJECTIVE Since the STAB cannot fully meet the 'A4 principle' for a bruxism assessment tool, i.e., being Accurate (reliable and valid), Applicable (feasible), Affordable (cost-effective), and Accessible (suitable for everyday clinical use), the Bruxism Screener (BruxScreen) has been developed to be used in large-scale epidemiological research projects and, especially, in general, dental practices. METHODS The BruxScreen consists of two parts: a questionnaire (BruxScreen-Q) to be completed by patients, and a clinical assessment form (BruxScreen-C) to be completed by dentists. RESULTS This paper describes the development of the BruxScreen and provides the outcomes of the pilot testing phase and the face validity assessment (i.e. that the first impressions of the tool indicate that it adequately reflects the construct to be measured). CONCLUSION The resulting BruxScreen is considered ready for more profound psychometric testing in the general dental setting.
Collapse
Affiliation(s)
- Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Merel C Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Alessandro Bracci
- School of Dentistry, Department of Neurosciences, University of Padova, Padova, Italy
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura Nykänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Magdalini Thymi
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Peter Wetselaar
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| |
Collapse
|
8
|
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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
|
9
|
Stanisic N, Do CT, Skarping S, Chrcanovic B, Bracci A, Manfredini D, Häggman-Henrikson B. Smartphone application to report awake bruxism: Development and testing of the Swedish version and a pilot study to evaluate family history in young adults and their parents. J Oral Rehabil 2024; 51:188-195. [PMID: 37210658 DOI: 10.1111/joor.13515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 04/24/2023] [Accepted: 05/14/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Together with psychosocial and hereditary factors, bruxism is a possible risk factor for orofacial pain. Bruxism is defined as a masticatory muscle activity characterized by repetitive or sustained tooth contact, or by bracing or thrusting of the mandible. A smartphone application to report awake bruxism (AB) has been developed and translated into more than 25 languages. OBJECTIVE(S) To translate the application into Swedish, adapt it to Swedish culture and conduct a study to evaluate the usability of the application for studies on family history and associated risk factors. METHODS Translation and cultural adaption of the Swedish version of the application (BruxApp) was carried out in a four-step sequential process. Ten young adults (22-30 years) were recruited together with ten parents (42-67 years) and reported their AB with the application over two seven-day periods. Pain, stress and parafunctional behaviours were assessed by questionnaires. RESULTS The back translation check showed minimal discrepancies between the translation and the English version. Participants did not report any problems with the application. Response rates for both groups were 65%. A difference in frequency of AB was shown between young adults and parents (22.0% vs. 12.5%, p < .001). A positive moderate correlation was found between AB and stress (r = 0.54, p = .017). CONCLUSION The use of application strategies enables data collection on AB which can be used in both clinical and research settings. The results suggest that the Swedish version is ready for implementation and for studies on the relationships between AB, family history and psychosocial factors.
Collapse
Affiliation(s)
- Nikola Stanisic
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden
- Folktandvården Skåne AB, Lund, Sweden
| | - Cam Tu Do
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden
| | - Sandra Skarping
- Department of Orofacial Pain and Jaw Function, Malmö University, Malmö, Sweden
| | | | | | | | | |
Collapse
|
10
|
Carboncini F, Landi M, Rossit M, Saracutu OI, Ferrari M, Manfredini D. Chewing performance of patients with worn dentition before and after restorations: A scoping review. J Oral Rehabil 2024; 51:218-225. [PMID: 37370261 DOI: 10.1111/joor.13549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/22/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Tooth wear is a multifactorial complex process related to the loss of dental tissue, due to chemical or mechanical processes, by abrasion, attrition, erosion. Restorative treatment represents an attempt to rebuild and recreate the lost structure. OBJECTIVE This scoping review aims to investigate whether restorative treatment of worn dentition (either with direct or indirect adhesive composite adhesive procedures or with prosthetic techniques) can have an impact on the masticatory performance parameters. METHODS A scoping review was conducted on multiple databases (Pubmed, Medline CENTRAL, ICTRP), following the PRISMA guidelines. Abstracts of research papers were screened for suitability, and full-text articles were obtained for those who satisfied the inclusion and exclusion criteria. RESULTS Only one article meet the inclusion criteria of the review. Restorative treatment of worn dentition although have a positive impact on the self-report ability to chew, has no effect on the masticatory performance test. CONCLUSION At the moment, not enough evidence to comment on the actual therapeutic role of restorative treatment on tooth wear is available. Clinicians, before taking any clinical decision, should carefully discuss with patients the needs and expectations of the treatment plan.
Collapse
Affiliation(s)
- Fabio Carboncini
- School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Matteo Landi
- School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marco Rossit
- School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Ovidiu Ionut Saracutu
- School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marco Ferrari
- School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Daniele Manfredini
- School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| |
Collapse
|
11
|
Poggio CE, Manfredini D. Does increasing vertical dimension of occlusion in centric relation affect muscular activity? An electromyographic study. J ESTHET RESTOR DENT 2024; 36:231-238. [PMID: 38108570 DOI: 10.1111/jerd.13186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE In many esthetic treatments, clinicians may consider the option to modify the maxillo mandibular position. A raise of the vertical dimension of occlusion (VDO) may help restore esthetics, increase the space for dental materials, and reduce the invasiveness of dental procedures. Traditionally, VDO increases are done by using the centric relation (CR) position. Despite a long history of use, the neuromuscular effects of different maxillo mandibular relations are not fully studied. The aim of this study was to investigate the effect of alterations of maxillo-mandibular relation from maximal intercuspal position (MIP) to a raised VDO CR position on jaw-elevator muscle activity. MATERIALS AND METHODS Fifteen healthy individuals were asked to carry out maximal voluntary clenching (MVC) in MIP and in CR on individual splints. Electromyographic (EMG) activity of the masseter and anterior temporalis muscles was assessed in μV as the root mean square of the amplitude. Specific indexes and ratios were also computed. Data analyzed in MIP and CR were compared by paired student's t-tests. RESULTS MVC levels were not negatively affected by a VDO increase in CR position. On the contrary masseter muscles showed a statistically significant increase (p < 0.005). No significant effect on the anterior temporalis was observed. CONCLUSION These results suggest that no immediate negative effect on maximum voluntary clenching was induced by a VDO increase in CR position. A slight increase observed in EMG clenching levels could be explained by the increase in VDO when clenching on the splint. CLINICAL IMPLICATIONS The results of this study support the use of CR position as a pragmatic reference position due to the absence of relevant or negative changes in neuromuscular function.
Collapse
Affiliation(s)
- Carlo E Poggio
- Eastman Institute of Oral Health, University of Rochester, New York, USA
- Studio Poggio, Private Practice, Milan, Italy
| | - Daniele Manfredini
- Orofacial Pain Unit, School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| |
Collapse
|
12
|
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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
13
|
Manfredini D, Ahlberg J, Aarab G, Bender S, Bracci A, Cistulli PA, Conti PC, De Leeuw R, Durham J, Emodi-Perlman A, Ettlin D, Gallo LM, Häggman-Henrikson B, Hublin C, Kato T, Klasser G, Koutris M, Lavigne GJ, Paesani D, Peroz I, Svensson P, Wetselaar P, Lobbezoo F. Standardised Tool for the Assessment of Bruxism. J Oral Rehabil 2024; 51:29-58. [PMID: 36597658 DOI: 10.1111/joor.13411] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/06/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. METHODS The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications. RESULTS The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration. CONCLUSIONS The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields.
Collapse
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
| | - Steven Bender
- Department of Oral and Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, Texas, USA
| | | | - Peter A Cistulli
- Sleep Research Group, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Respiratory & Sleep Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | | | - Reny De Leeuw
- Department of Oral Health Science, Orofacial Pain Center, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - 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
| | | | | | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Gary Klasser
- Department of Diagnostic Sciences, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gilles J Lavigne
- Faculty of Dental Medicine, Universite de Montréal, Quebec, Montréal, Canada
| | - Daniel Paesani
- School of Dentistry, University of Salvador/AOA, Buenos Aires, Argentina
| | - Ingrid Peroz
- Department for Prosthodontics, Gerodontology and Craniomandibular Disorders, Charité Centre for Oral Sciences, Charité - University Medicine of Berlin, 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
| |
Collapse
|
14
|
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: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
15
|
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: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
16
|
Lobbezoo F, Ahlberg J, Manfredini D. The advancement of a discipline: The past, present and future of bruxism research. J Oral Rehabil 2024; 51:1-4. [PMID: 37458517 DOI: 10.1111/joor.13562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (AC-TA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - 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
| |
Collapse
|
17
|
Ahlberg J, Lobbezoo F, Manfredini D, Piirtola M, Hublin C, Kaprio J. Self-reported sleep bruxism and mortality in 1990-2020 in a nationwide twin cohort. J Oral Rehabil 2024; 51:125-130. [PMID: 36840364 DOI: 10.1111/joor.13441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 01/18/2023] [Accepted: 02/20/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND The association of sleep bruxism with mortality has not been studied. OBJECTIVES Altogether 12 040 subjects from the nationwide Finnish twin cohort were included in the analyses. We examined whether self-reported sleep bruxism is associated with increased risk of mortality, and if so, whether the effect is independent of known common risk factors. The time span of the follow-up was 30 years. METHODS Cox proportional hazards regression models (Hazard Ratios and their 95% Confidence Intervals) adjusted by age, sex and covariates were used to assess the effect of baseline bruxism status in 1990 on future mortality in 1990-2020. RESULTS The risk of mortality among all participants (n = 12 040), independent of missing covariates and adjusted by age and sex, was 40% higher in weekly bruxers than in never bruxers (HR 1.40, 95% CI 1.16-1.68, p < .001). However, when adjusted by all studied covariates, (n = 11 427) the risk was no longer observed (HR 1.04, 95% CI 0.86-1.25, p = .717). Despite the overall lack of between bruxism and mortality after adjustment for covariates, we examined the cause-specific risks for major cause-of-death groups. There were no substantial associations of weekly bruxism with major disease outcomes by the fully adjusted hazard ratios for them. CONCLUSION Bruxism does not kill-in line with its definition of being rather a behaviour (with all its phenotypes) than a disease.
Collapse
Affiliation(s)
- Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, and Helsinki University 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
| | - Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | - Maarit Piirtola
- Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
- UKK Institute for Health Promotion Research, Tampere, Finland
| | | | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, HiLIFE, University of Helsinki, Helsinki, Finland
| |
Collapse
|
18
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
19
|
Alessandri-Bonetti G, Incerti-Parenti S, Bartolucci ML, Bortolotti F, Stipa C, Manfredini D. Response to letter to the Editor: Look at the elephant! Commentary on 'Prevalence of temporomandibular disorders in adult obstructive sleep apnoea patients: A cross-sectional controlled study'. J Oral Rehabil 2023; 50:1371-1372. [PMID: 37654158 DOI: 10.1111/joor.13582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/02/2023]
Abstract
Obstructive sleep apnoea and temporomandibular disorders are complex pathologies. Considering dento-skeletal occlusion as their main predisposing factor could be detrimental for optimal patient care.
Collapse
Affiliation(s)
- Giulio Alessandri-Bonetti
- Section of Orthodontics and Dental Sleep Medicine, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Serena Incerti-Parenti
- Section of Orthodontics and Dental Sleep Medicine, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Maria Lavinia Bartolucci
- Section of Orthodontics and Dental Sleep Medicine, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Francesco Bortolotti
- Section of Orthodontics and Dental Sleep Medicine, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Chiara Stipa
- Section of Orthodontics and Dental Sleep Medicine, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Daniele Manfredini
- Orofacial Pain Unit, School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| |
Collapse
|
20
|
Manfredini D, Ercoli C, Poggio CE, Carboncini F, Ferrari M. Centric relation-A biological perspective of a technical concept. J Oral Rehabil 2023; 50:1355-1361. [PMID: 37394665 DOI: 10.1111/joor.13553] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Few terms and concepts have been so extensively debated in dentistry as the words 'centric relation' (CR). Debates involve its biological, diagnostic and therapeutic usefulness. METHODS A review of the literature on the current concepts on CR as a diagnostic or therapeutic aid in dentistry was provided. Clinical trials assessing the superiority of one CR recording method over the others to identify patients with temporomandibular disorders (diagnostic use) or to manage patients with prosthodontic or orthodontic needs (therapeutic use) were tentatively included. RESULTS Due to the absence of literature addressing either of the above targets, a comprehensive overview was provided. The diagnostic use of CR as a reference position to identify the correct position of the temporomandibular joint condyle within the glenoid fossa is not supported and lacks anatomical support. From a therapeutic standpoint, the use of CR can be pragmatically useful in prosthodontics as a maxillo-mandibular reference position when occlusal re-organization is warranted and/or when the position of maximum intercuspation is no longer available. CONCLUSIONS The derived occlusal goals from a diagnostic misuse of CR are generally the result of circular reasoning, that is a technique is based on the recording of a certain condylar position that is believed to be 'ideal' and the treatment is considered successful when such position is shown by the specific instrument that was manufactured for that purpose. The term 'Centric Relation' might be replaced with the term 'Maxillo-Mandibular Utility Position'.
Collapse
Affiliation(s)
- Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | - Carlo Ercoli
- Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
| | - Carlo E Poggio
- Eastman Institute of Oral Health, University of Rochester, Rochester, New York, USA
| | - Fabio Carboncini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | - Marco Ferrari
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| |
Collapse
|
21
|
Saracutu OI, Pollis M, Cagidiaco EF, Ferrari M, Manfredini D. Repeatability of Teethan® indexes analysis of the masseter and anterior temporalis muscles during maximum clenching: a pilot study. Clin Oral Investig 2023; 27:5309-5316. [PMID: 37507600 PMCID: PMC10492765 DOI: 10.1007/s00784-023-05150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVES The aim of this study is to assess the repeatability of a surface electromyographic (EMG) device (Teethan®, Teethan S.p.A., Milan, Italy), designed for the analysis of the masseter and anterior temporalis muscles. MATERIALS AND METHODS Tests were performed on a sample of 30 healthy fully dentate TMD-free individuals randomly selected. Each test consisted of two distinct recordings performed at 5-min intervals: (i) the patient is asked to clench with maximum voluntary contraction (MVC), with two cotton rolls interposed between the dental arches; (ii) the patient is asked to repeat the same clenching activity without the cotton rolls. The outcomes of the study were the EMG indices conceptualized by the manufacturing company, based on the differences between the two test conditions (i.e., clenching on cotton rolls and on dentition). Pairwise correlation analysis and ANOVA test were performed to assess the strength of correlation and the significance of differences between the results of the three trials. RESULTS Thirty TMD-free healthy individuals (20 females and 10 males; mean age 44 years, range 16-60 years) took part in the study. ANOVA test did not show any statistically significant difference between the three trials. The Global Index, which is the mean of the other EMG indices, showed the highest correlation values between the three trials, while some other indices showed a weak-to-medium correlation level. One out of five participants showed a coefficient of variation higher than 10%. CONCLUSIONS The statistical analysis showed that the indices provided by the device are quite repeatable. However, this does not necessarily imply a specific clinical application of the device, which was here used in fully controlled experimental conditions. CLINICAL RELEVANCE The clinical usefulness of the applied protocol remains questionable. Further studies should test the repeatability of EMG findings gathered with this device under various circumstances, in a more heterogeneous population.
Collapse
Affiliation(s)
- Ovidiu Ionut Saracutu
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy.
| | - Matteo Pollis
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| | - Edoardo Ferrari Cagidiaco
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| | - Marco Ferrari
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100, Siena, Italy
| |
Collapse
|
22
|
Val M, Delcanho R, Ferrari M, Guarda Nardini L, Manfredini D. Is Botulinum Toxin Effective in Treating Orofacial Neuropathic Pain Disorders? A Systematic Review. Toxins (Basel) 2023; 15:541. [PMID: 37755967 PMCID: PMC10535201 DOI: 10.3390/toxins15090541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The aim of this paper is to provide a systematic review of the literature regarding the clinical use of botulinum toxin (BTX) to treat various orofacial neuropathic pain disorders (NP). METHODS A comprehensive literature search was conducted using Medline, Web of Science, and the Cochrane Library databases. Only randomized clinical trials (RCT) published between 2003 and the end of June 2023, investigating the use of BTX to treat NP, were selected. PICO guidelines were used to select and tabulate the articles. RESULTS A total of 6 RCTs were selected. Five articles used BTX injections to treat classical trigeminal neuralgia, and one to treat post-herpetic neuralgia. A total of 795 patients received BTX injections. The selected studies utilised different doses and methods of injections and doses. All the selected studies concluded superiority of BTX injections over placebo for reducing pain levels, and 5 out 6 of them highlighted an improvement in the patient's quality of life. Most of the studies reported transient and mild side effects. CONCLUSION There is evidence of the efficacy of BTX injections in orofacial pain management. However, improved study protocols are required to provide direction for the clinical use of BTX to treat various orofacial neuropathic pain disorders.
Collapse
Affiliation(s)
- Matteo Val
- Department of Biomedical Technologies, School of Dental Medicine, University of Siena, 53100 Siena, Italy
| | - Robert Delcanho
- School of Dentistry, University of Western Australia, Perth 6009, Australia
| | - Marco Ferrari
- Department of Biomedical Technologies, School of Dental Medicine, University of Siena, 53100 Siena, Italy
| | - Luca Guarda Nardini
- Unit of Oral and Maxillofacial Surgery, Ca’Foncello Hospital, 31100 Treviso, Italy
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dental Medicine, University of Siena, 53100 Siena, Italy
| |
Collapse
|
23
|
Dibello V, Lobbezoo F, Sardone R, Lozupone M, Castellana F, Zupo R, Pilotto A, Daniele A, Solfrizzi V, Manfredini D, Panza F. The Relationship between Oral Health-Related Quality of Life and Body Mass Index in an Older Population from Southern Italy: The Salus in Apulia Study. J Pers Med 2023; 13:1300. [PMID: 37763068 PMCID: PMC10533155 DOI: 10.3390/jpm13091300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The assessment of oral health-related quality of life (OHRQoL) evaluated the impact of an individual's oral health on the patient's physical and psychosocial status. We evaluated the association between subjective OHRQoL, measured with the Oral Health Impact Profile-14 (OHIP-14) questionnaire, and unfavorable body mass index (BMI) (i.e., too high or too low) in a large population-based study on older adults from Southern Italy. Moreover, we assessed which of the seven OHIP-14 domains was the most strongly associated with an unfavorable BMI. METHODS We used data on a subpopulation of the Salus in Apulia Study, including 216 older adults. BMI < 18.4 kg/m2 and >30 kg/m2 were classified as unfavorable, while values between 18.5 and 30 kg/m2 were classified as ideal. RESULTS A higher OHIP-14 total score increased the risk of an unfavorable BMI (odds ratio (OR): 1.08, 95% confidence interval (CI): 1.01-1.15). In the model adjusted for age, sex, education, hypertension, carbohydrate consumption, and alcohol consumption, this finding was confirmed with a higher OHIP-14 total score increasing the risk of an unfavorable BMI (OR: 1.10, 95% CI: 1.01-1.22), and higher age linked to a decreased risk of an unfavorable BMI (OR: 0.89, 95% CI: 0.82-0.97). In a random forest regression model, the most important predictive domains/sub-scales of OHIP-14 in the mean decrease in the Gini coefficient for unfavorable BMI were, in order of decreasing importance, physical pain, functional limitation, psychological discomfort, physical disability, social disability, psychological disability, and handicap. CONCLUSIONS In older age, negative OHRQoL, particularly linked to the physical pain domain, increased the risk of being underweight or overweight and obesity.
Collapse
Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | | | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Fabio Castellana
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni”, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Roberta Zupo
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni”, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Alberto Pilotto
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni”, University of Bari Aldo Moro, 70124 Bari, Italy
- Geriatrics Unit, Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, 16128 Genoa, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, 00168 Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, 00168 Rome, Italy
| | - Vincenzo Solfrizzi
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni”, University of Bari Aldo Moro, 70124 Bari, Italy
| | - Daniele Manfredini
- Department of Prosthodontics and Dental Materials, University of Siena, 53100 Siena, Italy
| | - Francesco Panza
- Department of Interdisciplinary Medicine, Clinica Medica e Geriatria “Cesare Frugoni”, University of Bari Aldo Moro, 70124 Bari, Italy
| |
Collapse
|
24
|
Greene CS, Manfredini D. Overtreatment "Successes"--What Are the Negative Consequences for Patients, Dentists, and the Profession? J Oral Facial Pain Headache 2023; 37:81-90. [PMID: 37389835 PMCID: PMC10627200 DOI: 10.11607/ofph.3290] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
AIMS To describe how some management practices in the field of orofacial musculoskeletal disorders (also described as temporomandibular disorders [TMDs]) are based on concepts about occlusal relationships, condyle positions, or functional guidance; for some patients, these procedures may be producing successful outcomes in terms of symptom reduction, but in many cases, they can be examples of unnecessary overtreatment. METHODS The authors discuss the negative consequences of this type of overtreatment for both doctors and patients, as well as the impact on the dental profession itself. Special focus is given to trying to move the dental profession away from the old mechanical paradigms for treating TMDs and forward to the more modern (and generally more conservative) medically based approaches, with emphasis on the biopsychosocial model. RESULTS The clinical implications of such a discussion are apparent. For example, it can be argued that the routine use of Phase II dental or surgical treatments for managing most orofacial pain cases represents overtreatment, which cannot be defended on the grounds of symptom improvement (ie, "successful" outcomes) alone. Similarly, there is enough clinical evidence to conclude that complex biomechanical approaches focusing on the search for an ideal specific condylar or neuromuscular position for the management of orofacial musculoskeletal disorders are not needed to produce a positive clinical result that is stable over time. CONCLUSION Typically, overtreatment successes cannot be easily perceived by the patients or the treating dentists because the patients are satisfied and the dentists feel good about those outcomes. However, neither party knows whether an excessive amount of treatment has been provided. Therefore, both the practical and ethical aspects of this discussion about proper treatment vs overtreatment deserve attention.
Collapse
|
25
|
Manfredini D, Ionut Saracutu O, Ferrari Cagidiaco E, Ferrari M. EPA Consensus Project Paper: The Relationship Between Prosthodontic Rehabilitations and Temporomandibular Disorders. Eur J Prosthodont Restor Dent 2023. [PMID: 37265245 DOI: 10.1922/ejprd_2484manfredini05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/15/2023] [Indexed: 06/03/2023]
Abstract
AIM The aim of this systematic review is to evaluate the relationship between prosthodontic treatment and temporomandibular disorders (TMD). MATERIALS AND METHODS Two clinical questions have been raised. Can prosthodontic treatment be used as a strategy to manage temporomandibular disorders? Is there any causal relationship between prosthodontic rehabilitation and the onset of TMD? A systematic search was performed in four medical databases to identify Clinical Trials (CT) and Randomized Clinical Trials (RCT) that could answer the two clinical questions. RESULTS Any articles fulfilling the inclusion criteria were found. Therefore, the best available evidence on TMD management and aetiology is discussed in a scoping review with focus on the relationship with prosthodontic treatment. CONCLUSIONS Based on current scientific evidence, prosthetic rehabilitation cannot be proposed as a treatment option for TMD patients, based on the effectiveness of other more conservative options as well as the absence of association between features of dental occlusion and TMD. Thanks to the high neuro plastic adaptation skills of the stomatognathic system, prosthodontic rehabilitation cannot be identified as a direct cause of TMD, but clinicians should pay caution when performing relevant occlusal modifications.
Collapse
Affiliation(s)
- D Manfredini
- School of Dentistry, Department of Medical Biotechnology, University of Siena, Siena. Italy
| | - O Ionut Saracutu
- School of Dentistry, Department of Medical Biotechnology, University of Siena, Siena. Italy
| | - E Ferrari Cagidiaco
- School of Dentistry, Department of Medical Biotechnology, University of Siena, Siena. Italy
| | - M Ferrari
- School of Dentistry, Department of Medical Biotechnology, University of Siena, Siena. Italy
| |
Collapse
|
26
|
Pontoriero DIK, Ferrari Cagidiaco E, Maccagnola V, Manfredini D, Ferrari M. Outcomes of Endodontic-Treated Teeth Obturated with Bioceramic Sealers in Combination with Warm Gutta-Percha Obturation Techniques: A Prospective Clinical Study. J Clin Med 2023; 12:jcm12082867. [PMID: 37109206 PMCID: PMC10143487 DOI: 10.3390/jcm12082867] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/30/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
The objective of this clinical study was to collect short-term endodontic outcomes of endodontic-treated teeth (ETT) obturated with different kinds of bioceramic sealers used in combination with warm gutta-percha obturation techniques. Methods: A total of 210 endodontic treatments in 168 patients were performed. At baseline, 155 sample teeth (73.8%) showed symptoms (tenderness or pain to percussion) and 125 (59.5%) showed periapical radiolucency. Periapical radiolucency was present in 125 cases (59.5%); of these, 79 showed a lesion of 5 mm or bigger (63.2%) while lower than 5 mm in 46 cases (36.8%). Regarding ETT with radiolucency, 105 of them (84%) were in coincidence with their need for retreatment and the other 20 (16%) were necrotic teeth. The obturation techniques that were used in this study were: the continuous wave of condensation technique in 75% of cases, and carrier-based technique in 25%. Four bioceramic sealers were used: CeraSeal in 115 cases, BioRoot in 35 cases, AH Plus Bio in 40 cases, and in 20 cases, BIO-C SEALER ION. Preoperative and recall radiographs of the roots were each assigned a periapical index (PAI) score by 2 blinded, independent, and calibrated examiners. The teeth were divided into outcome categories based on the following classification: healed, unhealed, and healing. The healed and healing categories were classified as success, and the unhealed category was classified as failure on the basis of loose criteria. Minimum follow-up period was 18 months. Results: The overall success rate was 99%, with 73.3% healed, 25.7% healing, and 0.95% not healed. The success rate was 100% for initial treatment and 98.2% for retreatment. Fifty-four (N = 54) teeth showed ongoing healing. All of them were retreatment cases with periapical lesions. Regarding the success (healed and healing) versus not healed, no significant difference was found between teeth with or without periapical lesions (p < 0.05). A statistically significant difference in the distribution of healed, healing, and not-healed teeth was found between the groups of teeth with baseline lesions < 5 mm and >5 mm in diameter (p < 0.01) and those with sealer groups (p < 0.01). The success rate of used bioceramic sealers was not statistically significant different (99.1%, 100%, 97.5% and 100%, respectively, for CeraSeal, BioRoot, AH Plus Bio, and BIO-C SEALER ION). Nonetheless, the distribution of healed, healing, and not-healed teeth was different between teeth sealed with different materials (p < 0.01). From the findings of this clinical study, the following conclusion can be drawn: a correct filling of root canals made with warm gutta-percha technique combined with a bioceramic sealer allows a high success rate in endodontically treated teeth.
Collapse
Affiliation(s)
| | | | | | - Daniele Manfredini
- Department of Prosthodontics and Dental Materials, University of Siena, 53100 Siena, Italy
| | - Marco Ferrari
- Department of Prosthodontics and Dental Materials, University of Siena, 53100 Siena, Italy
| |
Collapse
|
27
|
Mungia R, Lobbezoo F, Funkhouser E, Glaros A, Manfredini D, Ahlberg J, Taverna M, Galang-Boquiren MT, Rugh J, Truong C, Boone H, Cheney C, Verhoeff MC, Gilbert GH. Dental practitioner approaches to bruxism: Preliminary findings from the national dental practice-based research network. Cranio 2023:1-9. [PMID: 37016587 PMCID: PMC11011247 DOI: 10.1080/08869634.2023.2192173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
OBJECTIVE Bruxism is a repetitive masticatory muscle activity. This study investigates dental practitioners' approaches to bruxism assessment and treatment in practices. METHODS A brief 5 question questionnaire ("Quick Poll") on bruxism was conducted. RESULTS A total of 397 practitioners responded. More than half (55%) initiated treatment for bruxism on one to three patients per month. The majority believed that stress (97%) and sleep patterns (82%) affected bruxism in their patients. Interestingly, 96% offered an occlusal guard/appliance and 46% made occlusal adjustments. CONCLUSION This study highlights inconsistencies in practitioner approaches to bruxism assessment and management in clinical settings, suggesting gaps in practitioner knowledge evidenced by the varied responses. ABBREVIATIONS PBRN - Practice-Based Research NetworkMMA - Masticatory muscle activitySB - Sleep bruxismAB - Awake bruxismTMJ - Temporomandibular jointOSA - Obstructive sleep apnea.
Collapse
Affiliation(s)
- Rahma Mungia
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ellen Funkhouser
- Department of Medicine, School of Medicine, University of Alabama at Birmingham
| | - Alan Glaros
- School of Dentistry, The University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Daniele Manfredini
- Department of Medical Biotechnologies, Università degli Studi di Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Melanie Taverna
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | | | - John Rugh
- Department of Developmental Dentistry, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | - Clarisse Truong
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | - Honesty Boone
- Department of Periodontics, School of Dentistry, The University of Texas Health Science Center at San Antonio, Texas, USA
| | | | - Merel C. Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gregg H. Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham
| | | |
Collapse
|
28
|
Manfredini D, Thomas DC, Lobbezoo F. Temporomandibular Disorders Within the Context of Sleep Disorders. Dent Clin North Am 2023; 67:323-334. [PMID: 36965934 DOI: 10.1016/j.cden.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This paper provided an overview of the knowledge on the relationship between temporomandibular disorders (TMDs) and the main sleep conditions and disorders of dental interest, namely, sleep bruxism (SB), sleep apnea, and gastroesophageal reflux disease (GERD). It emerged that although the topic of SB as a possible detrimental factor for the stomatognathic structures has been the most studied, evidence is growing that SB, obstructive sleep apnea, and GERD, all belong to a circle of mutually interacting sleep disorders and conditions that, in turn, may be associated with TMDs. The pathophysiology of the cause-and-effect relationships, if existing, has to be elucidated yet.
Collapse
Affiliation(s)
- Daniele Manfredini
- Facial Pain Unit, Department of Biomedical Technologies, School of Dentistry, University of Siena, Viale Bracci c/o Policlinico Le Scotte, Siena 53100, Italy.
| | - Davis C Thomas
- Rutgers School of Dental Medicine, 110 Bergen St, Newark, NJ 07103, USA; Eastman Institute of Oral Health, Rochester, NY, USA
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, the Netherlands
| |
Collapse
|
29
|
Thomas DC, Khan J, Manfredini D, Ailani J. Temporomandibular Joint Disorder Comorbidities. Dent Clin North Am 2023; 67:379-392. [PMID: 36965938 DOI: 10.1016/j.cden.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Comorbidity is a distinct additional condition that either existed or exists during the clinical course of a patient afflicted by the condition/entity in question. The clinician attempting to manage temporomandibular joint disorder (TMD) and TMD pain must realize that recognition and management of the comorbidities are essential to the successful management of the same with optimal pain control. When TMD presents with multiple comorbidities, the task for the clinician becomes more complex. It is the hope of the authors that this condensed version of TMD-associated comorbidities acts as a primer for understanding the significance of the same in pain management.
Collapse
Affiliation(s)
- Davis C Thomas
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA; Eastman Institute of Oral Health, Rochester, NY, USA.
| | - Junad Khan
- Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, 2400 South Clinton Avenue, Building H, Suite #125, Rochester, NY 14618, USA
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Viale Bracci - 53100 Siena, Italy
| | - Jessica Ailani
- Georgetown Headache Center, Strategic Planning Neurology, Medstar Georgetown University Hospital 3800 Reservoir Road. NW, Washington, DC 20007, USA
| |
Collapse
|
30
|
Allison JR, Offen E, Cowley T, Clare D, Bergman S, Feldman JG, Schmidt LM, Kalinowski T, Türp JC, Manfredini D, Nixdorf DR, DePalma AMC, Durham J. How dental teams can help patients with temporomandibular disorders receive general dental care: An International Delphi process. J Oral Rehabil 2023; 50:482-487. [PMID: 36924116 DOI: 10.1111/joor.13444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/06/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Many patients with temporomandibular disorders (TMD) find it difficult to undergo dental care due to challenges caused by their condition, previous temporomandibular joint surgery or invasive dental procedures, and the impact of comorbid conditions. Managing routine dental care for some patients with TMD can be seen as challenging by some dental practitioners. OBJECTIVE The objective of this study was to work with patients experiencing TMD and clinicians to co-produce recommendations aimed at helping general dentists to provide routine dental care for patients with TMD. METHODS A modified Delphi process was used to co-produce recommendations. Six patients experiencing TMD, patient advocates and seven clinicians took part, including international TMD clinicians. Two meetings were held with patient participants, mediated by a trained facilitator. Recommendations suggested by patient participants were distributed to clinicians who were asked to add additional suggestions, but not to modify patients' recommendations unless to aid clarity. Additional themes were identified from the existing literature, and the recommendations were then reviewed by the International Network for Orofacial Pain and Related Disorders Methodology (INfORM) consortium. RESULTS Recommendations were given to support patients before, during and after dental treatment. Participants identified specific and practical recommendations to help patients with TMD receive routine dental care, but also emphasised the need for professionals to listen sensitively to patients' concerns and work with patients in an empathetic and non-judgmental way. CONCLUSION These recommendations, co-developed with patients experiencing TMD, should help dental professionals to provide supportive general dental care for patients with TMD.
Collapse
Affiliation(s)
- James R Allison
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
| | - Elizabeth Offen
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
| | - Terrie Cowley
- The TMJ Association Limited, Wisconsin, Milwaukee, USA
| | - Deanne Clare
- The TMJ Association Limited, Wisconsin, Milwaukee, USA
| | | | | | | | | | - Jens C Türp
- University Center of Dental Medicine Basel UZB, Basel, Switzerland
| | - Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | - Donald R Nixdorf
- Division of TMD and Orofacial Pain, School of Dentistry and Department of Neurology, Medical School, University of Minnesota, Minnesota, Minneapolis, USA
| | | | - Justin Durham
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, UK
| | | |
Collapse
|
31
|
Colonna A, Bracci A, Ahlberg J, Câmara-Souza MB, Bucci R, Conti PCR, Dias R, Emodi-Perlmam A, Favero R, Häggmän-Henrikson B, Michelotti A, Nykänen L, Stanisic N, Winocur E, Lobbezoo F, Manfredini D. Ecological Momentary Assessment of Awake Bruxism Behaviors: A Scoping Review of Findings from Smartphone-Based Studies in Healthy Young Adults. J Clin Med 2023; 12:jcm12051904. [PMID: 36902690 PMCID: PMC10003979 DOI: 10.3390/jcm12051904] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/29/2022] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND The recent introduction of ecological momentary assessment (EMA) smartphone-based strategies has allowed achieving some interesting data on the frequency of different awake bruxism (AB) behaviors reported by an individual in the natural environment. OBJECTIVE The present paper aims to review the literature on the reported frequency of AB based on data gathered via smartphone EMA technology. METHODS On September 2022, a systematic search in the Pubmed, Scopus and Google Scholar databases was performed to identify all peer-reviewed English-language studies assessing awake bruxism behaviors using a smartphone-based Ecological Momentary Assessment. The selected articles were assessed independently by two authors according to a structured reading of the articles' format (PICO). RESULTS A literature search, for which the search terms "Awake Bruxism" and "Ecological Momentary Assessment" were used, identified 15 articles. Of them, eight fulfilled the inclusion criteria. The results of seven studies using the same smartphone-based app reported a frequency of AB behaviors in the range between 28.3 and 40% over one week, while another investigation adopted a different smartphone-based EMA approach via WhatsApp using a web-based survey program and reported an AB frequency of 58.6%. Most included studies were based on convenience samples with limited age range, highlighting the need for more studies on other population samples. CONCLUSIONS Despite the methodological limits, the results of the reviewed studies provide a standpoint for comparison for future studies on the epidemiology of awake bruxism behaviors.
Collapse
Affiliation(s)
- Anna Colonna
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
- Correspondence: ; Tel.: +39-0039-349-1237077
| | - Alessandro Bracci
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00100 Helsinki, Finland
| | | | - Rosaria Bucci
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples “Federico II”, 80138 Naples, Italy
| | | | - Ricardo Dias
- Institute of Oral Implantology and Prosthodontics, Dentistry Department, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Alona Emodi-Perlmam
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Riccardo Favero
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Birgitta Häggmän-Henrikson
- Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, 211 19 Malmö, Sweden
| | - Ambrosina Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples “Federico II”, 80138 Naples, Italy
| | - Laura Nykänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, 00100 Helsinki, Finland
| | - Nikola Stanisic
- Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, 211 19 Malmö, Sweden
| | - Efraim Winocur
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
| |
Collapse
|
32
|
Reda B, Lobbezoo F, Contardo L, El-Outa A, Moro L, Pollis M, Aarab G, Manfredini D. Prevalence of oral behaviours in general dental patients attending a university clinic in Italy. J Oral Rehabil 2023; 50:370-375. [PMID: 36718600 DOI: 10.1111/joor.13427] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 10/30/2022] [Accepted: 01/13/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Oral behaviors represent a diverse array of habits beyond the physiological behaviors of the stomatognathic system. OBJECTIVE To describe the prevalence of different oral behaviors, as reported with the Oral Behavior Checklist (OBC-21), in a convenience sample of patients attending an Italian university clinic for routine dental cares. METHODS In this study, charts of adult patients presenting to the dental department of a regional hospital in Trieste, Italy, from January 2018 and January 2019 were reviewed. Patients with complete files were retrieved, and those with orofacial pain complaints were excluded. OBC-21 scores and grades (score of 0 corresponding to no risk, 1-24 to low risk, and higher than 24 to high risk) were analyzed and stratified according to age and sex. RESULTS Data from a total of 1424 patients were reported. The overall mean OBC score was 13.3 ± 9.9, with 6.7% no-risk grade, 79.6% low-risk grade, and 13.7% high-risk grade. In general, mean OBC scores decreased with increasing age. Females showed a higher frequency of high-risk grade than males. Most frequent prevalent habits included yawning (73.1%), eating between meals (66.9%) and chewing food on one side only (63.3%). Other behaviors were also highly prevalent, including pressing, touching, or holding teeth together other than while eating (52.7%) and awake clenching (47.5%). CONCLUSION A low-risk grade of oral behaviors has been found to be frequent in our sample. Future studies are warranted to confirm these findings in larger, representative general populations and to assess if any of these habits are linked to negative effects on the stomatognathic system.
Collapse
Affiliation(s)
- Bachar Reda
- Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, 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
| | - Luca Contardo
- Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, Italy
| | - Abbass El-Outa
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Luca Moro
- Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, Italy
| | - Matteo Pollis
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| |
Collapse
|
33
|
Câmara-Souza MB, Bracci A, Colonna A, Ferrari M, Rodrigues Garcia RCM, Manfredini D. Ecological Momentary Assessment of Awake Bruxism Frequency in Patients with Different Temporomandibular Disorders. J Clin Med 2023; 12:jcm12020501. [PMID: 36675431 PMCID: PMC9862722 DOI: 10.3390/jcm12020501] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023] Open
Abstract
Self-reported awake bruxism (AB) has been associated with temporomandibular disorders (TMD). However, the daily amount of AB behavior has not been quantified in pain patients. Therefore, this study aimed to assess AB frequency in patients with myofascial pain and temporomandibular joint (TMJ) pain and compare it to a group of pain-free individuals. Eighty-four individuals belonging to either a TMD group (n = 54) or a healthy control group (n = 30) were selected. AB frequency was obtained by ecological momentary assessment with a dedicated smartphone application that sent sound alerts at random intervals during the day for one week. Upon receiving the alert, the volunteer reported the current muscular condition and/or the teeth position, i.e., relaxed jaw muscle, jaw bracing, teeth contact, teeth clenching, or teeth grinding. Data were evaluated by independent t-test (α = 0.05). During the seven days, AB frequency was 62.1% ± 26.8% for TMD patients and 36.2% ± 27.3% for pain-free subjects (p < 0.001). Mandible bracing was most common in the TMD group (p < 0.001), while teeth contact, clenching, and grinding did not differ between groups. Moreover, no differences were found in AB frequency between myofascial pain and TMJ pain patients. Therefore, TMD patients have higher AB frequency characterized by jaw bracing, irrespective of pain location.
Collapse
Affiliation(s)
- Mariana Barbosa Câmara-Souza
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba 13414-903, Brazil
- School of Dentistry, Ingá University Center, Paraná 87035-510, Brazil
- Correspondence:
| | - Alessandro Bracci
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
| | - Anna Colonna
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
| | - Marco Ferrari
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
| | | | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, 53100 Siena, Italy
| |
Collapse
|
34
|
Dibello V, Lobbezoo F, Lozupone M, Sardone R, Ballini A, Berardino G, Mollica A, Coelho-Júnior HJ, De Pergola G, Stallone R, Dibello A, Daniele A, Petruzzi M, Santarcangelo F, Solfrizzi V, Manfredini D, Panza F. Oral frailty indicators to target major adverse health-related outcomes in older age: a systematic review. GeroScience 2022; 45:663-706. [PMID: 36242694 PMCID: PMC9886742 DOI: 10.1007/s11357-022-00663-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 09/14/2022] [Indexed: 02/03/2023] Open
Abstract
A well-preserved oral function is key to accomplishing essential daily tasks. However, in geriatric medicine and gerodontology, as age-related physiological decline disrupts several biological systems pathways, achieving this objective may pose a challenge. We aimed to make a systematic review of the existing literature on the relationships between poor oral health indicators contributing to the oral frailty phenotype, defined as an age-related gradual loss of oral function together with a decline in cognitive and physical functions, and a cluster of major adverse health-related outcomes in older age, including mortality, physical frailty, functional disability, quality of life, hospitalization, and falls. Six different electronic databases were consulted by two independent researchers, who found 68 eligible studies published from database inception to September 10, 2022. The risk of bias was evaluated using the National Institutes of Health Quality Assessment Toolkits for Observational Cohort and Cross-Sectional Studies. The study is registered on PROSPERO (CRD42021241075). Eleven different indicators of oral health were found to be related to adverse outcomes, which we grouped into four different categories: oral health status deterioration; decline in oral motor skills; chewing, swallowing, and saliva disorders; and oral pain. Oral health status deterioration, mostly number of teeth, was most frequently associated with all six adverse health-related outcomes, followed by chewing, swallowing, and saliva disorders associated with mortality, physical frailty, functional disability, hospitalization, and falls, then decline in oral motor skills associated with mortality, physical frailty, functional disability, hospitalization, and quality of life, and finally oral pain was associated only with physical frailty. The present findings could help to assess the contribution of each oral health indicator to the development of major adverse health-related outcomes in older age. These have important implications for prevention, given the potential reversibility of all these factors.
Collapse
Affiliation(s)
- Vittorio Dibello
- 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
| | - Madia Lozupone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario Ernesto Quagliariello, University of Bari Aldo Moro, Bari, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Hélio José Coelho-Júnior
- School of Physical Education, University of Campinas, Cidade Universitaria Zeferino Vaz, Barao Geraldo, Campinas, Brazil
| | - Giovanni De Pergola
- Department of Biomedical Science and Human Oncology, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Roberta Stallone
- Neuroscience and Education, Human Resources Excellence in Research, University of Foggia, Foggia, Italy
| | - Antonio Dibello
- Accident and Emergency Department (AED), F. Perinei Hospital, Altamura, Bari, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
- Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine, Section of Dentistry, University of Bari Medical School, Bari, Italy
| | | | - Vincenzo Solfrizzi
- Cesare Frugoni Internal and Geriatric Medicine and Memory Unit, University of Bari Aldo Moro, Bari, Italy
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology Saverio de Bellis, Research Hospital, Castellana Grotte, Bari, Italy.
| |
Collapse
|
35
|
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:jcm11175083. [PMID: 36079013 PMCID: PMC9457508 DOI: 10.3390/jcm11175083] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [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.
Collapse
Affiliation(s)
- Alessandro Bracci
- Department of Neurosciences, School of Dentistry, University of Padova, 35128 Padova, Italy
- Correspondence:
| | - 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
| | | |
Collapse
|
36
|
Pollis M, Lobbezoo F, Aarab G, Ferrari M, Marchese-Ragona R, Manfredini D. Correlation between Apnea Severity and Sagittal Cephalometric Features in a Population of Patients with Polysomnographically Diagnosed Obstructive Sleep Apnea. J Clin Med 2022; 11:jcm11154572. [PMID: 35956187 PMCID: PMC9369523 DOI: 10.3390/jcm11154572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 02/07/2023] Open
Abstract
Background and Objective: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder featuring a repeated closure of the upper airway during sleep. Craniofacial anatomy is a potential risk and worsening factor for OSA. This study aims to assess the relationship between cephalometric features of craniofacial morphology and OSA severity in a population of patients with OSA. Material and Methods: A sample of forty-two patients (n = 42, M = 76%, mean age = 57.8 ± 10.8) with a polysomnographically (PSG) confirmed diagnosis of OSA were recruited and underwent cephalometric evaluation of 16 cephalometric variables. In addition, the apnea−hypopnea index (AHI), oxygen desaturation (SatMin), Epworth sleepiness scale (ESS), and body mass index (BMI) were assessed. Then t-tests were performed to compare the values of all cephalometric variables between two AHI severity-based groups (mild-to-moderate = AHI ≤ 30; severe = AHI > 30). Single- and multiple-variable regression analyses were performed to assess the associations between AHI scores and cephalometric features. Results: Mean AHI, SatMin, and BMI were 31.4 ev/h, 78.7%, and 28.1, respectively. The cephalometric variables were not significantly different between the two OSA-severity groups (p > 0.05). Multiple-variable regression analyses showed that gonial angle and nasopharynx space were negatively associated with AHI, explaining 24.6% of the total variance. Conclusion: This investigation reported that severity of AHI scores in patients with OSA showed a negative correlation with gonial angle and nasopharynx space. As a general remark, although maxillofacial anatomy can be a predisposing factor for OSA, disease severity depends mainly upon other variables.
Collapse
Affiliation(s)
- Matteo Pollis
- Department of Medical Biotechnology, School of Dentistry, University of Siena, 53100 Siena, Italy
- Correspondence:
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Marco Ferrari
- Department of Medical Biotechnology, School of Dentistry, University of Siena, 53100 Siena, Italy
| | - Rosario Marchese-Ragona
- Department of Neurosciences, Otolaryngology Section, University of Padova, Via Belzoni, 160, 35121 Padova, Italy
| | - Daniele Manfredini
- Department of Medical Biotechnology, School of Dentistry, University of Siena, 53100 Siena, Italy
| |
Collapse
|
37
|
Lassmann Ł, Pollis M, Żółtowska A, Manfredini D. Gut Bless Your Pain—Roles of the Gut Microbiota, Sleep, and Melatonin in Chronic Orofacial Pain and Depression. Biomedicines 2022; 10:biomedicines10071528. [PMID: 35884835 PMCID: PMC9313154 DOI: 10.3390/biomedicines10071528] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background. Increased attention has been paid to the gut–brain axis recently, but little is known so far regarding how this translates into pain susceptibility. Aim. The aim of this review is to determine whether gastroenterological disorders and sleep disorders (directly or indirectly) contribute to an increased susceptibility to depression and chronic orofacial pain. Method. A search was performed in the U.S. National Library of Medicine (PubMed) database in order to find studies published before 19 December 2021. We used the following terms: gut microbiome, OR sleep quality, OR melatonin, OR GERD, OR IBS, AND: depression OR chronic pain, in different configurations. Only papers in English were selected. Given the large number of papers retrieved in the search, their findings were described and organized narratively. Results. A link exists between sleep disorders and gastroenterological disorders, which, by adversely affecting the psyche and increasing inflammation, disturb the metabolism of tryptophan and cause excessive microglial activation, leading to increased susceptibility to pain sensation and depression. Conclusions. Pain therapists should pay close attention to sleep and gastrointestinal disorders in patients with chronic pain and depression.
Collapse
Affiliation(s)
- Łukasz Lassmann
- Dental Sense Medicover, 80-283 Gdańsk, Poland
- Correspondence:
| | - Matteo Pollis
- Department of Medical Biotechnology, School of Dentistry, University of Siena, 53100 Siena, Italy; (M.P.); (D.M.)
| | - Agata Żółtowska
- Department of Conservative Dentistry, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Daniele Manfredini
- Department of Medical Biotechnology, School of Dentistry, University of Siena, 53100 Siena, Italy; (M.P.); (D.M.)
| |
Collapse
|
38
|
van Selms MKA, Reda B, Visscher CM, Manfredini D, Lobbezoo F. The effect of singing on pain and psychological wellbeing in a patient population with pain‐related temporomandibular disorders. J Oral Rehabil 2022; 49:841-848. [DOI: 10.1111/joor.13339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/21/2022] [Accepted: 04/28/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Maurits K. A. van Selms
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Bachar Reda
- Department of Medical, Surgical and Health Sciences, School of Dentistry University of Trieste Trieste Italy
| | - Corine M. Visscher
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - 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
| |
Collapse
|
39
|
De la Torre Canales G, Poluha RL, Alvarez Pinzón YN, Rodrigues Conti PC, Manfredini D, Sánchez-Ayala A, Rizzatti-Barbosa CM. Effects of Botulinum Toxin Type A on the Psychosocial Features of Myofascial Pain TMD Subjects: A Randomized Controlled Trial. J Oral Facial Pain Headache 2022; 35:288-296. [PMID: 34990497 DOI: 10.11607/ofph.2917] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIMS To determine the effects of botulinum toxin type A (BoNT-A) on the psychosocial features of patients with masticatory myofascial pain (MFP). METHODS A total of 100 female subjects diagnosed with MFP were randomly assigned into five groups (n = 20 each): oral appliance (OA); saline solution (SS); and three groups with different doses of BoNT-A. Chronic pain-related disability and depressive and somatic symptoms were evaluated with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis II instruments at baseline and after 6 months of treatment. Differences in treatment effects within and between groups were compared using chi-square test, and Characteristic Pain Intensity (CPI) was compared using two-way ANOVA. A 5% probability level was considered significant in all tests. RESULTS Most patients presented low pain-related disability (58%), and 6% presented severely limiting, high pain-related disability. Severe depressive and somatic symptoms were found in 61% and 65% of patients, respectively. In the within-group comparison, BoNT-A and OA significantly improved (P < .001) scores of pain-related disability and depressive and somatic symptoms after 6 months. Only the scores for pain-related disability changed significantly over time in the SS group. In the between-group comparison, BoNT-A and OA significantly improved (P < .05) scores of all variables at the final follow-up when compared to the SS group. No significant difference was found between the BoNT-A and OA groups (P > .05) for all assessed variables over time. CONCLUSION BoNT-A was at least as effective as OA in improving pain-related disability and depressive and somatic symptoms in patients with masticatory MFP.
Collapse
|
40
|
Delcanho R, Val M, Guarda Nardini L, Manfredini D. Botulinum Toxin for Treating Temporomandibular Disorders: What is the Evidence? J Oral Facial Pain Headache 2022; 36:6-20. [PMID: 35298571 PMCID: PMC10586579 DOI: 10.11607/ofph.3023] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/31/2021] [Indexed: 11/12/2022]
Abstract
AIMS To systematically review the scientific literature for evidence concerning the clinical use of botulinum toxin (BTX) for the management of various temporomandibular disorders (TMDs). METHODS A comprehensive literature search was conducted in the Medline, Web of Science, and Cochrane Library databases to find randomized clinical trials (RCT) published between 2000 and the end of April 2021 investigating the use of BTX to treat TMDs. The selected articles were reviewed and tabulated according to the PICO (patients/problem/population, intervention, comparison, outcome) format. RESULTS A total of 24 RCTs were selected. Nine articles used BTX injections to treat myofascial pain, 4 to treat temporomandibular joint (TMJ) articular TMDs, 8 for the management of bruxism, and 3 to treat masseter hypertrophy. A total of 411 patients were treated by injection of BTX. Wide variability was found in the methods of injection and in the doses injected. Many trials concluded superiority of BTX injections over placebo for reducing TMD pain levels and improving maximum mouth opening; however, this was not universal. CONCLUSION There is good scientific evidence to support the use of BTX injections for treatment of masseter hypertrophy and equivocal evidence for myogenous TMDs, but very little for TMJ articular disorders. Studies with improved methodologic design are needed to gain better insight into the utility and effectiveness of BTX injections for treating both myogenous and TMJ articular TMDs and to establish suitable protocols for treating different TMDs.
Collapse
|
41
|
Dibello V, Lozupone M, Manfredini D, Dibello A, Zupo R, Sardone R, Daniele A, Lobbezoo F, Panza F. Oral frailty and neurodegeneration in Alzheimer's disease. Neural Regen Res 2021; 16:2149-2153. [PMID: 33818486 PMCID: PMC8354109 DOI: 10.4103/1673-5374.310672] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/04/2020] [Accepted: 01/30/2021] [Indexed: 12/12/2022] Open
Abstract
Frailty is a critical intermediate status of the aging process with a multidimensional and multisystem nature and at higher risk for adverse health-related outcomes, including falls, disability, hospitalizations, institutionalization, mortality, dementia, and Alzheimer's disease. Among different frailty phenotypes, oral frailty has been recently suggested as a novel construct defined as a decrease in oral function with a coexisting decline in cognitive and physical functions. We briefly reviewed existing evidence on operational definitions of oral frailty, assessment and screening tools, and possible relationships among oral frailty, oral microbiota, and Alzheimer's disease neurodegeneration. Several underlying mechanism may explain the oral health-frailty links including undernutrition, sarcopenia linked to both poor nutrition and frailty, psychosocial factors, and the chronic inflammation typical of oral disease. Oral microbiota may influence Alzheimer's disease risk through circulatory or neural access to the brain and the interplay with periodontal disease, often causing tooth loss also linked to an increased Alzheimer's disease risk. On this bases, COR388, a bacterial protease inhibitor targeting Porphyromonas gingivalis implicated in periodontal disease, is now being tested in a double-blind, placebo-controlled Phase II/III study in mild-to-moderate Alzheimer's disease. Therefore, oral status may be an important contributor to general health, including Alzheimer's disease and late-life cognitive disorders, suggesting the central role of preventive strategies targeting the novel oral frailty phenotype and including maintenance and improvement of oral function and nutritional status to reduce the burden of both oral dysfunction and frailty.
Collapse
Affiliation(s)
- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | | | - Roberta Zupo
- Frailty Phenotypes Research Unit, “Salus in Apulia Study”, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, Bari, Italy
| | - Rodolfo Sardone
- Frailty Phenotypes Research Unit, “Salus in Apulia Study”, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, Bari, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
- Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, 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
| | - Francesco Panza
- Frailty Phenotypes Research Unit, “Salus in Apulia Study”, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, Bari, Italy
| |
Collapse
|
42
|
Colonna A, Cerritelli L, Lombardo L, Vicini C, Marchese-Ragona R, Guarda-Nardini L, Manfredini D. Temporal relationship between sleep-time masseter muscle activity and apnea-hypopnea events: A pilot study. J Oral Rehabil 2021; 49:47-53. [PMID: 34674282 DOI: 10.1111/joor.13271] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 08/18/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is the most common sleep disorder due mainly to peripheral causes, characterized by repeated episodes of obstruction of the upper airways, associated with arousals and snoring. Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or nonrhythmic (tonic) and is not a movement disorder or a sleep disorder in otherwise healthy individuals. Given the potentially severe consequences and complications of apnea, the concurrent high prevalence of SB in daily dental practice, getting deeper into the correlation between these phenomena is worthy of interest.. STUDY OBJECTIVES The aim of this study was to investigate the correlation between SB-related masseter muscle activity (MMA) and apnea-hypopnea events as well as to assess their temporal sequence. METHODS Thirty (N = 30) patients with sleep respiratory disorders and clinical suspicion of sleep bruxism (SB) were recruited. Ambulatory polygraphic recording was performed to detect apnea-hypopnea events (AHEs) and sleep bruxism episodes (SBEs). Pearson test was used to assess the correlation between apnea-hypopnea index (AHI) and SB index (SBI). A 5-s time window with respect to the respiratory events was considered to describe the temporal distribution of SBEs. Furthermore, SBI was compared between groups of patients with different AHI severity (i.e., mild, moderate and severe) using ANOVA. RESULTS On average, AHI was 27.1 ± 21.8 and SBI 9.1 ± 7.5. No correlation was shown between AHI and SBI. Most of SBEs (66.8%) occurred without a temporal relationship with respiratory events. Considering OSA, 65.7% of SBEs occurred within 5 s after AHEs, while in the case of central apnea (CA) 83.8% of SBEs occurred before the respiratory event. The participants with severe apnea (N = 9) show a tendency to have higher bruxism indexes when compared to patients with mild (N = 11) and moderate apnea (N = 10). CONCLUSIONS Findings suggest that: 1. At the study population level, there is no correlation between AHI and SBI, as well as any temporal relationship between SBEs and respiratory events. 2. Specific patterns of temporal relationship might be identified with future studies focusing on the different types of apnea-hypopnea events and bruxism activities.
Collapse
Affiliation(s)
- Anna Colonna
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Luca Cerritelli
- Department of Otolaryngology, Ospedale Morgani-Pierantoni, Forlì, Italy
| | - Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Claudio Vicini
- Department of Otolaryngology, Ospedale Morgani-Pierantoni, Forlì, Italy
| | | | - Luca Guarda-Nardini
- Section of Dentistry and Maxillofacial Surgery, Treviso Hospital, Treviso, Italy
| | | |
Collapse
|
43
|
Abstract
OBJECTIVE To investigate the effect of the Coronavirus pandemic on the report of psychological status, bruxism, and TMD symptoms. METHODS An online survey was drafted to report the presence of psychological status, bruxism activities, and reported symptoms of TMDs perceived during the COVID-19 pandemic in a population of 506 individuals. RESULTS Mental health is not positive during the Coronavirus pandemic: almost half the subjects reported an increase in bruxism behaviors, while up to one-third reported an increase in their symptoms involving the TMJ and jaw muscles. Specifically, 36% and 32.2% of participants reported increased pain in the TMJ and facial muscles, respectively, and almost 50% of the subjects also reported more frequent migraines and/or headaches. CONCLUSION Increased psychosocial distress during the COVID-19 pandemic can increase the frequency of TMD symptoms and bruxism behaviors, which, in turn, constitute a triangle of mutually interacting factors with the psychological and emotional status.
Collapse
Affiliation(s)
- Anna Colonna
- School of Dentistry, University of Siena, Siena, Italy
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Luca Guarda-Nardini
- Section of Dentistry and Maxillofacial Surgery, Treviso Hospital, Treviso, Italy
| | - Marco Ferrari
- School of Dentistry, University of Siena, Siena, Italy
| | | |
Collapse
|
44
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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.)
| |
Collapse
|
45
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| | | | | |
Collapse
|
46
|
Zani A, Lobbezoo F, Bracci A, Djukic G, Guarda‐Nardini L, Favero R, Ferrari M, Aarab G, Manfredini D. Smartphone-based evaluation of awake bruxism behaviours in a sample of healthy young adults: findings from two University centres. J Oral Rehabil 2021; 48:989-995. [PMID: 34041773 PMCID: PMC8453860 DOI: 10.1111/joor.13212] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/24/2021] [Accepted: 05/18/2021] [Indexed: 12/24/2022]
Abstract
A smartphone-based ecological momentary assessment (EMA) strategy was used to assess the frequency of awake bruxism behaviours, based on the report of five oral conditions (ie relaxed jaw muscles, teeth contact, mandible bracing, teeth clenching and teeth grinding). One hundred and fifty-three (N = 153) healthy young adults (mean ± SD age = 22.9 ± 3.2 years), recruited in two different Italian Universities, used a dedicated smartphone application that sent 20 alerts/day at random times for seven days. Upon alert receipt, the subjects had to report in real-time one of the above five possible oral conditions. Individual data were used to calculate an average frequency of the study population for each day. For each condition, a coefficient of variation (CV) of frequency data was calculated as the ratio between SD and mean values over the seven recording days. Average frequency of the different behaviours over the seven days was as follows: relaxed jaw muscle, 76.4%; teeth contact, 13.6%; mandible bracing, 7.0%; teeth clenching, 2.5%; and teeth grinding, 0.5%. No significant differences were found in frequency data between the two University samples. The relaxed jaw muscles condition was more frequent in males (80.7 ± 17.7) than in females (73.4 ± 22.2). The frequency of relaxed jaw muscles condition over the period of observation had a very low coefficient of variation (0.27), while for the different awake bruxism behaviours, CV was in a range between 1.5 (teeth contact) and 4.3 (teeth grinding). Teeth contact was the most prevalent behaviour (57.5-69.7). Findings from this investigation suggest that the average frequency of AB behaviours over one week, investigated using EMA-approach, is around 23.6%.
Collapse
Affiliation(s)
| | - Frank Lobbezoo
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry Amsterdam (ACTAUniversity of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | | | - Goran Djukic
- Department of Management and EngineeringUniversity of PadovaPadovaItaly
| | - Luca Guarda‐Nardini
- Department of Dentistry and Maxillo‐facial surgeryHospital of TrevisoTrevisoItaly
| | | | | | - Ghizlane Aarab
- Department of Orofacial Pain and DysfunctionAcademic Centre for Dentistry Amsterdam (ACTAUniversity of Amsterdam and Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | | |
Collapse
|
47
|
Serra-Negra JM, Dias RB, Manfredini D. Sleep bruxism, chronotype, and cardiovascular issues - an interesting triad. Dr. Júnia Serra-Negra et al.'s reply. Cranio 2021; 39:459-460. [PMID: 34369321 DOI: 10.1080/08869634.2021.1956788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Júnia Maria Serra-Negra
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil,
| | | | | |
Collapse
|
48
|
Guarda Nardini L, Meneghini M, Guido M, Baciorri F, Manfredini D. Histopathology of the temporomandibular joint disc: Findings in 30 samples from joints with degenerative disease. J Oral Rehabil 2021; 48:1025-1034. [PMID: 34185892 PMCID: PMC8456827 DOI: 10.1111/joor.13218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/15/2021] [Accepted: 06/22/2021] [Indexed: 01/18/2023]
Abstract
Aim The aim of this study is to show the anatomical and histological features of the displaced temporomandibular joint (TMJ) disc in joints with degenerative disease. Methods This study was performed on a total of 30 TMJ discs extracted from 22 patients, who underwent surgical discectomy after failure of conservative non‐surgical treatment regimens to control pain and/or limited range of motion. All joints had imaging signs of an anteriorized disc position and degenerative joint disease. Samples of the extracted discs were stored in formalin, cut into 3 micron‐thick sections imbedded in paraffin and processed with hematoxylin‐eosin. Result All the samples present irreversible morphologic and histological alterations. The macroscopical evaluation showed that 14 discs were worn and fragmented in several parts, and one disc was perforated. Morphological alterations with deformation and degenerative signs were shown in all discs, which were all severely worn and compromised. Histologically, various alterations were found, such as pre‐fibrous sclerosis with myxoid degeneration and collagen deposits (N = 25), an increase in fibro‐hyaline and fibrous tissues, with loss of elasticity (N = 25), scattered calcifications (N = 15), and synovial inflammation with microvascular proliferation and increased cellularity, presence of lymphocytes, histiocytes and plasma cells (N = 18). After the intervention, all patients reported decreased pain levels and showed improved function at 6 months. Conclusion These observations suggest that degenerative joint disease is accompanied by a anteriorized discs featuring abnormal macroscopical and histological changes. From a clinical viewpoint, this may suggest that, when treatment escalation leads to consider TMJ surgery, total discectomy is the most reasonable approach.
Collapse
Affiliation(s)
| | | | - Maria Guido
- Anatomical Pathology - Hospital of Treviso, Treviso, Italy
| | | | | |
Collapse
|
49
|
Val M, Ragazzo M, Bendini M, Manfredini D, Trojan D, Guarda Nardini L. Computer-assisted surgery with custom prostheses and human amniotic membrane in a patient with bilateral class IV TMJ reankylosis: a case report. Cell Tissue Bank 2021; 23:395-400. [PMID: 34176055 DOI: 10.1007/s10561-021-09940-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 06/20/2021] [Indexed: 11/29/2022]
Abstract
A gold-standard technique has yet to be found for the treatment of temporomandibular joint ankylosis (TMJa), particularly in patients with recurring ankylosis. A 58-year-old male patient, with a history of multiple TMJ surgeries and severe limitation of mouth opening (maximum interincisal distance [MID] was 10 mm). Computerised tomography (CT) imaging highlighted a bilateral type IV ankylosis. The surgical guides were manufactured using a 3D printing method after obtaining a proper design of the osteotomy lines. The positioning of the fossa and condyle components of the custom TMJ prosthesis was digitally performed. Osteotomies were carried out using surgical guides and TMJ prostheses were placed as per the virtual planning. A human amniotic mambrana is inserted between the two prosthetic components to avoid ranchylosis. The post-operative CT showed the correct positioning of the condylar prosthesis. MID after 10 days was 37 mm. Total joint reconstruction surgery using 3D virtual surgical planning may be an effective surgical option for achieving a precise surgical outcome and making use of a single-stage approach in cases of TMJa and the use of the amniotic membrane, thanks to its healing properties and reduction of pain perception, seems to improve the quality of the immediate post-operative period.
Collapse
Affiliation(s)
- Matteo Val
- Unit of Oral and Maxillofacial surgery, Ca Foncello Hospital, 31100, Treviso, Italy.
| | - Mirko Ragazzo
- Unit of Neuroradiology, Ca Foncello Hospital, 31100, Treviso, Italy
| | - Matteo Bendini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Daniele Manfredini
- Treviso Tissue Bank Foundation, Via dell'Ospedale 3, 31100, Treviso, Italy
| | - Diletta Trojan
- Unit of Oral and Maxillofacial surgery, Ca Foncello Hospital, 31100, Treviso, Italy
| | - Luca Guarda Nardini
- Unit of Oral and Maxillofacial surgery, Ca Foncello Hospital, 31100, Treviso, Italy
| |
Collapse
|
50
|
Guarda-Nardini L, Meneghini M, Zegdene S, Manfredini D. Temporomandibular Joint Arthrocentesis in Patients with Degenerative Joint Disease: A 10- to 22-year Follow-up. J Oral Facial Pain Headache 2021; 35:113-118. [PMID: 34129656 DOI: 10.11607/ofph.2871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIMS To report the effectiveness of temporomandibular joint (TMJ) arthrocentesis with viscosupplementation for degenerative joint disease (DJD) over a long-term (ie, 10-22 years) follow-up. METHODS A total of 103 patients aged between 30 and 91 years (13 men and 90 women; mean age 63.7 years) who received a cycle of five arthrocentesis sessions with HA viscosupplementation to manage their symptoms related to TMJ DJD during the time period from 1998 to 2010 were recalled for clinical evaluation. After the treatment cycle, clinical outcomes were assessed based on the following parameters: maximum mouth opening (MO), pain with function (PF), pain at rest (PR), and self-reported chewing efficiency (CE). Data were collected at baseline (T0) and at successive follow-up assessments, after at least 3 months (T1) and 1 year (T2), as per previous publications. Patients who had received treatment at least 10 years prior were then recalled for this study (T3: 10 to 22 years follow-up). Analysis of variance for repeated measures was performed to assess changes over time. RESULTS Significant improvement in all clinical parameters was achieved at T1 and was maintained for up to 10 years (T3), with P < .01 for each parameter. At T3, treatment effectiveness was perceived as excellent by 56% and as good by 26.5% of subjects, while 10.7% perceived a moderate improvement, and 6.8% referred a slight improvement or did not have any improvement. Only seven individuals required additional treatments after T2. CONCLUSION These findings suggest that the symptomatic management of TMJ DJD achieved in the short or medium term with a cycle of arthrocentesis and viscosupplementation was effectively maintained in the long term.
Collapse
|