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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
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2
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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.
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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
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3
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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.
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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
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Ahlberg J, Lobbezoo F, Hublin C, Piirtola M, Kaprio J. Self-reported sleep bruxism in 1990 and 2011 in a nationwide twin cohort: Evidence of trait persistence and genetic liability. J Oral Rehabil 2024; 51:119-124. [PMID: 36062358 DOI: 10.1111/joor.13368] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 04/23/2022] [Revised: 07/17/2022] [Accepted: 08/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Due to different assessment modes employed, a clear picture of the prevalence of sleep bruxism across time cannot be formed. Moreover, studies on the persistent or fluctuating nature of sleep bruxism have yielded divergent and even contradictory results. The aim of the present study was to evaluate in a nationwide twin cohort whether self-reported sleep bruxism was correlated longitudinally, pairwise and cross-twin over a 20-year period. OBJECTIVES Self-reported bruxism was assessed in 1990 and 2011 by mailed questionnaires in the Finnish Twin Cohort study of same-sex twins born 1945-1957. METHODS We assessed the phenotypic stability over time for all participating individuals (n = 4992). Among zygosity verified pairs (n = 516 MZ and n = 837 DZ), we estimated the cross-sectional zygosity correlations and the zygosity-specific cross-twin cross-time correlations. RESULTS Reported bruxism appeared rather persistent over time without significant difference regarding zygosity. The overall phenotypic longitudinal correlation was 0.540 and somewhat higher in men (0.596) than in women (0.507). Pairwise trait correlations in 1990 and 2011 were higher in MZ than in DZ pairs. The cross-twin cross-time correlations were higher in MZ twins than in DZ twins, but less than the cross-sectional MZ and DZ pairwise correlations. CONCLUSIONS The higher correlation of reported sleep bruxism in the cross-twin cross-time analyses in MZ than in DZ pairs implies a genetic background for bruxism persistence. Also, bruxism over time in individual twins appears to be fairly persistent and somewhat higher in men than women.
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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
| | | | - 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
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Nykänen L, Lobbezoo F, Kämppi A, Manfredini D, Ahlberg J. Awake bruxism in temporomandibular disorders patients referred to tertiary care: A retrospective study on its assessment and TMD management. J Oral Rehabil 2024; 51:181-187. [PMID: 37423766 DOI: 10.1111/joor.13559] [Citation(s) in RCA: 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.
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Affiliation(s)
- Laura Nykänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Head and Neck Center, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Antti Kämppi
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- Head and Neck Center, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland
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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.
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Affiliation(s)
- Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - 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
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7
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Bracci A, Lobbezoo F, Colonna A, Bender S, Conti PCR, Emodi-Perlman A, Häggman-Henrikson B, Klasser GD, Michelotti A, Lavigne GJ, Svensson P, Ahlberg J, Manfredini D. Research routes on awake bruxism metrics: Implications of the updated bruxism definition and evaluation strategies. J Oral Rehabil 2024; 51:150-161. [PMID: 37191494 DOI: 10.1111/joor.13514] [Citation(s) in RCA: 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.
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Affiliation(s)
- Alessandro Bracci
- Department of Neuroscience, School of Dentistry, University of Padova, Padova, Italy
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anna Colonna
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Steven Bender
- Department of Oral and Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, Texas, USA
| | - Paulo C R Conti
- Bauru School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Telaviv, Israel
| | | | - Gary D Klasser
- Department of Diagnostic Sciences, Louisiana State University School of Dentistry, New Orleans, Louisiana, USA
| | - Ambra Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Gilles J Lavigne
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal, and Universite de Montreal, Montreal, Quebec, Canada
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
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8
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Ahlberg J, Lobbezoo F, Hublin C, Piirtola M, Kaprio J. Smoking cessation is not associated with a decline in reported sleep bruxism in middle-aged Finnish twins: Data revisited. J Oral Rehabil 2024; 51:117-118. [PMID: 37248199 DOI: 10.1111/joor.13524] [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: 11/27/2022] [Revised: 04/17/2023] [Accepted: 05/22/2023] [Indexed: 05/31/2023]
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
| | | | - 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
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9
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Manfredini D, Ahlberg J, Aarab G, Bracci A, Durham J, Emodi-Perlman A, Ettlin D, Gallo LM, Häggman-Henrikson B, Koutris M, Peroz I, Svensson P, Wetselaar P, Lobbezoo F. The development of the Standardised Tool for the Assessment of Bruxism (STAB): An international road map. J Oral Rehabil 2024; 51:15-28. [PMID: 36261916 DOI: 10.1111/joor.13380] [Citation(s) in RCA: 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.
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Affiliation(s)
- Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial, Diseases, University of Helsinki, Helsinki, Finland
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Justin Durham
- Newcastle University's School of Dental Sciences, Newcastle, UK
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dominik Ettlin
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Berne, Berne, Switzerland
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Birgitta Häggman-Henrikson
- Department of Odontology/Clinical Oral Physiology, Faculty of Medicine, University of Umeå, Umeå, Sweden
- Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingrid Peroz
- Department for Prosthodontics, Charité-University Medicine of Berlin, Charité Centre for Dentistry, Gerodontology and Craniomandibular Disorders, Berlin, Germany
| | - Peter Svensson
- Department of Orofacial Pain and Jaw function, Faculty of Odontology, Malmö University, Malmö, Sweden
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Peter Wetselaar
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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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
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11
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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.
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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
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Nykänen L, Manfredini D, Lobbezoo F, Kämppi A, Bracci A, Ahlberg J. Assessment of awake bruxism by a novel bruxism screener and ecological momentary assessment among patients with masticatory muscle myalgia and healthy controls. J Oral Rehabil 2024; 51:162-169. [PMID: 37036436 DOI: 10.1111/joor.13462] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [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.
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Affiliation(s)
- Laura Nykänen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Daniele Manfredini
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Antti Kämppi
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | | | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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13
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Strausz T, Strausz S, Palotie T, Ahlberg J, Ollila HM. Genetic analysis of probable sleep bruxism and its associations with clinical and behavioral traits. Sleep 2023; 46:zsad107. [PMID: 37140068 PMCID: PMC10566239 DOI: 10.1093/sleep/zsad107] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 03/06/2023] [Indexed: 05/05/2023] Open
Abstract
STUDY OBJECTIVES Sleep bruxism (SB) can cause damage on teeth, headache and severe pain affecting both sleep and daily functioning. Yet despite the growing interest into bruxism, the underlying clinically relevant biological mechanisms remain unresolved. The aim of our study was to understand biological mechanisms and clinical correlates of SB including previously reported disease associations. METHODS We used data from the FinnGen release R9 (N = 377 277 individuals) that are linked with Finnish hospital and primary care registries. We identified 12 297 (3.26%) individuals with International Classification of Diseases (ICD)-10 codes used for SB. In addition, we used logistic regression to examine the association between probable SB and its clinically diagnosed risk factors and comorbidities using ICD-10 codes. Furthermore, we examined medication purchases using prescription registry. Finally, we performed the first genome-wide association analysis for probable SB and computed genetic correlations using questionnaire, lifestyle, and clinical traits. RESULTS The genome-wide association analysis revealed one significant association: rs10193179 intronic to Myosin IIIB (MYO3B) gene. In addition, we observed phenotypic associations and high genetic correlations with pain diagnoses, sleep apnea, reflux disease, upper respiratory diseases, psychiatric traits, and also their related medications such as antidepressants and sleep medication (p < 1e-4 for each trait). CONCLUSIONS Our study provides a large-scale genetic framework to understand risk factors for SB and suggests potential biological mechanisms. Furthermore, our work strengthens the important earlier work that highlights SB as a trait that is associated with multiple axes of health. As part of this study, we provide genome-wide summary statistics that we hope will be useful for the scientific community studying SB.
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Affiliation(s)
- Tommi Strausz
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Satu Strausz
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Tuula Palotie
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital, Helsinki, Finland
- Orthodontics, Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, Head and Neck Center, Helsinki University Hospital, Helsinki, Finland
| | - Hanna M Ollila
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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14
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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.
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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
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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.
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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
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16
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Bracci A, Lobbezoo F, Häggman-Henrikson B, Colonna A, Nykänen L, Pollis M, Ahlberg J, Manfredini D. Current Knowledge and Future Perspectives on Awake Bruxism Assessment: Expert Consensus Recommendations. J Clin Med 2022; 11: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.
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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
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17
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Penttilä E, Vuorinen VP, Kivimäki M, Ahlberg J, Airaksinen O, Tuomilehto H. Comparison of sleep between youth elite amateur athletes and professional athletes. Sport Sci Health 2021. [DOI: 10.1007/s11332-021-00780-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AbstractRecent studies suggest that professional athletes seem to experience significant sleeping problems. However, little is still known about the occurrence of sleeping challenges at different stages of an athletic career. This descriptive study aimed to compare the sleep of professional athletes with younger elite amateur athletes. A total of 401 sportsmen, 173 youth elite amateur athletes and 228 professional athletes fulfilled a validated questionnaire. The self-estimated quality of sleep (on a linear scale 0–10) was significantly better in youth, being 7.9 compared to 7.4 (p < 0.001). The professional athletes had a significantly higher risk for sleeping problems, especially during the competitive season (OR = 7.3, 95% confidence interval 4.1–12.9) and they also used significantly more sleep medications (OR = 8.3, 95% confidence interval 1.7–4.1). Interestingly, majority of youth athletes (85.4%) had received adequate sleep counselling compared with professional athletes (58.1%), (p < 0.001). Furthermore, 75.8% of professional athletes considered that additional sleep counselling would improve their performance compared with only 45.6% of youth athletes (p < 0.001). Our study demonstrates that compared with the younger counterparts, professional athletes experience impaired sleep quality and significantly more sleeping problems. There may be various underlying factors to induce the problems. The early intervention with sleep counselling may play an important role in preventing these problems and, therefore, it is recommended to be integrated in athletes’ overall training process.
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18
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Thymi M, Lobbezoo F, Aarab G, Ahlberg J, Baba K, Carra MC, Gallo LM, De Laat A, Manfredini D, Lavigne G, Svensson P. Signal acquisition and analysis of ambulatory electromyographic recordings for the assessment of sleep bruxism: A scoping review. J Oral Rehabil 2021; 48:846-871. [PMID: 33772835 PMCID: PMC9292505 DOI: 10.1111/joor.13170] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 12/07/2020] [Revised: 02/07/2021] [Accepted: 03/17/2021] [Indexed: 12/14/2022]
Abstract
Background Ambulatory electromyographic (EMG) devices are increasingly being used in sleep bruxism studies. EMG signal acquisition, analysis and scoring methods vary between studies. This may impact comparability of studies and the assessment of sleep bruxism in patients. Objectives (a) To provide an overview of EMG signal acquisition and analysis methods of recordings from limited‐channel ambulatory EMG devices for the assessment of sleep bruxism; and (b) to provide an overview of outcome measures used in sleep bruxism literature utilising such devices. Method A scoping review of the literature was performed. Online databases PubMed and Semantics Scholar were searched for studies published in English until 7 October 2020. Data on five categories were extracted: recording hardware, recording logistics, signal acquisition, signal analysis and sleep bruxism outcomes. Results Seventy‐eight studies were included, published between 1977 and 2020. Recording hardware was generally well described. Reports of participant instructions in device handling and of dealing with failed recordings were often lacking. Basic elements of signal acquisition, for example amplifications factors, impedance and bandpass settings, and signal analysis, for example rectification, signal processing and additional filtering, were underreported. Extensive variability was found for thresholds used to characterise sleep bruxism events. Sleep bruxism outcomes varied, but typically represented frequency, duration and/or intensity of masticatory muscle activity (MMA). Conclusion Adequate and standardised reporting of recording procedures is highly recommended. In future studies utilising ambulatory EMG devices, the focus may need to shift from the concept of scoring sleep bruxism events to that of scoring the whole spectrum of MMA.
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Affiliation(s)
- Magdalini Thymi
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Kazuyoshi Baba
- Department of Prosthodontics, Showa University School of Dentistry, Ohta-ku, Japan
| | - Maria Clotilde Carra
- UFR of Odontology Garanciere, Université de Paris and Service of Odontology, Rothschild Hospital (AP-HP), Paris, France
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Antoon De Laat
- Department of Oral Health Sciences, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dentistry, University Hospital, Leuven, Belgium
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | - Gilles Lavigne
- Faculty of Dental Medicine, Université de Montréal, Montreal, QC, Canada.,CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus Universitet Tandlageskolen, Aarhus, Denmark.,Faculty of Odontology, Malmø University, Malmø, Sweden
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19
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Lavigne G, Kato T, Herrero Babiloni A, Huynh N, Dal Fabbro C, Svensson P, Aarab G, Ahlberg J, Baba K, Carra MC, Cunha TCA, Gonçalves DAG, Manfredini D, Stuginski-Barbosa J, Wieckiewicz M, Lobbezoo F. Research routes on improved sleep bruxism metrics: Toward a standardised approach. J Sleep Res 2021; 30:e13320. [PMID: 33675267 DOI: 10.1111/jsr.13320] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 12/17/2022]
Abstract
A recent report from the European Sleep Research Society's task force "Beyond AHI" discussed an issue that has been a long-term subject of debate - what are the best metrics for obstructive sleep apnoea (OSA) diagnosis and treatment outcome assessments? In a similar way, sleep bruxism (SB) metrics have also been a recurrent issue for >30 years and there is still uncertainty in dentistry regarding their optimisation and clinical relevance. SB can occur alone or with comorbidities such as OSA, gastroesophageal reflux disorder, insomnia, headache, orofacial pain, periodic limb movement, rapid eye movement behaviour disorder, and sleep epilepsy. Classically, the diagnosis of SB is based on the patient's dental and medical history and clinical manifestations; electromyography is used in research and for complex cases. The emergence of new technologies, such as sensors and artificial intelligence, has opened new opportunities. The main objective of the present review is to stimulate the creation of a collaborative taskforce on SB metrics. Several examples are available in sleep medicine. The development of more homogenised metrics could improve the accuracy and refinement of SB assessment, while moving forward toward a personalised approach. It is time to develop SB metrics that are relevant to clinical outcomes and benefit patients who suffer from one or more possible negative consequences of SB.
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Affiliation(s)
- Gilles Lavigne
- Faculty of Dental Medicine, Universite de Montreal & CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada
| | - Takafumi Kato
- Department of Oral Physiology Graduate School of Dentistry, Sleep Medicine Center, Osaka University Hospital, Osaka University, Suita, Japan
| | - Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, QC, Canada.,CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine, Montreal, QC, Canada
| | - Nelly Huynh
- Faculty of Dental Medicine, Universite de Montreal and CHU Saint-Justine Research Center, Montreal, QC, Canada
| | - Cibele Dal Fabbro
- Faculty of Dental Medicine, Universite de Montreal & CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Faculty of Odontology, Malmø University, Malmø, Sweden
| | - Ghizlane Aarab
- 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
| | - Kazuyoshi Baba
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Maria Clotilde Carra
- UFR of Odontology Garanciere, Université de Paris and Service of Odontology, Rothschild Hospital (AP-HP), Paris, France
| | - Thays Crosara A Cunha
- Department of Genetics and Biochemistry, Federal University of Uberlandia, Uberlandia, Brazil
| | - Daniela A G Gonçalves
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (Unesp), Araraquara, Brazil
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | | | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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20
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Manfredini D, Ahlberg J, Lobbezoo F. Bruxism definition: Past, present, and future - What should a prosthodontist know? J Prosthet Dent 2021; 128:905-912. [PMID: 33678438 DOI: 10.1016/j.prosdent.2021.01.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 01/06/2023]
Abstract
STATEMENT OF PROBLEM The definition of bruxism has evolved, and the dental profession needs to align with the terminologies adopted in the current literature of sleep and orofacial pain medicine. PURPOSE The purpose of this review was to discuss the recent evolution of bruxism concepts and the implications for changing the definition that is currently used by the prosthodontic community. MATERIAL AND METHODS A historical perspective on the evolution of the definition of bruxism, as well as a systematic literature review on the validity of polysomnography (PSG)-based criteria for sleep bruxism diagnosis to detect the presence of clinical consequences, is presented. Selected articles were read in a structured Population, Intervention, Comparison, Outcome (PICO) format to answer the question "If a target population with conditions such as tooth wear, dental implant complications, and temporomandibular disorders (P) is diagnosed with sleep bruxism by means of PSG (I) and compared with a population of nonbruxers (C), is the occurrence of the condition under investigation (that is, the possible pathologic consequences of sleep bruxism) be different between the 2 groups (O)?" RESULTS Eight studies were eligible for the review, 6 of which assessed the relationship between PSG-diagnosed sleep bruxism and temporomandibular disorder pain, while the other 2 articles evaluated the predictive value of tooth wear for ongoing PSG-diagnosed sleep bruxism and the potential role of sleep bruxism in a population of patients with failed dental implants. Findings were contradictory and not supportive of a clear-cut relationship between sleep bruxism assessed based on available PSG criteria and any clinical consequence. The literature providing definitions of bruxism as a motor behavior and not pathology has been discussed. CONCLUSIONS The bruxism construct has shifted from pathology to motor activity with possibly even physiological or protective relevance. An expert panel including professionals from different medical fields published 2 consecutive articles focusing on the definition of bruxism, as well as an overview article presenting the ongoing work to prepare a Standardized Tool for the Assessment of Bruxism (STAB) to reflect the current bruxism paradigm shift from pathology to behavior (that is, muscle activity). As such, dental practitioners working in the field of restorative dentistry and prosthodontics are encouraged to appraise this evolution.
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Affiliation(s)
- Daniele Manfredini
- Professor, School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
| | - Jari Ahlberg
- Professor, Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Frank Lobbezoo
- Professor and Head, Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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21
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Ahlberg J, Manfredini D, Lobbezoo F. STAB—A response to the commentary “Questions on the clinical applicability on the international consensus on the assessment of bruxism” by Skarmeta and Hormazabal Navarrete. J Oral Rehabil 2020; 47:1574-1576. [DOI: 10.1111/joor.12987] [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: 04/04/2020] [Accepted: 04/26/2020] [Indexed: 11/26/2022]
Affiliation(s)
- 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
| | - Frank Lobbezoo
- Department of Orofacial pain and Dysfunction Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
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22
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van Selms M, Kroon J, Tuomilehto H, Peltomaa M, Savolainen A, Manfredini D, Lobbezoo F, Ahlberg J. Self-reported sleep bruxism among Finnish symphony orchestra musicians: Associations with perceived sleep-related problems and psychological stress. Cranio 2020:1-8. [PMID: 33252016 DOI: 10.1080/08869634.2020.1853310] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/11/2023]
Abstract
Objective: This study aimed to evaluate whether self-reported sleep bruxism among musicians is associated with sleep-related problems and/or psychological stress.Methods: Eight hundred-thirty-one Finnish orchestra musicians completed a questionnaire that covered, among others, indicators of sleep-related problems, possible sleep bruxism, and stress.Results: In total, 488 questionnaires were completed. The single variable ordinal logistic regression models revealed at least moderate associations between frequency of sleep bruxism and female gender, shorter sleep duration, longer sleep latency, problems in sleeping during concert season, feeling more often tired during the daytime, restless legs, a poor self-rated sleep quality, and more stress experience. The variables that remained in the final model were sleep duration, gender, and stress.Conclusion: Musicians who sleep 7 hours or less per night report more sleep bruxism, as compared to those who sleep 8 hours or more. Female gender and high-stress experience were associated with more sleep bruxism.
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Affiliation(s)
- Maurits van Selms
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Janine Kroon
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Henri Tuomilehto
- Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Miikka Peltomaa
- Department of Otolaryngology, University of Helsinki, Helsinki, Finland
| | - Aslak Savolainen
- Department of Public Health, 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
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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23
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Lobbezoo F, Ahlberg J, Aarab G, Manfredini D. Why using 'harmless behaviour', 'risk factor' and 'protective factor' as terms describing the various possible consequences of bruxism is still the best option. J Oral Rehabil 2020; 48:762-763. [PMID: 32812239 PMCID: PMC8247315 DOI: 10.1111/joor.13063] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/27/2020] [Indexed: 12/16/2022]
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
| | - 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
- School of Dentistry, Department of Biomedical Technologies, University of Siena, Siena, Italy
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24
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de Baat C, Verhoeff M, Ahlberg J, Manfredini D, Winocur E, Zweers P, Rozema F, Vissink A, Lobbezoo F. Medications and addictive substances potentially inducing or attenuating sleep bruxism and/or awake bruxism. J Oral Rehabil 2020; 48:343-354. [PMID: 32716523 PMCID: PMC7984358 DOI: 10.1111/joor.13061] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [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: 03/11/2020] [Revised: 05/30/2020] [Accepted: 07/16/2020] [Indexed: 12/22/2022]
Abstract
Bruxism is a repetitive jaw‐muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. It can occur during sleep, indicated as sleep bruxism, or during wakefulness, indicated as awake bruxism. Exogenous risk indicators of sleep bruxism and/or awake bruxism are, among others, medications and addictive substances, whereas also several medications seem to have the potential to attenuate sleep bruxism and/or awake bruxism. The objective of this study was to present a narrative literature on medications and addictive substances potentially inducing or aggravating sleep bruxism and/or awake bruxism and on medications potentially attenuating sleep bruxism and/or awake bruxism. Literature reviews reporting evidence or indications for sleep bruxism and/or awake bruxism as an adverse effect of several (classes of) medications as well as some addictive substances and literature reviews on medications potentially attenuating sleep bruxism and/or awake bruxism were used as starting point and guidelines to describe the topics mentioned. Additionally, two literature searches were established on PubMed. Three types of bruxism were distinguished: sleep bruxism, awake bruxism and non‐specified bruxism. Generally, there are insufficient evidence‐based data to draw definite conclusions concerning medications and addictive substances inducing or aggravating sleep bruxism and/or awake bruxism as well as concerning medications attenuating sleep bruxism and/or awake bruxism. There are insufficient evidence‐based data to draw definite conclusions concerning medications and addictive substances inducing or aggravating sleep bruxism and/or awake bruxism as well as concerning medications attenuating sleep bruxism and/or awake bruxism.
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Affiliation(s)
- Cees de Baat
- Foundation for Oral Health and Parkinson's Disease, Oegstgeest, The Netherlands.,Fresh Unieke Mondzorg, Woerden, The Netherlands.,Department of Oral Function and Prosthetic Dentistry, Radboud university medical center, Nijmegen, The Netherlands
| | - Merel Verhoeff
- 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
| | - Daniele Manfredini
- Department of Biomechanical Diseases, School of Dentistry, University of Siena, Siena, Italy
| | - Ephraim Winocur
- Department of Oral Rehabilitation, Dental School, Tel Aviv University, Tel Aviv, Israel
| | - Petra Zweers
- Netherlands pharmacovigilance centre LAREB, Hertogenbosch, The Netherlands
| | - Fred Rozema
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Frank Lobbezoo
- Foundation for Oral Health and Parkinson's Disease, Oegstgeest, The Netherlands.,Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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25
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Ahlberg J, Piirtola M, Lobbezoo F, Manfredini D, Korhonen T, Aarab G, Hublin C, Kaprio J. Correlates and genetics of self‐reported sleep and awake bruxism in a nationwide twin cohort. J Oral Rehabil 2020; 47:1110-1119. [DOI: 10.1111/joor.13042] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/16/2020] [Accepted: 06/23/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Jari Ahlberg
- Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki Finland
| | - Maarit Piirtola
- Institute for Molecular Medicine Finland FIMM HiLIFEUniversity of Helsinki 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
| | - Tellervo Korhonen
- Institute for Molecular Medicine Finland FIMM HiLIFEUniversity 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
| | - Christer Hublin
- Finnish Institute of Occupational Health Helsinki Finland
- Department of Public Health Faculty of Medicine University of Helsinki Helsinki Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM HiLIFEUniversity of Helsinki Helsinki Finland
- Department of Public Health Faculty of Medicine University of Helsinki Helsinki Finland
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26
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Vuorjoki-Ranta TR, Kämppi A, Aarab G, Tuomilehto H, Pihakari A, Lobbezoo F, Ahlberg J. Mandibular advancement device therapy for obstructive sleep apnea: A longitudinal study among patients treated in community dental care in Finland - Potential for the precision medicine approach. Cranio 2020; 40:268-273. [PMID: 32306855 DOI: 10.1080/08869634.2020.1752431] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: Obstructive sleep apnea (OSA) is an increasing health problem worldwide. The aim was to evaluate long-term mandibular advancement device (MAD) therapy outcomes in community dental care among OSA patients in Finland.Methods: In all, 142 (77.2%) respondents of a questionnaire, with recently initiated treatment, were included in the study in 2010. Follow-up questionnaires were mailed in 2012 and 2017.Results: Problems occurred with the device long-term. Orofacial pain was reported more often in 2012 than in 2010 (p < 0.01). Snoring (p < 0.01) and tiredness (p < 0.05) were also significantly increased. In 2017, 50 subjects were still continuing with MAD, 20 of them as a single treatment modality. Treatment modalities in combination with MAD were CPAP, nutrition counseling, and position treatment.Discussion: Long-term MAD treatment may lead to a changing treatment-mix and set-backs. This may not only be a treatment adherence issue but also a lack of precision medicine approach regarding OSA.
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Affiliation(s)
- Tiina-Riitta Vuorjoki-Ranta
- City of Helsinki, Department of Social Services and Health Care, Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Antti Kämppi
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, 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
| | - Henri Tuomilehto
- Oivauni Sleep Clinic, Kuopio, Finland.,Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, 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
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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27
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Nikolopoulou M, Aarab G, Ahlberg J, Hamburger HL, de Lange J, Lobbezoo F. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: A randomized, placebo-controlled trial on temporomandibular side-effects. Clin Exp Dent Res 2020; 6:400-406. [PMID: 32246748 PMCID: PMC7453778 DOI: 10.1002/cre2.288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 01/04/2020] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose To assess the differences in the frequency of clinical signs of temporomandibular disorder (TMD) pain and mandibular function impairment between mandibular advancement device (MAD) and nasal continuous positive airway pressure (nCPAP) therapies in obstructive sleep apnea (OSA) patients at baseline and after 6 month of treatment. Methods This study concerns a secondary analysis of a randomized placebo‐controlled trial in which different treatment effects of an objectively titrated MAD were compared with those of nCPAP and an intra‐oral placebo appliance in a parallel design. Sixty‐four mild to severe OSA patients (52.0 ± 9.6 years) were randomly assigned to these three groups. All patients underwent a shortened functional examination of their masticatory system at baseline and after 6 months to establish the presence of clinical signs of TMD pain. Mandibular function impairment was assessed with a questionnaire. Results Clinical signs of TMD pain were only rarely present at baseline and therapy evaluation. No significant differences were found between the three groups in the (low) frequency of clinical signs of TMD pain at both time points (p = .401–.176). In addition, the (low) scores of mandibular function impairment did not differ between the three groups either, neither at baseline (p = .744) nor after 6 months (p = .359). Conclusions A low frequency of clinical signs of TMD pain in mild to severe OSA patients was found after 6 months, regardless of treatment with MAD or nCPAP. In addition, no difference in mandibular function impairment was observed between the different treatment modalities.
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Affiliation(s)
- Maria Nikolopoulou
- Department of Orofacial Pain and Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre of 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
| | - Hans L Hamburger
- Amsterdam Sleep Centre, Boerhaave Medical Centre, Amsterdam, The Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Centre and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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28
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Manfredini D, Ahlberg J, Aarab G, Bracci A, Durham J, Ettlin D, Gallo LM, Koutris M, Wetselaar P, Svensson P, Lobbezoo F. Towards a Standardized Tool for the Assessment of Bruxism (STAB)—Overview and general remarks of a multidimensional bruxism evaluation system. J Oral Rehabil 2020; 47:549-556. [DOI: 10.1111/joor.12938] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/03/2020] [Accepted: 01/22/2020] [Indexed: 12/14/2022]
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 Oral and Maxillofacial Diseases University of Helsinki Helsinki Finland
| | - Alessandro Bracci
- Department of Neuroscience School of Dentistry University of Padova Padova Italy
| | - Justin Durham
- Newcastle University’s School of Dental Sciences Newcastle UK
| | - Dominik Ettlin
- Clinic of Masticatory Disorders Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Luigi M. Gallo
- Clinic of Masticatory Disorders Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Michail Koutris
- 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
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function Department of Dentistry and Oral Health Aarhus University Aarhus Denmark
- Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON) Aarhus Denmark
| | - Frank Lobbezoo
- Department of Orofacial pain and Dysfunction Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
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29
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van Selms MKA, Wiegers JW, van der Meer HA, Ahlberg J, Lobbezoo F, Visscher CM. Temporomandibular disorders, pain in the neck and shoulder area, and headache among musicians. J Oral Rehabil 2019; 47:132-142. [PMID: 31520546 PMCID: PMC7004094 DOI: 10.1111/joor.12886] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 06/20/2019] [Revised: 08/20/2019] [Accepted: 09/11/2019] [Indexed: 12/14/2022]
Abstract
Background Uncertainties still exist about the role of playing musical instruments on the report of musculoskeletal complaints and headache. Objectives To evaluate the prevalence of and risk indicators for symptoms of temporomandibular disorders, pain in the neck or shoulder, and headache among musicians. Methods A questionnaire was distributed among 50 Dutch music ensembles. Results The questionnaire was completed by 1470 musicians (response rate 77.0%). Of these, 371 musicians were categorised as woodwind players, 300 as brass players, 276 as upper strings players, 306 as vocalists and 208 as controls; nine musicians had not noted their main instrument. The mean age was 41.6 years (standard deviation [SD] 17.2), and 46.5% were male. Irrespective of instrumentalist group, 18.3% of the musicians reported TMD pain, 52.5% reported pain in the neck and shoulder area, and 42.5% reported headache. Of the functional complaints, 18.3% of the musicians reported TMJ sounds, whereas a jaw lock or catch on opening or on closing was reported by 7.1% and 2.4%, respectively. TMD pain was associated with playing a woodwind instrument, whereas pain in the neck and shoulder was associated with playing the violin or viola. For each complaint, oral behaviours were found as risk indicator, supplemented by specific risk indicators for the various complaints. Conclusions The current finding that pain‐related symptoms varied widely between instrumentalist groups seems to reflect the impact of different instrument playing techniques. Playing a musical instrument appears not the primary aetiologic factor in precipitating a functional temporomandibular joint problem.
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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
| | - Jetske W Wiegers
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hedwig A van der Meer
- 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
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - 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
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30
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Manfredini D, Ahlberg J, Wetselaar P, Svensson P, Lobbezoo F. The bruxism construct: From cut‐off points to a continuum spectrum. J Oral Rehabil 2019; 46:991-997. [DOI: 10.1111/joor.12833] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 04/29/2019] [Accepted: 06/10/2019] [Indexed: 12/31/2022]
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
| | - Peter Wetselaar
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health Aarhus University Aarhus Denmark
- Department of Dental Medicine Karolinska Institutet Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON) Aarhus Denmark
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
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31
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Ahlberg J, Wiegers JW, van Selms MKA, Peltomaa M, Manfredini D, Lobbezoo F, Savolainen A, Tuomilehto H. Oro-facial pain experience among symphony orchestra musicians in Finland is associated with reported stress, sleep bruxism and disrupted sleep-Independent of the instrument group. J Oral Rehabil 2019; 46:807-812. [PMID: 31081155 DOI: 10.1111/joor.12818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 02/05/2019] [Revised: 04/27/2019] [Accepted: 05/09/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND To evaluate whether oro-facial pain experience was related to the type of musical instrument and to learn more about the roles of sleep and sleep-related issues in the pain among professional musicians. OBJECTIVES A standard questionnaire was sent to all Finnish symphony orchestras (n = 19), with altogether 1005 professional musicians and other personnel. METHODS The questionnaire covered descriptive data, instrument group, items on perceived quality of sleep, possible sleep bruxism, stress experience and oro-facial pain experience during the past 30 days. RESULTS In the present study, which included the musicians only, the response rate was 58.7% (n = 488). All orchestras participated in the study, and there was no significant difference in the response rate between the orchestras. The mean age of men (52.3%) was 47.7 (SD 10.3) and of women (47.7%) was 43.4 (SD 9.8) years (P < 0.001). Overall, current pain in the oro-facial area was reported by 28.9%, frequent bruxism by 12.1% and frequent stress by 20.8%. According to Somers' d, there were statistically significant but moderate correlations between overall pain reports in the oro-facial area and disrupted sleep (d = 0.127, P = 0.001), sleep bruxism (d = 0.241, P < 0.001) and stress experiences (d = 0.193, P < 0.001). Logistic regression revealed, independent of the instrument group (string, woodwind, brass wind, percussion), that current oro-facial pain experience was significantly associated with disrupted sleep (P = 0.001), frequent sleep bruxism (P < 0.001) and frequent stress (P = 0.002) experiences. CONCLUSIONS Among symphony orchestra musicians, oro-facial pain experience seems to be related to perceptions of stress, sleep bruxism and disrupted sleep rather than the instrument group.
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Affiliation(s)
- Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jetske W Wiegers
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - 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
| | - Miikka Peltomaa
- Department of Otolaryngology, Head and Neck Surgery, University of Helsinki, 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
| | - Aslak Savolainen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Henri Tuomilehto
- Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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Wetselaar P, Manfredini D, Ahlberg J, Johansson A, Aarab G, Papagianni CE, Reyes Sevilla M, Koutris M, Lobbezoo F. Associations between tooth wear and dental sleep disorders: A narrative overview. J Oral Rehabil 2019; 46:765-775. [PMID: 31038764 PMCID: PMC6852513 DOI: 10.1111/joor.12807] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [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: 10/20/2018] [Revised: 04/11/2019] [Accepted: 04/25/2019] [Indexed: 12/16/2022]
Abstract
Objectives Tooth wear is a common finding in adult patients with dental sleep disorders. The aim of this paper was to review the literature on the possible associations between tooth wear and the following dental sleep disorders: sleep‐related oro‐facial pain, oral moistening disorders, gastroesophageal reflux disease (GERD), obstructive sleep apnoea syndrome (OSAS) and sleep bruxism. Methods A PubMed search was performed on 1 June 2018 using MeSH terms in the following query: Tooth Wear AND (Facial Pain OR Temporomandibular Joint Disorders OR Xerostomia OR Sialorrhea OR Gastroesophageal Reflux OR Sleep Apnea Syndrome OR Sleep Bruxism). Results The query yielded 706 reports on tooth wear and the mentioned dental sleep disorders. Several associations between tooth wear and the dental sleep disorders were suggested in the literature. It could be concluded that: (a) tooth wear is associated with dental pain and/or hypersensitivity; (b) oral dryness is associated with tooth wear, oro‐facial pain and sleep bruxism; (c) GERD is associated with tooth wear, oro‐facial pain, oral dryness, OSAS and sleep bruxism; (d) OSAS is associated with oral dryness, GERD and sleep bruxism; and (e) sleep bruxism is associated with tooth wear. Conclusions Tooth wear is associated with the dental sleep disorders oro‐facial pain, oral dryness, GERD and sleep bruxism. The dental sleep disorders are interlinked with each other, which leads to indirect associations as well, and makes the consequences of each single condition difficult to disentangle. Knowledge of these associations is clinically relevant, but more research is needed to confirm their validity.
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Affiliation(s)
- Peter Wetselaar
- 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, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anders Johansson
- Departement of Clinical Dentistry-Prosthodontics, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Chryssa E Papagianni
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marisol Reyes Sevilla
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Osiewicz MA, Lobbezoo F, Bracci A, Ahlberg J, Pytko-Polończyk J, Manfredini D. Ecological Momentary Assessment and Intervention Principles for the Study of Awake Bruxism Behaviors, Part 2: Development of a Smartphone Application for a Multicenter Investigation and Chronological Translation for the Polish Version. Front Neurol 2019; 10:170. [PMID: 30890999 PMCID: PMC6411636 DOI: 10.3389/fneur.2019.00170] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 01/06/2019] [Accepted: 02/08/2019] [Indexed: 12/17/2022] Open
Abstract
Objectives: The aim is to describe the process of translating the smartphone application BruxApp into Polish within the context of an ongoing multicenter project on awake bruxism (AB) epidemiology. Material and Methods: An ongoing cooperation involving 11 universities is based on the adoption of the smartphone-based EMA protocol to collect real time report of AB behaviors in the natural environment. The English version of BruxApp is adopted as a template for the multi-language translation, according to a step-by-step procedure led by mother-tongue experts in the field. A dedicated web platform for translation (viz., POEditor) is used. The process of translation into Polish is here described as an example. Results: There are two software versions available, viz., BruxApp and BruxApp Research. For both versions, back translation from Polish to English was performed to verify the accuracy of the translation procedure. The validity of the translation has been confirmed by the perfect agreement between the original and back-translated English versions, and the Polish version of BruxApp can thus be introduced in the clinical and research setting to get deeper into the study of AB epidemiology in Poland. Conclusions: As far as clinical studies are concerned, the described strategy to record data can be very useful—patients can acknowledge their habits, monitor changes over time, and implement remedial measures. In the field of research, BruxApp makes it possible to collect and store a huge amount of data about the epidemiology of different forms of awake bruxism, both at the individual level and at the population level.
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Affiliation(s)
- Magdalena A Osiewicz
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Jolanta Pytko-Polończyk
- Department of Integrated Dentistry, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
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Zani A, Lobbezoo F, Bracci A, Ahlberg J, Manfredini D. Ecological Momentary Assessment and Intervention Principles for the Study of Awake Bruxism Behaviors, Part 1: General Principles and Preliminary Data on Healthy Young Italian Adults. Front Neurol 2019; 10:169. [PMID: 30881335 PMCID: PMC6405426 DOI: 10.3389/fneur.2019.00169] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [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: 01/06/2019] [Accepted: 02/08/2019] [Indexed: 12/19/2022] Open
Abstract
Background: Awake bruxism (AB) is an oral condition that has some uncertainties concerning the epidemiology, also due to the different diagnostic strategies that have been adopted to address it in the research setting. The recent new definition of AB suggests that an ecological momentary assessment (EMA), which enables real-time reporting of the condition under study, can implement knowledge on the topic. Objectives: This article will discuss the general principles of EMA and EMI (Ecological Momentary Intervention) and comment on a preliminary dataset gathered with a smartphone application in a population of Italian young adults. Materials and Methods: A dedicated smartphone application has been used (BruxApp®) on a sample of 30 University students (mean age 24 ± 3.5 years) to record real time report on five specific oral conditions (relaxed jaw muscles, tooth contact, teeth clenching, teeth grinding, mandible bracing) that are related with the spectrum of AB activities. Data were recorded over a 7-day period for two times, with a 1-month interval between the two observation periods. The purpose of collecting data over a second week, 1-month later, was to monitor AB behaviors over time, and test for potential "EMI" effects. Results: Over the first 7 days (T1), the average frequency of relaxed jaw muscles reports at the population level was 62%. Teeth contact (20%) and mandible bracing (14%) were the most frequent AB behaviors. No significant gender differences were detected. One month later, during the second week of data collection (T2), the frequency of the conditions was as follows: relaxed jaw muscles 74%, teeth contact 11% and mandible bracing 13%. Conclusions: These data recorded do not allow any generalization due the unrepresentativeness of the study population. On the other hand, they can be used as templates for future comparisons to get deeper into the study of natural fluctuations of AB behaviors as well as into the potential biofeedback effect of an ecological momentary assessment/intervention. It is important to recognize that the use of smartphone technology may help to set range of values for AB frequency in otherwise healthy individuals, in order to stand as comparisons for selected populations with risk or associated factors.
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Affiliation(s)
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
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Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, Santiago V, Winocur E, De Laat A, De Leeuw R, Koyano K, Lavigne GJ, Svensson P, Manfredini D. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil 2018; 45:837-844. [PMID: 29926505 PMCID: PMC6287494 DOI: 10.1111/joor.12663] [Citation(s) in RCA: 543] [Impact Index Per Article: 90.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2018] [Indexed: 12/23/2022]
Abstract
In 2013, consensus was obtained on a definition of bruxism as repetitive masticatory muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible and specified as either sleep bruxism or awake bruxism. In addition, a grading system was proposed to determine the likelihood that a certain assessment of bruxism actually yields a valid outcome. This study discusses the need for an updated consensus and has the following aims: (i) to further clarify the 2013 definition and to develop separate definitions for sleep and awake bruxism; (ii) to determine whether bruxism is a disorder rather than a behaviour that can be a risk factor for certain clinical conditions; (iii) to re-examine the 2013 grading system; and (iv) to develop a research agenda. It was concluded that: (i) sleep and awake bruxism are masticatory muscle activities that occur during sleep (characterised as rhythmic or non-rhythmic) and wakefulness (characterised by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible), respectively; (ii) in otherwise healthy individuals, bruxism should not be considered as a disorder, but rather as a behaviour that can be a risk (and/or protective) factor for certain clinical consequences; (iii) both non-instrumental approaches (notably self-report) and instrumental approaches (notably electromyography) can be employed to assess bruxism; and (iv) standard cut-off points for establishing the presence or absence of bruxism should not be used in otherwise healthy individuals; rather, bruxism-related masticatory muscle activities should be assessed in the behaviour's continuum.
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Affiliation(s)
- F Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - K G Raphael
- Department of Oral & Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
| | - P Wetselaar
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A G Glaros
- School of Dentistry, University of Missouri-Kansas City, Kansas City, MO, USA
| | - T Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Osaka, Japan
- Sleep Medicine Center, Osaka University Hospital, Osaka, Japan
| | - V Santiago
- Department of Oral & Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
| | - E Winocur
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A De Laat
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
- Department of Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - R De Leeuw
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, Lexington, KY, USA
| | - K Koyano
- Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - G J Lavigne
- Centre d'étude du sommeil, Faculty of Dental Medicine, Université de Montréal and Hôpital du Sacré Coeur, Montréal, PQ, Canada
| | - P Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- Scandinavian Center for Orofacial Neurosciences
| | - D Manfredini
- School of Dentistry, University of Siena, Siena, Italy
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36
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Lobbezoo F, Ahlberg J, Manfredini D. How to label bruxism that is a sign of a disorder? That's the question! Response to letter by Meira e Cruz & Ettlin (2018). J Oral Rehabil 2018; 45:922-923. [DOI: 10.1111/joor.12717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 09/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Frank Lobbezoo
- Department of Oral Kinesiology; 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
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37
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Manfredini D, Greene CS, Ahlberg J, De Laat A, Lobbezoo F, Klasser GD. Evidence‐based dentistry or meta‐analysis illness? A commentary on current publishing trends in the field of temporomandibular disorders and bruxism. J Oral Rehabil 2018; 46:1-4. [DOI: 10.1111/joor.12707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/06/2018] [Accepted: 08/15/2018] [Indexed: 12/21/2022]
Affiliation(s)
| | | | - Jari Ahlberg
- Institute of DentistryKuopio University HospitalUniversity of Eastern Finland Kuopio Finland
| | - Antoon De Laat
- Department of Oral Health SciencesDepartment of DentistryK.U. LeuvenUniversity Hospitals Leuven Leuven Belgium
| | - Frank Lobbezoo
- Department of Oral KinesiologyAcademic Centre for Dentistry Amsterdam (ACTA)University of Amsterdam and Vrije University Amsterdam Amsterdam The Netherlands
| | - Gary D. Klasser
- Department of Diagnostic SciencesSchool of DentistryLouisiana State University Health Sciences Center New Orleans Louisiana
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Abstract
Background Playing a musical instrument that loads the masticatory system has frequently been linked to temporomandibular disorders (TMDs). Previous literature reviews on this topic do not conform to the current standards of evidence-based medicine. Aims To investigate the effects of playing a musical instrument (i.e. violin/viola and wind instruments) or singing on the presence of TMDs, based on evidence derived from observational studies. Methods Databases of Medline, Web of Science and Google Scholar were searched using MeSH and other relevant terms. For each study, a quality assessment was undertaken using a modified version of the Newcastle-Ottawa Scale (NOS). Results Fifteen relevant papers were identified for inclusion in this review. Of the seven possible points that could be scored with the NOS, the majority of these studies scored under half. Based on the available evidence, the purported relationship between the playing of specific musical instruments and TMDs was not as evident as reported in previous literature reviews. Conclusions There is limited evidence to conclude that playing a wind instrument is a hazard to the temporomandibular system. Furthermore, there is no available evidence to suggest that vocalists experience more TMDs than controls. The studies that investigated the presence of TMDs among violists and violinists yielded ambiguous outcomes; some studies reported no association between the playing of these instruments and the presence of signs and symptoms of TMDs, whereas in studies where a clinical examination was performed (though of lower methodological quality), an association was found.
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Affiliation(s)
- M K A van Selms
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands
| | - J Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, PO Box 41, Mannerheimintie 172, FIN-00014, Helsinki, Finland
| | - F Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands
| | - C M Visscher
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands
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Miettinen T, Myllymaa K, Westeren-Punnonen S, Ahlberg J, Hukkanen T, Töyräs J, Lappalainen R, Mervaala E, Sipilä K, Myllymaa S. At-home quantification of sleep characteristics with self-applicable facial electrode set. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Miettinen T, Myllymaa K, Westeren-Punnonen S, Ahlberg J, Hukkanen T, Toyras J, Lappalainen R, Mervaala E, Sipila K, Myllymaa S, Miettinen T, Myllymaa K, Westeren-Punnonen S, Ahlberg J, Hukkanen T, Toyras J, Lappalainen R, Mervaala E, Sipila K, Myllymaa S. Success Rate and Technical Quality of Home Polysomnography With Self-Applicable Electrode Set in Subjects With Possible Sleep Bruxism. IEEE J Biomed Health Inform 2017; 22:1124-1132. [PMID: 28829322 DOI: 10.1109/jbhi.2017.2741522] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Using sleep laboratory polysomnography (PSG) is restricted for the diagnosis of only the most severe sleep disorders due to its low availability and high cost. Home PSG is more affordable, but applying conventional electroencephalography (EEG) electrodes increases its overall complexity and lowers the availability. Simple, self-administered single-channel EEG monitors on the other hand suffer from poor reliability. In this study, we aimed to quantify the reliability of self-administrated home PSG recordings conducted with a newly designed ambulatory electrode set (AES) that enables multichannel EEG, electrooculography, electromyography, and electrocardiography recordings. We assessed the sleep study success rate and technical quality of the recordings performed in subjects with possible sleep bruxism (SB). Thirty-two females and five males aged 39.6 ± 11.6 years (mean±SD) with self-reported SB were recruited in the study. Self-administrated home PSG recordings with two AES designs were conducted (n = 19 and 21). The technical quality of the recordings was graded based on the proportion of interpretable data. Technical failure rate for AES (both designs) was 5% and SB was scorable for 96.9% of all recorded data. Only one recording failed due to mistakes in self-applying the AES. We found that the proportion of good quality self-administrated EEG recordings is significantly higher when multiple channels are used compared to using a single channel. Sleep study success rates and proportion of recordings with high quality interpretable data from EEG channels of AES were comparable to that of conventional home PSG. Self-applicable AES has potential to become a reliable tool for widely available home PSG.
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Nikolopoulou M, Byraki A, Ahlberg J, Heymans MW, Hamburger HL, De Lange J, Lobbezoo F, Aarab G. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnoea syndrome: a randomised, placebo-controlled trial on self-reported symptoms of common sleep disorders and sleep-related problems. J Oral Rehabil 2017; 44:452-460. [PMID: 28294380 DOI: 10.1111/joor.12505] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2017] [Indexed: 11/30/2022]
Abstract
Obstructive sleep apnoea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomised placebo-controlled trial, sixty-four OSAS patients (52·0 ± 9·6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design. All participants filled out the validated Dutch Sleep Disorders Questionnaire (SDQ) twice: one before treatment and one after six months of treatment. With 88 questions, thirteen scales were constructed, representing common sleep disorders and sleep-related problems. Linear mixed model analyses were performed to study differences between the groups for the different SDQ scales over time. The MAD group showed significant improvements over time in symptoms corresponding with 'insomnia', 'excessive daytime sleepiness', 'psychiatric sleep disorder', 'periodic limb movements', 'sleep apnoea', 'sleep paralysis', 'daytime dysfunction', 'hypnagogic hallucinations/dreaming', 'restless sleep', 'negative conditioning' and 'automatic behaviour' (range of P values: 0·000-0·014). These improvements in symptoms were, however, not significantly different from the improvements in symptoms observed in the nCPAP and placebo groups (range of P values: 0·090-0·897). It can be concluded that there is no significant difference between MAD and nCPAP in their positive effects on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. These beneficial effects may be a result of placebo effects.
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Affiliation(s)
- M Nikolopoulou
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - A Byraki
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - J Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - M W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - H L Hamburger
- Amsterdam Sleep Centre, Boerhaave Medical Centre, Amsterdam, The Netherlands
| | - J De Lange
- Department of Oral and Maxillofacial Surgery, Academic Medical Centre of the University of Amsterdam and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - F Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - G Aarab
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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Nordin P, Ahlberg J, Johansson H, Holmberg H, Hafström L. Risk factors for injuries associated with damage claims following groin hernia repair. Hernia 2017; 21:215-221. [PMID: 28181088 PMCID: PMC5359381 DOI: 10.1007/s10029-017-1585-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 01/16/2016] [Accepted: 01/19/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Surgical repair of groin hernia should be carried out with minimal complication rates, and it is important to have regular quality control and accurate means of assessment. The Swedish healthcare system has a mutual insurance company (LÖF) that receives claims from patients who have suffered healthcare-related damage or malpractice. The Swedish Hernia Register (SHR) currently covers around 98% of all Swedish groin hernia operations. The aim of this study was to analyse damage claims following groin hernia repair surgery and link these with entries in the SHR, in order to identify risk factors and causes of injuries and malpractice associated with hernia repair. METHODS Data on all 48,574 groin hernia operations registered in the SHR between 2008 and 2010 were compared and linked with data on claims made to the Swedish National Patient Injury Insurance (LÖF). RESULTS Of the 130 damage claims received by LÖF, 26 dealt with bleeding, 20 with testicular injury and 7 with intestinal lesions. Eighty (62%) of the complications were considered malpractice according to the Swedish Patient Injury Act. Acute and recurrent surgery, sutured repair and general anaesthesia were associated with a significantly increased risk for a damage claim independently the patients were compensated or not. Females filed claims in greater proportion than males. There was no significant difference in background factors between claims accepted by LÖF and compensated and those who were rejected compensation. CONCLUSION Risk factors for filing a damage claim included acute surgery, operation for recurrence, sutured repair and general anaesthesia, whereas local anaesthesia reduced the risk.
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Affiliation(s)
- P Nordin
- Department of Surgical and Perioperative Sciences, Umeå University, Swedish Hernia Register, Östersund, 901 85, Umeå, Sweden.
| | - J Ahlberg
- Swedish National Patient Insurance Company; LÖF, Stockholm, Sweden
| | - H Johansson
- Department of Surgical Sciences, University Hospital, Uppsala and the Swedish Patient Claims Panel, Stockholm, Sweden
| | - H Holmberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - L Hafström
- Transplant Institute, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Sweden and the Swedish Patient Claims Panel, Gothenburg, Stockholm, Sweden
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Aarab G, Nikolopoulou M, Ahlberg J, Heymans MW, Hamburger HL, de Lange J, Lobbezoo F. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea: a randomized, placebo-controlled trial on psychological distress. Clin Oral Investig 2017; 21:2371-2378. [PMID: 28083705 PMCID: PMC5559560 DOI: 10.1007/s00784-016-2045-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/07/2016] [Indexed: 11/30/2022]
Abstract
Objectives The aim of this randomized placebo-controlled trail was to compare the effects of an objectively titrated mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) and an intraoral placebo device on symptoms of psychological distress in OSA patients. Materials and methods In a parallel design, 64 mild/moderate OSA patients (52.0 ± 9.6 years) were randomly assigned to an objectively titrated MAD, nCPAP, or an intraoral placebo appliance. All patients filled out the Symptom Checklist-90-Revised twice: one before treatment and one after 6 months of treatment. The Symptom Checklist-90-Revised is a multidimensional symptom inventory designed to measure symptomatic psychological distress over the past week. Linear mixed model analyses were performed to study differences between the therapy groups for the different dimensions of the Symptom Checklist-90-Revised over time. Results The MAD group showed significant improvements over time in the dimensions “somatization,” “insufficiency of thinking and acting,” “agoraphobia,” “anxiety,” “sleeping problems,” and “global severity index” (F = 4.14–16.73, P = 0.048–0.000). These improvements in symptoms of psychological distress were, however, not significantly different from those observed in the nCPAP and placebo groups (P = 0.374–0.953). Conclusion There is no significant difference between MAD, nCPAP, and an intraoral placebo appliance in their beneficial effects on symptoms of psychological distress. Clinical relevance The improvement in psychological distress symptoms in mild/moderate OSA patients under MAD or nCPAP treatment may be explained by a placebo effect.
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Affiliation(s)
- Ghizlane Aarab
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - Maria Nikolopoulou
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Hans L Hamburger
- Department of Clinical Neurophysiology and Center for Sleep-Wake Disorders, Slotervaart Medical Center, Amsterdam, The Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery of the Academic Medical Centre of the University of Amsterdam and Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
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Vuorjoki-Ranta TR, Lobbezoo F, Vehkalahti M, Tuomilehto H, Ahlberg J. Treatment of obstructive sleep apnoea patients in community dental care: knowledge and attitudes among general dental practitioners and specialist dentists. J Oral Rehabil 2016; 43:937-942. [DOI: 10.1111/joor.12441] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2016] [Indexed: 01/11/2023]
Affiliation(s)
- T.-R. Vuorjoki-Ranta
- Department of Social Services and Health Care; City of Helsinki; Helsinki Finland
| | - F. Lobbezoo
- Department of Oral Kinesiology; Academic Centre for Dentistry Amsterdam (ACTA), Research Institute MOVE; University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - M. Vehkalahti
- Department of Oral and Maxillofacial Diseases; Faculty of Medicine; University of Helsinki; Helsinki Finland
| | - H. Tuomilehto
- Oivauni Sleep Clinic; Kuopio Finland
- Department of Clinical Nutrition; Institute of Public Health and Clinical Nutrition; University of Eastern Finland; Kuopio Finland
| | - J. Ahlberg
- Department of Oral and Maxillofacial Diseases; Faculty of Medicine; University of Helsinki; Helsinki Finland
- Unit for Specialized Oral Care in the Metropolitan Area and Kirkkonummi; Department of Social Services and Health Care; City of Helsinki; Helsinki Finland
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Abstract
The absorbed dose from 99Tcm-DTPA was estimated from 12 investigations in 9 patients who were evaluated for the patency of ventriculo-peritoneal shunts. The distribution of 99Tcm-DTPA in the ventricles, urinary bladder and peritoneal cavity was determined in regions of interest from repeated static gamma camera images. The effective dose equivalent was calculated to be less than 0.10 mSv for an injected activity of 15 MBq.
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Affiliation(s)
- R. Jonson
- Departments of Radiation Physics, Neurology and Diagnostic Radiology, Sahlgrenska Sjukhuset, University of Gothenburg, S-41345 Gothenburg, Sweden
| | - J. Ahlberg
- Departments of Radiation Physics, Neurology and Diagnostic Radiology, Sahlgrenska Sjukhuset, University of Gothenburg, S-41345 Gothenburg, Sweden
| | - S. Mattsson
- Departments of Radiation Physics, Neurology and Diagnostic Radiology, Sahlgrenska Sjukhuset, University of Gothenburg, S-41345 Gothenburg, Sweden
| | - C. Wikkelsø
- Departments of Radiation Physics, Neurology and Diagnostic Radiology, Sahlgrenska Sjukhuset, University of Gothenburg, S-41345 Gothenburg, Sweden
| | - S. Lindberg
- Departments of Radiation Physics, Neurology and Diagnostic Radiology, Sahlgrenska Sjukhuset, University of Gothenburg, S-41345 Gothenburg, Sweden
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46
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Manfredini D, De Laat A, Winocur E, Ahlberg J. Why not stop looking at bruxism as a black/white condition? Aetiology could be unrelated to clinical consequences. J Oral Rehabil 2016; 43:799-801. [PMID: 27545318 DOI: 10.1111/joor.12426] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- D Manfredini
- School of Dentistry, University of Padova, Padova, Italy.
| | - A De Laat
- Department of Oral Health Sciences, K.U. Leuven and Department of Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - E Winocur
- Orofacial Pain & TMD Clinic, Department of Oral Rehabilitation, The Goldschleger School of Dental Medicine, Tel Aviv, Israel
| | - J Ahlberg
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Affiliation(s)
- Daniele Manfredini
- Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy
| | - Rossano Mura
- Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy
| | - Jari Ahlberg
- Department of Stomatognathic Physiology and Prosthetic Dentistry, Institute of Dentistry, University of Helsinki, Helsinki, Finland
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
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48
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Manfredini D, Ahlberg J, Winocur E, Lobbezoo F. Management of sleep bruxism in adults: a qualitative systematic literature review. J Oral Rehabil 2015; 42:862-74. [PMID: 26095208 DOI: 10.1111/joor.12322] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2015] [Indexed: 11/28/2022]
Abstract
This paper updates the bruxism management review published by Lobbezoo et al. in 2008 (J Oral Rehabil 2008; 35: 509-23). The review focuses on the most recent literature on management of sleep bruxism (SB) in adults, as diagnosed with polysomnography (PSG) with audio-video (AV) recordings, or with any other approach measuring the sleep-time masticatory muscles' activity, viz., PSG without AV recordings or electromyography (EMG) recorded with portable devices. Fourteen (N = 14) papers were included in the review, of which 12 were randomised controlled trials (RCTs) and 2 were uncontrolled before-after studies. Structured reading of the included articles showed a high variability of topics, designs and findings. On average, the risk of bias for RCTs was low-to-unclear, whilst the before-after studies had several methodological limitations. The studies' results suggest that (i) almost every type of oral appliance (OA) (seven papers) is somehow effective to reduce SB activity, with a potentially higher decrease for devices providing large extent of mandibular advancement; (ii) all tested pharmacological approaches [i.e. botulinum toxin (two papers), clonazepam (one paper) and clonidine (one paper)] may reduce SB with respect to placebo; (iii) the potential benefit of biofeedback (BF) and cognitive-behavioural (CB) approaches to SB management is not fully supported (two papers); and (iv) the only investigation providing an electrical stimulus to the masseter muscle supports its effectiveness to reduce SB. It can be concluded that there is not enough evidence to define a standard of reference approach for SB treatment, except for the use of OA. Future studies on the indications for SB treatment are recommended.
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Affiliation(s)
- Daniele Manfredini
- Temporomandibular Disorders Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Ephraim Winocur
- Rehabilitation Department, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
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Ralph K, Nicoletti A, Musvasva E, Cannan S, VanTongeren S, Blanset D, Brodeur S, Ahlberg J, Li H, Fogal S, Desai S, O'Shea K, Kroe-Barrett R, Mainolfi E, Nabozny G, Wu H, Hansen G, Canada K, Singh S, Zhu X, Ramanujam M, Grimaldi C. THU0407 Preclinical Characterization of a Highly Selective and Potent Antagonistic Anti-CD40 mAb. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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50
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Vervoorn-Vis GMGJ, Wetselaar P, Koutris M, Visscher CM, Evälahti M, Ahlberg J, Lobbezoo F. Assessment of the progression of tooth wear on dental casts. J Oral Rehabil 2015; 42:600-4. [PMID: 25752246 DOI: 10.1111/joor.12292] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 11/28/2022]
Abstract
Many methods are available for the grading of tooth wear, but their ability to assess the progression of wear over time has not been studied frequently. The aim was to assess whether the occlusal/incisal grading scale of the Tooth Wear Evaluation System (TWES) was sensitive enough for the detection of tooth wear progression from 14 to 23 years of age. A total of 120 sets of dental casts were gathered from 40 people, of whom impressions were made at 14, 18 and 23 years. The TWES was used to assess loss of clinical crown height throughout the entire dentition. There was a significant difference in the TWES scores between the three age groups on all teeth (Friedman tests; P < 0.005 in all cases). Post hoc Wilcoxon tests revealed that the difference between the scores between 14 and 18 years and between 18 and 23 was significant for most teeth. It was concluded that the TWES is sensitive enough to detect changes in tooth wear over time.
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Affiliation(s)
- G M G J Vervoorn-Vis
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - P Wetselaar
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - M Koutris
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - C M Visscher
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - M Evälahti
- Department of Orthodontics, Institute of Dentistry, University of Helsinki, Helsinki, Finland
| | - J Ahlberg
- Department of Stomatognathic Physiology and Prosthetic Dentistry, Institute of Dentistry, University of Helsinki, Helsinki, Finland
| | - F Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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