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Noguchi T, Kashiwagi K, Fukuda K. The effectiveness of stabilization appliance therapy among patients with myalgia. Clin Exp Dent Res 2020; 6:244-253. [PMID: 32250573 PMCID: PMC7133723 DOI: 10.1002/cre2.266] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The efficacy of stabilization appliance therapy for masticatory muscle pain is debated. Therefore, there are currently no clear usage standards. We analyzed patient factors influencing its efficacy and characterized masticatory muscle pain subtypes to determine appropriate therapy candidates. METHODS This case series study recruited patients diagnosed with local myalgia or myofascial pain and used variables related to temporomandibular disorders in the analysis. We used temporary appliance to screen patients for sleep bruxism for 2 weeks. Afterwards, we initiated therapy with stabilization appliances. Efficacy was evaluated via tenderness intensity during muscle palpation and the treatment satisfaction score after 2 months of treatment. RESULTS We analyzed 62 (91%) patients. Tenderness upon muscle palpation was mitigated in 27 patients. Mitigated tenderness odds ratios were 0.035 for myofascial pain, 0.804 for 15-item Patient Health Questionnaire scores, and 1.915 for facet length. Thirty-nine patients expressed satisfaction; satisfaction odds ratios were 0.855 for 9-item Patient Health Questionnaire scores, 1.606 for facet length, and 4.023 for awake bruxism awareness. CONCLUSIONS Stabilization appliance therapy is most effective for patients with awake bruxism awareness, local myalgia, long facets, and no psychosocial risk factors.
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Affiliation(s)
- Tomoyasu Noguchi
- Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical ScienceTokyo Dental CollegeTokyoJapan
| | - Kosuke Kashiwagi
- Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical ScienceTokyo Dental CollegeTokyoJapan
| | - Kenichi Fukuda
- Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical ScienceTokyo Dental CollegeTokyoJapan
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Klasser GD, Rei N, Lavigne GJ. Sleep bruxism etiology: the evolution of a changing paradigm. J Can Dent Assoc 2015; 81:f2. [PMID: 25633110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Various definitions, classifications and theories been ascribed to bruxism. Knowledge gained through expanding research initiatives have transformed some of the concepts that were once held as truths. Sleep bruxism is no longer considered a parasomnia nor is its etiology believed to be based on purely mechanical factors or psychological Issues. It is now considered to be primarily a sleep-related movement disorder with a yet to be determined multifactorial etiology involving complex multisystem physiological processes. Dental practitioners should recognize the transformation occurring in the study of sleep bruxism, understand the evolution in both definitions and classification of this phenomenon and embrace and consider new concepts related to its etiology. This paradigm shift will certainly affect the daily practice of dentistry.
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Affiliation(s)
- Gary D Klasser
- Louisiana State University School of Dentistry, New Orleans, LA
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Manfredini D, Fabbri A, Peretta R, Guarda-Nardini L, Lobbezoo F. Influence of psychological symptoms on home-recorded sleep-time masticatory muscle activity in healthy subjects. J Oral Rehabil 2011; 38:902-11. [PMID: 21569074 DOI: 10.1111/j.1365-2842.2011.02226.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The present investigation attempts to describe the correlation between sleep-time masticatory muscle activity (MMA) and psychological symptoms by the use of a four-channel electromyography (EMG) home-recording device in a group of 15 healthy volunteers completing a battery of psychometric questionnaires for the assessment of anxiety, depression and anger. The integrated EMG signal was adopted to quantify the work (μV × s) produced by each of the four muscles (bilateral masseter and temporal) during the 5-h recording span and per each 1-h increment. The duration of MMA events and the muscle work during the first hour of sleep was related to trait anxiety scores for both masseter (P = 0·007) and temporalis muscles (P = 0·022). Trait anxiety was also significantly correlated to the total amount of MMA duration (in seconds) of the temporalis muscles (r = 0·558; P = 0·031). The present investigation provides support to the hypothesis that the duration of sleep-time masticatory muscle activity, especially during the early phases of a night's sleep, may be related to anxiety trait and not to anxiety state, depression or anger. These findings may support the view that features related to the individual management of anxiety, viz. trait, are likely to be more important than acute episodes of anxiety, viz. state, in the aetiology of sleep-time masticatory muscle activity. The role of other psychological symptoms is likely to be less important.
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Affiliation(s)
- D Manfredini
- TMD Clinic, Department of Maxillofacial Surgery, University of Padova, Padova, Italy
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Makino M, Masaki C, Tomoeda K, Kharouf E, Nakamoto T, Hosokawa R. The relationship between sleep bruxism behavior and salivary stress biomarker level. INT J PROSTHODONT 2009; 22:43-48. [PMID: 19260426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE Bruxism and parafunctions are potential risk factors for implant and prosthodontic treatment failure. However, the etiology of bruxism remains unknown. This study sought to clarify the relationship between bruxism behavior and a salivary stress biomarker level. MATERIALS AND METHODS Forty-six volunteers (23 men, 23 women) participated in this study. Bruxism behavior was assessed using a self-administered questionnaire, study casts, and BiteStrip, a miniature electronic screener used to detect sleep bruxism. The questionnaire consisted of six items asking about bruxism, occlusion, jaw functional limitation, and dentition. Occlusal wear was assessed from dental casts and calculated as the sum of the facets in the maxillary arch segment. Participants used BiteStrip at home for one night and the score was evaluated. Two-minute stimulated whole saliva samples were collected from participants to measure daytime levels of chromogranin A (CgA), a major salivary stress biomarker. Nonparametric tests of the relationship between variables were performed using the Spearman R and Kendall tau statistical correlation tests. RESULTS There was a positive correlation between self-reported bruxism and self-reported jaw functional limitation. Occlusal wear did not significantly correlate with occlusion, jaw functional limitation, or dentition, but it did significantly correlate with self-reported bruxism behavior, as well as the BiteStrip score. It was interesting to find that the CgA level was significantly negative in correlation with the BiteStrip score. CONCLUSION Sleep bruxism is believed to be a stress-related sleep disorder. The results suggest that daytime psychological stress level is significantly negative in correlation with sleep bruxism behavior.
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Affiliation(s)
- Michiko Makino
- Department of Oral Reconstruction and Rehabilitation, Kyushu Dental College, Graduate School, Fukuoka, Japan
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Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology of bruxism. J Orofac Pain 2009; 23:153-166. [PMID: 19492540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIMS To summarize literature data about the role of psychosocial factors in the etiology of bruxism. METHODS A systematic search in the National Library of Medicine's PubMed Database was performed to identify all peer-reviewed papers in the English literature dealing with the bruxism-psychosocial factors relationship. All studies assessing the psychosocial traits of bruxers (by using questionnaires, interviews, and instrumental and laboratory exams) and reviews discussing the contribution of those factors to the etiology of bruxism were included in this review. RESULTS A total of 45 relevant papers (including eight reviews) were retrieved with a search strategy combining the term "bruxism" with the words stress, anxiety, depression, psychosocial and psychological factors. The majority of data about the association between psychosocial disorders and bruxism came from studies adopting a clinical and/or self-report diagnosis of bruxism. These studies showed some association of bruxism with anxiety, stress sensitivity, depression and other personological characteristics, apparently in contrast with sleep laboratory investigations. A plausible hypothesis is that clinical studies are more suitable to detect awake bruxism (clenching type), while polysomnographic studies focused only on sleep bruxism (grinding type). CONCLUSION Wake clenching seems to be associated with psychosocial factors and a number of psychopathological symptoms, while there is no evidence to relate sleep bruxism with psychosocial disorders. Future research should be directed toward the achievement of a better distinction between the two forms of bruxism in order to facilitate the design of experimental studies on this topic.
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Takemura T, Takahashi T, Fukuda M, Ohnuki T, Asunuma T, Masuda Y, Kondoh H, Kanbayashi T, Shimizu T. A psychological study on patients with masticatory muscle disorder and sleep bruxism. Cranio 2006; 24:191-6. [PMID: 16933460 DOI: 10.1179/crn.2006.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Sleep bruxism (SB) has been believed to be related to stress and psychosocial factors, however their implicit relationship has remained unclear. This study was conducted on patients visiting our clinic with SB and masticatory muscle disorders (MMD) for the purpose of clarifying personality and behavioral traits. This study was conducted on patients of MMD visiting our clinic. The Rosenzweig Picture-Frustration study was performed on each patient. Twenty-seven (27) patients were divided into two groups: 17 patients with SB and 10 patients without. The SB group showed a significantly lower level of E (extrapunitive) reaction than the nonSB group. SB patients showed a significantly higher level of M (impunitive) reaction than those without SB. Concerning the directions of aggression, the percentage of E-A (extraaggression) was significantly lower in SB patients than in those without. On the other hand, the percentage of I-A (intraaggression) was significantly higher in patients with SB than those without. Our study found a new aspect of the patients with MMD and SB: they are not only intraaggressive, but are also unable to be extrapunitive and extraaggressive. Consequently, they are unable to demonstrate adequate self-assertiveness in stressful situations.
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Affiliation(s)
- Takaubu Takemura
- Dept. of Neuropsychiatry, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
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Huynh N, Kato T, Rompré PH, Okura K, Saber M, Lanfranchi PA, Montplaisir JY, Lavigne GJ. Sleep bruxism is associated to micro-arousals and an increase in cardiac sympathetic activity. J Sleep Res 2006; 15:339-46. [PMID: 16911037 DOI: 10.1111/j.1365-2869.2006.00536.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Sleep bruxism (SB) subjects show a higher incidence of rhythmic masticatory muscle activity (RMMA) than control subjects. RMMA is associated with sleep micro-arousals. This study aims to: (i) assess RMMA/SB episodes in relation to sleep cycles; (ii) establish if RMMA/SB and micro-arousals occur in relation to the slow wave activity (SWA) dynamics; (iii) analyze the association between RMMA/SB and autonomic cardiac activity across sleep cycles. Two nights of polygraphic recordings were made in three study groups (20 subjects each): moderate to high SB, low SB and control. RMMA episodes were considered to occur in clusters when several groups of RMMA or non-specific oromotor episodes were separated by less than 100 s. Correlations between sleep, RMMA/SB index and heart rate variability variables were assessed for the first four sleep cycles of each study group. Statistical analyses were done with SYSTAT and SPSS. It was observed that 75.8% of all RMMA/SB episodes occurred in clusters. Micro-arousal and SB indexes were highest during sleep cycles 2 and 3 (P < 0.001). Within each cycle, micro-arousal and RMMA/SB indexes showed an increase before each REM sleep (P <or= 0.02). The cross-correlation plot for micro-arousal index showed positive association from 4 min preceding SB onset in the moderate to high SB subjects (P <or= 0.06). The cross-correlation plot revealed that SWA decreases following SB onset (P <or= 0.05). Further cross-correlation analysis revealed that a shift in sympatho-vagal balance towards increased sympathetic activity started 8 min preceding SB onset (P <or= 0.03). In moderate to severe SB subjects, a clear increase in sympathetic activity precedes SB onset.
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Affiliation(s)
- N Huynh
- Facultés de médecine dentaire et de médecine, Université de Montréal, Montréal, QC, Canada
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Abstract
There is a growing interest in bruxism, as evidenced by the rapidly increasing number of papers about this subject during the past 5 years. The aim of the present review was to provide an update of two previous reviews from our department (one about the aetiology of bruxism and the other about the possible role of this movement disorder in the failure of dental implants) and to describe the details of the literature search strategies used, thus enabling the readers to judge the completeness of the review. Most studies that were published about the etiology during the past 5 years corroborate the previously drawn conclusions. Similarly, the update of the review about the possible causal relationship between bruxism and implant failure reveals no new points of view. Thus, there is no reason to assume otherwise than that bruxism is mainly regulated centrally, not peripherally, and that there is still insufficient evidence to support or refute a causal relationship between bruxism and implant failure. This illustrates that there is a vast need for well-designed studies to study both the aetiology of bruxism and its purported relationship with implant failure.
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Affiliation(s)
- F Lobbezoo
- Department of Oral Function, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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9
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Antonio AG, Pierro VSDS, Maia LC. Bruxism in children: a warning sign for psychological problems. J Can Dent Assoc 2006; 72:155-60. [PMID: 16545178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Bruxism is nonfunctional clenching or grinding of the teeth. It is a destructive habit that may result in tooth wear. Although research on bruxism is extensive, its etiology remains debatable. The literature suggests that bruxism is correlated with both experienced and anticipated life stress. The purpose of this report is to describe 2 cases of severe bruxism in children of similar age with different life histories and to discuss the factors that could have triggered this parafunctional condition.
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Affiliation(s)
- Andréa Gonçalves Antonio
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Brazil..
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Camparis CM, Siqueira JTT. Sleep bruxism: Clinical aspects and characteristics in patients with and without chronic orofacial pain. ACTA ACUST UNITED AC 2006; 101:188-93. [PMID: 16448920 DOI: 10.1016/j.tripleo.2005.01.014] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [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: 09/15/2004] [Revised: 11/29/2004] [Accepted: 01/03/2005] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Evaluation of long-standing sleep bruxism (SB) patients. STUDY DESIGN Descriptive study. RESULTS One hundred subjects with SB (80 women and 20 men, mean age: 36.1+/-11.3 years) were evaluated according to the RDC/TMD and a pain questionnaire (EDOF-HC). The patients were divided into 2 groups: Group A-without (30.0%) and Group B-with orofacial pain (70.0%). AM stiffness: 36.4% in Group A and 88.6% in Group B; mean pain duration: 6.92 years; mean intensity of pain: 4.33 (VAS); quality of pain: tightness/pressure (84.3%); 95.7% of Group B had myofascial pain. Depression and somatization levels were different between the groups (p = 0.001). Higher frequency of depression was found with body pain or presence of comorbidities. CONCLUSION The data presented in this study showed statistical differences between long-standing bruxism without and with chronic facial pain; the two questionnaires allowed interaction between the chief complaint and the clinical findings; depression levels increased with pain in several regions of the body.
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Affiliation(s)
- C M Camparis
- Faculty of Dentistry, State University of São Paulo Julio de Mesquita Filho, São Paulo, Brazil
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11
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Abstract
Evaluation of the prevalence and characteristics of tinnitus in a Brazilian series of sleep bruxism patients. In this descriptive study, 100 patients (80 women and 20 men) were selected through the self-report of grinding teeth during sleep, confirmed by room mate or family member. They were evaluated according to a systematized approach: a questionnaire for orofacial pain and the Portuguese version of the Research Diagnostic Criteria for Temporomandibular Disorders. The patients were divided into two groups: group A, 54 patients with complaint of tinnitus and group B, 46 patients without tinnitus complaint. The mean age was 37.85 (13-66 years) and 34.02 years (20-59 years), respectively, for groups A and B (P = 0.1164). There was statistically significant difference between the two groups, with higher prevalence for the group A, in relation to: presence of chronic facial pain (P = 0.0007); number of areas painful to palpation in the masticatory and cervical muscles (P = 0.0032); myofascial pain in the masticatory muscles (P = 0.0003); absence of teeth without prosthetic replacement (P = 0.0145) and indices of depression (P = 0.0234). Structural alterations of the TMJ, like disc displacement and vertical dimension loss did not differ for the two groups. Tinnitus frequency was higher in patients with sleep bruxism and chronic facial pain. Myofascial pain, number of areas painful to palpation in the masticatory and cervical muscles, higher levels of depression and tooth absence without prosthetic replacement were more frequent in the group with tinnitus.
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Affiliation(s)
- C M Camparis
- Araraquara School of Dentistry, São Paulo State University (UNESP), São Paulo, Brazil
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12
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Watanabe T, Ichikawa K, Clark GT. Bruxism levels and daily behaviors: 3 weeks of measurement and correlation. J Orofac Pain 2004; 17:65-73. [PMID: 12756933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
AIMS To test whether 3-week duration recordings of sleep bruxism are correlated with daily behaviors. METHODS Twelve patients with a sleep bruxism disorder were monitored to see if any daily behaviors (stress, physical activity, anger), jaw-pain/headache symptoms, or sleep quality were correlated with their sleep bruxism levels. A telemetric-based system was used for monitoring bruxism levels, which were detected with an intra-appliance piezoelectric film system. Bruxism was defined as a force applied to the occlusal surface of the splint at or above a level of 10% maximum voluntary contraction. Bruxism levels were recorded at night for at least 3 weeks on the 12 subjects in this study (6 females and 6 males). Patients used standard (100 mm) visual analog scaling methods during this period to rate their daily behaviors, sleep quality, and jaw-pain/headache symptoms in a diary. Correlation analysis was performed between these recorded variables. RESULTS The subjects demonstrated both bruxism and sleep disturbance, and the mean bruxism score for the male subjects was significantly higher than that for the female subjects. Overall, no single diary variable was consistently correlated with the bruxism levels in these subjects. CONCLUSION These data support the conclusion that bruxism is not strongly related to any of the subject's self-monitored daytime activities or sleep quality.
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Affiliation(s)
- Tatsutomi Watanabe
- Showa University, Faculty of Dentistry, Department of Geriatric Dentistry, Tokyo, Japan
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Abstract
PURPOSE The purpose of this clinical pilot study was to evaluate the effect of a tricyclic antidepressant, amitriptyline, on pain-intensity level and level of stress in bruxers. MATERIALS AND METHODS In a randomized, double-blind, crossover experimental design, 10 subjects received active (amitriptyline 25 mg/night) and inactive (placebo 25 mg/night) medication, over a period of 4 weeks. RESULTS The administration of amitriptyline for 4 weeks did not significantly (p >.05) reduce pain intensity. However, it significantly (p <.05) reduced the level of stress perception. CONCLUSION The results of this limited study do not support the administration of small doses of amitriptyline over a period of 4 weeks for the management of pain resulting from sleep bruxism. However, the results support the administration of small doses of amitriptyline for the management of the perception of stress levels associated with sleep bruxism.
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Affiliation(s)
- A J Raigrodski
- Department of Prosthodontics, Louisiana State University School of Dentistry, 1100 Florida Avenue, New Orleans, LA 70119, USA.
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Muzyka BC. Sleep bruxism--new findings. Pract Proced Aesthet Dent 2001; 13:190. [PMID: 11360765] [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] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- B C Muzyka
- Oral Medicine Residency Program, LSU Medical Center, New Orleans, Louisiana, USA
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Major M, Rompré PH, Guitard F, Tenbokum L, O'Connor K, Nielsen T, Lavigne GJ. A controlled daytime challenge of motor performance and vigilance in sleep bruxers. J Dent Res 1999; 78:1754-62. [PMID: 10576172 DOI: 10.1177/00220345990780111301] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Many etiological factors have been suggested for sleep bruxism. Among these, elevated mental and physical alertness has been proposed to characterize sleep bruxers. The present study tests the hypothesis that, during the day-time, sleep bruxers are more vigilant and more prone to react to a motor command than are control subjects. Seven sleep bruxers, diagnosed polysomnographically according to validated research criteria, were matched for age and gender to seven control subjects. A simple reaction time task was selected to assess daytime vigilance and motor responsiveness. The following physiological measures were recorded: reaction time, error rate, electroencephalography, electrocardiography, electromyography, and video detection of body movements. Analysis of these variables showed no differences between groups. During the test, bruxers and controls showed a parallel decrease in EEG vigilance and heart rate over time. Frequency of orofacial and body movements was the same in both groups, and no clenching activity was observed during the experimental test. Subjects' visual analog scale ratings revealed that both controls and bruxers were more competitive after the test than before, and bruxers were slightly more anxious than controls before and after the test. Together, the results indicate that sleep bruxers are neither more vigilant nor more prone to react to a motor command during the daytime than are control subjects.
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Affiliation(s)
- M Major
- Faculté de médecine dentaire, Département de santé buccale, Université de Montréal, Québec, Canada
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