Sleep bruxism: validity of clinical research diagnostic criteria in a controlled polysomnographic study.

Faculté de médecine dentaire, Université de Montréal, Centre-Ville, Canada.
Journal of Dental Research (Impact Factor: 3.83). 02/1996; 75(1):546-52. DOI: 10.1177/00220345960750010601
Source: PubMed

ABSTRACT The clinical validity of diagnostic criteria for sleep orofacial motor activity--more specifically, bruxism--has never been tested. Polysomnographic recordings from 18 bruxers and 18 asymptomatic subjects, selected according to American Sleep Disorders Association criteria, were analyzed (1) to discriminate sleep bruxism from other orofacial motor activities and (2) to calculate sensitivity, specificity, and predictive values of research criteria. Clinical observations and reports revealed that all 18 bruxers reported frequent tooth-grinding during sleep. Tooth wear was noted in 16 out of 18 bruxers and jaw discomfort reported by six of them. These findings were present in none of the controls. The analysis of polysomnographic data showed that the asymptomatic subjects presented a mean of 1.7 +/- 0.3 bruxism episodes per hour of sleep (sustained or repetitive bursting activity in jaw closer muscles), while bruxers had a significantly higher level of activity: 5.4 +/- 0.6. Controls exhibited 4.6 +/- 0.3 bruxism bursts per episode and 6.2 (from 0 to 23) bruxism bursts per hour of sleep, whereas bruxers showed, respectively, 7.0 +/- 0.7 and 36.1 (5.8 to 108). Bruxism-like episodes with at least two grinding sounds were noted in 14 of the 18 bruxers and in one control. The two groups exhibited no difference in any of the sleep parameters. Based on the present findings, the following polysomnographic diagnostic cut-off criteria are suggested: (1) more than 4 bruxism episodes per hour, (2) more than 6 bruxism bursts per episode and/or 25 bruxism bursts per hour of sleep, and (3) at least 2 episodes with grinding sounds. When the polysomnographic bruxism-related variables were combined under logistic regression, the clinical diagnosis was correctly predicted in 81.3% of the controls and 83.3% of the bruxers. The validity of these clinical research criteria needs now to be challenged in a larger population, over time, and in subjects presenting various levels of severity of sleep bruxism.

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    ABSTRACT: Nocturnal bruxism is associated with gastroesophageal reflux disease (GERD), and GERD is strongly associated with obstructive sleep apnea (OSA). Gender and ethnic differences in the prevalence and clinical presentation of these often overlapping sleep disorders have not been well documented. Our aim was to examine the associations between, and the symptoms associated with, nocturnal GERD and sleep bruxism in patients with OSA, and to examine the influence of gender and ethnicity.
    The Open Respiratory Medicine Journal 01/2014; 8:34-40.
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    ABSTRACT: Objective: Despite theoretical speculation and strong clinical belief, recent research using laboratory polysomnographic (PSG) recording has provided new evidence that frequency of sleep bruxism (SB) masseter muscle events, including grinding or clenching of the teeth during sleep, is not increased for women with chronic myofascial temporomandibular muscle and joint disorder (TMJD). The current project examines lower background masticatory muscle EMG activity during sleep, occurring outside of defined SB and other motor events and reflecting general low-level increase in muscle tone, on myofascial TMJD. Method: The current case-control study compares a large sample of women suffering from chronic myofascial TMJD (n=124) with a demographically matched control group without TMJD (n=46) on sleep background electromyography (EMG) during a laboratory PSG study. Background EMG activity was measured as EMG root mean square (RMS) from the right masseter muscle after lights out. Sleep background EMG activity was defined as EMG RMS remaining after activity attributable to SB, other orofacial activity, other oromotor activity and movement artifacts were removed. Result: Results indicated that median background EMG during these non SB-event periods was significantly higher (p<.01) for women with myofascial TMJD (median=3.31 µV and mean=4.98 µV) than for control women (median=2.83 µV and mean=3.88 µV) with median activity in 72% of cases exceeding control activity. Moreover, for TMD cases, background EMG was positively associated and SB event-related EMG was negatively associated with pain intensity ratings (0-10 numerical scale) on post sleep waking. Conclusion: These data provide the foundation for a new focus on small, but persistent, elevations in sleep EMG activity over the course of the night as a mechanism of myofascial TMJD pain induction or maintenance.
    AADR Annual Meeting & Exhibition 2014; 03/2014
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    ABSTRACT: Introduction: The focus of this investigation is alternative methods of technical fabrication аnd clinical application of eclipse occlusal splints with light polymerization. Purpose: The consideration of the fact that the bruxism is present in up to 90% of our population, led us to our goal to help these patients through exhibition of a method for fabrication of hard and soft occlusal eclise splints whose indication is dependent upon the type of bruxism. Material and methods: To evaluate the effectiveness of manufactured occlusal therapeutic appliances and to discern the advantages and disadvantages arising from this technique of preparation, we treated 120 patients divided into two groups which were again divided into two subgroups. The first subset of the first group of patients had masticatory muscles complaints, and in the second TMJ afflictions. The second group consisted of bruxism patients with solitary attrition in the first and additional hyperemia of the dental pulp in the second subgroup. Results: Registration of the results was performed according to anamnestic data of the patients. After 6 months in the first group, first and second subset, ratio between recovered patients to treated patients was 8/14 and 6/10, in the second group the first and second sub-group was 4/26, 10/20. After 18 months this ratio in the first and second subset of the first group was 8/22 and 12/18 ,while the first and second subset of the second group was 0/30 and 2/28. Conclusion: We conclude that the quality of technical development and clinical application of eclipse splints is better compared to the conservative method of making splints for occlusal treatment. Indexing terms/Keywords: eclipse occlusal splints, repositioning splints, solid occlusal splints soft occlusal splints, bruxism
    Journal Of Harmonized Research (JOHR). 07/2014; 1(1):38-46.

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