Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activity

Department of Operative and Preventive Dentistry and Endodontics, Faculty of Medicine Heinrich-Heine-University, Düsseldorf, Germany.
European Journal Of Oral Sciences (Impact Factor: 1.49). 03/2007; 115(1):7-14. DOI: 10.1111/j.1600-0722.2007.00417.x
Source: PubMed


The impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluate the efficacy of an OS with CBT in SB patients. Following a randomized assignment, the OS group consisted of 29, and the CBT group of 28, SB patients. The CBT comprised problem-solving, progressive muscle relaxation, nocturnal biofeedback, and training of recreation and enjoyment. The treatment took place over a period of 12 wk, and the OS group received an OS over the same time period. Both groups were examined pretreatment, post-treatment, and at 6 months of follow-up for SB activity, self-assessment of SB activity and associated symptoms, psychological impairment, and individual stress-coping strategies. The analyses demonstrated a significant reduction in SB activity, self-assessment of SB activity, and psychological impairment, as well as an increase of positive stress-coping strategies in both groups. However, the effects were small and no group-specific differences were seen in any dependent variable. This is an initial attempt to compare CBT and OS in SB patients, and the data collected substantiate the need for further controlled evaluations, using a three-group randomized design with repeated measures to verify treatment effects.

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    • "Studies focusing physical therapy treatments to improve symptoms of bruxism such as massage of the masticatory and cervical muscles [15], stretching exercises [16], and relaxation therapies [18] are few and often do not describe in detail the treatment. Even rarer are studies that compare physical and dental therapies in individuals with bruxism [14,18]. "
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    ABSTRACT: Bruxism is a parafunctional habit characterized by grinding and/or clenching of the teeth. It may happen while awake (awake bruxism) or while sleeping (sleep bruxism). In adults, the prevalence is 20% for the awake bruxism and 8% for the sleep bruxism. Peripheral, central, and psychosocial factors influence the disorder, which may predispose to pain in the masticatory muscles and neck, headache, decreased pain thresholds in the masticatory and cervical muscles, limitation mandibular range of motion, sleep disorders, stress, anxiety, depression, and overall impairment of oral health. The aim of this study is to compare two distinct physical therapy interventions with dental treatment in pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism. Participants will be randomized into one of three groups: Group 1 (n = 24) intervention will consist of massage and stretching exercises; Group 2 (n = 24) will consist of relaxation and imagination therapies; and Group 3 (n = 24) will receive dental treatment. The evaluations will be performed at baseline, immediately after treatment, and at 2-month follow-up. Pain intensity will be assessed using the visual analogical scale, while pain thresholds will be determined using dolorimetry. Mandibular range of motion will be assessed using digital pachymeter. Sleep quality will be assessed by the Pittsburgh Sleep Quality Index, anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale-10, depression by the Beck Depression Inventory, and oral health will be assessed using the Oral Health Impact Profile - 14. Significance level will be determined at the 5% level. This project describes the randomization method that will be used to compare two physical therapy interventions with dental treatment in the management of pain, mandibular range of motion, sleep quality, anxiety, stress, depression, and oral health in individuals with bruxism. The study will support the practice of evidence-based physical therapy for individuals with bruxism. Data will be published after study is completed.Trial registration: NCT01778881.
    Trials 01/2014; 15(1):8. DOI:10.1186/1745-6215-15-8 · 1.73 Impact Factor
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    • "Some authors believe that childhood bruxism does not always need to be treated since the child is in the growing process and is resistant to bruxism [1]. However, if damage to the stomatognathic system is present, occlusal adjustment and orthodontic braces [15], an interdental splint [20], psychotherapy [15,20—22], and exercise [15] are prescribed. Additional therapeutic modalities have been suggested, but there is no consensus about the most efficient one [23]. "
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    ABSTRACT: Bruxism is characterized by repeated tooth grinding or clenching. The condition can occur in all age ranges and in both genders, being related or not to other oral habits. The objective of the present study was to investigate the occurrence of bruxism in children with nasal obstruction and to determine its association with other factors. Sixty children with nasal obstruction seen at the Otorhinolaryngology Outpatient Clinic of the University Hospital of Ribeirão Preto participated in the study. The data were obtained using a pre-established questionnaire applied to the person responsible and by orofacial evaluation of the patient. The participants were divided into two groups: group with bruxism (GB) as reported by the relatives and with the presence of tooth wear detected by clinical evaluation, and group without bruxism (GWB), consisting of children with none of the two symptoms of bruxism mentioned above. The presence of bruxism exceeded its absence in the sample studied (65.22%). There was no significant difference (P<0.05) between groups regarding gender, phase of dentition, presence of hearing diseases, degree of malocclusion, or child behavior. Bruxism and deleterious oral habits such as biting behavior (objects, lips and nails) were significantly present, together with the absence of suction habits, in the children with nasal obstruction.
    International Journal of Pediatric Otorhinolaryngology 04/2008; 72(3):391-6. DOI:10.1016/j.ijporl.2007.11.014 · 1.19 Impact Factor

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