No abstract available.
Brain ; Brain Injuries ; Bruxism

OBJECTIVETo study the short-term effects of nociceptive trigeminal inhibitory tension suppression system (NTI-tss) and occlusal stabilization splint (OS) on sleep bruxism patients.

METHODSTen patients received the two splint treatments in a randomized cross-over fashion: An NTI-tss and an OS for a 1-week period, respectively. Record the bruxism episodes per hour, micro-arousals per hour of the patients before wearing the splints (baseline), the first night and 1 week after wearing the splints with polysomnography. Statistical analysis was performed with SAS 9.1 by means of mixed effect model analysis.

RESULTSThere were no differences among the micro-arousal index of the baseline, the first night and 1 week later with both types of the splints (P>0.05). The NTI-tss was associated with a significant reduction in bruxism index compared with baseline. The bruxism index of baseline, the first night and 1 week later were 7.50 +/- 1.11, 3.45 +/- 1.22, and 3.51 +/- 1.03 per hour(the first night vs baseline, t=26.52, P<0.01; 1 week vs baseline, t=26.12, P<0.01). There were also significant differences in the bruxism index after wearing the OS. The bruxism index of baseline, the first night and 1 week later were 7.44 +/- 1.23, 2.97 +/- 0.91 and 6.43 +/- 1.02 per hour(the first night vs baseline, t=16.79, P<0.01; 1 week vs baseline, t=3.79, P<0.01). Compared with the NTI-tss group, the reduction was much less, especially 1 week later.

CONCLUSIONBoth the NTI-tss and the OS splints can reduce the bruxism index, and have no affect the incidence of micro-arousal. In this short term study, the NTI-tss was more effective than the OS for the treatment of sleep bruxism.

PURPOSE: Occlusal splints are commonly used to prevent tooth wear caused by bruxism. However, the effects of splints on occlusion are still unclear. Although it is rarely alluded in literature, splints can provoke severe occlusal alterations and other complications. This study was aimed to identify differences in the responses of individuals with bruxism and healthy individuals to a full-arch maxillary stabilization splint in terms of occlusal changes. MATERIALS AND METHODS: Occlusal contacts in 20 (5 male, 15 female) bruxism patients and 20 (5 male, 15 female) controls with normal occlusion were evaluated before and after occlusal splint therapy. T-Scan III, a computerized occlusal analysis system, was used to simultaneously measure occlusion and disclusion times as well as left-right and anterior-posterior contact distributions before splint therapy and 3 months after therapy. Wilcoxon and Mann-Whitney U tests were used for statistical analyses (alpha=.05). RESULTS: No differences were found in the posterior contact of bruxism patients before and after stabilization splint treatment. However, differences in posterior contact were observed between bruxists and normal individuals prior to treatment, and this difference disappeared following treatment. CONCLUSION: The results of this study showed the use of a stabilization splint may not have an effect on occlusion. However, the area of posterior occlusal contact among bruxists was found to be greater than that of normal individuals. According to this study, the clinical use of splints may be harmless.
Bruxism ; Humans ; Male ; Occlusal Splints ; Splints ; Tooth Wear

Bruxism has been defined as an oral parafunctional activity characterized by clenching, bracing, gnashing and grinding of teeth while asleep and or awake. While bruxism has been associated with a number of neurological diseases, it has been mostly highlighted following drug medication. We report 2 female patients of awake bruxism after citalopram medication. The bruxism in these patients was completely or significantly improved after cessation of citalopram. We discuss the pathophyisological mechanism of bruxsm associated with selective serotonin reuptake inhibitors (SSRIs). These cases highlight that bruxism can occur in response to citalopram, as do in other SSRIs.
Braces ; Bruxism* ; Citalopram* ; Female ; Humans ; Serotonin Uptake Inhibitors ; Tooth

This study aimed to assess changes in maximum bite force and psychological elements in patients with bruxism treated with botulinum toxin who visited the hospital with a chief complaint of masseter hypertrophy. From among the subjects with masseter hypertrophy as the chief complaint, 10 patients with and 10 without bruxism were selected. We measured bite force prior to botulinum toxin injection and at 2, 4, 8, and 12 weeks after the injection and assessed changes in psychological elements by using Symptom Checklist 90 Revision. The study results showed statistically significant differences in maximum bite force on both the right and left sides between the patients with and those without bruxism, according to periodic changes (p<0.05). Depression elements showed statistically significant changes in the patients with bruxism (p<0.05). In the bruxism and non-bruxism groups, the patients recovered from anxiety in accordance with the periodic changes (p<0.05). Our study results indicate that the patients with bruxism show significant changes in interpersonal sensitivity, depression, and anxiety according to the treatment periods, and that occlusal force and depression were significantly related. Therefore, when setting a treatment plan for bruxism, multilateral psychological elements must be considered, along with functional elements.
Anxiety ; Bite Force ; Botulinum Toxins* ; Bruxism* ; Checklist ; Depression ; Humans ; Hypertrophy*

OBJECTIVE: To establish a complete workflow of digital design and manufacturing occlusal splint for sleep bruxism, which can be preliminarily applied in clinical use, thus observe the clinical efficacy. METHODS: Twenty-four patients with sleep bruxism were recruited in the study and randomly divided into two groups by using random number tables. Digital-occlusal-splint (experimental group) treatment plan and traditional-occlusal-splint (control-group) treatment plan were carried out for each group, respectively. For experimental group, digital models of patients' both dental arches and the occlusion relationship after elevation were captured using an intraoral scanner. The occlusal splint was carried out by computer aided design/computer aided manufacturing (CAD/CAM), including splint designing and milling. For control group, the traditional soft occlusal splint was fabricated by vacuum laminator. The two kinds of occlusal splints were tried in the patients from each group, and the occlusal contacts were tested respectively by T-scan analysis system, which recorded the changes of occlusal indicators in the two groups. The retention, appearance and occlusal comfort degree were evaluated by the two groups of patients. Mann-Whitney test was performed with IBM SPSS 20.0 software, and bilateral test was performed. P<0.05 was considered to be statistically significant. RESULTS: The complete workflow of digital design and manufacturing occlusal splint was successfully established. During the clinical use, there was no statistical difference in the retention evaluation of two kinds of occlusal splints between the two groups of patients (Z=-0.538, P=0.590). The appearance score (Z=2.038, P=0.042) and the occlusal comfort score (Z=-2.579, P=0.010) of the experimental group were higher than those of the control group, with statistically significant differences. The T-scan analysis results showed that only the second molar on both sides of the traditional occlusal splint had occlusal contact in intercupsal position, while the digital occlusal splint had stable and bilaterally balanced contact between the maxillary and mandibular teeth. Furthermore, the occlusal force was uniformly distributed in the experimental group. CONCLUSION The complete workflow of digital occlusal splint improves the occlusal design, greatly simplifies and optimizes the traditional process of making occlusal splint. This new method is resource-saving and environmental-friendly, and it is able to serve patients more conveniently and efficiently.
Dental Arch ; Dental Occlusion ; Humans ; Occlusal Splints ; Sleep Bruxism ; Workflow

OBJECTIVES: The aim of this study was to evaluate the psychological characteristics of the patients with bruxism by Minnesota Multiphase Personality Inventory(MMPI). METHODS: MMPI was administered to 87 patients(46 bruxism group and 41 control group) who had visited a local dental clinic from January to August 1998. RESULTS: The bruxism group had a higher score than control group in Masculinity-Femininity(Mf) scale. There were no differences between bruxism group and control group on the distribution of Depression(D), Psychopatic Deviate(Pd), Paranoia(Pa), Psychasthenia(Pt) scales. The bruxism group with the family history showed higher score than the bruxism group without family history in Pd scale. Male bruxism group had a higher score than female bruxism group in Defensiveness(K) scale and female bruxism group had higher score than male bruxism group in Pa scale. The bruxism group of clenching type had higher score than the bruxism group of mixed type in Social Introversion(Si) scale. There were no differences in MMPI score between those who had and did not have symptoms such as masticatory musle pain, neck pain and headache. CONCLUSION: It is concluded that individualized approach may be effective to the evaluation of psychological disturbances which might be related to sex, family history and, type of bruxism, while we did not find significant differences in personality charateristics between the bruxism and control groups.
Bruxism* ; Dental Clinics ; Female ; Headache ; Humans ; Male ; Minnesota ; MMPI* ; Neck Pain ; Weights and Measures

PURPOSE: The occlusal splint has been used for many years as an effective treatment of sleep bruxism. Several methods have been used to evaluate efficiency of the occlusal splints. However, the effect of the occlusal splints on occlusal force has not been clarified sufficiently. The purpose of this study was to evaluate the effect of occlusal splints on maximum occlusal force in patients with sleep bruxism and compare two type of splints that are Bruxogard-soft splint and canine protected hard stabilization splint. MATERIALS AND METHODS: Twelve students with sleep bruxism were participated in the present study. All participants used two different occlusal splints during sleep for 6 weeks. Maximum occlusal force was measured with two miniature strain-gage transducers before, 3 and 6 weeks after insertion of occlusal splints. Clinical examination of temporomandibular disorders was performed for all individuals according to the Craniomandibular Index (CMI) before and 6 weeks after the insertion of splints. The changes in mean occlusal force before, 3 and 6 weeks after insertion of both splints were analysed with paired sample t-test. The Wilcoxon test was used for the comparison of the CMI values before and 6 weeks after the insertion of splints. RESULTS: Participants using stabilization splints showed no statistically significant changes in occlusal force before, 3, and 6 weeks after insertion of splint (P>.05) and participants using Bruxogard-soft splint had statistically significant decreased occlusal force 6 weeks after insertion of splint (P<.05). There was statistically significant improvement in the CMI value of the participants in both of the splint groups (P<.05). CONCLUSION: Participants who used Bruxogard-soft splint showed decreases in occlusal force 6 weeks after insertion of splint. The use of both splints led to a significant reduction in the clinical symptoms.
Bite Force* ; Humans ; Occlusal Splints* ; Pilot Projects* ; Sleep Bruxism* ; Splints ; Temporomandibular Joint Disorders ; Transducers

PURPOSE: Various treatment methods have been utilized for recurrent dislocation of the TMJ (temporomandibular joint). The purpose of this study is to define the effect of the eminectomy with discoplasty that had been performed in patients with TMJ luxation. MATERIALS AND EMTHODS: Twenty patients (22 joints), whose diagnosis were TMJ dislocation were selected in 772 patients (871 joints) who had been underwent TMJ surgery between 1988 and 2000. The selected patients were divided into two groups. Group I (12 joints) was the habitual-luxation group which involves the recurrent TMJ dislocation patients. Group II (10 joints) was the open lock-history group which involves the patients who had more than two episodes of TMJ luxation and TMJ disorders. The history of TMJ luxation, maximum mouth opening and other TMJ signs and symptoms before and after surgery were reviewed. RESULTS: In group I, one patient who had been underwent both TMJ operation had a intermittent locking, but it disappeared after post-operative 32 months. In group II, intermittent pain was present in one patient who had bruxism, but it was disappeared by splint therapy. No more TMJ dislocations and other pains were checked in other patients of group I and II. CONCLUSION: Eminectomy with discoplasty may be used to successfully treat the TMJ habitual luxation accompanied with abnormal condition of the disc-condyle complex.
Bruxism ; Diagnosis ; Dislocations* ; Humans ; Mouth ; Splints ; Temporomandibular Joint Disorders ; Temporomandibular Joint*

BACKGROUND: This study clinically evaluated the effect of botulinum toxin type A (BTX-A) in the temporomandibular disorder (TMD) treatment using Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). METHODS: A total of 21 TMD patients were recruited to be treated with BTX-A injections on the bilateral masseter and temporalis muscles and were followed up by an oral and maxillofacial surgeon highly experienced in the TMD treatment. For each patient, diagnostic data gathering were conducted according to the RDC/TMD. Characteristic pain intensity, disability points, chronic pain grade, depression index, and grade of nonspecific physical symptoms were evaluated. Wilcoxon signed-rank test was applied for statistical analysis. RESULTS: The results showed that more than half of the participants (85.7 %) had parafunctional oral habits such as bruxism or clenching. In comparison between pre- and post-treatment results, graded pain score, characteristic pain intensity, disability points, chronic pain grade, and grade of nonspecific physical symptoms showed statistically significant differences after the BTX-A injection therapy (p < 0.05). Most patients experienced collective decrease in clinical manifestations of TMD including pain relief and improved masticatory functions after the treatment. CONCLUSIONS: Within the limitation of our study, BTX-A injections in masticatory musculatures of TMD patients could be considered as a useful option for controlling complex TMD and helping its associated symptoms.
Botulinum Toxins, Type A ; Bruxism ; Chronic Pain ; Depression ; Humans ; Muscles ; Oral and Maxillofacial Surgeons ; Temporomandibular Joint Disorders*