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.

Bruxism ; Humans ; Occlusal Splints ; Polysomnography ; Sleep Bruxism ; Splints

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

OBJECTIVE: To investigate the correlation between the clinical diagnostic criteria of sleep bruxism and the frequency of mandibular movements during sleep. METHODS: Video polysomnography was used to record 20 healthy adults with at least one of the following clinical symptoms and signs: 1) report of frequent tooth grinding; 2) tooth wear and dentin exposure with at least three occlusal surfaces; 3) masticatory muscle symptoms in the morning; 4) masseter muscle hypertrophy. The rhythmic masticatory muscle activity (RMMA) and isolated tonic activity were scored to compare the correlations with clinical symptoms and signs. Finally, the incidence of temporomandibular disorders (TMD) was investigated in patients with isolated tonic and RMMA subjects. RESULTS: Among the 20 subjects, RMMA events were observed (5.8±3.1) times·h⁻¹ and isolated tonic episodes were observed (2.1±0.9) times·h⁻¹. The frequency of RMMA events was significantly greater in the patients with acoustic molars than in those without (P<0.05). Similarly, the frequency of RMMA events was significantly greater in the patients with tooth attrition than in those without (P<0.05). However, no difference was observed between the occurrence of RMMA and the symptoms of masticatory muscles or masseter hypertrophy in the morning. The incidence of TMD was significantly higher in the patients with RMMA than in the isolated tonic patients. CONCLUSIONS The clinical symptoms and signs often used to diagnose sleep bruxism are different clinical and physiological mandibular movements during sleep. RMMA during sleep can reflect the occurrence of tooth attrition and the high risk of TMD.
Adult ; Electromyography ; Humans ; Masticatory Muscles ; Polysomnography ; Sleep ; Sleep Bruxism ; Tooth Attrition

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

OBJECTIVETo access the effect of wireless biofeedback therapy on bruxism.

METHODSTen voluntary bruxers (seven female and three male, mean age 26.1 years) were invited to participate in this clinical research. An electric resistance strain gauge was embedded in the position of canine of a maxillary splint for monitoring the abnormal clenching or grinding movement of teeth during sleep. The relevant details of bruxism events, including value of relative force, occurring time and duration were recorded and analyzed by the receiver device and monitoring program respectively. Meanwhile, for the purpose of nerve system and muscle relaxation, a watch-style device around the patient's wrist will vibrate to alert the patient of teeth grinding or clenching if the value of biting force and duration exceed the threshold. Total average episodes of bruxism and duration was observed during eight hours sleep, and was analyzed with one-way analysis of variance in SPSS 19.0 by the end of 6th week and three months following biofeedback therapy.

RESULTSThe average episodes of bruxism has declined dramatically from (9.8 ± 2.2) times to (3.0 ± 1.2) times during one night (P < 0.05), and the average duration of bruxism events was reduced from (20.7 ± 12.2) s to (10.0 ± 3.4) s (P < 0.05) after six weeks biofeedback therapy. By the end of three months, the average episodes declined to (2.9 ± 1.2) times (P < 0.05), and the average duration decline to (9.2 ± 2.9) s (P < 0.05) with contrast to preliminary night.

CONCLUSIONSThe pressure-based wireless biofeedback device is able to monitoring clenching and grinding of bruxism. The results suggest that biofeedback therapy may be an effective, novel and convenient measure for treatment of bruxism according to several months therapy.

Adult ; Biofeedback, Psychology ; instrumentation ; Female ; Humans ; Male ; Occlusal Splints ; Sleep Bruxism ; therapy ; Young Adult

OBJECTIVETo analyze the sleep electrophysiological changes and the sleep structure changes in children with bruxism by use of the polysomnography.

METHODSTwelve children with severe bruxism and 11 children who had no systemic diseases or sleep disorders were selected for polysomnography.

RESULTSThe proportion of nonrapid eye movements sleep (NREMS)II and NREMS IV stages in bruxism group were (45.7 ± 7.1)% and (19.2 ± 4.9)%, while the control group were (52.9 ± 5.8)% and (13.3 ± 5.3)% respectively. The sleep efficiency and the latency of sleep were (84.0 ± 8.0)% and (39.33 ± 28.73) min in bruxism group, and (94.0 ± 3.7)% and (10.27 ± 7.57) min in the control group respectively. The difference was statistically significant.

CONCLUSIONSThe sleep structure is inordinate in bruxism children.

Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Male ; Polysomnography ; Sleep ; physiology ; Sleep Bruxism ; physiopathology ; Sleep Stages ; physiology ; Sleep, REM ; physiology

OBJECTIVES: The purpose of this study was to investigate the prevalence of sleep problems in Korean elementary school children and the differences in sleep problems related to their school grade and gender. METHODS: One public elementary school in Dae-gu, Korea was randomly selected. And, parents who agreed to participate this study were asked to complete a modified version of Tucson Children's Assessment of Sleep Apnea screening questionnaire (TuCASA). RESULTS: The most common sleep problem was 'falling asleep in a vehicle (44.2%)' and the prevalence rate of this problem differed by school grade. The prevalence rate of falling asleep while watching TV before 8 P.M. (8.0%), daytime fatigue (21.9%) and nocturnal enuresis during the past 6 months (5.3%) were significantly differed by school grade. The prevalence rate of falling asleep while doing home work, falling asleep during a lesson, snoring and bruxism were 12.6%, 1.0%, 26.7% and 13.2% respectively. Although these rates did not show any differences between grades, snoring was more in boys and daytime fatigue was more in girls.. CONCLUSION: This study demonstrates that many elementary school children may have various sleep problems. Lower grade elementary schoolers had sleep problems which related to neuro-developmental factors, whereas higher grade elementary schoolers had sleep problems related to sleep deprivation and stress. Finally, more female schooler showed signs of fatigue or sleepiness than male schoolers.
Bruxism ; Child ; Fatigue ; Female ; Humans ; Korea ; Male ; Mass Screening ; Nocturnal Enuresis ; Parents ; Prevalence ; Sex Characteristics ; Sleep Apnea Syndromes ; Sleep Deprivation ; Snoring ; Surveys and Questionnaires

PURPOSE: To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces. METHODS: Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire. RESULTS: Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was 4.35±3.02 years (range, 0–18 years). The male to female ratio was 1:0.93 (466 boys, 435 girls). Habitual snoring (>3 day/week) was reported in 16.9% of the participants. The prevalence of habitual snoring in children <2 years and those between 2–5 years was 9% and 18%, respectively. Sleep disordered breathing was found in 15.1% (106 of 700) of children >2 years. Insomnia was reported in 13.2% of children. The prevalence of sleepwalking, night terrors, and bruxism, is 1.6%, 19%, and 21.1%, respectively. Snoring was associated with increased incidence of sleepwalking, night terrors, and bruxism. Age was associated with insomnia and habitual snoring (P<0.05). Insomnia was more prevalent in younger (21%) than in older children (6%). Snoring was more frequent in both preschool (34%) and school-aged children (33%). The frequency of sleep disordered breathing and insomnia did not vary significantly with gender. However, snoring was more prevalent in boys. CONCLUSION: Sleep problems are frequent among children in Korea. Children with snoring have an increased risk of sleepwalking, night terror, and bruxism. Primary clinicians should consider children's sleep habits to improve their health.
Adolescent* ; Ambulatory Care Facilities ; Bruxism ; Child* ; Female ; Gyeonggi-do ; Humans ; Incidence ; Korea ; Male ; Night Terrors ; Parents ; Prevalence ; Seoul ; Sleep Apnea Syndromes ; Sleep Initiation and Maintenance Disorders ; Snoring ; Somnambulism

PURPOSE: This study was performed to investigate the relationship between sleep bruxism (SB) and pulpal calcifications in young women. MATERIALS AND METHODS: A total of 100 female participants between 20 and 31 years of age who were referred to our radiology clinic for a dental check-up, including 59 SB and 41 non-SB patients, were sampled for the analysis. SB was diagnosed based on the American Academy of Sleep Medicine criteria. All teeth were evaluated on digital panoramic radiographs to detect pulpal calcifications, except third molars, teeth with root canal treatment, and teeth with root resorption. Binary logistic regression analysis was used to determine the risk factors for pulpal calcifications. The Spearman correlation coefficient was applied and the Pearson chi-square test was used for categorical variables. To test intra-examiner reproducibility, Cohen kappa analysis was applied. P values < .05 were considered to indicate statistical significance. RESULTS: A total of 2800 teeth were evaluated (1652 teeth from SB patients and 1148 from non-SB patients), and 61% of patients had at least 1 dental pulpal calcification. No statistically significant relationship was found between SB and pulpal calcifications (P>0.05). In SB patients, the total number of pulpal calcifications was 129, while in non-SB patients, it was 84. Binary logistic analysis showed that SB was not a risk factor for the presence of pulpal calcifications (odds ratio, 1.19; 95% CI, 0.52–2.69, P>.05). CONCLUSION: No relationship was found between SB and pulpal calcifications.
Dental Pulp ; Dental Pulp Calcification ; Dental Pulp Cavity ; Female ; Humans ; Logistic Models ; Molar, Third ; Radiography, Panoramic ; Risk Factors ; Root Resorption ; Sleep Bruxism ; Sleep Medicine Specialty ; Tooth

A case of methylenedioxymethamphetamine(MDMA)-dependent patient, who showed brief flashbacks, mild cognitive impairment and depression after the cessation of MDMA, were reported and its' related references were reviewed. The flashbacks were consisted of spontaneous recurrences of somatic symptoms such as tachycardia, palpitation, tremor, sweating, increased blood pressure which reflected sympathetic activation, trismus, headache, insomnia, bruxism and nightmares as well as behavioral symptoms such as aggressiveness, perceptual disturbances, paranoid ideation, feelings of closeness with others and anxiety, etc. Thereafter, mild cognitive impairments including reduced attention, concentration, visuospatial ability, uncued recall and verbal fluency were persisted with mild depression.
Anxiety ; Behavioral Symptoms ; Blood Pressure ; Bruxism ; Depression ; Dreams ; Headache ; Humans ; Mild Cognitive Impairment ; N-Methyl-3,4-methylenedioxyamphetamine* ; Recurrence ; Sleep Initiation and Maintenance Disorders ; Sweat ; Sweating ; Tachycardia ; Tremor ; Trismus