1
|
Cavalcante-Leao BL, Porporatti AL, Cíntia Felicio Adriano R, Santos RS, Vanelli MI, Perez I, Miranda de Araújo C, Stechman-Neto J, Zeigelboim BS. Effects of respiratory exercises in sleep bruxism and associated obstructive sleep apnea: a double-blind, placebo-controlled randomized clinical trial. Acta Odontol Scand 2024; 83:120-125. [PMID: 38578211 DOI: 10.2340/aos.v83.40252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/30/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE The aim of this study is to assess the effects of respiratory exercises (inspiratory and expiratory) in individuals with sleep bruxism (SB) and associated obstructive sleep apnea (OSA). METHODS This is a double-blind, placebo-controlled randomized clinical trial including individuals with SB and associated respiratory events in OSA. Respiratory physical therapy was performed using inspiratory (Threshold® IMT), expiratory (Threshold® PEP) muscle training, and compared with a placebo group. A total of 30 daily respiratory cycles (inspiration and expiration) were performed five times a week for 12 weeks. Individuals were reassessed at two times, at baseline (T1) and after 12 weeks of training (T2) by means of the Pittsburgh Sleep Quality Index and Polysomnography. RESULTS Awakening was significantly different (p ≤ 0.05) between the inspiratory group and placebo 12 weeks after respiratory physical therapy. The number of contractions of the masseter muscle differed between the inspiratory, expiratory, and placebo groups (p ≤ 0.05). CONCLUSION Respiratory physical therapy for OSA improved awaking levels in 80 and 67% of the number of masseter muscle contractions, when compared to placebo. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (No. RBR-9F6JKM).
Collapse
Affiliation(s)
| | - André Luís Porporatti
- Laboratoire de Neurobiologie Oro-Faciale, Université Paris Cité, Paris, France; GHPS Assistance Publique Hopitaux de Paris, Paris, France
| | | | - Rosane Sampaio Santos
- Faculty of Health Sciences, Speech Therapy, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil
| | - Maria Isabel Vanelli
- Faculty of Health Sciences, Dentistry, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil
| | - Isabella Perez
- Faculty of Health Sciences, Dentistry, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil
| | | | - José Stechman-Neto
- Faculty of Health Sciences, Speech Therapy, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil
| | - Bianca Simone Zeigelboim
- Faculty of Health Sciences, Speech Therapy, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil. b
| |
Collapse
|
2
|
Alessandri-Bonetti A, Guglielmi F, Deledda G, Sangalli L, Brogna C, Gallenzi P. Malocclusions, Sleep Bruxism, and Obstructive Sleep Apnea Risk in Pediatric ADHD Patients: A Prospective Study. J Atten Disord 2024; 28:1017-1023. [PMID: 38327066 DOI: 10.1177/10870547231226139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVES Literature presents conflicting results regarding malocclusions, Obstructive Sleep Apnea (OSA) and sleep bruxism in children with ADHD. Aim of this study was to evaluate the prevalence of these parameters. METHODS A prospective study was conducted on 40 consecutive ADHD children referred to the Paediatric Dentistry Unit of Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome. All subjects underwent an orthodontic examination and were screened for OSA and sleep bruxism. Data were compared to a sex- and aged-matched control group. RESULTS Prevalence of high risk of OSA in children with ADHD was 62.5% compared to 10% in the control group (p < .00001). No differences were found in any of the occlusal variables examined between children with ADHD and controls (p > .05). An increased prevalence of sleep bruxism was observed in ADHD children (40%) compared to controls (7.5%) (p < .001). CONCLUSIONS A higher prevalence of OSA risk and probable sleep bruxism were observed in ADHD patients compared with controls. No significant differences were observed in malocclusions d.
Collapse
Affiliation(s)
| | | | - Giulia Deledda
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome
| | | | - Claudia Brogna
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome
| | - Patrizia Gallenzi
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome
| |
Collapse
|
3
|
Thomas DC, Manfredini D, Patel J, George A, Chanamolu B, Pitchumani PK, Sangalli L. Sleep bruxism: The past, the present, and the future-evolution of a concept. J Am Dent Assoc 2024; 155:329-343. [PMID: 38363252 DOI: 10.1016/j.adaj.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/26/2023] [Accepted: 12/26/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND The concept of sleep bruxism (SB) has evolved exponentially over the past several decades. Many theories and hypotheses have been proposed as to the definition, pathophysiology, and management of SB, from the early 1960s through the present. The role of peripheral factors, such as dental occlusion, in the pathogenesis of SB has been discarded. TYPES OF STUDIES REVIEWED The authors searched several electronic databases (ie, PubMed, Google Scholar, Web of Science, Embase, and Ovid MEDLINE) for studies on bruxism. The search was conducted from January 1961 through May 2023 and yielded 4,612 articles, of which 312 were selected for comprehensive review after eliminating duplicates and nonfocused articles. RESULTS There has been an evident progressive shift from the role of peripheral factors, such as dental occlusion, to more central factors, such as the involvement of a central pattern generator as well as the autonomic nervous system, in the genesis of bruxing movements. There is continued robust interest in the dental community to elucidate the contributing factors involved in SB. CONCLUSIONS AND PRACTICAL IMPLICATIONS The neurophysiology of SB appears to be leaning more toward central rather than peripheral factors. There is increasing evidence of the role of the autonomic nervous system, genetics, and comorbidities in the genesis of SB. The scientific literature seems to refute the role of dental occlusion in the causation of bruxing movements. As per the literature, there has been a paradigm shift in the definition and genesis of SB and its possible dental implications and management, which also highlights the need for succinct scientific studies in this regard.
Collapse
|
4
|
Cid-Verdejo R, Chávez Farías C, Martínez-Pozas O, Meléndez Oliva E, Cuenca-Zaldívar JN, Ardizone García I, Martínez Orozco FJ, Sánchez Romero EA. Instrumental assessment of sleep bruxism: A systematic review and meta-analysis. Sleep Med Rev 2024; 74:101906. [PMID: 38295573 DOI: 10.1016/j.smrv.2024.101906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/09/2024] [Accepted: 01/13/2024] [Indexed: 02/02/2024]
Abstract
This systematic review and meta-analysis (MA) aimed to evaluate the diagnostic validity of portable electromyography (EMG) diagnostic devices compared to the reference standard method polysomnography (PSG) in assessing sleep bruxism. This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and was registered with PROSPERO prior to the accomplishment of the main search. Ten clinical studies on humans, assessing the diagnostic accuracy of portable instrumental approaches with respect to PSG, were included in the review. Methodological shortcomings were identified by QUADAS-2 quality assessment. The certainty of the evidence analysis was established by different levels of evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. A meta-analysis of diagnostic test accuracy was performed with multiple thresholds per study applying a two-stage random effects model, using the thresholds offered by the studies and based on the number of EMG bruxism events per hour presented by the participants. Five studies were included. The MA indicated that portable EMG diagnostic devices showed a very good diagnostic capacity, although a high variability is evident in the studies with some outliers. Very low quality of evidence due to high risk of bias and high heterogeneity among included studies suggests that portable devices have shown high sensitivity and specificity when diagnosing sleep bruxism (SB) compared to polysomnography. The tests performed in the MA found an estimated optimal cut-off point of 7 events/hour of SB with acceptably high sensitivity and specificity for the EMG portable devices.
Collapse
Affiliation(s)
- Rosana Cid-Verdejo
- Faculty of Dentistry, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040, Madrid, Spain; Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, Plaza de Francisco Morano s/n, 28670, Madrid, Spain.
| | - Camilo Chávez Farías
- Faculty of Dentistry, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040, Madrid, Spain
| | - Oliver Martínez-Pozas
- Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28933, Alcorcón, Spain; Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009, Madrid, Spain
| | - Erika Meléndez Oliva
- Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Spain; Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009, Madrid, Spain; Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Valencia, Pg. de L'Albereda, 7, 46010, Valencia, Spain
| | - Juan Nicolás Cuenca-Zaldívar
- Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Spain; Grupo de Investigación en Fisioterapia y Dolor, Departamento de Enfermería y Fisioterapia, Facultad de Medicina y Ciencias de La Salud, Universidad de Alcalá, 28801, Alcalá de Henares, Spain; Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), 28222, Majadahonda, Spain; Physical Therapy Unit, Primary Health Care Center "El Abajón", 28231, Madrid, Spain
| | - Ignacio Ardizone García
- Faculty of Dentistry, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040, Madrid, Spain
| | | | - Eleuterio A Sánchez Romero
- Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Spain; Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009, Madrid, Spain; Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| |
Collapse
|
5
|
De Luca Canto G, Pauletto P. Letter to the editor regarding 'Prevalence of bruxism in obstructive sleep apnea patients: A systematic review conducted according to PRISMA guidelines and the Cochrane handbook for systematic reviews of interventions'. J Oral Rehabil 2024; 51:625-627. [PMID: 38012103 DOI: 10.1111/joor.13624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/19/2023] [Accepted: 10/28/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Graziela De Luca Canto
- Department of Dentistry, Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Patrícia Pauletto
- Department of Dentistry, Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
- Faculty of Dentistry, Universidad De Las Américas (UDLA), Quito, Ecuador
| |
Collapse
|
6
|
de Oliveira Chami V, da Rocha JG, Knorst JK, Fensterseifer CK, Ferrazzo VA, Serra-Negra JMC, Marquezan M. Effects of rapid maxillary expansion on sleep disturbance scale for children: A longitudinal CASE-series study. Orthod Craniofac Res 2024; 27:27-32. [PMID: 37282841 DOI: 10.1111/ocr.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/02/2023] [Accepted: 05/10/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the effects of rapid maxillary expansion (RME) on Sleep Disturbance Scale for Children (SDSC) with maxillary atresia. MATERIALS AND METHODS The sample consisted of 27 paediatric patients evaluated through a Brazilian version of the SDSC, answered by their guardians at the following experimental time points: T0 (before installing the Hyrax expander), T1 (on the day of expander stabilization), T2 (3 months after expander stabilization), T3 (immediately after expander removal, following 6 months of retention), and T4 (3 months post-retention). Multilevel Poisson analysis adjusted for repeated measures was performed to compare outcomes across the assessment time points. RESULTS The mean age of patients was 9.1 years (SD = 1.46). The total SDSC scores decreased and were statistically significant from T2 onwards (P < .01), with a decrease of 24% at T4 compared with T1 (IRR 0.76; 95% CI 0.69-0.84). The mean scores at T4 were already lower than the cutoff point for risk of sleep disorders. Regarding the specific domains, there was a significant reduction in sleep breathing disorders, sleep-wake transition disorders, and disorders of excessive somnolence as of T2 (P < .01), T3 (P < .05) and T4 (P < .05), respectively. CONCLUSION RME in children with maxillary atresia had a positive effect on the reduction of total SDSC scores after 3 months of expander stabilization, sustained over 6 and 9 months and significant reduction in sleep breathing disorders domain, sleep-wake transition disorders domain, and disorders of excessive somnolence domain over time points.
Collapse
Affiliation(s)
- Vitória de Oliveira Chami
- Post-Graduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Jessica Klockner Knorst
- Post-Graduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Vilmar Antônio Ferrazzo
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Junia Maria Cheib Serra-Negra
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mariana Marquezan
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| |
Collapse
|
7
|
Cid-Verdejo R, Domínguez Gordillo AA, Hallal-Peche F, Ardizone García I, Martínez Orozco FJ. Is there an association between sleep bruxism and obstructive sleep apnea? A case-control polysomnographic investigation. Sleep Med 2024; 114:1-7. [PMID: 38141521 DOI: 10.1016/j.sleep.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 11/30/2023] [Accepted: 12/10/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES To estimate the statistical and epidemiological association between Sleep bruxism (SB) and Obstructive sleep apnea (OSA) based on OSA severity, and to describe sleep data findings within the analyzed population. METHODS A case-control study (N = 37) was conducted on subjects with and without OSA. All subjects underwent a full-night polysomnographic recording at the Sleep Unit (Clinical Neurophysiology Department) of San Carlos University Hospital. The diagnosis and severity of OSA were determined using ICSD-3 and AASM-2.6 scoring. The definitive SB diagnosis was obtained through a self-report test, physical examination, and PSG recordings. Variables used to study the association between both conditions included the apnea and hypopnea episodes, the Apnea-hypopnea index (AHI), the number of SB episodes per night, and the bruxism index. Chi2, correlations, and ANOVA were calculated. The epidemiological association was calculated using the OR. RESULTS SB showed an epidemiological association with OSA, with an OR of 0.15 (0.036-0.68), suggesting it could be considered a protective factor (p < 0.05). OSA patients presented fewer average SB episodes (6.8 ± 12.31) than non-OSA patients (25.08 ± 31.68). SB episodes correlated negatively (p < 0.05) with the AHI and the number of hypopneas (p < 0.05). The average number of SB episodes was significantly higher in patients with mild OSA compared to those with severe OSA. CONCLUSIONS In this sample of patients with subclinical and mild OSA, SB may act as a protective factor. However, confirmation of these results with a larger sample size is necessary.
Collapse
Affiliation(s)
- Rosana Cid-Verdejo
- Faculty of Dentistry, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040, Madrid, Spain; Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, 28005, Madrid, Spain.
| | | | - Fadi Hallal-Peche
- Clinical Neurophysiology Department, Hospital Central de la Defensa Gómez Ulla, 28028, Madrid, Spain
| | - Ignacio Ardizone García
- Faculty of Dentistry, Universidad Complutense de Madrid, Plaza de Ramón y Cajal s/n, 28040, Madrid, Spain
| | | |
Collapse
|
8
|
Moreno-Hay I, Bender SD. Bruxism and oro-facial pain not related to temporomandibular disorder conditions: Comorbidities or risk factors? J Oral Rehabil 2024; 51:196-201. [PMID: 37644702 DOI: 10.1111/joor.13581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
INTRODUCTION Bruxism has historically been of particular interest to the field of dentistry, primarily due to the inferred damage it may cause to the dentition and supporting periodontal structures. The definition of bruxism itself has undergone multiple changes over time. In addition, the effects of bruxism as it relates to oro-facial pain conditions has remained a debatable topic. PURPOSE To review the available literature relating to bruxism and non-temporomandibular disorder (TMD) pain conditions. METHODS A literature search was conducted with the assistance of an expert librarian. The following databases were reviewed: PubMed, MEDLINE, EMBASE and Google Scholar. For additional references, articles were also retrieved by hand search from the selected papers. Any articles that were not published in English, or the focus were related to temporomandibular disorders were excluded. CONCLUSIONS While bruxism and certain headache conditions do tend to occur together frequently, evidence relating to any clear common pathophysiological mechanism has yet to be fully elucidated. Robust evidence as it relates to the relationship between bruxism and other non-TMD oro-facial pains is also lacking.
Collapse
Affiliation(s)
- Isabel Moreno-Hay
- Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Steven D Bender
- Clinical Center for Facial Pain and Sleep Medicine, Texas A&M Health, Texas A&M School of Dentistry, Dallas, Texas, USA
| |
Collapse
|
9
|
Conti PCR, Cunha CO, Conti ACDCF, Bonjardim LR, Barbosa JS, Costa YM. Secondary bruxism: A valid diagnosis or just a coincidental finding of additional masticatory muscle activity? A narrative review of literature. J Oral Rehabil 2024; 51:74-86. [PMID: 37688286 DOI: 10.1111/joor.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023]
Abstract
INTRODUCTION Bruxism is defined as a repetitive masticatory muscle activity that can manifest it upon awakening (awake bruxism-AB) or during sleep (sleep bruxism-SB). Some forms of both, AB and SB can be associated to many other coexistent factors, considered of risk for the initiation and maintenance of the bruxism. Although controversial, the term 'secondary bruxism' has frequently been used to label these cases. The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques, however, are important factors to be considered when judging the literature findings. The use (and abuse) of drugs, caffeine, nicotine, alcohol and psychoactive substances, the presence of respiratory disorders during sleep, gastroesophageal reflux disorders and movement, neurological and psychiatric disorders are among these factors. The scarcity of controlled studies and the complexity and interactions among all aforementioned factors, unfortunately, does not allow to establish any causality or temporal association with SB and AB. The supposition that variables are related depends on different parameters, not clearly demonstrated in the available studies. OBJECTIVES This narrative review aims at providing oral health care professionals with an update on the co-risk factors and disorders possibly associated with bruxism. In addition, the authors discuss the appropriateness of the term 'secondary bruxism' as a valid diagnostic category based on the available evidence. CONCLUSION The absence of an adequate definition of bruxism, the non-distinction between the circadian manifestations and the report of many different measurement techniques found in many studies preclude any solid and convincing conclusion on the existence of the 'secondary' bruxism.
Collapse
Affiliation(s)
- Paulo Cesar R Conti
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
| | - Carolina Ortigosa Cunha
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
| | - Ana Cláudia de Castro F Conti
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
- Department of Orthodontics and Pediatric Dentistry, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Leonardo R Bonjardim
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
- Department of Biologic Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | | | - Yuri Martins Costa
- Bauru Orofacial Group, University of São Paulo, Bauru, Brazil
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| |
Collapse
|
10
|
Cid-Verdejo R, Domínguez Gordillo AA, Sánchez-Romero EA, Ardizone García I, Martínez Orozco FJ. Diagnostic Accuracy of a Portable Electromyography and Electrocardiography Device to Measure Sleep Bruxism in a Sleep Apnea Population: A Comparative Study. Clocks Sleep 2023; 5:717-733. [PMID: 37987398 PMCID: PMC10660473 DOI: 10.3390/clockssleep5040047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND The gold standard for diagnosing sleep bruxism (SB) and obstructive sleep apnea (OSA) is polysomnography (PSG). However, a final hypermotor muscle activity often occurs after apnea episodes, which can confuse the diagnosis of SB when using portable electromyography (EMG) devices. This study aimed to compare the number of SB episodes obtained from PSG with manual analysis by a sleep expert, and from a manual and automatic analysis of an EMG and electrocardiography (EKG) device, in a population with suspected OSA. METHODS Twenty-two subjects underwent a polysomnographic study with simultaneous recording with the EMG-EKG device. SB episodes and SB index measured with both tools and analyzed manually and automatically were compared. Masticatory muscle activity was scored according to published criteria. Patients were segmented by severity of OSA (mild, moderate, severe) following the American Academy of Sleep Medicine (AASM) criteria. ANOVA and the Bland-Altman plot were used to quantify the agreement between both methods. The concordance was calculated through the intraclass correlation coefficient (ICC). RESULTS On average, the total events of SB per night in the PSG study were (8.41 ± 0.85), lower than the one obtained with EMG-EKG manual (14.64 ± 0.76) and automatic (22.68 ± 16.02) analysis. The mean number of SB episodes decreases from the non-OSA group to the OSA group with both PSG (5.93 ± 8.64) and EMG-EKG analyses (automatic = 22.47 ± 18.07, manual = 13.93 ± 11.08). However, this decrease was minor in proportion compared to the automatic EMG-EKG analysis mode (from 23.14 to 22.47). The ICC based on the number of SB episodes in the segmented sample by severity degree of OSA along the three tools shows a moderate correlation in the non-OSA (0.61) and mild OSA (0.53) groups. However, it is poorly correlated in the moderate (0.24) and severe (0.23) OSA groups: the EMG-EKG automatic analysis measures 14.27 units more than PSG. The results of the manual EMG-EKG analysis improved this correlation but are not good enough. CONCLUSIONS The results obtained in the PSG manual analysis and those obtained by the EMG-EKG device with automatic and manual analysis for the diagnosis of SB are acceptable but only in patients without OSA or with mild OSA. In patients with moderate or severe OSA, SB diagnosis with portable electromyography devices can be confused due to apneas, and further study is needed to investigate this.
Collapse
Affiliation(s)
- Rosana Cid-Verdejo
- Faculty of Dentistry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.A.D.G.); (I.A.G.)
- Department of Clinical Dentistry, Faculty of Biomedical Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | | | - Eleuterio A. Sánchez-Romero
- Interdisciplinary Group on Musculoskeletal Disorders, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
| | - Ignacio Ardizone García
- Faculty of Dentistry, Universidad Complutense de Madrid, 28040 Madrid, Spain; (A.A.D.G.); (I.A.G.)
| | | |
Collapse
|
11
|
Oudkerk J, Grenade C, Davarpanah A, Vanheusden A, Vandenput S, Mainjot AK. Risk factors of tooth wear in permanent dentition: A scoping review. J Oral Rehabil 2023; 50:1110-1165. [PMID: 37147932 DOI: 10.1111/joor.13489] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 03/20/2023] [Accepted: 04/22/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Tooth wear (TW) prevalence is high and increasing and has important consequences on the patient's quality of life. Knowledge of risk factors is crucial to promote diagnosis, prevention strategies and timely interceptive treatment. Many studies have identified TW risk factors. OBJECTIVE This scoping review aims to map and describe suspected available factors associated with TW in permanent dentition based on quantitative measurement. METHODS The scoping review was conducted using the PRISMA extension of the Scoping Reviews checklist. The search was conducted in October 2022 from the Medline® (PubMed® interface) and Scopus® databases. Two independent reviewers selected and characterised the studies. RESULTS 2702 articles were identified for assessment of titles and abstracts, and 273 articles were included in the review. The results show a need to standardise TW measurement indices and the study design. The included studies highlighted various factors, classified into nine domains: sociodemographic factors, medical history, drinking habits, eating habits, oral hygiene habits, dental factors, bruxism and temporomandibular disorders, behavioural factors, and stress. Results related to chemical TW (erosion) risk factors underline the importance of eating disorders, gastroesophageal reflux and lifestyle, particularly drinking and eating behaviours, which supports developing public health information campaigns and interventions. Besides chemical, this review identifies evidence of several mechanical TW risk factors, such as toothbrushing and bruxism; the influence of this last factor needs to be further explored. CONCLUSIONS TW management and prevention require a multidisciplinary approach. Dentists are in the first line to detect associated diseases such as reflux or eating disorders. Consequently, practitioners' information and guideline diffusion should be promoted, and a TW risk factors checklist (the ToWeR checklist) is proposed to help diagnostic approaches.
Collapse
Affiliation(s)
- Julie Oudkerk
- Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium
- Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), Liège, Belgium
| | - Charlotte Grenade
- Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium
- Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), Liège, Belgium
| | - Anoushka Davarpanah
- Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium
| | - Alain Vanheusden
- Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium
- Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), Liège, Belgium
| | | | - Amélie K Mainjot
- Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium
- Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), Liège, Belgium
| |
Collapse
|
12
|
Chang JL, Goldberg AN, Alt JA, Alzoubaidi M, Ashbrook L, Auckley D, Ayappa I, Bakhtiar H, Barrera JE, Bartley BL, Billings ME, Boon MS, Bosschieter P, Braverman I, Brodie K, Cabrera-Muffly C, Caesar R, Cahali MB, Cai Y, Cao M, Capasso R, Caples SM, Chahine LM, Chang CP, Chang KW, Chaudhary N, Cheong CSJ, Chowdhuri S, Cistulli PA, Claman D, Collen J, Coughlin KC, Creamer J, Davis EM, Dupuy-McCauley KL, Durr ML, Dutt M, Ali ME, Elkassabany NM, Epstein LJ, Fiala JA, Freedman N, Gill K, Boyd Gillespie M, Golisch L, Gooneratne N, Gottlieb DJ, Green KK, Gulati A, Gurubhagavatula I, Hayward N, Hoff PT, Hoffmann OM, Holfinger SJ, Hsia J, Huntley C, Huoh KC, Huyett P, Inala S, Ishman SL, Jella TK, Jobanputra AM, Johnson AP, Junna MR, Kado JT, Kaffenberger TM, Kapur VK, Kezirian EJ, Khan M, Kirsch DB, Kominsky A, Kryger M, Krystal AD, Kushida CA, Kuzniar TJ, Lam DJ, Lettieri CJ, Lim DC, Lin HC, Liu SY, MacKay SG, Magalang UJ, Malhotra A, Mansukhani MP, Maurer JT, May AM, Mitchell RB, Mokhlesi B, Mullins AE, Nada EM, Naik S, Nokes B, Olson MD, Pack AI, Pang EB, Pang KP, Patil SP, Van de Perck E, Piccirillo JF, Pien GW, Piper AJ, Plawecki A, Quigg M, Ravesloot MJ, Redline S, Rotenberg BW, Ryden A, Sarmiento KF, Sbeih F, Schell AE, Schmickl CN, Schotland HM, Schwab RJ, Seo J, Shah N, Shelgikar AV, Shochat I, Soose RJ, Steele TO, Stephens E, Stepnowsky C, Strohl KP, Sutherland K, Suurna MV, Thaler E, Thapa S, Vanderveken OM, de Vries N, Weaver EM, Weir ID, Wolfe LF, Tucker Woodson B, Won CH, Xu J, Yalamanchi P, Yaremchuk K, Yeghiazarians Y, Yu JL, Zeidler M, Rosen IM. International Consensus Statement on Obstructive Sleep Apnea. Int Forum Allergy Rhinol 2023; 13:1061-1482. [PMID: 36068685 PMCID: PMC10359192 DOI: 10.1002/alr.23079] [Citation(s) in RCA: 46] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHODS Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULTS The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
Collapse
Affiliation(s)
- Jolie L. Chang
- University of California, San Francisco, California, USA
| | | | | | | | - Liza Ashbrook
- University of California, San Francisco, California, USA
| | | | - Indu Ayappa
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | - Maurits S. Boon
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Pien Bosschieter
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Itzhak Braverman
- Hillel Yaffe Medical Center, Hadera Technion, Faculty of Medicine, Hadera, Israel
| | - Kara Brodie
- University of California, San Francisco, California, USA
| | | | - Ray Caesar
- Stone Oak Orthodontics, San Antonio, Texas, USA
| | | | - Yi Cai
- University of California, San Francisco, California, USA
| | | | | | | | | | | | | | | | | | - Susmita Chowdhuri
- Wayne State University and John D. Dingell VA Medical Center, Detroit, Michigan, USA
| | - Peter A. Cistulli
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - David Claman
- University of California, San Francisco, California, USA
| | - Jacob Collen
- Uniformed Services University, Bethesda, Maryland, USA
| | | | | | - Eric M. Davis
- University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Mohan Dutt
- University of Michigan, Ann Arbor, Michigan, USA
| | - Mazen El Ali
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | | | | | - Kirat Gill
- Stanford University, Palo Alto, California, USA
| | | | - Lea Golisch
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | | | | | - Arushi Gulati
- University of California, San Francisco, California, USA
| | | | | | - Paul T. Hoff
- University of Michigan, Ann Arbor, Michigan, USA
| | - Oliver M.G. Hoffmann
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | - Jennifer Hsia
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Colin Huntley
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | | | - Sanjana Inala
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | | | | | | | | | | | - Meena Khan
- Ohio State University, Columbus, Ohio, USA
| | | | - Alan Kominsky
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Meir Kryger
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Derek J. Lam
- Oregon Health and Science University, Portland, Oregon, USA
| | | | | | | | | | | | | | - Atul Malhotra
- University of California, San Diego, California, USA
| | | | - Joachim T. Maurer
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Anna M. May
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Ron B. Mitchell
- University of Texas, Southwestern and Children’s Medical Center Dallas, Texas, USA
| | | | | | | | | | - Brandon Nokes
- University of California, San Diego, California, USA
| | | | - Allan I. Pack
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | | | | - Mark Quigg
- University of Virginia, Charlottesville, Virginia, USA
| | | | - Susan Redline
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Armand Ryden
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | | | - Firas Sbeih
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | | | | | | | | | - Jiyeon Seo
- University of California, Los Angeles, California, USA
| | - Neomi Shah
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Ryan J. Soose
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Erika Stephens
- University of California, San Francisco, California, USA
| | | | | | | | | | - Erica Thaler
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sritika Thapa
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Nico de Vries
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | | | - Ian D. Weir
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Josie Xu
- University of Toronto, Ontario, Canada
| | | | | | | | | | | | - Ilene M. Rosen
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
13
|
Yanez-Regonesi F, Eisa E, Judge S, Carlson C, Okeson J, Moreno-Hay I. Diagnostic accuracy of a portable device (Bruxoff®) to measure sleep bruxism. J Oral Rehabil 2023; 50:258-266. [PMID: 36648354 DOI: 10.1111/joor.13416] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 10/05/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Diagnosis of sleep bruxism (SB) challenges clinicians every day due to multiple forms of assessment tools available, including self-reported questionnaires, clinical examinations, portable devices and laboratory polysomnography (PSG). PSG has become the gold standard for evaluating SB, but it can be limited due to cost and restricted accessibility which often is characterised by long waiting times. Hence, there is a need for the development of a reliable method that can assess SB in a simple and portable manner, which would offer acceptable sensitivity and specificity to evaluate SB. OBJECTIVE The objective of this study was to investigate reliability and validity of the Bruxoff® device for the diagnosis of SB compared to the PSG. METHODS Forty-nine subjects underwent one night of polysomnographic study with simultaneous recording with the Bruxoff® device. Rhythmic masticatory muscle activity (RMMA) index was scored according to published criteria. Pearson correlation, Bland-Altman plot and receiver operating characteristic (ROC) curve outcomes were used to quantify the agreement between both methods. RESULTS Receiver operating characteristic analysis showed an acceptable accuracy for the Bruxoff® with sensitivity of 83.3% and specificity of 72% when the cut-off was set at two events per hour. Pearson correlation analysis showed a nearly significant correlation between PSG and Bruxoff® for RMMA index (r = .282 p = .071) and for total SB episodes per night (r = .295 p = .058). Additionally, the Bland-Altman plot revealed a consistent and systematic difference in the measurement of events between devices. CONCLUSION The Bruxoff® device appears to be a promising diagnostic method for clinical use, but further study is needed.
Collapse
Affiliation(s)
- Fernanda Yanez-Regonesi
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Elfatih Eisa
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Stephanie Judge
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Charles Carlson
- Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Jeffrey Okeson
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Isabel Moreno-Hay
- Division of Orofacial Pain, Department of Oral Health Science, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| |
Collapse
|
14
|
González González A, Montero J, Gómez Polo C. Sleep Apnea-Hypopnea Syndrome and Sleep Bruxism: A Systematic Review. J Clin Med 2023; 12:jcm12030910. [PMID: 36769558 PMCID: PMC9918154 DOI: 10.3390/jcm12030910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023] Open
Abstract
The aim of this study was o determine the relationship between sleep bruxism (SB) and sleep apnea-hypopnea syndrome (SAHS) at the pathophysiological level, the risk factors, as well as the common signs and symptoms. A search was carried out using the databases PubMed, Web of Science, Scopus, and the Cochrane Library together with the Boolean equation "bruxism" AND "sleep apnea" AND "relation*"; the systematic search strategy limited the results to English language articles published from 2013 until December 2021. This review was conducted in accordance with the PRISMA statement. Nine articles were reviewed to relate SAHS and SB at different levels: two were systematic reviews (22%) and seven were research studies (78%). According to the literature reviewed, SB and SAHS occur simultaneously in 21.0% to 41.3% of cases. There are signs and symptoms that are common to both SAHS and SB. Rhythmic masticatory muscle activity (RMMA) precedes an SAHS event in 25% of subjects with SB, in contrast to 55% of the general population. SB and SAHS seem to have a certain concomitance, ranging between 20% and 40%, and they also share some risk factors such as advanced age, obesity, smoking, and alcohol consumption. Dentists should be aware of this relationship, as part of a multidisciplinary team, for early diagnosis.
Collapse
|
15
|
Okura M, Kato T, Mashita M, Muraki H, Sugita H, Ohi M, Taniguchi M. Relationships between respiratory and oromotor events differ between motor phenotypes in patients with obstructive sleep apnea. Front Neurol 2023; 14:1150477. [PMID: 37025207 PMCID: PMC10071011 DOI: 10.3389/fneur.2023.1150477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 03/02/2023] [Indexed: 04/08/2023] Open
Abstract
Purpose The present study investigated the relationship between sleep bruxism (SB) and obstructive sleep apnea (OSA) in relation to the sleep architecture. Methods We conducted a cross-sectional study. Polysomnographic recordings were performed on 36 patients. Sleep, respiratory, and oromotor variables, such as rhythmic masticatory muscle activity (RMMA) and non-specific masticatory muscle activity (NSMA), were compared between OSA patients with or without SB. A correlation analysis of the frequency of respiratory and oromotor events in NREM and REM sleep was performed. The frequency of oromotor events following respiratory events was also assessed. Results The proportion of REM sleep was higher in OSA patients with SB than in those without SB (p = 0.02). The apnea-hypopnea index (AHI) did not significantly differ between the two groups; however, AHI was approximately 8-fold lower during REM sleep in OSA patients with SB (p = 0.01) and the arousal threshold was also lower (p = 0.04). Although the RMMA index was higher in OSA patients with than in those without SB (p < 0.01), the NSMA index did not significantly differ. The percentage of RMMA following respiratory events was significantly higher in OSA patients with than in those without SB, whereas that of NSMA did not significantly differ. The frequency of oromotor events throughout the whole night positively correlated with AHI. However, regardless of the sleep state, AHI did not correlate with the RMMA index, but positively correlated with the NSMA index. Conclusion In consideration of the limitations of the present study, the results obtained indicate that OSA patients with SB have a unique phenotype of OSA and also emphasize the distinct relationship of respiratory events with RMMA and NSMA.
Collapse
Affiliation(s)
- Mutsumi Okura
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- Sleep Medical Center, Osaka Kaisei Hospital, Osaka, Japan
- Center for Sleep Medicine, Asahi University Hospital, Gifu, Japan
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
- *Correspondence: Takafumi Kato,
| | - Midori Mashita
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hisae Muraki
- Sleep Medical Center, Osaka Kaisei Hospital, Osaka, Japan
- Center for Sleep Medicine, Asahi University Hospital, Gifu, Japan
| | - Hideko Sugita
- Sleep Medical Center, Osaka Kaisei Hospital, Osaka, Japan
| | - Motoharu Ohi
- Sleep Medical Center, Osaka Kaisei Hospital, Osaka, Japan
| | | |
Collapse
|
16
|
Smardz J, Wieckiewicz M, Wojakowska A, Michalek-Zrabkowska M, Poreba R, Gac P, Mazur G, Martynowicz H. Incidence of Sleep Bruxism in Different Phenotypes of Obstructive Sleep Apnea. J Clin Med 2022; 11:jcm11144091. [PMID: 35887854 PMCID: PMC9323077 DOI: 10.3390/jcm11144091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/07/2022] [Accepted: 07/10/2022] [Indexed: 02/06/2023] Open
Abstract
(1) Background: Sleep bruxism (SB) is a common sleep behavior. Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder with potential long-term major neurocognitive and cardiovascular sequelae. Although the co-occurrence of SB and OSA has been described previously, the exact relationship remains unclear. The present study aimed to evaluate the incidence of SB in different phenotypes of OSA. (2) Methods: The participants of this study were adult patients referred to the Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology at the Wroclaw Medical University. They underwent a single-night video polysomnography in a sleep laboratory. The data related to common OSA phenotypes were analyzed in two separate groups of patients: body position related (n = 94) and rapid eye movement (REM) related (n = 85). (3) Results: The obtained results showed that the incidence of SB and severe SB was higher for body position-related OSA phenotype (p < 0.05 for all comparisons). No statistically significant differences were observed for REM-related OSA phenotype (p > 0.05 for all comparisons). (4) Conclusions: Body position-related OSA phenotype seems to be associated with higher SB and severe SB incidence, but the relationship is not independent. However, in the light of the unclear relationship between SB and sleep-disordered breathing, the topic needs further study.
Collapse
Affiliation(s)
- Joanna Smardz
- Department of Experimental Dentistry, Wroclaw Medical University, 50-425 Wroclaw, Poland;
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, 50-425 Wroclaw, Poland;
- Correspondence:
| | - Anna Wojakowska
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.W.); (M.M.-Z.); (R.P.); (G.M.); (H.M.)
| | - Monika Michalek-Zrabkowska
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.W.); (M.M.-Z.); (R.P.); (G.M.); (H.M.)
| | - Rafal Poreba
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.W.); (M.M.-Z.); (R.P.); (G.M.); (H.M.)
| | - Pawel Gac
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, 50-345 Wroclaw, Poland;
| | - Grzegorz Mazur
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.W.); (M.M.-Z.); (R.P.); (G.M.); (H.M.)
| | - Helena Martynowicz
- Department and Clinic of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland; (A.W.); (M.M.-Z.); (R.P.); (G.M.); (H.M.)
| |
Collapse
|
17
|
Pauletto P, Polmann H, Conti Réus J, Massignan C, de Souza BDM, Gozal D, Lavigne G, Flores-Mir C, De Luca Canto G. Sleep bruxism and obstructive sleep apnea: association, causality or spurious finding? A scoping review. Sleep 2022; 45:6571501. [DOI: 10.1093/sleep/zsac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/26/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study Objectives
To evaluate the available evidence on the putative relationships between sleep bruxism (SB) and, obstructive sleep apnea (OSA) to assess the extent of research on this topic, and to formulate suggestions for future research.
Methods
A scoping review including studies examining temporal and overall association and prevalence of SB and OSA was performed. Six main databases and gray literature were searched. The studies selection was conducted by three independent reviewers. A narrative synthesis of the results was carried out.
Results
Thirteen studies in adults and eight studies in children were finally included. The median of concomitant conditions prevalence was 39.3% in adults and 26.1% in children. Marked methodological variability was identified among studies in adults and even more when we compared detection methods in children. No significant association between OSA and SB emerged in most studies in adults, while an association may be possible in children.
Conclusions
Based on the current literature, it is not possible to confirm that there is a relationship between SB and OSA in adults. In patients under pediatric care, although this association seems plausible, there is currently insufficient supportive evidence. Standardized validated methodologies for identifying SB should be consistently used in both populations before reaching any conclusion regarding such association. Furthermore, assessment of shared phenotypes between patients with SB and patients with OSA may reveal new insights that will contribute to personalized approaches aiming to optimize the management of such comorbidities.
Collapse
Affiliation(s)
- Patrícia Pauletto
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis , Brazil
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
| | - Helena Polmann
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis , Brazil
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
| | - Jéssica Conti Réus
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis , Brazil
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
| | - Carla Massignan
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
- Department of Dentistry, University of Brasília , Brasília , Brazil
| | | | - David Gozal
- Department of Child Health, University of Missouri , Columbia, Missouri , United States
| | - Gilles Lavigne
- Department of Dentistry, Faculty of Dental Medicine, Université de Montreal, Montréal , Canada
| | | | - Graziela De Luca Canto
- Department of Dentistry, Federal University of Santa Catarina , Florianópolis , Brazil
- Brazilian Centre for Evidence-Based Research (COBE), Federal University of Santa Catarina , Florianópolis , Brazil
| |
Collapse
|
18
|
OSAS Severity and Occlusal Parameters: A Prospective Study among Adult Subjects with Comorbidities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095517. [PMID: 35564910 PMCID: PMC9105419 DOI: 10.3390/ijerph19095517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/21/2022] [Accepted: 04/28/2022] [Indexed: 11/18/2022]
Abstract
Introduction: OSAS is an emerging public health problem. Early diagnosis in adults with comorbidities is the gold standard to avoid complications caused by a late diagnosis. The aim of the study, part of the SLeeP@SA project, was to identify within a population with dysmetabolic comorbidities the association of occlusal clinical signs, defined by orthodontic parameters, and of the anthropometric phenotype, with the severity of OSAS. Materials and Methods: A dedicated questionnaire containing questions regarding the presence of deep bite, augmented overjet, partial edentulism, and bruxism was completed by clinic staff. OSAS was evaluated using an unattended home PSG device, which recorded the AHI value. BMI and neck circumference were also measured. The Kolmogorov-Smirnov test was performed to evaluate the association of the AHI with occlusal clinical signs. The significance was set at p ≤ 0.05. The association of AHI with BMI and neck circumference was evaluated with the Pearson correlation coefficient. Results: In total, 199 subjects were evaluated. No statistically significant association between occlusal parameters and AHI was found, while the AHI showed a positive correlation with BMI and neck circumference. The neck circumference seemed to be a better clinical predictor for OSAS severity than BMI, especially for females. Conclusions: These results highlight how the orthodontic clinical data alone are not sufficient to establish an association between occlusal anomalies and OSAS severity, but further investigation involving a specialist orthodontic diagnosis is necessary.
Collapse
|
19
|
The effects of mandibular advancement appliance therapy on the sequence of jaw-closing muscle activity and respiratory events in individuals with obstructive sleep apnea. Sleep Breath 2022; 27:757-764. [DOI: 10.1007/s11325-022-02624-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/16/2022] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
Abstract
Abstract
Purpose
To determine the effects of a mandibular advancement appliance (MAA) on sequences of jaw-closing muscle activity (JCMA) and apneic or hypopneic event (AHE) in individuals with obstructive sleep apnea (OSA).
Methods
Individuals with OSA were included in a secondary analysis of a randomized controlled crossover trial, in which two ambulatory polysomnographic recordings were performed: one with MAA in situ and the other without MAA. A time span of 16 s between JCMA and AHE was applied to classify JCMAs into four sequences: (1) JCMA occurs before AHE (B-type); (2) both events occur simultaneously (S-type); (3) JCMA occurs after AHE (A-type); and (4) JCMA is time-unrelated to AHE (U-type). The effects of MAA on the distribution of these sequences were analyzed by Wilcoxon signed-rank test.
Results
Among 16 individuals (10 men, mean age 51.3 ± 8.5 years) baseline apnea–hypopnea index and JCMA index were 23.8 ± 16.0 events/h and 10.8 ± 10.3 events/h, respectively. In both conditions, i.e., without and with MAA, most JCMAs were U-type (48% and 65%, respectively), followed by A-type (41% and 22%), B-type (25% and 21%), and S-type (2% and 1%). With MAA in situ, only the A-type JCMA index decreased significantly (P = 0.005), while B-type, S-type, and U-type JCMA indices did not change significantly (all P > 0.05).
Conclusion
MAA therapy only significantly reduces the jaw-closing muscle activities that occur after apneic or hypopneic events in individuals with OSA.
Trial registration
www.clinicaltrials.gov (NCT02011425); December 13, 2013.
Collapse
|
20
|
Li D, Aarab G, Lobbezoo F, Arcache P, Lavigne GJ, Huynh N. Accuracy of sleep bruxism scoring based on electromyography traces of different jaw muscles in individuals with obstructive sleep apnea. J Clin Sleep Med 2022; 18:1609-1615. [PMID: 35212262 DOI: 10.5664/jcsm.9940] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Sleep bruxism is characterized by rhythmic masticatory muscle activity (RMMA). This study aimed to determine the number and type of jaw muscles needed for a valid RMMA scoring in individuals with obstructive sleep apnea (OSA). METHODS 10 individuals with OSA (4 males; age = 50.1 ± 8.1 years) were included in this study. RMMA was scored using one or more of the following jaw muscles' electromyography (EMG) traces of polysomnography recordings: bilateral masseter and temporalis (4MT; the reference standard), unilateral masseter (1M), bilateral masseter (2M), unilateral temporalis (1T), bilateral temporalis (2T), unilateral chin EMG (1C), and bilateral chin EMG (2C). RESULTS 1M, 2M, 1T, and 2T showed excellent agreement with 4MT (intraclass correlation coefficient [ICC] = 0.751, 0.976, 0.815, and 0.950, respectively), while 1C and 2C presented fair agreement (ICC= 0.662 and 0.657). Besides, 2M and 2T displayed good sensitivity (87.8% and 72.0%) and positive predictive value (PPV; 83.1% and 76.0%). In contrast, 1M and 1T had good sensitivity (88.4% and 87.8%) but fair PPV (60.1% and 53.2%). 1C and 2C showed poor sensitivity (41.1% and 40.3%) and fair PPV (62.9% and 60.6%). CONCLUSIONS Polysomnography with bilateral masseter or temporalis muscle EMG traces is regarded valid in RMMA scoring in individuals with OSA. In contrast, unilateral masseter or temporalis muscle EMG showed only fair accuracy, and chin EMG had poor accuracy. Consequently, these montages cannot be recommended for RMMA scoring in the presence of OSA. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: The Effects of Oral Appliance Therapy on Masseter Muscle Activity in Obstructive Sleep Apnea; Identifier: NCT02011425.
Collapse
Affiliation(s)
- Deshui Li
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Faculté de Médicine Dentaire, Université de Montréal, Montréal, Canada
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Patrick Arcache
- Faculté de Médicine Dentaire, Université de Montréal, Montréal, Canada
| | - Gilles J Lavigne
- Faculté de Médicine Dentaire, Université de Montréal, Montréal, Canada
| | - Nelly Huynh
- Faculté de Médicine Dentaire, Université de Montréal, Montréal, Canada
| |
Collapse
|
21
|
Emodi-Perlman A, Soliman J, Frideman-Rubin P, Eli I. Symptoms of Nocturnal Masticatory Muscle Activity among Women of Different Age Groups and Their Association to Obstructive Sleep Apnea-A Cross Sectional Study. J Clin Med 2022; 11:jcm11051199. [PMID: 35268290 PMCID: PMC8911247 DOI: 10.3390/jcm11051199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/11/2022] [Accepted: 02/20/2022] [Indexed: 11/16/2022] Open
Abstract
Sleep bruxism (SB), snoring, and excessive daytime sleepiness are often associated with obstructive sleep apnea (OSA). OSA, which is characterized by a repetitive collapse of the upper airway during sleep, can cause oxygen desaturation and lead to adverse medical conditions, such as cardiovascular events, hypertension, heart attack, and stroke. In the present study, 112 Arab women aged 20−40 years (Early Adulthood/Adulthood−EarlyA) and 116 Arab women aged 50 and above (Middle Age−MiddleA), were requested to complete questionnaires regarding demographic variables, symptoms of nocturnal masticatory muscle activity (possible SB, headache, and stiffness of the oral and/or neck musculature upon awakening), risk of OSA (STOP-BANG questionnaire), and daytime sleepiness (Epworth sleepiness scale—ESS). Women, who reported snoring, experienced more SB (35.8% vs. 20.6%, chi-square, p < 0.05), more headaches (33.3% vs. 19.3%, p < 0.05), and more muscle stiffness upon awakening (34.3% vs. 16.3%, p < 0.005), than their non-snoring counterparts. Out of the women who snore, 11% showed high risk for OSA, as compared to only 1% among the non-snoring participants (p < 0.000). Symptoms of nocturnal masticatory muscle activity and/or snoring can serve as initial indicators of OSA. Higher awareness of dentists to such symptoms, particularly among their middle-aged female patients, can prevent a development of harmful conditions associated with OSA.
Collapse
|
22
|
de Barros Massahud ML, Bruzinga FFB, de Miranda Diniz SA, de Aguilar Seraidarian KK, de Magalhães Lopes R, de Magalhães Barros V, Seraidarian PI. Association between sleep bruxism, use of antidepressants, and obstructive sleep apnea syndrome: a cross-sectional study. J Oral Rehabil 2022; 49:505-513. [PMID: 35149999 DOI: 10.1111/joor.13312] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/29/2021] [Accepted: 02/01/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sleep bruxism (SB) is a condition regulated centrally, with a multifactorial etiology, which can occur secondary to systemic disorders and use of certain medications. OBJECTIVE The aim of this study was to identify associations between sleep bruxism, obstructive sleep apnea and hypopnea syndrome (OSAHS) and the use of antidepressants. MATERIAL AND METHODS In this cross-sectional study, 240 individuals underwent a full-night polysomnography, for medical reasons. Anamnesis was performed to collect data about the use of antidepressants and general health conditions. Polysomnography was performed to analyze sleep data and assess respiratory-related events and apnea and hypopnea index (AHI). The polysomnographic assessment of sleep bruxism was performed, from electrodes placed on masseter muscles and chin. SB was defined by the presence of more than two events of rhythmic masticatory muscles activity (RMMA) per hour of sleep. Statistical analyzes were performed to compare the presence of SB and AHI, severity of OSAHS and use of antidepressants. RESULTS There were statistically significant differences between bruxers and non-bruxers, when comparing AHI (48.28±25.84; p=0.001) and severity of OSAHS (p=0.015). Regarding the use of antidepressants, comparative analyzes did not shown correlations with bruxism (p=0.072). However, logistic regression suggests that the use of these medications may represent increased odds for SB development (OR=2.387; p=0.005). CONCLUSION The relationship between the use of antidepressants and SB remains inconclusive. SB is associated with OSAHS, mainly in its severe form. Therefore, identifying SB can raise the suspicion of the occurrence of other systemic disturbances.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Paulo Isaias Seraidarian
- Dentistry Department, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
23
|
Duarte J, Pauletto P, Polmann H, Réus JC, de Souza JF, Gaio DC, Brancher JA, Vieira A, Machado-Souza C, de Souza Melo G, Maia IS, De Luca Canto G. Is there an association of genetic polymorphisms of the catechol-O-methyltransferase gene (rs165656 and rs174675) and the 5-hydroxytryptamine receptor 2A gene (rs4941573 and rs6313) with sleep bruxism in individuals with obstructive sleep apnea? Arch Oral Biol 2021; 133:105315. [PMID: 34808513 DOI: 10.1016/j.archoralbio.2021.105315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/05/2021] [Accepted: 11/06/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To evaluate the association of single-nucleotide polymorphisms within the catechol-O-methyltransferase and 5-hydroxytryptamine receptor 2A genes with sleep bruxism in individuals diagnosed with obstructive sleep apnea. DESIGN Sixty-nine individuals with suspected sleep-related problems were evaluated by polysomnography, following the recommendations of the American Academy of Sleep Medicine. Deoxyribonucleic acid (DNA) samples were collected only from 48 of the study participants because of missing polysomnographic data. DNA samples were collected and two single-nucleotide polymorphisms in the 5-hydroxytryptamine receptor 2A encoding HTR2A gene (rs4941573 and rs6313) and two in the catechol-O-methyltransferase gene (rs165656 and rs174675) were selected to be genotyped using real-time polymerase chain reaction. The association between sleep bruxism and genetic polymorphisms was investigated by recessive and dominant models. Association analyses were performed using a 95% confidence interval and the level of statistical significance was p < 0.05. RESULTS From the 69 study participants, 48 were included in the polymorphism analysis and sleep bruxism was present in 35.4%. No significant differences were observed in the dominant and recessive models (p > 0.05). Haplotype and diplotype analyses revealed the predicted four haplotypes and two diplotypes were not associated with sleep bruxism. CONCLUSION Polymorphisms rs174675 and rs165656 in the catechol-O-methyltransferase gene and rs4941573 and rs6313 in the 5-hydroxytryptamine receptor 2A gene were not significantly associated with sleep bruxism in individuals with obstructive sleep apnea.
Collapse
Affiliation(s)
- Joyce Duarte
- Brazilian Center for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil.
| | - Patrícia Pauletto
- Brazilian Center for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Helena Polmann
- Brazilian Center for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Jéssica Conti Réus
- Brazilian Center for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | | | - André Vieira
- Graduate Program in Biotechnology Applied to Child and Adolescent Health - Pequeno Príncipe College, Pelé Research Institute, Curitiba, Paraná, Brazil
| | - Cleber Machado-Souza
- Graduate Program in Biotechnology Applied to Child and Adolescent Health - Pequeno Príncipe College, Pelé Research Institute, Curitiba, Paraná, Brazil
| | - Gilberto de Souza Melo
- Brazilian Center for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | - Graziela De Luca Canto
- Brazilian Center for Evidence-Based Research (COBE), Federal University of Santa Catarina, Florianópolis, Brazil; Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| |
Collapse
|
24
|
Colonna A, Cerritelli L, Lombardo L, Vicini C, Marchese-Ragona R, Guarda-Nardini L, Manfredini D. Temporal relationship between sleep-time masseter muscle activity and apnea-hypopnea events: A pilot study. J Oral Rehabil 2021; 49:47-53. [PMID: 34674282 DOI: 10.1111/joor.13271] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 08/18/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is the most common sleep disorder due mainly to peripheral causes, characterized by repeated episodes of obstruction of the upper airways, associated with arousals and snoring. Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or nonrhythmic (tonic) and is not a movement disorder or a sleep disorder in otherwise healthy individuals. Given the potentially severe consequences and complications of apnea, the concurrent high prevalence of SB in daily dental practice, getting deeper into the correlation between these phenomena is worthy of interest.. STUDY OBJECTIVES The aim of this study was to investigate the correlation between SB-related masseter muscle activity (MMA) and apnea-hypopnea events as well as to assess their temporal sequence. METHODS Thirty (N = 30) patients with sleep respiratory disorders and clinical suspicion of sleep bruxism (SB) were recruited. Ambulatory polygraphic recording was performed to detect apnea-hypopnea events (AHEs) and sleep bruxism episodes (SBEs). Pearson test was used to assess the correlation between apnea-hypopnea index (AHI) and SB index (SBI). A 5-s time window with respect to the respiratory events was considered to describe the temporal distribution of SBEs. Furthermore, SBI was compared between groups of patients with different AHI severity (i.e., mild, moderate and severe) using ANOVA. RESULTS On average, AHI was 27.1 ± 21.8 and SBI 9.1 ± 7.5. No correlation was shown between AHI and SBI. Most of SBEs (66.8%) occurred without a temporal relationship with respiratory events. Considering OSA, 65.7% of SBEs occurred within 5 s after AHEs, while in the case of central apnea (CA) 83.8% of SBEs occurred before the respiratory event. The participants with severe apnea (N = 9) show a tendency to have higher bruxism indexes when compared to patients with mild (N = 11) and moderate apnea (N = 10). CONCLUSIONS Findings suggest that: 1. At the study population level, there is no correlation between AHI and SBI, as well as any temporal relationship between SBEs and respiratory events. 2. Specific patterns of temporal relationship might be identified with future studies focusing on the different types of apnea-hypopnea events and bruxism activities.
Collapse
Affiliation(s)
- Anna Colonna
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Luca Cerritelli
- Department of Otolaryngology, Ospedale Morgani-Pierantoni, Forlì, Italy
| | - Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Claudio Vicini
- Department of Otolaryngology, Ospedale Morgani-Pierantoni, Forlì, Italy
| | | | - Luca Guarda-Nardini
- Section of Dentistry and Maxillofacial Surgery, Treviso Hospital, Treviso, Italy
| | | |
Collapse
|
25
|
Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KG, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2021; 126:276-359. [PMID: 34489050 DOI: 10.1016/j.prosdent.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.
Collapse
Affiliation(s)
- David R Cagna
- Professor, Associate Dean, Chair and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor, Department of Comprehensive Oral Health, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Frederick Eichmiller
- Vice President and Science Officer, Delta Dental of Wisconsin, Stevens Point, Wis
| | | | - Jean-Pierre Albouy
- Assistant Professor of Prosthodontics, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin G Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, Md; Private practice, Baltimore, Md
| | - Matthias Troeltzsch
- Associate Professor, Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University of Munich, Munich, Germany; Private practice, Ansbach, Germany
| |
Collapse
|
26
|
Oyarzo JF, Valdés C, Bravo R. Etiología, diagnóstico y manejo de bruxismo de sueño. REVISTA MÉDICA CLÍNICA LAS CONDES 2021. [DOI: 10.1016/j.rmclc.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
27
|
Singman E. From Provider to Advocate: The Complexities of Traumatic Brain Injury Prompt the Evolution of Provider Engagement. J Clin Med 2021; 10:jcm10122598. [PMID: 34204619 PMCID: PMC8231255 DOI: 10.3390/jcm10122598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/09/2021] [Accepted: 06/11/2021] [Indexed: 12/18/2022] Open
Abstract
Treating a patient with traumatic brain injury requires an interdisciplinary approach because of the pervasive, profound and protean manifestations of this condition. In this review, key aspects of the medical history and review of systems will be described in order to highlight how the role of any provider must evolve to become a better patient advocate. Although this review is written from the vantage point of a vision care provider, it is hoped that patients, caregivers and providers will recognize the need for a team approach.
Collapse
Affiliation(s)
- Eric Singman
- Wilmer Eye Institute, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21287, USA
| |
Collapse
|
28
|
Lavigne G, Herrero Babiloni A, Fabbro CD, Mayer P. Could Atomoxetine-Oxybutynin, a Combination of Medications Being Explored for OSA Management, Have Any Effect on Sleep Bruxism or Jaw Muscle Tone? Chest 2021; 159:2117-2118. [PMID: 33965144 DOI: 10.1016/j.chest.2020.11.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 10/21/2022] Open
Affiliation(s)
- Gilles Lavigne
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l'Île-de-Montréal), Stomatology, Centre Hospitalier de l'Universite de Montréal (CHUM) and Université de Montreal, Montréal, QC, Canada; Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada.
| | - Alberto Herrero Babiloni
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada; Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Division of Experimental Medicine, McGill University, Montréal, QC, Canada
| | - Cibele Dal Fabbro
- Center for Advanced Research in Sleep Medicine, Research Centre, Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord de-l'Île-de-Montréal), Stomatology, Centre Hospitalier de l'Universite de Montréal (CHUM) and Université de Montreal, Montréal, QC, Canada; Instituto do Sono, São Paulo, São Paulo State, Brazil
| | - Pierre Mayer
- Centre Hospitalier de l'Université de Montréal (CHUM), Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| |
Collapse
|
29
|
Lavigne G, Kato T, Herrero Babiloni A, Huynh N, Dal Fabbro C, Svensson P, Aarab G, Ahlberg J, Baba K, Carra MC, Cunha TCA, Gonçalves DAG, Manfredini D, Stuginski-Barbosa J, Wieckiewicz M, Lobbezoo F. Research routes on improved sleep bruxism metrics: Toward a standardised approach. J Sleep Res 2021; 30:e13320. [PMID: 33675267 DOI: 10.1111/jsr.13320] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 12/17/2022]
Abstract
A recent report from the European Sleep Research Society's task force "Beyond AHI" discussed an issue that has been a long-term subject of debate - what are the best metrics for obstructive sleep apnoea (OSA) diagnosis and treatment outcome assessments? In a similar way, sleep bruxism (SB) metrics have also been a recurrent issue for >30 years and there is still uncertainty in dentistry regarding their optimisation and clinical relevance. SB can occur alone or with comorbidities such as OSA, gastroesophageal reflux disorder, insomnia, headache, orofacial pain, periodic limb movement, rapid eye movement behaviour disorder, and sleep epilepsy. Classically, the diagnosis of SB is based on the patient's dental and medical history and clinical manifestations; electromyography is used in research and for complex cases. The emergence of new technologies, such as sensors and artificial intelligence, has opened new opportunities. The main objective of the present review is to stimulate the creation of a collaborative taskforce on SB metrics. Several examples are available in sleep medicine. The development of more homogenised metrics could improve the accuracy and refinement of SB assessment, while moving forward toward a personalised approach. It is time to develop SB metrics that are relevant to clinical outcomes and benefit patients who suffer from one or more possible negative consequences of SB.
Collapse
Affiliation(s)
- Gilles Lavigne
- Faculty of Dental Medicine, Universite de Montreal & CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada
| | - Takafumi Kato
- Department of Oral Physiology Graduate School of Dentistry, Sleep Medicine Center, Osaka University Hospital, Osaka University, Suita, Japan
| | - Alberto Herrero Babiloni
- Division of Experimental Medicine, McGill University, Montreal, QC, Canada.,CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine, Montreal, QC, Canada
| | - Nelly Huynh
- Faculty of Dental Medicine, Universite de Montreal and CHU Saint-Justine Research Center, Montreal, QC, Canada
| | - Cibele Dal Fabbro
- Faculty of Dental Medicine, Universite de Montreal & CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine & Stomatology, CHUM, Montreal, QC, Canada
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Faculty of Odontology, Malmø University, Malmø, Sweden
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jari Ahlberg
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Kazuyoshi Baba
- Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Maria Clotilde Carra
- UFR of Odontology Garanciere, Université de Paris and Service of Odontology, Rothschild Hospital (AP-HP), Paris, France
| | - Thays Crosara A Cunha
- Department of Genetics and Biochemistry, Federal University of Uberlandia, Uberlandia, Brazil
| | - Daniela A G Gonçalves
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (Unesp), Araraquara, Brazil
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Siena, Italy
| | | | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
30
|
Yap AU, Cao Y, Zhang MJ, Lei J, Fu KY. Temporomandibular disorder severity and diagnostic groups: Their associations with sleep quality and impairments. Sleep Med 2021; 80:218-225. [PMID: 33607558 DOI: 10.1016/j.sleep.2021.01.063] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/28/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVES This study evaluated the impact of TMD severity on sleep quality and established the associations between TMD diagnostic groups/pain subtypes and sleep impairments. METHODS A total of 1151 patients from a tertiary Dental Hospital were screened for eligibility. Consenting subjects who met the inclusion criteria were directed to complete a general/health questionnaire, the Fonseca Anamnestic Index (FAI), Diagnostic Criteria for Temporomandibular disorders (DC/TMD) Symptom Questionnaire, and Pittsburgh Sleep Quality Index (PSQI) at their intake visit. Patients who screened positive for TMDs with the FAI were subjected to a protocolized physical examination and TMD diagnostic groups/subtypes were subsequently derived based on the DC/TMD "diagnostic tree" and algorithms. Statistical analyses were conducted using non-parametric methods and logistic regression (α = 0.05). RESULTS The final sample consisted of 845 subjects with TMDs and 116 TMD-free controls. The mean age of the TMD and TMD-free subjects were 33.17 ± 13.55 and 31.66 ± 9.50 years. Subjects with severe and moderate TMDs had significantly greater global PSQI scores than those with mild and no TMDs (p < 0.001). Those with pain-related, intra-articular, and combined TMDs reported significantly poorer sleep quality than those with no TMDs (p < 0.001). Moreover, subjects with myalgia and myalgia plus arthralgia presented significantly greater sleep impairments than their counterparts with intra-articular disorders (p < 0.001). Multivariate logistic regression indicated that pain-related (OR = 3.23; CI = 1.69-6.14) and intra-articular TMDs (OR = 1.91; CI = 1.15-3.16) were most related to poor sleep. CONCLUSIONS Sleep quality worsened with increasing TMD severity and the presence of painful and intra-articular TMDs increased the likelihood of poor sleep.
Collapse
Affiliation(s)
- Adrian Ujin Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, Singapore; Faculty of Dentistry, National University of Singapore, Singapore; Duke-NUS Medical School, Singapore; National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
| | - Ye Cao
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Min-Juan Zhang
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jie Lei
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Kai-Yuan Fu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China.
| |
Collapse
|
31
|
Martinot JB, Le-Dong NN, Cuthbert V, Denison S, Gozal D, Lavigne G, Pépin JL. Artificial Intelligence Analysis of Mandibular Movements Enables Accurate Detection of Phasic Sleep Bruxism in OSA Patients: A Pilot Study. Nat Sci Sleep 2021; 13:1449-1459. [PMID: 34466045 PMCID: PMC8397703 DOI: 10.2147/nss.s320664] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/05/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Sleep bruxism (SBx) activity is classically identified by capturing masseter and/or temporalis masticatory muscles electromyographic activity (EMG-MMA) during in-laboratory polysomnography (PSG). We aimed to identify stereotypical mandibular jaw movements (MJM) in patients with SBx and to develop rhythmic masticatory muscles activities (RMMA) automatic detection using an artificial intelligence (AI) based approach. PATIENTS AND METHODS This was a prospective, observational study of 67 suspected obstructive sleep apnea (OSA) patients in whom PSG with masseter EMG was performed with simultaneous MJM recordings. The system used to collect MJM consisted of a small hardware device attached on the chin that communicates to a cloud-based infrastructure. An extreme gradient boosting (XGB) multiclass classifier was trained on 79,650 10-second epochs of MJM data from the 39 subjects with a history of SBx targeting 3 labels: RMMA episodes (n=1072), micro-arousals (n=1311), and MJM occurring at the breathing frequency (n=77,267). RESULTS Validated on unseen data from 28 patients, the model showed a very good epoch-by-epoch agreement (Kappa = 0.799) and balanced accuracy of 86.6% was found for the MJM events when using RMMA standards. The RMMA episodes were detected with a sensitivity of 84.3%. Class-wise receiver operating characteristic (ROC) curve analysis confirmed the well-balanced performance of the classifier for RMMA (ROC area under the curve: 0.98, 95% confidence interval [CI] 0.97-0.99). There was good agreement between the MJM analytic model and manual EMG signal scoring of RMMA (median bias -0.80 events/h, 95% CI -9.77 to 2.85). CONCLUSION SBx can be reliably identified, quantified, and characterized with MJM when subjected to automated analysis supported by AI technology.
Collapse
Affiliation(s)
- Jean-Benoit Martinot
- Sleep Laboratory, CHU Université Catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, 5000, Belgium.,Institute of Experimental and Clinical Research, UCL Bruxelles Woluwe, Brussels, 1200, Belgium
| | | | - Valérie Cuthbert
- Sleep Laboratory, CHU Université Catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, 5000, Belgium
| | | | - David Gozal
- Department of Child Health and Child Health Research Institute, University of Missouri, Columbia, MO, 65201, USA
| | - Gilles Lavigne
- Faculté de médecine dentaire, Université de Montréal, Montréal, Québec, H3C 3J7, Canada
| | - Jean-Louis Pépin
- HP2 Laboratory, Inserm U1042, University Grenoble Alpes, Grenoble, 38000, France
| |
Collapse
|
32
|
Michalek-Zrabkowska M, Wieckiewicz M, Macek P, Gac P, Smardz J, Wojakowska A, Poreba R, Mazur G, Martynowicz H. The Relationship between Simple Snoring and Sleep Bruxism: A Polysomnographic Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8960. [PMID: 33276496 PMCID: PMC7731201 DOI: 10.3390/ijerph17238960] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022]
Abstract
Simple snoring is defined as the production of sound in the upper aerodigestive tract during sleep, not accompanied by other pathologies. Sleep bruxism (SB) refers to repetitive phasic, tonic, or mixed masticatory muscle activity during sleep. In this study, we investigated the relationship between simple snoring and SB in patients without obstructive sleep apnea (OSA). A total of 565 snoring subjects underwent polysomnography. After examination, individuals with OSA were excluded from the study group. Finally, 129 individuals were analyzed. The bruxism episode index was positively correlated with maximum snore intensity. Phasic bruxism was positively correlated with snore intensity in all sleep positions. Bruxers had a significantly decreased average and minimum heart rate compared with non-bruxers. Supine sleep position seemed to have a significant impact on snore intensity and SB. In summary, our study showed the relationship between SB, snore intensity, and body position. Phasic bruxism was positively correlated with snore intensity despite the body position, which is an interesting and novel finding.
Collapse
Affiliation(s)
- Monika Michalek-Zrabkowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland;
| | - Piotr Macek
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Pawel Gac
- Department of Hygiene, Wroclaw Medical University, 7 Mikulicza-Radeckiego St., 50-345 Wroclaw, Poland;
| | - Joanna Smardz
- Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland;
| | - Anna Wojakowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Rafal Poreba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| | - Helena Martynowicz
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (M.M.-Z.); (P.M.); (A.W.); (R.P.); (G.M.); (H.M.)
| |
Collapse
|
33
|
Lobbezoo F, Lavigne GJ, Kato T, de Almeida FR, Aarab G. The face of Dental Sleep Medicine in the 21st century. J Oral Rehabil 2020; 47:1579-1589. [PMID: 32799330 PMCID: PMC7754359 DOI: 10.1111/joor.13075] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/31/2020] [Accepted: 08/11/2020] [Indexed: 12/12/2022]
Abstract
It becomes increasingly clear that some sleep disorders have important diagnostic and/or management links to the dental domain, hence the emergence of the discipline ‘Dental Sleep Medicine’. In this review, the following topics are discussed: 1. the reciprocal associations between oro‐facial pain and sleep; 2. the associations between sleep bruxism and other sleep‐related disorders; 3. the role of the dentist in the assessment and management of sleep bruxism; and 4. the dental management of obstructive sleep apnoea. From these topics' descriptions, it becomes clear that the role of the dentist in the recognition and management of sleep‐related oro‐facial pain, sleep bruxism and obstructive sleep apnoea is large and important. Since many dental sleep disorders can have severe consequences for the individual's general health and well‐being, it is imperative that dentists are not only willing to take on that role, but are also able to do so. This requires more attention for Dental Sleep Medicine in the dental curricula worldwide, as well as better postgraduate training of dentists who are interested in specialising in this intriguing domain. This review contributes to increasing the dental researcher's, teacher's and care professional's insight into the discipline ‘Dental Sleep Medicine’ as it has taken shape in the 21st century, to the benefit of all patients suffering from dental sleep disorders.
Collapse
Affiliation(s)
- Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gilles J Lavigne
- Faculty of Dental Medicine, Centre d'étude du sommeil, Université de Montréal and Hôpital du Sacré Coeur, Montréal, QC, Canada
| | - Takafumi Kato
- Department of Oral Physiology, Sleep Medicine Center, Osaka University Hospital, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Fernanda R de Almeida
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|