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Zeineddine S, Undevia NS. Movement Disorders. Respir Med 2022. [DOI: 10.1007/978-3-030-93739-3_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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George S, Joy R, Roy A. Drug-Induced Bruxism: a Comprehensive Literature Review. JOURNAL OF ADVANCED ORAL RESEARCH 2021. [DOI: 10.1177/2320206821992534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Bruxism is a parafunctional teeth grinding activity that is attributed to be of multifactorial origin. The aim of this article is to provide a brief overview on drug-induced bruxism, commonly associated drugs, and its possible pathogenic mechanisms. Around 43 relevant publications were selected after a comprehensive search in PubMed, Cochrane library, Science Direct, and Google Scholar with appropriate keywords to collect data and compile this review. Disturbances in the neurotransmitters and their receptors in the central nervous system may play a significant role, particularly in sleep bruxism. Drugs that interfere normal secretion and function of neurotransmitters are documented to be capable of inducing bruxism. Such psychotropic drugs are being used in clinical practice chiefly for the management of mood disorders, anxiety, and depression. Although bruxism is a well-recognized side effect of certain medications, the extent of awareness about the same is still inadequate among dental professionals.
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Affiliation(s)
- Sosa George
- Department of Oral Medicine and Radiology, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India
| | - Rini Joy
- Department of Oral Medicine and Radiology, SRM Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Anitha Roy
- Faculty of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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Guler Aksu G, Bozduman S. Aripiprazole-induced bruxism in a child: A case report. Asia Pac Psychiatry 2020; 12:e12389. [PMID: 32367695 DOI: 10.1111/appy.12389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 03/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Gulen Guler Aksu
- Department of Child and Adolescent Psychiatry, Mersin University School of Medicine, Mersin, Turkey
| | - Seda Bozduman
- Department of Child and Adolescent Psychiatry, Mersin University School of Medicine, Mersin, Turkey
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Reyad AA, Girgis E, Ayoub A, Mishriky R. Bruxism and psychotropic medications. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2020. [DOI: 10.1002/pnp.560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ayman Antoun Reyad
- Dr Antoun Reyad is a Senior Lecturer in Pharmacology, School of PharmacyUniversity of Wolverhampton
| | - Eriny Girgis
- Dr Girgis is a Dental Officer, Community Dental Service, City of Coventry Health Centre, Coventry and Warwickshire Partnership NHS Trust
| | - Amin Ayoub
- Dr Ayoub is an Associate Professor of DentistryNew York University New York
| | - Raafat Mishriky
- Dr Mishriky is Consultant Psychiatrist, Birmingham and Solihull Mental Health NHS Foundation Trust
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Jose SP. Venlafaxine-induced severe sleep bruxism in a patient with generalized anxiety disorder. Indian J Psychol Med 2015; 37:249-50. [PMID: 25969621 PMCID: PMC4418268 DOI: 10.4103/0253-7176.155679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Sam Padamadan Jose
- Department of Psychiatry, Chalmeda Ananda Rao Institute of Medical Sciences, Karimnagar, Andhra Pradesh, India
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Affiliation(s)
- Hyeyun Kim
- Department of Neurology; International St. Mary Hospital; Catholic Kwandong University; Incheon Republic of Korea
| | - Hyun Jeong Han
- Department of Neurology; Myongji Hospital; Goyang Republic of Korea
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Hermesh H, Schapir L, Marom S, Skopski R, Barnea E, Weizman A, Winocur E. Bruxism and oral parafunctional hyperactivity in social phobia outpatients. J Oral Rehabil 2014; 42:90-7. [DOI: 10.1111/joor.12235] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2014] [Indexed: 11/28/2022]
Affiliation(s)
- H. Hermesh
- Geha Mental Health Center; Petah Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - L. Schapir
- Geha Mental Health Center; Petah Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - S. Marom
- Geha Mental Health Center; Petah Tikva Israel
| | - R. Skopski
- Department of Oral Rehabilitation; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
| | - E. Barnea
- Geha Mental Health Center; Petah Tikva Israel
| | - A. Weizman
- Geha Mental Health Center; Petah Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
- Felsenstein Medical Research Center; Rabin Medical Center; Sackler Faculty of Medicine; Tel Aviv University; Petah Tikva Israel
| | - E. Winocur
- Department of Oral Rehabilitation; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv Israel
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Falisi G, Rastelli C, Panti F, Maglione H, Quezada Arcega R. Psychotropic drugs and bruxism. Expert Opin Drug Saf 2014; 13:1319-26. [PMID: 25195948 DOI: 10.1517/14740338.2014.947262] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Sleep and awake bruxism is defined as 'a parafunctional activity including clenching, bracing, gnashing, and grinding of the teeth'. Some evidence suggests that bruxism may be caused by, or associated with, alterations in the CNS neurotransmission. Several classes of psychotropic drugs interfering with CNS activity may potentially contribute to bruxism. Thus, the purpose of this study was to examine relevant peer-reviewed papers to identify and describe the various classes of psychotropic substances that may cause, exacerbate or reduce bruxism as the result of their pharmacological action in CNS neurons. AREAS COVERED A literature search from 1980 to the present was performed using PubMed database. The term 'bruxism' was used in association with 'psychotropic', 'dopamine (DA)', 'serotonin', 'histamine', 'antipsychotics', 'antidepressants', 'antihistaminergics' and 'stimulants'. EXPERT OPINION Studies on the effects of DA agonists (Levo-DOPA, psychostimulants) and antagonists (antipsychotics) identified a central role of DA in the pathogenesis of pharmacologically induced bruxism. Important information from studies on drugs acting on serotonin neurotransmission (antidepressants) was recognized. Other mechanisms involving different neurotransmitters are emerging. This is the case of antihistaminergic drugs which may induce bruxism as a consequence of their disinhibitory effect on the serotonergic system.
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Affiliation(s)
- Giovanni Falisi
- University of L'Aquila, School of Dentistry, Department of Life, Health, and Environmental Sciences , Piazzale Salvatore Tommasi 1, 67100 Coppito (AQ), L'Aquila , Italy +39 0862433202 ; +39 08624332 ;
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Chaudhuri PNK. Bruxism in patients of moderate to severe traumatic brain injury: Management results suggesting an etiological mechanism. INDIAN JOURNAL OF NEUROTRAUMA 2014. [DOI: 10.1016/j.ijnt.2014.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Carra MC, Huynh N, Lavigne G. Sleep bruxism: a comprehensive overview for the dental clinician interested in sleep medicine. Dent Clin North Am 2012; 56:387-413. [PMID: 22480810 DOI: 10.1016/j.cden.2012.01.003] [Citation(s) in RCA: 149] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sleep bruxism (SB) is a common sleep-related motor disorder characterized by tooth grinding and clenching. SB diagnosis is made on history of tooth grinding and confirmed by polysomnographic recording of electromyographic (EMG) episodes in the masseter and temporalis muscles. The typical EMG activity pattern in patients with SB is known as rhythmic masticatory muscle activity (RMMA). The authors observed that most RMMA episodes occur in association with sleep arousal and are preceded by physiologic activation of the central nervous and sympathetic cardiac systems. This article provides a comprehensive review of the cause, pathophysiology, assessment, and management of SB.
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Affiliation(s)
- Maria Clotilde Carra
- Faculty of Dental Medicine, Univeristé de Montréal, CP 6128 Succursale Centre-Ville, Montreal, Quebec, H3C 3J7, Canada.
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Orsagh-Yentis DK, Wink LK, Stigler KA, Erickson CA, McDougle CJ. Buspirone for bruxism in a child with pervasive developmental disorder-not otherwise specified. J Child Adolesc Psychopharmacol 2011; 21:643-5. [PMID: 22136097 DOI: 10.1089/cap.2010.0137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Danielle K. Orsagh-Yentis
- Department of Child and Adolescent Psychiatry, Christian Sarkine Autism Treatment Center, Indianapolis, Indiana
| | - Logan K. Wink
- Department of Child and Adolescent Psychiatry, Christian Sarkine Autism Treatment Center, Indianapolis, Indiana
| | - Kimberly A. Stigler
- Department of Child and Adolescent Psychiatry, Christian Sarkine Autism Treatment Center, Indianapolis, Indiana
| | - Craig A. Erickson
- Department of Child and Adolescent Psychiatry, Christian Sarkine Autism Treatment Center, Indianapolis, Indiana
| | - Christopher J. McDougle
- Department of Child and Adolescent Psychiatry, Christian Sarkine Autism Treatment Center, Indianapolis, Indiana
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Abstract
BACKGROUND Antipsychotics are effective in treating the symptoms of schizophrenia, but they may induce adverse effects, some of which-those that impact negatively on physical appearance-have not been sufficiently discussed in the psychiatric literature. AIM Through a narrative review, to catalog antipsychotic side effects that interfere with physical attractiveness and to suggest ways of addressing them. METHOD PubMed databases were searched for information on the association between "antipsychotic side effects" and "attractiveness" using those two search phrases plus the following terms: "weight," "teeth," "skin," "hair," "eyes," "gait," "voice," "odor." Data from relevant qualitative and quantitative articles were considered, contextualized, and summarized. RESULTS Antipsychotics, as a group, increase weight and may lead to dry mouth and bad breath, cataracts, hirsutism, acne, and voice changes; they may disturb symmetry of gait and heighten the risk for tics and spasms and incontinence, potentially undermining a person's attractiveness. CONCLUSIONS Clinicians need to be aware of the impact of therapeutic drugs on appearance and how important this issue is to patients. Early in treatment, they need to plan preventive and therapeutic strategies.
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Fonseca CME, dos Santos MBF, Consani RLX, dos Santos JFF, Marchini L. Incidence of sleep bruxism among children in Itanhandu, Brazil. Sleep Breath 2010; 15:215-20. [DOI: 10.1007/s11325-010-0427-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 09/17/2010] [Accepted: 09/25/2010] [Indexed: 12/01/2022]
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Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC. Bruxism: a literature review. J Indian Prosthodont Soc 2010; 10:141-8. [PMID: 21886404 PMCID: PMC3081266 DOI: 10.1007/s13191-011-0041-5] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Accepted: 01/04/2011] [Indexed: 10/18/2022] Open
Abstract
Bruxism is a movement disorder characterized by grinding and clenching of teeth. Awake bruxism is found more in females as compared to males while sleep bruxism shows no such gender prevalence. Etiology of bruxism can be divided into three groups psychosocial factors, peripheral factors and pathophysiological factors. Treatment modalities involve occlusal correction, behavioural changes and pharmacological approach. A literature search was performed using National Library of Medicine's (NLM) Medical Subject Headings (MeSH) Database, Pubmed and Google search engines. The search term 'Bruxism' yielded 2,358 papers out of which 230 were review papers. Most of the papers selected were recently published during the period of 1996-2010 and very few of them were published before 1996.
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Affiliation(s)
| | - Varun Pitti
- Department of Prosthodontics, V.S. Dental College and Hospital, K.R. Road, V.V. Puram, Bangalore, 560004 India
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Kwak YT, Han IW, Lee PH, Yoon JK, Suk SH. Associated conditions and clinical significance of awake bruxism. Geriatr Gerontol Int 2010; 9:382-90. [PMID: 20002758 DOI: 10.1111/j.1447-0594.2009.00538.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Awake bruxism is defined as an oral parafunctional activity that includes clenching and grinding of teeth during wakefulness. Confirming the possible related anatomy and the clinical significance of awake bruxism in geriatric hospitals is the aim of this study. METHODS We analyzed the medical records of 503 patients who were admitted to hospital from April to June 2008. After the recognition of bruxism, the clinical, brain imaging studies and statistical parametric mapping (SPM) of brain single photon emission computed tomography were performed. RESULTS In each disease group, five of 125 Alzheimer's disease (AD) patients (4.0%), three of 11 frontotemporal dementia (FTD) patients (27.3%), seven of 230 stroke patients (including two patients related to citalopram, 3.0%), one of 45 Parkinson's disease patients (2.2%) and four of 17 hydrocephalus patients (23.5%) had bruxism. Even though awake bruxism occurred early after stroke onset, it occurred late after AD and FTD onset. This occurred in a far advanced stage of AD, while it occurred in a moderately advanced stage of FTD. SPM analysis in AD and FTD patients with awake bruxism revealed significant hypoperfusion in frontotemporal and other subcortical structures. Surface electromyography recordings from the masseter muscle showed rhythmic regular motor activity at a rate of 1-2/s. CONCLUSION This study suggests that awake bruxism is encountered not infrequently in various diseases in geriatric hospitals. It is frequently observed in FTD and normal pressure hydrocephalus, which characteristically shows frontal lobe dysfunction. These facts and SPM analysis show that awake bruxism can be regarded as a frontal neurological sign of various neurological disorders.
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Affiliation(s)
- Yong Tae Kwak
- Department of Neurology, Hyoja Geriatric Hospital, Sanghari 33, Guseong-myeon, Yongin-si Gyeongi-do 449-914, Korea.
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Diniz MB, Silva RCD, Zuanon ACC. Bruxismo na infância: um sinal de alerta para odontopediatras e pediatras. REVISTA PAULISTA DE PEDIATRIA 2009. [DOI: 10.1590/s0103-05822009000300015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Apresentar uma revisão de literatura sobre o bruxismo na infância, abordando os fatores etiológicos, as características clínicas, os sinais e sintomas, a importância do diagnóstico por parte dos pediatras e odontopediatras e o tratamento multidisciplinar desta condição parafuncional. FONTES DE DADOS: Foram selecionados os artigos mais relevantes sobre o tema publicados desde 1907 até 2007, com pesquisa realizada no Medline, na Bibliografia Brasileira de Odontologia (BBO) e em livros de Odontologia. SÍNTESE DOS DADOS: O bruxismo é definido como um hábito não funcional do sistema mastigatório, caracterizado pelo ato de ranger ou apertar os dentes, podendo ocorrer durante o dia e durante o sono. A etiologia é multifatorial e a literatura sugere vários fatores associados: dentário, fisiológico, psicológico e neurológico. As forças exercidas pelo bruxismo podem provocar distúrbios em diferentes graus nos dentes e nos tecidos de suporte, na musculatura e na articulação têmporo-mandibular. O sinal mais comum é o desgaste nas faces incisais dos dentes anteriores e oclusais nos posteriores, além de mobilidade e hipersensibilidade dentárias, fratura de cúspides e restaurações e hipertonicidade dos músculos mastigatórios. CONCLUSÃO: O conhecimento dos fatores etiológicos e das características clínicas do bruxismo na infância é fundamental para que o diagnóstico seja precoce, permitindo que pediatras, odontopediatras e psicólogos possam estabelecer um tratamento multidisciplinar e favoreçam o desenvolvimento integral da criança para a promoção de saúde e bem-estar individual.
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Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K. Bruxism physiology and pathology: an overview for clinicians. J Oral Rehabil 2009; 35:476-94. [PMID: 18557915 DOI: 10.1111/j.1365-2842.2008.01881.x] [Citation(s) in RCA: 412] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Awake bruxism is defined as the awareness of jaw clenching. Its prevalence is reported to be 20% among the adult population. Awake bruxism is mainly associated with nervous tic and reactions to stress. The physiology and pathology of awake bruxism is unknown, although stress and anxiety are considered to be risk factors. During sleep, awareness of tooth grinding (as noted by sleep partner or family members) is reported by 8% of the population. Sleep bruxism is a behaviour that was recently classified as a 'sleep-related movement disorder'. There is limited evidence to support the role of occlusal factors in the aetiology of sleep bruxism. Recent publications suggest that sleep bruxism is secondary to sleep-related micro-arousals (defined by a rise in autonomic cardiac and respiratory activity that tends to be repeated 8-14 times per hour of sleep). The putative roles of hereditary (genetic) factors and of upper airway resistance in the genesis of rhythmic masticatory muscle activity and of sleep bruxism are under investigation. Moreover, rhythmic masticatory muscle activity in sleep bruxism peaks in the minutes before rapid eye movement sleep, which suggests that some mechanism related to sleep stage transitions exerts an influence on the motor neurons that facilitate the onset of sleep bruxism. Finally, it remains to be clarified when bruxism, as a behaviour found in an otherwise healthy population, becomes a disorder, i.e. associated with consequences (e.g. tooth damage, pain and social/marital conflict) requires intervention by a clinician.
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Affiliation(s)
- G J Lavigne
- Faculty of Dentistry, Surgery Department, Pain, Sleep and Trauma Unit, Université de Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Canada.
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LOBBEZOO F, van der ZAAG J, van SELMS MKA, HAMBURGER HL, NAEIJE M. Principles for the management of bruxism. J Oral Rehabil 2008; 35:509-23. [DOI: 10.1111/j.1365-2842.2008.01853.x] [Citation(s) in RCA: 168] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Urinary levels of catecholamines among individuals with and without sleep bruxism. Sleep Breath 2008; 13:85-8. [PMID: 18516634 DOI: 10.1007/s11325-008-0193-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2007] [Revised: 01/31/2008] [Accepted: 04/02/2008] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Sleep bruxism (SB) is characterized by repetitive and coordinated mandible movements and non-functional teeth contacts during sleep time. Although the etiology of SB is controversial, the literature converges on its multifactorial origin. Occlusal factors, smoking, alcoholism, drug usage, stress, and anxiety have been described as SB trigger factors. Recent studies on this topic discussed the role of neurotransmitters on the development of SB. OBJECTIVE Thus, the purpose of this study was to detect and quantify the urinary levels of catecholamines, specifically of adrenaline, noradrenaline and dopamine, in subjects with SB and in control individuals. MATERIALS AND METHODS Urine from individuals with SB (n = 20) and without SB (n = 20) was subjected to liquid chromatography. The catecholamine data were compared by Mann-Whitney's test (p </= 0.05). RESULTS Our analysis showed higher levels of catecholamines in subjects with SB (adrenaline = 111.4 microg/24 h; noradrenaline = 261,5 microg/24 h; dopamine = 479.5 microg/24 h) than in control subjects (adrenaline = 35,0 microg/24 h; noradrenaline = 148,7 microg/24 h; dopamine = 201,7 microg/24 h). Statistical differences were found for the three catecholamines tested. CONCLUSION It was concluded that individuals with SB have higher levels of urinary catecholamines.
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Mascaro MB, Bittencourt JC, Casatti CA, Elias CF. Alternative pathways for catecholamine action in oral motor control. Neurosci Lett 2005; 386:34-9. [PMID: 15978723 DOI: 10.1016/j.neulet.2005.05.062] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2005] [Revised: 05/19/2005] [Accepted: 05/19/2005] [Indexed: 12/16/2022]
Abstract
Orofacial movement is a complex function performed by facial and jaw muscles. Jaw movement is enacted through the triggering of motoneurons located primarily in the trigeminal motor nucleus (Mo5). The Mo5 is located in the pontine reticular formation, which is encircled by premotor neurons. Previous studies using retrograde tracers have demonstrated that premotor neurons innervating the Mo5 are distributed in brainstem areas, and electrophysiological studies have suggested the existence of a subcortical relay in the corticofugal-Mo5 pathway. Various neurotransmitters have been implicated in oral movement. Dopamine is of special interest since its imbalance may produce changes in basal ganglia activity, which generates abnormal movements, including jaw motor dysfunction, as in oral dyskinesia and possibly in bruxism. However, the anatomical pathways connecting the dopaminergic systems with Mo5 motoneurons have not been studied systematically. After injecting retrograde tracer fluorogold into the Mo5, we observed retrograde-labeled neurons in brainstem areas and in a few forebrain nuclei, such as the central nucleus of the amygdala, and the parasubthalamic nucleus. By using dual-labeled immunohistochemistry, we found tyrosine hydroxylase (a catecholamine-processing enzyme) immunoreactive fibers in close apposition to retrograde-labeled neurons in brainstem nuclei, in the central nucleus of the amygdala and the parasubthalamic nucleus, suggesting the occurrence of synaptic contacts. Therefore, we suggested that catecholamines may regulate oralfacial movements through the premotor brainstem nuclei, which are related to masticatory control, and forebrain areas related to autonomic and stress responses.
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Affiliation(s)
- Marcelo Betti Mascaro
- Laboratory of Chemical Neuroanatomy, Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo - USP, Av. Prof. Lineu Prestes, 2415 Ed. B-III, 05508-900 São Paulo, SP, Brazil.
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Saletu A, Parapatics S, Saletu B, Anderer P, Prause W, Putz H, Adelbauer J, Saletu-Zyhlarz GM. On the pharmacotherapy of sleep bruxism: placebo-controlled polysomnographic and psychometric studies with clonazepam. Neuropsychobiology 2005; 51:214-25. [PMID: 15915004 DOI: 10.1159/000085917] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Sleep bruxism (SB) is a parasomnia defined as a stereotyped movement disorder characterized by grinding or clenching of the teeth during sleep. Pathophysiologically, SB is the result of biological and psychosocial influences. Treatment comprises behavioral, orthodontic and pharmacological interventions. While benzodiazepines and muscle relaxants have been reported by clinicians to reduce bruxism-related motor activity, placebo-controlled studies are lacking. Thus, the aim of the present study was to investigate the acute effects of clonazepam (Rivotril) as compared with placebo, utilizing polysomnography and psychometry. METHOD Ten drug-free outpatients (6 females, 4 males), aged 46.5 +/- 13.1 years, suffering from SB (ICD-10: F45.8; ICSD: 306.8) and having been treated by bite splints were included in the trial. Comorbidity was high: 7 patients presented nonorganic insomnia related to adjustment or anxiety disorders (5 patients) or depression (2 patients); all patients had a concomitant movement disorder (6 restless legs syndrome, 4 periodic leg movement disorder). After one adaptation night, patients received placebo and 1 mg clonazepam 1/2 hour before lights out in a single-blind, nonrandomized study design. Objective sleep quality was determined by polysomnography, subjective sleep and awakening quality by rating scales, objective awakening quality by psychometric tests. Clinical evaluation was based on the Pittsburgh Sleep Quality Index (PSQI), the Zung Depression (SDS) and Anxiety (SAS) Scales, the Quality of Life Index, the Epworth Sleepiness Scale and the International Restless Legs Syndrome Study Group (IRLSSG) Scale. RESULTS On admission, SB patients exhibited deteriorated PSQI, SAS, SDS and IRLSSG measures. As compared with placebo, 1 mg clonazepam significantly improved the mean bruxism index from 9.3 to 6.3/h of sleep. Furthermore, it significantly improved the total sleep period, total sleep time, sleep efficiency, sleep latency and time awake during the total sleep period, and increased stage 2 sleep and movement time. Periodic leg movements decreased significantly, while the apnea index and apnea-hypopnea index increased marginally, but remained within normal limits. Subjective sleep quality improved as well, while in mood, performance and psychophysiology no changes were observed. CONCLUSION Acute clonazepam therapy significantly improved not only the bruxism index but also objective and subjective sleep quality, with unchanged mood, performance and psychophysiological measures upon awakening, suggesting good tolerability of the drug.
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Affiliation(s)
- Alexander Saletu
- Department of Dental Medicine, Medical University of Vienna, Währinger Strasse 25a, AT-1090 Vienna, Austria.
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Abstract
BACKGROUND Primary parasomnias are undesirable motor or verbal phenomena which occur during sleep and result in abnormal arousals. They occur out of all sleep stages or during transitions between sleep and awake. Secondary parasomnias are sleep disturbances that are caused by disorders of other organ systems. This review addresses only primary parasomnias. Arousal disorders and the parasomnias associated with REM sleep are the primary parasomnias most likely to be seen in a neurology practice. Sleep-wake transition disorders are also discussed with nocturnal leg cramps, probably the most common in this group. REVIEW SUMMARY The salient clinical features of the primary parasomnias are discussed. Emphasis is placed on the differential diagnosis of the different conditions and the best management strategies. Parasomnias encountered in infancy, such as infant sleep apnea, are not discussed in this review. CONCLUSIONS Parasomnias are common disturbances of sleep that may significantly affect the patient's quality of life and that of the bed partner. Most parasomnias can be diagnosed with careful history taking and polysomnography, and management is usually safe and effective.
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Affiliation(s)
- Pierre Giglio
- Sleep Disorders Center, University of Chicago Hospitals, Chicago, Illinois 60637, USA
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25
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Miyaoka T, Yasukawa R, Mihara T, Shimizu Y, Tsubouchi K, Maeda T, Mizuno S, Uegaki J, Inagaki T, Horiguchi J, Tachibana H. Successful electroconvulsive therapy in major depression with fluvoxamine-induced bruxism. J ECT 2003; 19:170-2. [PMID: 12972988 DOI: 10.1097/00124509-200309000-00010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 61-year-old patient with major depression and selective serotonin reuptake inhibitor-induced bruxism was successfully treated with a course of bilateral electroconvulsive therapy. Both the depressive symptoms and bruxism completely remitted after six treatments. Possible mechanisms of this effect are discussed.
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Affiliation(s)
- Tsuyoshi Miyaoka
- Department of Psychiatry, Shimane Medical University, Izumo, Japan
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26
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Lavigne GJ, Kato T, Kolta A, Sessle BJ. Neurobiological mechanisms involved in sleep bruxism. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2003; 14:30-46. [PMID: 12764018 DOI: 10.1177/154411130301400104] [Citation(s) in RCA: 300] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sleep bruxism (SB) is reported by 8% of the adult population and is mainly associated with rhythmic masticatory muscle activity (RMMA) characterized by repetitive jaw muscle contractions (3 bursts or more at a frequency of 1 Hz). The consequences of SB may include tooth destruction, jaw pain, headaches, or the limitation of mandibular movement, as well as tooth-grinding sounds that disrupt the sleep of bed partners. SB is probably an extreme manifestation of a masticatory muscle activity occurring during the sleep of most normal subjects, since RMMA is observed in 60% of normal sleepers in the absence of grinding sounds. The pathophysiology of SB is becoming clearer, and there is an abundance of evidence outlining the neurophysiology and neurochemistry of rhythmic jaw movements (RJM) in relation to chewing, swallowing, and breathing. The sleep literature provides much evidence describing the mechanisms involved in the reduction of muscle tone, from sleep onset to the atonia that characterizes rapid eye movement (REM) sleep. Several brainstem structures (e.g., reticular pontis oralis, pontis caudalis, parvocellularis) and neurochemicals (e.g., serotonin, dopamine, gamma aminobutyric acid [GABA], noradrenaline) are involved in both the genesis of RJM and the modulation of muscle tone during sleep. It remains unknown why a high percentage of normal subjects present RMMA during sleep and why this activity is three times more frequent and higher in amplitude in SB patients. It is also unclear why RMMA during sleep is characterized by co-activation of both jaw-opening and jaw-closing muscles instead of the alternating jaw-opening and jaw-closing muscle activity pattern typical of chewing. The final section of this review proposes that RMMA during sleep has a role in lubricating the upper alimentary tract and increasing airway patency. The review concludes with an outline of questions for future research.
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Affiliation(s)
- G J Lavigne
- Faculté de Médecine, Université de Montréal, Succursale Centre-ville, Montréal, PQ, Canada.
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27
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Abstract
1014 subjects on the island of Sardinia (Italy) were interviewed regarding the habit of clenching and grinding their teeth. They had to specify if this activity occurred during the day, during the night, or both. Other information recorded was their age, gender, marital status, and occupation. Overall prevalence of bruxism was 27.2% (276 subjects). No association was found between bruxism and age, gender and job. Even differentiating diurnal, nocturnal, diurnal and nocturnal bruxism, associations were non-significant. Marital status seems to make some difference: divorced people reported higher parafunctional activity compared to widows and widowers who reported the least. Although awareness of bruxism is not a precise measure of parafunction, based on the results we cannot support the role of stress on bruxism etiology.
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Affiliation(s)
- Marcello Melis
- Gelb Orofacial Pain Center at Tufts University, Boston, Massachusetts, USA.
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28
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Lavigne GJ, Soucy JP, Lobbezoo F, Manzini C, Blanchet PJ, Montplaisir JY. Double-blind, crossover, placebo-controlled trial of bromocriptine in patients with sleep bruxism. Clin Neuropharmacol 2001; 24:145-9. [PMID: 11391125 DOI: 10.1097/00002826-200105000-00005] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study was designed to assess the effects of bromocriptine, a dopamine D2 receptor agonist, on sleep bruxism. Seven otherwise healthy patients with severe and frequent sleep bruxism participated in this randomized, double-blind, placebo-controlled study. The study used a crossover design that included 2 weeks of active treatment or placebo with a washout period of 1 week. To further evaluate whether bromocriptine influences striatal D2 receptor binding, we used iodine-123-iodobenzamide single photon emission computed tomography (SPECT) under both placebo and bromocriptine regimens. Bromocriptine did not reduce the frequency of episodes of bruxism during sleep (mean +/- SEM, 9.0 +/- 1.0 and 9.6 +/- 1.5 bruxism episodes per hour for placebo and bromocriptine, respectively) or the amplitude of masseter muscle contractions (root mean square values, 48.2 +/- 15.5 microV and 46.9 +/- 12.7 microV for placebo and bromocriptine, respectively). SPECT also failed to reveal that either treatment had any influence on striatal D2 binding (values for total binding in counts/pixel, 1.80 [1.72-1.93] and 1.79 [1.56-1.87] for placebo and bromocriptine, respectively). This study shows that a nightly dose of bromocriptine does not exacerbate or reduce sleep bruxism motor activity.
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Affiliation(s)
- G J Lavigne
- Center d'étude du sommeil, Hôpital du Sacré-Coeur de Montréal, Québec, Canada
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29
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Bader G, Lavigne G. Sleep bruxism; an overview of an oromandibular sleep movement disorder. REVIEW ARTICLE. Sleep Med Rev 2000; 4:27-43. [PMID: 12531159 DOI: 10.1053/smrv.1999.0070] [Citation(s) in RCA: 192] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Sleep bruxism (SB) is a stereotyped movement disorder characterized by grinding or clenching of the teeth during sleep. The majority of the population will at some time during their lifetime grind or clench their teeth. It becomes a pathological condition when the subject presents severe tooth damage or complains of non-restorative sleep. The prevalence of SB is difficult to estimate, since quite often the subjects are unaware of having the disorder. There is no gender difference. SB is more frequent in the younger generation, with a decline over age. The symptom recognized in children can persist in adulthood. The aetio-pathophysiology is still unclear. SB has been associated with tooth interference, psychosocial and environmental factors, brain transmitters and basal ganglia dysfunction. Attempts have been made to specify the personality traits of bruxers, reported to be greater anxiety or vulnerability to stress; however, this is still controversial. SB subjects were observed to present vigilance-sleepiness and somatic problems. However, they are generally good sleepers. Some authors reported SB during all sleep stages, others observed the majority of bruxe episodes during light sleep and REM and often associated with arousal transients. No abnormalities of the autonomic nervous system could be shown in awake SB subjects. While some studies have shown an association between SB and PLM or breathing disorders, others did not confirm this. There is no specific treatment for SB: each subject has to be individually evaluated and treated. Three management alternatives are used: dental, pharmacological and psychobehavioural.
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Affiliation(s)
- Gaby Bader
- Sleep Unit, Department of Clinical Neurophysiology, Institute of Clinical Neuroscience, University of Gothenburg, Gothenburg, Sweden
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30
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Lavigne GJ, Goulet JP, Zuconni M, Morrison F, Lobbezoo F. Sleep disorders and the dental patient: an overview. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1999; 88:257-72. [PMID: 10503851 DOI: 10.1016/s1079-2104(99)70025-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This article is intended to briefly describe common sleep disorders of interest to the dental profession and to render general management guidelines. Topics include sleep-related bruxism, xerostomia, hypersalivation, gastroesophageal reflux, apnea, and the effect of orofacial pain on sleep quality. The term sleep-related is used instead of the term nocturnal because some of the activities described can occur with daytime sleep.
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Affiliation(s)
- G J Lavigne
- Centre d'etude sur le sommeil, Hôpital Du Sacre-Coeur, Université De Montreal, Québec, Canada
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31
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Abstract
To characterize the relationship between bruxism and dystonia, 79 patients (28 men and 51 women) with cranial-cervical dystonia were studied. Sixty-two patients (78.5%), 22 men and 40 women, had bruxism. The mean age at onset of dystonia in patients with bruxism was 52.4 +/- 12.6 years (range 14-80), similar to patients with cranial-cervical dystonia without bruxism. Involuntary oromandibular movements (46 patients) and blepharospasm (34 patients) were the most common initial symptoms among patients with dystonia. About one-fourth of bruxism patients had associated dental problems including TMD (21%) and tooth wear (5%). A majority (58%) of the bruxism patients had diurnal bruxism and 12% had nocturnal bruxism. The bruxism patients were compared to 100 patients with Parkinson's disease (PD), cervical dystonia, cranial dystonia, and normal controls, respectively. The prevalence of bruxism was much higher in the cranial-cervical dystonia patients when compared to normal controls (P < 0.001); however, this difference was not significant between other diseased groups and controls. Medications and botulinum toxin injections, used in the treatment of focal dystonia also provided effective relief of bruxism.
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Affiliation(s)
- M W Watts
- Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA
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32
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Areso MP, Giralt MT, Sainz B, Prieto M, García-Vallejo P, Gómez FM. Occlusal disharmonies modulate central catecholaminergic activity in the rat. J Dent Res 1999; 78:1204-13. [PMID: 10371243 DOI: 10.1177/00220345990780060301] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Occlusal disharmonies have classically been thought to be involved in the etiopathogenesis of bruxism, as have, more recently, alterations in central neurotransmission, particularly dopaminergic neurotransmission. However, the connection between these two factors has still not been established. In this study, we assessed the effects of diverse occlusal disharmonies, maintained for either 1 day or 14 days, on neurochemical indices of dopaminergic and noradrenergic activity in the striatum, frontal cortex, and hypothalamus of the rat. The in vivo activity of tyrosine hydroxylase, determined as the accumulation of 3,4-dihydroxyphenylalanine (DOPA), 30 min after the administration of 3-hydroxybenzylhydrazine, a DOPA decarboxylase inhibitor, and dopamine and noradrenaline contents were quantified by high-performance liquid chromatography with electrochemical detection. The wearing of an acrylic cap on both lower incisors for 1 day induced a significant increase in DOPA accumulation in the regions analyzed, with parallel increases in dopamine levels in the hypothalamus and dopamine and noradrenaline in the frontal cortex. After the cap was maintained for 14 days, DOPA accumulation tended to return to control values, except in the left striatum, thereby causing an imbalance between hemispheres. In contrast, 1 or 14 days after the lower left and the upper right incisors were cut, less pronounced changes in catecholaminergic neurotransmission were found in the brain areas studied. Moreover, the cutting of one lower incisor did not modify either DOPA accumulation or dopamine and noradrenaline contents in the striatum or hypothalamus. These results provide experimental evidence of a modulation of central catecholaminergic neurotransmission by occlusal disharmonies, being dependent on the nature of the incisal alteration and on the time during which it was maintained.
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Affiliation(s)
- M P Areso
- Department of Pharmacology, Faculty of Medicine and Odontology, University of the Basque Country, Leioa, Bizkaia, Spain
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33
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Lobbezoo F, Soucy JP, Hartman NG, Montplaisir JY, Lavigne GJ. Effects of the D2 receptor agonist bromocriptine on sleep bruxism: report of two single-patient clinical trials. J Dent Res 1997; 76:1610-4. [PMID: 9294496 DOI: 10.1177/00220345970760091401] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
An altered dopamine receptor status has been associated with sleep bruxism. Evidence from a functional neuro-imaging study has implicated an abnormal side imbalance in striatal D2 receptor expression in its pathophysiology. To assess the significance of this finding, we studied the effects of short-term administration of the preferential dopamine D2 receptor agonist bromocriptine on sleep bruxism in a double-blind, placebo-controlled polysomnographic and neuro-imaging study with a single crossover design. Six otherwise healthy and drug-free patients with sleep bruxism were entered into the trial. One of the patients dropped out due to an intercurrent illness, while three others were discontinued from the study due to severe adverse reactions to bromocriptine. Because of the high frequency and intensity of the side-effects, the trial was interrupted. Two patients, however, completed the trial without any adverse reactions. Their outcome measures are presented as single-patient clinical trials. Following a two-week administration of bromocriptine, both patients showed a decrease in the number of bruxism episodes per hour of sleep of about 20% to 30% with respect to the placebo. WHile no significant differences between both conditions (i.e., placebo and bromocriptine) were found for the number of bruxism bursts per episode, significantly lower root-mean-squared EMG levels per bruxism burst occurred during bromocriptine use. In association with this polysomnographically established attenuation of sleep bruxism, bromocriptine afforded a decreased normal side distribution of striatal D2 receptor binding, as was evidenced by single-photon-emission computed tomography using the radioactive D2 receptor antagonist iodine-123-iodobenzamide. This study supports previous suggestions that the central dopaminergic system may be involved in the modulation of sleep bruxism. To see if the present findings apply across a population, investigators should use a peripheral D-2 antagonist to prevent side-effects.
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Affiliation(s)
- F Lobbezoo
- Faculté de Médecine Dentaire, Université de Montréal, Québec, Canada
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