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A broad consensus does exist among main authors on the importance of parafunctional habits in the etiopathogenesis of temporomandibular disorders (TMD). Mechanisms through which an intense parafunctional activity determined a pathological effect on the temporomandibular joints (TMJs) and their related structures have still not been definitively clarified; nevertheless, before investigating those mechanisms, it's useful to study predisposing, triggering and/or worsening factors of parafunctions themselves. At present the theory, once widely accepted, according to which occlusal interferences can trigger a muscular hyperactivity through the activation of periodontal receptors, has lost a lot of credit. Recently, the hypothesis that bruxism and other parafunctions have a central etiology has become more and more accepted. In such a context, the role of the psychic component assumes a strong relevance, particularly for its relation with the limbic system, which is the part of the central nervous system (CNS) that regulates emotions. Such a hypothesis is confirmed by clinical practice, but it doesn't explain why some patients have reported a worsening of parafunctional activities after occlusal adjustment. The aim of this study is to investigate this issue through a critical review of the literature, indicating how the 2 theories might be complementary for the development and worsening of a parafunctional habit. From this review, despite the number of clinical opinions, there emerges a lack of methodologically appropriate associative works and controlled clinical trials which consent to clarify the effective importance of psychic and/or occlusal factors in the etiopathogenesis of parafunctional habits.

Background: The etiopathogenesis of bruxism in children is not clear although different authors would associate it with several factors, changes in dentition, malocclusions, certain parasomnias and most notably emotional stress. This study was performed to test the hypothesis that anxiety states measured by "Anxiety Scale for evolutive age" may affect the development of bruxism., Methods: A total of eighty-six children, aged between 7 and 1, were evaluated. In the study-group were enlisted forty-three children with bruxism selected among patients afferent to the paediatric dentistry clinic. The forty-three non bruxer children, the control group, were chosen through the Pair Matching procedures, so that each bruxer child had a matching age case control. The gravity of bruxism was scored by means of 0 to 3 graduated scale of dental wear. The psychological aspects were estimated by means of an Anxiety Scale for evolutive age. Statistical analysis was undertaken using the "Odds Ratio" on statistically significant values. The most significant level was evaluated by the Mc Nemar test., Results: Remarkable differences in anxiety levels were found among the children of the two groups; 72% of bruxers showed significant anxiety scores versus 12% of non bruxers. The results of Odds Ratio reveal that a bruxer child has a 16 times greater probability to be anxious than an non bruxer one., Conclusions: The data provide support for the concept that anxiety state is a prominent factor in the development of bruxing behaviour in children.

Research is presented into the psychosomatic aetiology of bruxism with emphasis on the personality of the individual and his response to pain. An analysis of the various treatments proposed highlights the value of hypnosis as the ideal way to eliminate the psychological factors causing the onset of bruxism and to provide adequate relaxation while modifying pain perception.