Search

Background: Most of the respiratory events in adults with obstructive sleep apnea (OSA) occurs in supine position. It has been reported that the contraction of masseter muscles is dependent on the occurrence of arousals rather than on the occurrence of respiratory events. Objectives: This study had two aims: (1) to compare the rhythmic masticatory muscle activity (RMMA) index in supine position (RMMA_sup) and in non‐supine positions (RMMA_nsup) in adults with OSA; and (2) to determine the associations between RMMA index in both supine position and non‐supine positions on the one hand, and several demographic and polysomnographic variables on the other hand. Methods: One hundred OSA participants (36 females and 64 males; mean age = 50.3 years (SD = 10.5)) were selected randomly from among patients with a full‐night polysomnographic recording. RMMA_sup index and RMMA_nsup index were compared using Mann–Whitney U‐test. Multivariate linear regression analyses were used to predict RMMA index both in supine and non‐supine positions based on several demographic and polysomnographic variables. Results: In patients with OSA, the RMMA_sup index was significantly higher than the RMMA_nsup index (p <.001). RMMA_sup index was significantly associated with the arousal index (p =.002) and arousal index in supine position (p <.001). RMMA_nsup index was only significantly associated with the arousal index in non‐supine positions (p =.004). Conclusion: Within the limitations of this study, RMMAs occur more frequently in supine position than in non‐supine positions in patients with OSA. In both sleep positions, RMMAs are associated with arousals. [ABSTRACT FROM AUTHOR]

Objective: The objective of this commentary is to advocate for a holistic, ontology‐based definition of bruxism. The intention is to synthesise the best aspects of current definitions into a structured ontological model, thereby refining and enhancing a comprehensive understanding of the full spectrum of bruxism. Materials and Methods: The commentary elaborates on the process of integrating these insights into a hierarchical ontology that aligns with ontological principles. Settings and Sample Population: Not directly applicable as this is a commentary. Results/Conclusion: The proposed ontology‐based definition of bruxism aims to clarify communication within the medical community and advance research by enabling a comprehensive ontology‐based classification of bruxism. By aligning with ontological principles, this approach aspires to act as a catalyst for further research, discussion and consensus in the field. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusion Somatosensory tinnitus (ST) is associated with activation of the auditory pathway by trigeminal or cervical afferents.This is a cross‐sectional observational study that aims to verify the association of ST with TMD, bruxism, migraine and psychosocial aspects.This study was conducted at the Tinnitus Outpatient Clinic of the Clinical Hospital Complex of the Federal University of Paraná. Specific ST characteristics, were evaluated according to the last consensus for the diagnosis of ST. Two groups with 39 individuals each one were formed, the ST group (STG) and the comparison group (CG). TMD was classified according to the Diagnostic Criteria for Temporomandibular Disorders and migraine by the International Classification of Headaches. The presence of probable sleep and awake bruxism was associated with individual's reports and clinical inspections. The applied questionnaires investigated oral behaviours (OB), sleep quality (SQ), psychosocial aspects (PA), central sensitization (CS), tinnitus impact on quality of life (TIQF), and graded chronic pain scale (GCPS).The STG showed a significant association with modulation manoeuvres and trigger points; myalgias and arthralgia; disc displacement with and without reduction; subluxation; bruxism; and presence of migraine. For the same group, we found a significant association with OB, PA, CS, TIQF and GCPS. There was no significant difference between groups regarding SQ.There is a significant association between the presence of ST and the occurrence of TMD, probable sleep and awake bruxism, and migraine. There is also a greater impairment of OB, PA, CS and TIQF. [ABSTRACT FROM AUTHOR]

Background Objective(s) Methods Results Conclusion Chronic painful temporomandibular disorders (TMD), awake bruxism and sleep bruxism are often comorbid with post‐traumatic stress disorder (PTSD), but the implications for treatment are unknown.To explore the effects of PTSD treatment on these conditions. We hypothesized that chronic painful TMD, pain intensity, pain interference, awake bruxism and sleep bruxism would decrease after evidence‐based trauma‐focused treatment and that this decrease would be maintained at the 6‐month follow‐up.Individuals referred for PTSD treatment were assessed for chronic painful TMD (temporomandibular disorder pain screener), pain intensity, pain interference (Graded Chronic Pain Scale 2.0), awake bruxism and sleep bruxism (oral behaviours checklist) pre‐, post‐treatment and at the 6‐month follow‐up. Hypotheses were tested using the Friedman test, followed by a post hoc Wilcoxon signed‐rank test. Effect sizes (Cohen's r) are reported. Barely any pain interference was reported, therefore these outcomes were not analysed.In individuals with chronic painful TMD (n = 98), pain intensity, awake bruxism and sleep bruxism decreased across the three time points. Post hoc tests showed that chronic painful TMD (r = 0.59), pain intensity (r = 0.28), awake bruxism (r = 0.51) and sleep bruxism (r = 0.35) decreased between pre‐ and post‐treatment. Between pre‐treatment and the 6‐month follow‐up, chronic painful TMD (r = 0.58), awake bruxism (r = 0.30) and sleep bruxism (r = 0.39) decreased as well.The results provide preliminary support for a trauma‐sensitive approach for patients with chronic painful TMD and PTSD and suggest that trauma‐focused treatment may be beneficial for chronic painful TMD, awake bruxism and sleep bruxism in patients with PTSD and chronic painful TMD. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusion Although biofeedback with contingent electrical stimulation (CES) has demonstrated the reduction effect on sleep bruxism (SB), the relationship between the actual applied CES intensity and efficacy remains uncertain.This study aimed to investigate whether the reduction of bruxism events and jaw muscle symptoms could vary according to the intensity of CES and in probable sleep bruxers.Twenty probable sleep bruxers were initially screened for bruxer confirmation based on a 2‐week recording of SB events with a portable electromyography recorder (BUTLER®GrindCare®, GC4). A 3‐week recording was conducted without CES using a GC4, followed by another 3‐week recording with CES. At baseline and before and after the CES (+) session, clinical muscle symptoms were assessed using a 0–10 numerical rating scale (NRS). The relationships between the actual applied CES intensity and the number of SB events/hour, as well as the NRS of clinical muscle symptoms, were analysed.The actual applied CES intensity was positively correlated with the reduction rate of the number of SB events/hour (R = .643, p = .002), as well as with the reduction rate of NRS for pain, unpleasantness, fatigue, tension and stiffness (R > .500, p < .011).Higher CES elicited a more robust reduction in SB events and clinical muscle symptoms, in probable bruxers. Prior to selecting CES biofeedback as a management option for SB, it would be beneficial to assess the tolerance threshold of CES in each bruxer in order to predict the effectiveness of CES in probable sleep bruxers. [ABSTRACT FROM AUTHOR]

Introduction: Comorbid insomnia and obstructive sleep apnea (COMISA) is not a well-identified sleep disorder, despite having a significant impact on health. This study investigates the relationship between sleep bruxism (SB) and sleep architecture in patients with COMISA, obstructive sleep apnea (OSA), and in those without any sleep disorders. Methods: 119 patients were included in the study and divided into three groups: OSA, COMISA, and a control group. Polysomnographic (PSG) examination provided parameters related to sleep architecture, OSA, and characteristics of SB. Results: The bruxism episode index (BEI) and other SB parameters were not found to be statistically different between the three groups (p > 0.05). There was no statistical difference in measured sleep architecture between the COMISA and OSA groups (p > 0.05). In comparison to the control group, participants in the COMISA group were found to have an increased apnea–hypopnea index (AHI), oxygen desaturation index (ODI), respiratory disturbance index (RDI), all arousals (AA), and respiratory arousals (RA) (p < 0.05). Among COMISA patients, AA and RA were shown to have a positive linear correlation with the number of bradycardia events per hour (r = 0.49, r = 0.48, p < 0.05). Conclusions: SB does not occur in patients with COMISA more frequently than in patients with OSA or those without any sleep disorders. PSG parameters are not specific for COMISA; therefore, in order to differentiate this disorder from OSA alone, a comprehensive patient assessment has to be performed. [ABSTRACT FROM AUTHOR]

Summary Intracranial pressure is one of the determinants of sympathetic activities, and sleep bruxism is associated with increased sympathetic activities. This study aimed to investigate effects of the low Fowler's sleep position and methazolamide treatment on the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes in patients with sleep bruxism in a randomized controlled trial. Polysomnographic recordings were performed on the patients with sleep bruxism sleeping in the low Fowler's (15°–30°) or supine position (n = 11), and with methazolamide or placebo treatment (100 mg, 3–4 hr before bedtime, P.O., n = 9), and changes in sleep variables and heart rate variance during sleep in the low Fowler's position or with methazolamide treatment were determined. Sleep bruxism index, number of masseter muscle electromyographic bursts per hour of sleep, ratio of rhythmic masticatory muscle activities/sleep bruxism duration to the total sleep duration, index of total limb movements, index of limb movements with rhythmic masticatory muscle activities, and number of sleep bruxism clusters per hour of sleep in the low Fowler's position and after methazolamide intake were significantly smaller (p < 0.05–0.001) than those in the supine position and after placebo intake, respectively. The low‐frequency heart rate variance powers during non‐rapid eye movement sleep stage 2 (N2) in the low Fowler's position and with methazolamide treatment were significantly lower (p < 0.05) than those during sleep in the supine position and with placebo treatment, respectively. In conclusion, sleep in the low Fowler's position and methazolamide treatment were associated with significant decreases in the occurrence of rhythmic masticatory muscle activities/sleep bruxism episodes, which might be due to a reduction in intracranial pressure and sympathetic activities mainly during non‐rapid eye movement sleep stage 2. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusion Polysomnography (PSG) is the gold standard for sleep bruxism (SB) assessment, it is expensive, not widely accessible, and time‐consuming.Given the increasing prevalence of SB, there is a growing need for an alternative, readily available, reliable and cost‐effective diagnostic method. This study aimed to evaluate the diagnostic validity of portable respiratory polygraphy (PRPG) compared with PSG for SB diagnosis.One hundred and three subjects underwent simultaneous examinations using PRPG (NOX T3, NOX Medical) and PSG (NOX A1, NOX Medical) in a sleep laboratory.The mean Bruxism Episodes Index (BEI) measured by PRPG was 4.70 ± 3.98, whereas PSG yielded a mean BEI of 3.79 ± 3.08. The sensitivity for detecting sleep bruxism (BEI >2) by PRPG was 48.3%, with a specificity of 81.2%. The positive predictive value was estimated at 51.9%, and the negative predictive value at 78.9%. However, when distinguishing between mild bruxism (BEI >2 < 4) and severe bruxism (BEI >4), PRPG demonstrated a sensitivity of 77.8% and 68.3% and a specificity of 48.6% and 71.4%, respectively.Polysomnography continues to be the SB diagnostic gold standard tool, as the sensitivity and specificity of PRPG are significantly lower when compared with PSG. Nevertheless, PRPG could serve as an alternative tool for SB screening or diagnosis, despite its limitations. Furthermore, our data indicate that comorbidities such as sleep apnea and sleep quality do not influence the diagnostic accuracy of PSG, suggesting its potential as a screening instrument in individuals with other sleep disorders. [ABSTRACT FROM AUTHOR]

A correction to an article about the prevalence of painful temporomandibular disorders, awake bruxism and sleep bruxism among patients with severe post-traumatic stress disorders is presented.

Summary: Insufficient sleep syndrome possibly represents the worldwide leading cause of daytime sleepiness, but remains poorly recognised and studied. The aim of this case series is to comprehensively describe a cohort of patients with insufficient sleep syndrome. Eighty‐two patients were studied concerning demographic and socio‐economic features, medical, psychiatric and sleep comorbidities, substance use, sleep symptoms, actigraphy, video‐polysomnography, multiple sleep latency tests and treatment. The typical patient with insufficient sleep syndrome is a middle‐aged adult (with no difference of gender), employed, who has a family, often carrying psychiatric and neurological comorbidities, in particular headache, anxiety and depression. Other sleep disorders, especially mild sleep apnea and bruxism, were common as well. Actigraphy was a valuable tool in the characterisation of insufficient sleep syndrome, showing a sleep restriction during weekdays, associated with a recovery rebound of night sleep during weekends and a high amount of daytime sleep. An over‐ or underestimation of sleeping was common, concerning both the duration of night sleep and daytime napping. The average daily sleep considering both daytime and night‐time, weekdays and weekends corresponds to the recommended minimal normal duration, meaning that the burden of insufficient sleep syndrome could mainly depend on sleep fragmentation and low quality. Sleep efficiency was elevated both in actigraphy and video‐polysomnography. Multiple sleep latency tests evidenced a tendency toward sleep‐onset rapid eye movement periods. Our study offers a comprehensive characterisation of patients with insufficient sleep syndrome, and clarifies their sleeping pattern, opening avenues for management and treatment of the disorder. Current options seem not adapted, and in our opinion a cognitive‐behavioural psychotherapy protocol should be developed. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the immediate and late impact of the COVID‐19 pandemic on the occurrence of possible sleep bruxism (SB) among adolescents in Brazil. Design: This is a longitudinal study performed with adolescents (11–15 years old) from Southern Brazil. Baseline data were collected before the Brazilian COVID‐19 outbreak (T1). Posteriorly, data were collected after 3 (T2) and 15 months under the Brazilian COVID‐19 outbreak. The possible SB was evaluated by the question: 'Do you grind your teeth during your sleep?'. Sociodemographic, psychosocial and clinical variables were also collected. Changes in SB were evaluated by multilevel logistic regression models for repeated measures. Results: Of the 290 adolescents assessed at T1, 182 were reassessed at both follow‐ups. The prevalence of possible SB was 13% at T1, 11% at T2 and 22% at T3. There were no immediate effects of the COVID‐19 pandemic on the occurrence of possible SB (T2). Adolescents had odds 2.77 times greater of presented possible SB after 15 months (T3) of COVID‐19 pandemic scenarios when compared to T1. Conclusion: There was a considerable and late increase in the possible SB in adolescents in Brazil during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

This systematic review answers the question: "Does occlusal appliance use influence masticatory muscle function of dentate individuals with sleep bruxism?". The literature search included six databases, grey literature, and manual search for articles. Randomized and non‐randomized clinical trials were included comparing muscle function of sleep bruxers before and after receiving occlusal appliances. Risk of bias was assessed with risk of bias assessment for randomized and non‐randomized clinical trials tool. Twelve studies, three represent randomized clinical trials, were included. Risk of bias was considered low, moderate, or serious. Meta‐analyses indicated that soft and hard appliances did not influence muscle activity and bite force of bruxers. Qualitative analysis showed that occlusal appliance use did not influence masticatory performance and muscle volume. However, it was effective in reducing tongue force. Certainty of evidence was considered very low for muscle activity when evaluated with hard appliances, and for bite force evaluated with both appliance materials. Low certainty of evidence was observed for muscle activity with soft appliances. Based on the findings of this meta‐analysis, occlusal appliances do not affect masticatory muscle function of sleep bruxers. Regardless of appliance material, the activity of masseter and temporal, and bite force of sleep bruxers was not influenced. [ABSTRACT FROM AUTHOR]

Summary: Sleep bruxism (SB) has been associated with biological and psychosocial factors. The assessment of SB includes self‐report, clinical evaluation, and polysomnography. This study aimed to investigate the associations of self‐reported SB with other sleep disorders and demographic, psychological, and lifestyle factors in the adult general population, and to investigate whether self‐reported SB and polysomnographically (PSG) confirmed SB provide similar outcomes in terms of their associated factors. We recruited 915 adults from the general population in Sao Paulo, Brazil. All participants underwent a one‐night PSG recording and answered questions about sex, age, BMI, insomnia, OSA risk, anxiety, depression, average caffeine consumption, smoking frequency, and alcohol consumption frequency. We investigated the link between SB and the other variables in univariate, multivariate, and network models, and we repeated each model once with self‐reported SB and once with PSG‐confirmed SB. Self‐reported SB was only significantly associated with sex (p = 0.042), anxiety (p = 0.002), and depression (p = 0.03) in the univariate analysis, and was associated with insomnia in the univariate (p < 0.001) and multivariate (β = 1.054, 95%CI 1.018–1.092, p = 0.003) analyses. Network analysis showed that self‐reported SB had a direct positive edge to insomnia, while PSG‐confirmed SB was not significantly associated with any of the other variables. Thus, sleep bruxism was positively associated with insomnia only when self‐reported, while PSG‐confirmed SB was not associated with any of the included factors. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular disorders (TMDs) are the most prevalent non-dental pain issues in the maxillofacial region. Despite advancements, diagnosing and managing TMDs continues to pose challenges. This study aimed to assess the efficacy of cannabidiol (CBD) formulations, with different concentrations, in patients experiencing sleep bruxism and muscle-related TMDs, with a particular emphasis on their myorelaxant, pain-relieving, and bruxism-reducing properties. Methods: The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMDs) was utilized as the diagnostic framework. Sixty patients completed the study, which followed a parallel-group, three-arm, randomized, double-blind clinical trial design, with a 1:1:1 allocation ratio across three groups: 1a, 1b, and 2. Groups 1a and 1b received CBD formulations at concentrations of 10% and 5%, respectively, while Group 2 received a placebo formulation. The trial consisted of four main visits, namely screening, baseline, first follow-up after 14 days, and second follow-up after 30 days, during which surface electromyography (sEMG), the visual analogue scale (VAS) for pain assessment, and Bruxoff examinations were conducted. Results: The reduction in pain, as measured by the visual analogue scale (VAS), among patients using the 10% CBD formulation was 57.4% (p < 0.05), accompanied by a decrease in sEMG activity by 42.1% (p < 0.05). Conversely, individuals using the 5% CBD formulation experienced a 40.8% (p < 0.05) decrease in pain. Regarding the decrease in the sleep bruxism index, users of the 10% CBD formulation saw the highest reduction of 51% (p < 0.05). These findings underscore the efficacy of the proposed treatment in both experimental groups, with a notable advantage observed in Group 1a. Conversely, the outcomes of the selected variables for the control group did not exhibit significant differences throughout the study. Conclusions: The intraoral use of CBD formulations in patients with TMDs have proven to be a successful treatment for reducing pain, muscle tension, and bruxing activity in individuals with sleep bruxism and muscle-related TMDs. Specifically, a concentration of 10% CBD has demonstrated superior results compared to 5% CBD. [ABSTRACT FROM AUTHOR]

Temporomandibular disorders (TMDs) are debilitating and can be difficult to diagnose. Internal disc derangement is one of more than 30 TMDs. Appropriate treatment and use of multiprofessional resources are critical to providing care essentials for these temporomandibular joint conditions. [ABSTRACT FROM AUTHOR]

(1) Background: This study aims to compare the effects of 3D-printed splints and conventional manufactured splints on sleep bruxism (SB) EMG activity. (2) Methods: Twenty-six patients (19 M, 7 F, 25.8 ± 2.6 years) were randomly allocated to a study group (3D splints) and a control group (conventional manufactured splints) and followed for a period of three months with night EMG–ECG recordings. Samples of the involved materials were analyzed for nanoindentation. The outcomes of interest considered were the overall SB index, the total amount of surface masseter muscle activity (sMMA), and general and SB-related phasic and tonic contractions. A statistical evaluation was performed with a confidence interval (CI) between 2.5% and 97.5%. (3) Results: Differences between groups with OAs were observed for general tonic contraction (p = 0.0009), while differences between recording times were observed for general phasic contractions (p = 0.002) and general tonic contractions (p = 0.00001). Differences between recording times were observed for the total amount of sMMA (p = 0.01), for general phasic contractions (p = 0.0001), and for general tonic contractions (p = 0.000009) during night recordings without OAs. (4) Conclusions: Three-dimensional splints seem to have a higher impact on SB-related electromyographic activity but not on the overall sleep bruxism index. The more regular surfaces offered by 3D splints could be related to phasic contraction stabilization. [ABSTRACT FROM AUTHOR]

Background: Sleep bruxism (SB) is a common sleep-related movement behavior with a multifaceted etiology and a deficiently understood pathophysiology. A recent hypothesis suggests a link between SB and systemic inflammation. The scope of the study was to determine whether bruxers have altered sleep structure and different levels of inflammatory parameters compared to nonbruxers. Methods: A total of 83 adults underwent full-night polysomnography. The polysomnograms were evaluated using the American Academy of Sleep Medicine (AASM) guidelines. Then, the blood samples were obtained from the participants by venipuncture and the analyses were performed. The study group was divided based on bruxism episode index (BEI) into two groups: BEI ≤ 4 and BEI > 4. Results: In comparison with nonbruxers, the oxygen desaturation index (ODI) was significantly higher in severe bruxers (7.5 ± 11.08 vs. 3.33 ± 5.75, p < 0.005), as well as the arousal parameters (7.77 ± 4.68 vs. 4.03 ± 2.97, p < 0.001), and the mean oxygen desaturation (3.49 ± 0.69 vs. 3.01 ± 0.67, p < 0.05). Moreover, the differences in sleep architecture and deprivation of the deep sleep phase were observed, the non-REM sleep stage 3 was significantly shorter in severe bruxers (p < 0.03). Differences were also noted in non-REM sleep stage 1 and REM sleep phase. In the investigated group, there were no statistical differences in inflammatory cytokines levels between bruxers and nonbruxers. Conclusions: Sleep bruxism is associated with sleep structure alterations and may be associated with deep sleep phase deprivation. The inflammatory markers are not linearly correlated with the severity of sleep bruxism expressed as BEI. [ABSTRACT FROM AUTHOR]

Introduction: Dental sleep medicine (DSM) is an emerging discipline that studies the oral and maxillofacial causes and consequences of sleep‐related problems. DSM is of upmost importance given the major medical challenge it represents. Therefore, to verify whether the future generation of dentists would be ready to face this challenge, the main objective of this study was to assess the degree of involvement of the French dental schools in teaching DSM at the undergraduate level. Materials and Methods: All 16 dental schools in France were asked to participate in the study by answering to an online survey concerning the DSM curriculum during the 2018–2019 academic year. The survey was addressed to the head of the dental school and/or to relevant course coordinators and contained 10 questions related to the type, content and amount of DSM teaching to undergraduate dental students. Results: Nine of the 16 (56.2%) French dental schools responded to the questionnaire. All these nine reported the inclusion of DSM in their undergraduate curriculum. The total average hours dedicated to teaching DSM was 5.6 h (SD 4.2; range 1–15 h). Seven of the 9 dental schools spent most of their DSM curriculum teaching time in the fifth year. All of them reviewed obstructive sleep apnoea and sleep‐related bruxism and covered some topics related to therapies for sleep‐related breathing disorders, such as the use of oral appliance. Conclusion: The results of this survey showed that, although the average hourly volume is relatively high, the DSM teaching in French dental schools appeared to be non‐standardised, heterogeneous and often lacunar. It is therefore essential to develop a common curriculum and implement it in all dental schools to provide undergraduate students a comprehensive and updated teaching in DSM. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. • This study examined sleep bruxism (SB) and obstructive sleep apnea (OSA) correlation using type I polysomnography. • Mild OSA patients had more frequent SB episodes than those with moderate to severe OSA. • SB and OSA are positively associated; SB may be a protective response to upper ariway obstruction. • More research and standard neurophysiological parameters needed to understand SB-OSA link better. [ABSTRACT FROM AUTHOR]

Summary: Sleep‐related rhythmic movement disorder is characterised by stereotyped and repetitive rhythmic movements involving large muscle groups during sleep with frequencies between 0.5 and 2 Hz. Most of the published studies on sleep‐related rhythmic movement disorder have focussed on children. Therefore, we performed a systematic review on this topic focussing on the adult population. The review is followed by a case report. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 2020 guidelines. A total of seven manuscripts (n = 32 individuals) were included in the review. The clinical manifestation of body or head rolling predominated in the majority of included cases (53.13% and 43.75%, respectively). In n = 11 (34.37%) cases, a combination of rhythmic movements was observed. The literature review also revealed a wide spectrum of co‐morbidities: insomnia, restless leg syndrome, obstructive sleep apnea, ischaemic stroke, epilepsy, hypertension, alcohol and drug dependency, mild depression, and diabetes mellitus. The case report presented a 33‐year‐old female who was referred to the sleep laboratory due to a suspicion of sleep bruxism and obstructive sleep apnea. Although the patient was initially suspected of having obstructive sleep apnea and sleep bruxism, after conducting video‐polysomnography she met the criteria for sleep‐related rhythmic movement disorder as she presented body rolling, which were surprisingly most evident during the rapid eye movement sleep stage. In summary, the prevalence of sleep‐related rhythmic movement disorder among adults has not been determined yet. The present review and case report is a good starting point for discussion regarding rhythmic movement disorder in adults and further research on this topic. [ABSTRACT FROM AUTHOR]

(1) Background: The relationship between sleep bruxism (SB) and psychological distress has been investigated in numerous studies and is heterogeneous. Different diagnostic procedures have been applied to determine SB. The aim of this study was to directly compare the association between psychological distress and SB diagnosed by different accepted methods. (2) Methods: Data of N = 45 subjects were analyzed, including group comparisons and correlation analyses. Following diagnostic methods for the determination of SB were used in one sample: self-report, clinical assessment, polysomnography with audio–video recording and a novel diagnostic sheet with analyzing software. Psychological distress was measured using the global severity index (GSI) of the Symptom Checklist-90-Standard (SCL-90-S). (3) Results: The GSI did not differ significantly between subjects with and without SB, regardless of the underlying diagnostic classification (p > 0.05). In-depth correlation analyses of self-report and clinical data revealed a weak-to-medium correlation with the GSI (r = 0.12–0.44). Due to non-normally distributed data, a test of statistical significance was not possible. Variables of instrumental methods such as the SB index (amount of SB activity per hour) of polysomnography (PSG) showed almost no correlation with psychological distress (r = −0.06–0.05). (4) Conclusions: Despite these limitations, the results provide an indication that the choice of diagnostic procedure may elucidate the variance in the correlation between SB and psychological distress. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effects of parental anxiety, depression levels and psychiatric symptom profiles of parents on the occurrence of sleep bruxism in children. This cross-sectional study was carried out with a sample of 94 children aged 6 to 12 years, divided into two groups: with sleep bruxism (bruxism group-BG) and without sleep bruxism (control group-CG). Beck Depression Inventory (BDI), Symptom Checklist (SCL-90-R), Symptom Checklist and Screen for Child Anxiety Related Emotional Disorders-Parent (SCARED-P) scale were used to assess anxiety and depression levels of parents. All questionnaires were filled out by parents of children. Intraoral and extraoral examinations were carried out of children in the clinic and sleep bruxism was determined. All stress conditions were investigated by logistic regression analysis. In the comparison of the qualitative data, chi-square and Fisher exact tests were used. The data revealed that participants whose mothers had high anxiety and interpersonal sensitivity scores, and participants whose fathers had a medium level of obsessive-compulsive disorder were more likely to have an SB problem (p < 0.05). According to the results of BDI, the fathers' results between the BG and the CG were not statistically significant (p > 0.05). However, the mothers' results between the BG and the CG were statistically significant (p < 0.05) When all subscales of SCARED-P were evaluated, the separation anxiety disorder subscore was statistically significant in the bruxism group. The psychological status of parents is a significant risk factor associated with SB development in school-age children. [ABSTRACT FROM AUTHOR]

Background and Objective: This review paper focuses on sleep bruxism (SB) in children and adolescents. It aims to assess the landscape of knowledge published in the last 20 years. Methods: A total of 144 relevant publications from 386 previously identified through Medline were included, of which 83 were on possible SB, 37 on probable SB, 20 on definite SB and 4 were non‐applicable. The review places emphasis on the recent evidence on prevalence, pathophysiology, diagnosis and management of SB in children and adolescents, with special focus on probable and definitive SB. Results: The prevalence ranges from 5% to 50% depending on the age range and on the SB diagnosis (possible, probable or definitive). The pathophysiology is multifactorial, arousal associated and with behavioural problems and sleep disorders (obstructive sleep apnoea, snoring, nightmares) as risk factors, as well as respiratory conditions (allergies, oral breathing). Screening should include questionnaires and dental assessment. Instrumental recording is helpful to confirm diagnosis although more studies are needed to validate this approach in children. SB management includes controlling orofacial and dental consequences and assessing for any other comorbidity. Management options include occlusal splints, oral appliances (advancement mandibular), rapid maxillary expansion and some medications, although this last option is supported by limited evidences in children. Conclusion: Suggestions of future topics in research are delivered to better understand comorbidities, diagnosis and management with improved outcomes compared to what is currently available. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background and Objectives: With the increasing attention to bruxism, the research on bruxism is increasing rapidly. However, there is still a lack of systematic bibliometric analysis in the field of bruxism in adults. This study aimed to comprehensively explore and visualize the global trends and research hotspots in the field of bruxism in adults during 1991–2021. Methods: The study searched the literature published during 1991–2021 in the Web of Science Core Collection database without language restrictions. VOSviewer, CiteSpace and Microsoft Excel were applied to analyse the authors, institutions, journals, countries, cited references, keywords and other information of the included publications, and construct visualized cooperation networks. Results: A total of 878 articles were finally included. The top two most productive authors in the past 30 years were Lobbezoo F and Manfredini D. ACTA‐Amsterdam, Univ Sao Paulo, Univ Helsinki, Univ Padua, Univ Montreal, et al. were prominent institutions in this field. Journal of Oral Rehabilitation made outstanding contributions in this field. The United States produced the most documents in this field, followed by Brazil. Both countries and authors cooperated closely around the world. The two most cited articles focused on the definition, assessment and classification of bruxism. In recent years, diagnostic criteria and stress have begun to receive a lot of attention. Conclusion: From 1991 to 2021, the attention to bruxism in adults continued to increase. Diagnostic criteria and stress may be potential research hotspots in this field. This study references relevant scholars on development trends and research hotspots. [ABSTRACT FROM AUTHOR]

Background: Due to different assessment modes employed, a clear picture of the prevalence of sleep bruxism across time cannot be formed. Moreover, studies on the persistent or fluctuating nature of sleep bruxism have yielded divergent and even contradictory results. The aim of the present study was to evaluate in a nationwide twin cohort whether self‐reported sleep bruxism was correlated longitudinally, pairwise and cross‐twin over a 20‐year period. Objectives: Self‐reported bruxism was assessed in 1990 and 2011 by mailed questionnaires in the Finnish Twin Cohort study of same‐sex twins born 1945–1957. Methods: We assessed the phenotypic stability over time for all participating individuals (n = 4992). Among zygosity verified pairs (n = 516 MZ and n = 837 DZ), we estimated the cross‐sectional zygosity correlations and the zygosity‐specific cross‐twin cross‐time correlations. Results: Reported bruxism appeared rather persistent over time without significant difference regarding zygosity. The overall phenotypic longitudinal correlation was 0.540 and somewhat higher in men (0.596) than in women (0.507). Pairwise trait correlations in 1990 and 2011 were higher in MZ than in DZ pairs. The cross‐twin cross‐time correlations were higher in MZ twins than in DZ twins, but less than the cross‐sectional MZ and DZ pairwise correlations. Conclusions: The higher correlation of reported sleep bruxism in the cross‐twin cross‐time analyses in MZ than in DZ pairs implies a genetic background for bruxism persistence. Also, bruxism over time in individual twins appears to be fairly persistent and somewhat higher in men than women. [ABSTRACT FROM AUTHOR]

Background: Sleep on the first night in a sleep laboratory is characterized by a lower sleep quality and frequency of rhythmic masticatory muscle activity (RMMA) than that on the second night in moderate to severe sleep bruxism (SB) patients. Objective: The aims of this study was to clarify the physiological factors contributing to the first night effect on oromotor activity during sleep and investigate whether physiological factors involved in the first night effect differed between rhythmic and non‐rhythmic oromotor activities. Methods: Polysomnographic data collected on two consecutive nights from 15 moderate to severe SB subjects (F 7: M 8; age: 23.2 ± 1.3 [mean ± SD] years) were retrospectively analysed. Sleep variables, RMMA and non‐specific masticatory muscle activity (NSMA) were scored in relation to episode types (i.e. phasic or tonic and cluster or isolated), sleep architecture and transient arousals. The relationships between nightly differences in oromotor and sleep variables were assessed. The distribution of oromotor events, arousals, cortical electroencephalographic power, RR intervals and heart rate variability were examined in relation to sleep cycle changes. These variables were compared between the first and second nights and between RMMA and NSMA. Results: Sleep variables showed a lower sleep quality on Night 1 than on Night 2. In comparisons with Night 1, the RMMA index increased by 18.8% (p <.001, the Wilcoxon signed‐rank test) on Night 2, while the NSMA index decreased by 17.9% (p =.041). Changes in the RMMA index did not correlate with those in sleep variables, while changes in the NSMA index correlated with those in arousal‐related variables (p <.001, Spearman's rank correlation). An increase in the RMMA index on Night 2 was found for the cluster type and stage N1 related to sleep cyclic fluctuations in cortical and cardiac activities. In contrast, the decrease in the NSMA index was associated with increases in the isolated type and the occurrence of stage N2 and wakefulness regardless of the sleep cycle. Conclusion: Discrepancies in first night effect on the occurrence of RMMA and NSMA represent unique sleep‐related processes in the genesis of oromotor phenotypes in SB subjects. [ABSTRACT FROM AUTHOR]

Background: With time, due to the poor knowledge on it epidemiology, the need to focus on awake bruxism as a complement of sleep studies emerged. Objective: In line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, that is better assessment and more efficient management. Methods: We summarised current strategies for AB assessment and proposed a research route for improving its metrics. Results: Most of the literature focuses on bruxism in general or SB in particular, whilst knowledge on AB is generally fragmental. Assessment can be based on non‐instrumental or instrumental approaches. The former include self‐report (questionnaires, oral history) and clinical examination, whilst the latter include electromyography (EMG) of jaw muscles during wakefulness as well as the technology‐enhanced ecological momentary assesment (EMA). Phenotyping of different AB activities should be the target of a research task force. In the absence of available data on the frequency and intensity of wake‐time bruxism‐type masticatory muscle activity, any speculation about the identification of thresholds and criteria to identify bruxers is premature. Research routes in the field must focus on the improvement of data reliability and validity. Conclusions: Probing deeper into the study of AB metrics is a fundamental step to assist clinicians in preventing and managing the putative consequences at the individual level. The present manuscript proposes some possible research routes to advance current knowledge. At different levels, instrumentally based and subject‐based information must be gathered in a universally accepted standardised approach. [ABSTRACT FROM AUTHOR]

Background: Sleep bruxism (SB), an oral behaviour in otherwise healthy individuals, is characterised by frequent rhythmic masticatory muscle activity (RMMA) during sleep. RMMA/SB episodes occur over various sleep stages (N1‐N3 and rapid eye movement (REM)), sleep cycles (non‐REM to REM), and frequently with microarousals. It currently remains unclear whether these characteristics of sleep architecture are phenotype candidates for the genesis of RMMA/SB. Objectives: This narrative review investigated the relationship between sleep architecture and the occurrence of RMMA as a SB phenotype candidate. Methods: PubMed research was performed using keywords related to RMMA/SB and sleep architecture. Results: In non‐SB and SB healthy individuals, RMMA episodes were most frequent in the light non‐REM sleep stages N1 and N2, particularly during the ascending phase of sleep cycles. The onset of RMMA/SB episodes in healthy individuals was preceded by a physiological arousal sequence of autonomic cardiovascular to cortical activation. It was not possible to extract a consistent sleep architecture pattern in the presence of sleep comorbidities. The lack of standardisation and variability between subject complexified the search for specific sleep architecture phenotype(s). Conclusion: In otherwise healthy individuals, the genesis of RMMA/SB episodes is largely affected by oscillations in the sleep stage and cycle as well as the occurrence of microarousal. Furthermore, a specific sleep architecture pattern cannot be confirmed in the presence of sleep comorbidity. Further studies are needed to delineate sleep architecture phenotype candidate(s) that contribute to the more accurate diagnosis of SB and treatment approaches using standardised and innovative methodologies. [ABSTRACT FROM AUTHOR]

Background: The association of sleep bruxism with mortality has not been studied. Objectives: Altogether 12 040 subjects from the nationwide Finnish twin cohort were included in the analyses. We examined whether self‐reported sleep bruxism is associated with increased risk of mortality, and if so, whether the effect is independent of known common risk factors. The time span of the follow‐up was 30 years. Methods: Cox proportional hazards regression models (Hazard Ratios and their 95% Confidence Intervals) adjusted by age, sex and covariates were used to assess the effect of baseline bruxism status in 1990 on future mortality in 1990–2020. Results: The risk of mortality among all participants (n = 12 040), independent of missing covariates and adjusted by age and sex, was 40% higher in weekly bruxers than in never bruxers (HR 1.40, 95% CI 1.16–1.68, p <.001). However, when adjusted by all studied covariates, (n = 11 427) the risk was no longer observed (HR 1.04, 95% CI 0.86–1.25, p =.717). Despite the overall lack of between bruxism and mortality after adjustment for covariates, we examined the cause‐specific risks for major cause‐of‐death groups. There were no substantial associations of weekly bruxism with major disease outcomes by the fully adjusted hazard ratios for them. Conclusion: Bruxism does not kill—in line with its definition of being rather a behaviour (with all its phenotypes) than a disease. [ABSTRACT FROM AUTHOR]

Background: Sleep bruxism (SB) occurring during No‐REM (nREM) sleep and increase in microarousals per hour have been described in adults, but not in children. Objective: To assess the correlation between sleep architecture and masseter muscle activity related to sleep bruxism (SB/MMA) in children. Materials and methods: Forty‐three children aged 7–12 years (mean age: 9.4 ± 1.3) with confirmed SB underwent a two‐night polysomnographic (PSG) study in a sleep laboratory, for accommodation (first night) and data collection (second night). Data on sleep architecture (total sleep duration (TSD), sleep efficiency (SE), sleep onset latency (SOL), REM and nREM sleep duration and proportion and microarousals/hour during REM and nREM sleep) and episodes/hour of SB/MMA were recorded. Single and multiple‐variable linear regression analyses were performed to assess the correlation between data on sleep architecture (predictors) and SB/MMA (dependent variable). Results: Shorter TSD, REM and nREM stage 1 sleep duration, longer SOL and more microarousals/hour during REM and nREM sleep were found to be positive predictors of SB/MMA in children in the multiple‐variable regression analysis (R2 = 0.511). Conclusion: Within the limitations of this study, it can be concluded that SB/MMA is correlated with altered sleep architecture in children (shorter total sleep duration (TSD), shorter nREM and REM sleep and higher microarousals during REM and nREM sleep). Nevertheless, the clinical significance of these findings need to be demonstrated in future studies. [ABSTRACT FROM AUTHOR]

Objective: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. Methods: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications. Results: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self‐reported information on bruxism status and possible consequences (subject‐based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject‐Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self‐report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra‐ and Extra‐Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self‐reported information (subject‐based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep‐related Conditions Assessment (B2), Concurrent Non‐Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration. Conclusions: The instrument is now ready for on‐field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields. [ABSTRACT FROM AUTHOR]

This paper summarises the background reasoning and work that led to the selection of the items included in the Standardised Tool for the Assessment of Bruxism (STAB), also introducing the list of items. The instrument is currently being tested for face validity and on‐field comprehension. The underlying premise is that the different motor activities included in the bruxism spectrum (e.g. clenching vs. grinding, with or without teeth contact) potentially need to be discriminated from each other, based on their purportedly different aetiology, comorbidities and potential consequences. Focus should be on a valid impression of the activities' frequency, intensity and duration. The methods that can be used for the above purposes can be grouped into strategies that collect information from the patient's history (subject‐based), from the clinical assessment performed by an examiner (clinically based) or from the use of instruments to measure certain outcomes (instrumentally based). The three strategies can apply to all aspects of bruxism (i.e. status, comorbid conditions, aetiology and consequences). The STAB will help gathering information on many aspects, factors and conditions that are currently poorly investigated in the field of bruxism. To this purpose, it is divided into two axes. Axis A includes the self‐reported information on bruxism status and potential consequences (subject‐based report) together with the clinical (examiner report) and instrumental assessment (technology report). Axis B includes the self‐reported information (subject‐based report) on factors and conditions that may have an etiological or comorbid role for bruxism. This comprehensive multidimensional assessment system will allow building predictive model for clinical and research purposes. [ABSTRACT FROM AUTHOR]

Background and aims. Bruxism is associated with a variety of factors, some of which are oral (occlusion, joint, face shape) while others are of a systemic nature (respiratory, cardiac, neurotransmitters, stress). The relationship between bruxism and occlusion has received great attention, but it still has a lot of ambiguity. This study aimed at investigating the parameters that may affect bruxism: dental interferences or premature contacts, vicious habits, temporomandibular joint (TMJ) pain, TMJ noises, TMJ morning fatigue, snoring, obstructive sleep apnea, which may occur before bruxism, or because of chronic parafunction. Methods. We conducted an observational, analytical case-control study to determine the association between bruxism and oral cavity factors as well as general factors. Participants were chosen from a group of middle-aged Romanian population. An online questionnaire was used for data collection. A total of one hundred subjects were included in the sample. Fifty cases with bruxism were chosen as a study group, and another fifty persons of similar ages were chosen as a control group. Statistical analysis was performed using the MedCalc version 20.110 software. Results. The study comprised subjects between 18 and 42 years old. The most prevalent age range was between 20-25 years. The female-male ratio was almost similar; 62% of the participants had sleep bruxism, 10% had awake bruxism and 28% had a combined form. The arithmetic means of the daily stress levels for both research groups' scores were 3.0 for the bruxism group and 3.24 for the control group, while the work stress was 3.04 for the bruxism group and 3.41 for the control group. Dental interferences or premature contacts, vicious habits, TMJ pain, TMJ noises, TMJ morning fatigue, snoring, and obstructive sleep apnea were evaluated. The majority of subjects received an oral splint (n=26). Conclusions. Bruxism was associated with stress, occlusal parameters (premature contacts and occlusion interferences), and joint pathologies. Bruxism was not found to be positively correlated with obstructive sleep apnea syndrome. There was a moderately significant association between bruxism and snoring. There was no evidence of an association between bruxism and vicious habits, dental aesthetics, or obstructive sleep apnea. Treatment significantly improved the quality of life, the masticatory and joint functions. [ABSTRACT FROM AUTHOR]

The present study examined rates of sleep disorders and sleep medication use, and predictors of sleep disturbance in children with persistent tic disorders (PTD). Sixty-three parents of children aged 10-17 years with PTDs completed an internet survey evaluating sleep patterns and clinical symptoms. Insomnia (19.4%), nightmares (16.1%), and bruxism (13.1%) were the most commonly reported lifetime sleep disorders. Fifty-two percent endorsed current sleep medication use. Higher ADHD severity, overall life impairment, and female sex predicted greater sleep disturbance. Findings suggest the utility of clinical management of co-occurring ADHD and impairment to mitigate sleep disturbance in children with PTDs. [ABSTRACT FROM AUTHOR]

Objective Materials and Methods Results Conclusion Sleep bruxism (SB) is a repetitive rhythmic and nonrhythmic activity. It can be a comorbid condition for other disorders, such as sleep breathing disorders (SBD). However, a clear causal link between these factors is yet to be established. Moreover, this relationship is even more unknown in children. Thus, this systematic review aimed to determine the relationship between SB and SBD in children and teenagers and consolidate the current knowledge about the possible association between both phenomena at the pediatric age.Advanced searches were performed in five electronic databases with the last search updated on February 1, 2023. The methodological quality of the selected studies was analyzed using the quality assessment tool for experimental bruxism studies.Twenty‐nine of 6378 articles were selected for detailed analyses. Most articles found a comorbid relationship between SB and SBD, though no study analyzed a temporary relationship. Due to the heterogeneity of the studies, a meta‐analysis could not be performed.Despite the limitations of this systematic review, it can be concluded that there is an association between SB and SBD in children. However, the level of evidence is low. [ABSTRACT FROM AUTHOR]

Summary It has been suggested that sleep bruxism may interrupt sleep continuity, hence potentially influencing sleep quality. The aim of this study was to systematically review the relationship between possible, probable, and definite sleep bruxism and sleep quality in otherwise healthy individuals. A systematic search on sleep bruxism and sleep quality was performed in seven databases until 19 December 2022. Eligible articles were screened, and quality assessment was performed via the Joanna Briggs Institute Scale. Of 3681 articles screened, 13 were included in this study. Of these, six evaluated the relationship between sleep quality and possible sleep bruxism, three with probable sleep bruxism, and four with definite sleep bruxism. An association between poor sleep quality and sleep bruxism was found among those individuals diagnosed with possible and probable sleep bruxism. However, the studies conducted in individuals with definite sleep bruxism failed to demonstrate any association. With more reliable measures to evaluate sleep bruxism, a relationship between sleep bruxism and sleep quality was not evident. [ABSTRACT FROM AUTHOR]

Background and Objectives: Bruxism is a parafunctional activity that can have several causes. Patients with bruxism need an interdisciplinary approach to treatment planning and individualized treatment options. The present study evaluates dentists' knowledge of the bruxism condition and their need for further education. Diagnosis and treatment methods used by practicians from different specialties are emphasized. Materials and Methods: A prospective cross-sectional, observational, and analytical cohort study was conducted. It employed a questionnaire based on information on etiology, diagnosis, and treatment methods and included data from 80 dental practitioners from Cluj County. Results: Most dentists (81.3%) recognized awake and sleep bruxism as separate entities. Most participants identified psychological status as the primary etiological factor (80%), followed by occlusal interferences (13.8%) and other factors (genetics). Anamnesis and clinical examination were performed for bruxism diagnosis (90%). Occlusal balance (%) and occlusal splints (%) were the most encountered treatment methods. Only 27.5% of the practitioners referred patients to other specialists. Physiotherapy and psychotherapy were the primary interdisciplinary approaches. Cognitive behavioral therapy was employed by 43.8%, whereas pharmaceutical therapy by 20% of the practitioners. Conclusions. There is a need for standardized training among dentists due to a lack of information on this topic. When combined with an interdisciplinary approach, complementary diagnostic methods such as polysomnography and BruxApp can yield accurate diagnosis. [ABSTRACT FROM AUTHOR]

Background: Bruxism is a parafunctional activity characterised by grinding or clenching of teeth and is a common oral health concern in individuals with down syndrome (DS). Understanding the prevalence of bruxism in this population is crucial for developing effective management strategies. This systematic review and meta‐analysis is aimed to investigate the prevalence of bruxism among individuals with DS and explore its association with other oral health issues. Methods: A comprehensive search was conducted across multiple electronic databases to identify relevant studies. Cross‐sectional and observational studies were included. Data on bruxism prevalence and associated factors were extracted, and a meta‐analysis was performed using both fixed‐effects (FE) and random‐effects (RE) models of MedCalc software. Heterogeneity among studies was assessed using I2 statistics. New Castle‐Ottawa Scale was used to evaluate methodological quality of the included studies. Results: Eight studies met the pre‐defined inclusion criteria and were included in the analysis. Seven studies used a questionnaire to assess bruxism. The pooled proportion estimate for occurrence of DS across the included studies was found to be 0.33 (95% CI: 0.22–0.45) as per the RE model and 0.35 (95% CI: 0.31–0.450) as per FE model in the quantitative analysis. All studies exhibited good methodological quality. Conclusion: This systematic review and meta‐analysis provide evidence of a significant prevalence of bruxism among individuals with DS. The findings highlight the association of bruxism with other oral health issues and specific chromosomal abnormalities. Comprehensive oral health assessments, including diagnostic procedures like Polysomnography, are essential for addressing the unique oral health needs of individuals with DS. Further studies are recommended with a valid tool for the diagnosis. Early interventions and management strategies need to be tailored to this population, considering the multifaceted nature of oral health concerns in individuals with DS. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association of the severity of temporomandibular disorders (TMD) pain and dysfunction with the frequency of self-reported awake bruxism (AB), sleep bruxism (SB), and stress in an adult TMD-patient population. Materials and Methods: This cross-sectional study included 237 TMD patients based on the Diagnostic Criteria for TMD. Age, sex, frequency of self-reported AB and SB, and stress were included as independent variables. TMD pain and TMD dysfunction were included as dependent variables in regression analyses. Univariate and multivariable linear regression analyses were used to predict TMD pain and TMD dysfunction in two separate models. Finally, network analysis was performed to investigate the associations between all variables. Results: In the univariate analyses, TMD pain was significantly associated with self-reported AB-frequent (unstandardized coefficient (B) = 3.196, 95%CI 1.198-5.195, p = 0.002). TMD dysfunction was significantly associated with AB-frequent (B = 2.208, 95%CI 0.177-4.238, p = 0.033) and SB-sometimes (B = 1.698, 95%CI 0.001-3.394, p = 0.050). In the multivariable analyses, TMD pain was significantly associated with TMD dysfunction (B = 0.370, p < 0.001), stress (B=0.102, p < 0.001). TMD dysfunction was significantly associated with TMD pain (B = 0.410, p < 0.001) only. Network analysis showed that TMD pain is a bridge factor between AB, stress, and TMD dysfunction. Conclusions: TMD pain is directly associated with AB, stress, and TMD dysfunction, while TMD dysfunction is only associated with TMD pain. Clinical Relevance: Reducing pain may improve pain-related dysfunction, and the management of AB and stress may improve TMD pain and dysfunction, and vice versa. [ABSTRACT FROM AUTHOR]

The prevalence of sleep disorders in the population is remarkably high, and poor sleep quality can lead to various health problems. Current standard treatments for sleep disorders involve pharmacological and psychotherapeutic approaches. A new potentially effective method that could be introduced is repetitive transcranial magnetic stimulation (rTMS). Repetitive TMS is a modern non-invasive biological treatment method that has been used in the treatment of psychiatric and neurological disorders for many years. The principle of rTMS involves the application of repeated pulses of magnetic field, which subsequently induce electrical activity in the stimulated area of the brain. The advantage of this therapy is its excellent tolerance and minimal side effects. Its role in the treatment of sleep disorders has not yet been sufficiently explored. This paper reviews the potential use of rTMS in the management of different sleep disorders, including a summary of recent studies, the stimulation protocols employed, their effectiveness, and possible underlying biological mechanisms. Strongest evidence for the effectiveness of rTMS has been found for the treatment of primary insomnia, but it has also been effective in addressing restless legs syndrome, sleep disorders in Parkinson's disease, and insomnia comorbid with psychiatric disorders. There have even been isolated reports of successful rTMS treatments for sleep-related bruxism, obstructive sleep apnea, and narcolepsy. [ABSTRACT FROM AUTHOR]

Background: Sleep bruxism (SB) and obstructive sleep apnea syndrome (OSAS) are two sleep‐related conditions that have been associated with significantly conflicting results in literature. Understanding the prevalence of bruxism among OSA patients is crucial for identifying possible comorbidities and optimising treatment strategies. Objective: This systematic review aimed at analysing the prevalence of SB in OSAS sufferers and understanding the association between the two. Methods: Five online databases were searched for relevant articles in accordance with the PRISMA guidelines for conduction of systematic reviews. Studies reporting the prevalence of bruxism in OSAS patients and diagnosed through clinical assessments or polysomnography were included. Data extraction and quality assessment were performed independently by two reviewers. Methodological quality of the included studies was assessed using Risk of Bias In Non‐randomised Studies of Interventions (ROBINS‐I). Results: A thorough search of literature yielded only two studies were eligible for this review. SB was found to be significantly present in the OSAS group. Despite methodological variations, the majority of studies reported higher rates of bruxism in OSAS patients compared to the general population or control groups. Conclusion: The results of this systematic review point to a significant association between bruxism and obstructive sleep apnea. Further research is required to determine a more precise prevalence rate and investigate the potential therapeutic implications of the bruxism‐OSAS association that uses a standardised assessment techniques and larger sample sizes. [ABSTRACT FROM AUTHOR]

Background: Bruxism is an umbrella term that encompass a multidimensional spectrum of masticatory muscle activities. Objective: The purpose of this study was to do a bibliometric analysis including citation performance in the research topic of bruxism, by using an innovative method including details of article title, author keyword, KeyWords Plus and abstracts. Methods: The data were retrieved 2022‐12‐19 from the Clarivate Analytics Web of Science Core Collection, and the online version of the Science Citation Index Expanded (SCI‐EXPANDED) for studies published 1992 to 2021. To evaluate research trends, the distribution of keywords in the article title and author‐selected keywords were used. Results: The search yielded 3233 documents in SCI‐EXPANDED, of which 2598 were of the document‐type 'articles' published in 676 journals. The analysis of the articles revealed that "bruxism/sleep bruxism," "electromyography," "temporomandibular disorders" and "masticatory muscles" are the most used keywords by the authors. Further, the most frequently cited study was published 9 years ago and handles the present definition of bruxism. Conclusion: The most productive authors and those with the highest performance have some common features; they have several national and international collaborations; and they have published articles about the definition, aetiology/pathophysiology and prevalence of bruxism, all senior researchers in the field of TMD. Hopefully, based on this study, researchers and clinicians will have information to be stimulated to outline future research projects on bruxism‐related aspects, and to initiate new international or multinational collaborations. [ABSTRACT FROM AUTHOR]

Summary Rhythmic masticatory muscle activity (RMMA) is a periodic muscle activity that characterises sleep bruxism (SB) events. These can occur as a single event, in pairs, or in clusters. Since RMMA episodes often occur in clusters and the relevance of this occurrence is unknown, we conducted a study to investigate the effect of RMMA clusters on sleep fragmentation and the severity of orofacial muscle pain. This study involved a secondary analysis using data from 184 adult subjects with orofacial muscle pain who underwent definitive polysomnography (PSG) for sleep bruxism diagnosis. Self‐reported orofacial muscle pain (OFMP) was assessed using the numeric rating scale, and additional evaluation of side‐to‐side equivalence (symmetry) was described using a binary system. Among the 184 participants, 60.8% (n = 112) did not exhibit clusters and among the 72 participants with clusters, 36.1% (n = 26) and 63.9% (n = 46) were in the high and low RMMA frequency groups, respectively. The high SB group had significantly three times more phasic RMMA events than the noncluster group. A total of 89.67% (n = 165) of subjects reported orofacial muscle pain. While there was no difference in the severity of OFMP among groups, a significant decrease in symmetry between the severity of temporal muscle pain on the left and right sides was noted in the cluster group compared with the noncluster group. Clustering of RMMA events is associated with sleep fragmentation. The asymmetry of temporal muscle pain is related to the presence of RMMA clusters in sleep bruxism. [ABSTRACT FROM AUTHOR]

Bruxism is a parafunctional activity represented by the gnashing and clenching of one's teeth. The aim of this study was to determine the utility of screening and monitoring with a Bruxoff device during nocturnal bruxism in 51 children and adolescents (36 with bruxism and 15 without bruxism) by assessing the variations in the intensity and duration of parafunctional activity in each patient. Bruxoff measurements were recorded for at least 60 min for three consecutive nights for each subject. All the parameters recorded using Bruxoff in the control and the study groups showed a statistically significant difference (p < 0.05). The differences found by comparing the values recorded in the male and female study groups are significant for heart rate, the number of masseter muscle contractions during one night, and mixed contractions. The Bruxoff device proved to be important in diagnosing patients with bruxism in our practice. [ABSTRACT FROM AUTHOR]

Summary: Due to potential issues, several sleep laboratories conduct sleep bruxism diagnosis without the use of a camera, instead relying mostly on electromyographic monitoring. The purpose of the study was to determine if a camera is necessary for the polysomnographic evaluation of sleep bruxism and how sleep bruxism parameters change when a camera is not utilised. The study material was actual polysomnographic recordings made in the years 2017–2020. A total of 199 single‐night video‐polysomnographic recordings of patients who were suspected of having sleep bruxism were chosen at random. The first analysis involved the evaluation of the video recording, while in the second video recording was not used. The findings revealed that all the examined sleep bruxism indices had statistically significantly higher values for the recordings made without the use of a camera. According to the findings, noncamera recordings had decreased sensitivity and specificity when the criteria of bruxism and mild‐to‐moderate bruxism were taken into account, and decreased sensitivity in the case of the criterion of severe bruxism. Sleep efficiency, the apnea/hypopnea index, and arousals had independent effects on the bruxism episode index value in the analysis of noncamera recordings. In conclusion, camera‐based polysomnography still appears to be the most reliable way to assess the severity of sleep bruxism, particularly in patients who also report other sleep disturbances. The presence of symptoms of sleep‐disordered breathing, insomnia, or other sleep disorders should prompt us to use camera‐based diagnostics. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the prevalence of probable sleep bruxism (SB) in children aged 7–8 years and its association with sleep pattern and the time spent using devices with a screen. Material and Methods: A cross‐sectional study was conducted with children from Pelotas, Brazil (n = 556). Parents/caregivers were interviewed and provided demographic/socioeconomic information, children's daily screen time, nighttime tooth grinding or clenching, sleep duration and answered the Biological Rhythms Interview for Assessment in Neuropsychiatry for Kids (BRIAN‐K‐sleep domain). Probable SB was determined based on a positive clinical inspection with/without a positive parental/caregiver's reports of tooth clenching or grinding. Hierarchical Poisson regression was performed. Results: The prevalence of probable SB was 15.83% (n = 88). There was no difference in the probable SB prevalence according to the daily screen time (p = 0.744), and low family socioeconomic status was associated with higher SB prevalence (Prevalence Ratio [PR] = 1.95; 95% Confidence Interval [95% CI]: 1.21–3.17; p = 0.006). Higher scores in the sleep domain of the BRIAN‐K scale were associated with probable SB [PR = 1.07; 95% CI: 1.01–1.30; p = 0.013]. Conclusions: Difficulties in maintaining sleep and low family socioeconomic status were associated with probable SB in schoolchildren, while screen time spent using devices with a screen was not associated. [ABSTRACT FROM AUTHOR]