Search Results (134)

Background: Sleep bruxism involves repetitive jaw-muscle activity, including teeth clenching, grinding, or mandibular bracing. Despite the growing interest in botulinum toxin type A (BTX-A) as a therapeutic intervention for bruxism, evidence remains limited, particularly regarding studies using portable electromyography (EMG) monitoring devices. This study evaluated the effects of BTX-A injections into the masseter muscle on the reduction of bruxism activity, as measured using the portable electromyographic Holter Bruxoff system. Methods: Adult patients with diagnosed sleep bruxism were monitored for two nights using the Bruxoff device to record masseter EMG activity, respiratory rate, and heart rate. After receiving standardized bilateral masseter BTX-A injections, participants underwent the same monitoring protocol 40 days later. Statistical analyses compared pre- and post-treatment values, and effect sizes were calculated. Results: Ten participants (60% women; mean age 47.6 ± 4.4 years) completed the study. The Bruxism Index showed a marked reduction, dropping from 12.2 ± 1.32 at baseline to 7.4 ± 1.35 after 40 days, a statistically significant change (t (9) = 10.23, p < 0.001; Cohen’s d = 3.25). Average heart rate also decreased significantly, from 64.4 ± 2.99 to 62.6 ± 2.63 (t (9) = 2.86, p = 0.018; Cohen’s d = 0.91). However, the respiratory rate measurement remains stable. Conclusions: BTX-A injections into the masseter muscles produced a marked reduction in sleep-related bruxism activity as measured by portable EMG. These findings support BTX-A as a promising and effective treatment option for sleep bruxism. Full article

Bruxism is increasingly recognized as a psychosomatic behavior influenced by stress, anxiety, and sleep disturbances, which generates occlusal forces of non-physiological magnitude, potentially compromising the stability of dental implants. This narrative review examines the causal pathway linking psychological factors, bruxism, and implant complications. The literature from PubMed, Scopus, and Cochrane (2000–2025) was analyzed. Evidence consistently associates psychosocial stressors with increased mechanical complications, while biological outcomes remain heterogeneous. Digital occlusal analysis, finite element modeling, and AI-based monitoring show promise for early overload detection. An interdisciplinary model integrating dentistry, psychology, and sleep medicine is proposed to optimize implant outcomes and guide future research. Full article

Background/Objectives: Fibromyalgia (FM) is a chronic pain syndrome often associated with musculoskeletal tenderness, fatigue, and sleep disturbances. Temporomandibular disorders (TMDs) and bruxism are frequently observed comorbidities in patients with FM, yet their objective assessment remains limited. This study aimed to evaluate masticatory muscle activity in patients with fibromyalgia and temporomandibular disorders using both static surface electromyography (sEMG) and a 24 h portable EMG device (Dia-BRUXO^®). Methods: Thirty female patients (mean age 53.6 ± 10.5 years) underwent comprehensive clinical and gnathological evaluations, followed by static EMG recordings of the masseter and temporalis muscles and continuous monitoring of the left masseter over a 24 h period. Results: Results revealed a significantly higher number of bruxism episodes during wakefulness (80.9 ± 130.8) compared to sleep (24.0 ± 26.8; p < 0.0001). The Masseter Time Index (MTI) and Masseter Work Index (MWI) were also significantly higher during wakefulness (p < 0.001), indicating a predominance of daytime masticatory muscle activity. Static sEMG analysis showed generally preserved bilateral muscle symmetry, accompanied by mild imbalances in occlusal load distribution and increased global muscle activation. Conclusions: These findings suggest that patients with fibromyalgia and temporomandibular disorders exhibit increased baseline masticatory muscle activity, particularly during wakefulness, possibly reflecting sustained neuromuscular tension. Continuous EMG monitoring appears to provide an objective tool for characterizing bruxism patterns and complements clinical assessment and self-reported data. However, the absence of a control group and the exclusive inclusion of female patients limit the generalizability of the results. Further studies including appropriate comparison groups are needed to clarify the specificity and clinical implications of these findings. Full article

Background: Sleep disorders are common in childhood and adolescence and can negatively affect cognitive development, mood regulation, behaviour, and quality of life. Parents frequently seek complementary therapies such as homoeopathy, yet the scientific evidence for homoeopathic treatments in paediatric sleep disorders remains uncertain. This systematic review examines the effectiveness of homoeopathic interventions for sleep disorders in children and adolescents according to evidence-based medicine principles. Objectives: To systematically review and evaluate the effectiveness of homoeopathic treatments for sleep disorders in children and adolescents, following evidence-based principles. We aimed to summarise current clinical evidence from 2015–2025 on whether homoeopathy improves paediatric insomnia and other sleep-related disorders and to assess the quality of that evidence. Methods: PubMed, Scopus, and allied databases were searched for RCTs and observational studies involving participants <18 years with sleep disorders (insomnia, bruxism, and enuresis) treated with homoeopathy. English-language studies were screened manually, and bias was assessed qualitatively. Results: Five studies (four RCTs, one observational; 451 participants) met inclusion criteria: Two RCTs reported complex homoeopathic remedies showing some improvement over glycine or placebo for insomnia symptoms. A crossover RCT reported nearly significant bruxism improvement with Melissa officinalis 12C versus placebo (Visual Analogic Scale 0–10; ΔVAS −2.36 vs. −1.72, p = 0.05) and significant VAS improvement in comparison to Phytolacca (p = 0.018). A double-blind RCT in enuretic children showed individualised homoeopathy reduced weekly bedwetting episodes (median −2.4 nights, p < 0.04). One observational study also noted symptom improvement of nocturnal enuresis. No serious adverse effects were reported. Bias risk varied: one open-label trial showed high risk; others were adequately blinded. Conclusions: Current evidence suggests preliminary signals that homoeopathy may have modest benefits for paediatric insomnia, bruxism, and enuresis, with an acceptable safety profile. However, the number and quality of studies are limited, and findings should be interpreted cautiously. Larger, high-quality trials are needed to clarify the potential role of homoeopathic interventions in paediatric sleep disorders. Current epistemological advances in study planning and medical student training should be taken into account: critical and intersectional (or better still, transdisciplinary) thinking with retrospective examination of heuristic initial theses, gender aspects, life course health, context variables and criteria for individualised, patient-related precision medicine. Full article

Background/Objectives: Occlusal splints are widely used for managing sleep bruxism (SB), providing uniform contact across the entire dentition in the centric relation. Nonetheless, different guidance schemes, such as bilateral balanced occlusion (BBO) and canine guidance (CG), are used during eccentric movements, and the optimal design remains unclear. This study compared the effects of BBO and CG on masticatory muscle activity, sleep architecture, and subjective outcomes during sleep. Methods: This non-blinded randomized crossover trial enrolled 24 healthy adults diagnosed with SB (16 men and 8 women; mean age, 26.1 years) who were randomly assigned to either a BBO-first or CG-first sequence. Individual splints of both types were milled from the polymethyl methacrylate discs. After a 5-night baseline period, each splint was worn for 33 nights in a home environment, and data from nights 29 to 33 were analyzed. Masseter muscle activity was assessed using single-channel electromyography (EMG), yielding EMG parameters, including integrated EMG per hour, number of episodes and bursts per hour, mean episode duration, and total episode duration per hour. Sleep architecture was assessed using portable polysomnography with automatic scoring, and subjective outcomes were assessed for sleep disturbance, morning symptoms, and splint comfort. Differences between splints were analyzed using Wilcoxon signed-rank tests (α = 0.05). Results: Twenty-three participants completed the study. No statistically significant differences were found between the BBO and CG splints for any EMG parameters, sleep variables, or subjective measures. Conclusions: Splint guidance design differences showed no significant effects; however, smaller, potentially clinically relevant effects cannot be excluded. Full article

Background: Temporomandibular disorders (TMDs) exhibit a complex relationship with depression, anxiety disorders, and oral behaviors. This cross-sectional study aimed to assess the differences in oral behaviors among subgroups of TMD-related pain and patients with varying levels of anxiety and depression. Methods: A total of 120 patients diagnosed with TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), completed the Oral Behavior Checklist (OBC), Visual Analog Scale (VAS), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder (GAD-7), Graded Chronic Pain Scale (GCPS), Patient Health Questionnaire-15 (PHQ-15), and Jaw Functional Limitation Scale-8 (JFLS-8). Associations were examined using Chi-square, Fisher’s exact, and Spearman’s correlation; logistic regression and multivariable linear regression were performed (p < 0.05). Results: In univariate analyses, several item-level OBs were more prevalent with higher anxiety, including nocturnal bruxism, sleep positions exerting jaw pressure, daytime grinding, and gum chewing (p = 0.007, 0.041, 0.011, and 0.014, respectively). A modest difference among pain subgroups was observed for sleep position (p = 0.044). In multivariable models, anxiety was independently associated only with nocturnal bruxism (OR = 2.95; 95% CI: 1.30–6.67; p = 0.010), whereas depression showed no independent associations. Pain intensity remained the sole predictor of total OBC scores (Coef = 1.829; 95% CI: 0.51–3.15; p = 0.007). No independent effects were detected for TMD subgroups. Conclusions: Psychosocial factors appeared related to OBs in univariate analyses, but these associations were explained by confounding influences. After adjustment, pain intensity and anxiety emerged as key determinants. These findings highlight the need for comprehensive TMD management integrating pain control with behavioral strategies. Full article

Objectives: The aim of this study is to assess the impact of screen time on the incidence of sleep bruxism in children during the COVID-19 pandemic. Methods: The parents of 266 children, aged 3–14 years, participated in the present study. They were provided with a 36-item questionnaire in order to collect data about their child’s personal information, general health, sleep bruxism, and the effects of the COVID-19 pandemic on them. The collected data were analyzed statistically using a chi-square (χ²) test, ANOVA with post hoc analysis (Tukey’s HSD), and a t-test. Results: Screen time increased significantly during the pandemic, especially among children using screens ≥180 min/day. The proportion of children spending 180–360 min/day doubled to 24.4%. Lower secondary school children had the highest screen time, with an increase of ~60 min/day during the pandemic. Smartphones were the most used device (50.8%), and on average, children with bruxism spent 32 min longer in front of screens than children without bruxism (p < 0.05). Conclusions: Daily screen use is common in children, and this increased during the COVID-19 pandemic. Children with sleep bruxism exhibit longer screen time than those without bruxism, suggesting that the former is a potential risk factor for the latter. Full article

Background and Objectives: Harmful repetitive oral behaviors impose an excessive load on the stomatognathic system. Being unconscious and involuntary, patients are often unaware of their occurrence and, consequently, of their potential consequences. We aimed to screen the Romanian population for harmful oral habits, while simultaneously emphasizing the importance of employing validated and internationally accepted diagnostic instruments for a better approach to these conditions. Materials and Methods: An observational, descriptive study was conducted on 459 adults, recruited through a multiregional convenience sampling from the general population in Romania. Oral behaviors were assessed using the validated Oral Behaviors Checklist (OBC-21) questionnaire. Data was analyzed using descriptive and comparative statistics, with significance set at p < 0.05. Results: The sample included 363 women (79.1%) and 96 men (20.9%), with a mean age of 33.3 years. The mean total OBC score was 22.45 ± 10.27, indicating a moderate prevalence of oral behaviors. 60.1% of participants were classified as low-risk and 39.9% as high-risk, with none in the no-risk category. The most frequently reported behaviors were sleeping positions exerting pressure on the mandible (57.7% “very often”), sustained talking (11.3%), and nocturnal bruxism (10.5%). Younger adults (20–49 years) presented significantly higher OBC scores compared to both younger extremes (18 years) and older adults (>60 years) (p < 0.001). No significant gender differences were observed in total OBC scores; however, unilateral chewing, sustained talking, and holding objects between the teeth were significantly more frequent among women (p < 0.05). Conclusions: This is the first study to investigate oral behaviors in a Romanian adult population. Postural and involuntary activities were the most prevalent and age influenced OBC scores, while gender differences were limited to individual behaviors. Conducting screening and implementing therapeutic interventions based on the assessed level of risk could enhance the overall management of the condition. Full article

Background: Bruxism is defined as repetitive activity of the masticatory muscles characterized by clenching or grinding of the teeth and/or stiffening or protrusion of the mandible, referred to as sleep bruxism or awake bruxism. It is believed that in generally healthy individuals, bruxism should not be considered a disorder, but rather a behavior that may be a risk factor (and/or protective factor) for certain clinical consequences. The aim of the study was to assess the occurrence and strength of the correlation between bruxism and sleep disorders (parasomnias and insomnia), as well as to evaluate the correlation between bruxism and the nature of dreams. Methods: The study involved 276 people aged 18–55. The research was conducted using an online survey in the period from January to March 2022. The author’s own questionnaire was composed of five segments of test questions (basic questions, bruxism severity test, Athens Insomnia Scale, parasomnia test, sleep evaluation test). The respondents were divided into groups based on the severity of bruxism, insomnia, parasomnias and the occurrence of dreams related to the oral cavity and teeth. Statistical analysis included Spearman’s correlation coefficients, chi-square test, Kruskal–Wallis ANOVA, and Mann–Whitney U test. Results: The analysis revealed a significant correlation between the severity of bruxism and insomnia symptoms. Participants with moderate and severe bruxism reported insomnia more frequently and with greater intensity. Similar correlations were observed with parasomnias and the frequency of dreams concerning the oral cavity and teeth. The strongest association with bruxism was found for physical dreams. Moreover, correlations were also noted between insomnia and parasomnias. Conclusions: These findings suggest that individuals experiencing bruxism, particularly sleep bruxism, may be more vulnerable to other sleep disturbances. Addressing one of these conditions could potentially have a beneficial impact on the others. Full article

Background/Objectives: Tooth wear (TW) is a prevalent multifactorial condition resulting from chemical erosion and mechanical forces, yet the contributions of risk-group status and salivary factors remain insufficiently characterized. This study aimed to investigate the relationship between salivary characteristics and the severity of chemical and mechanical TW in at-risk groups, including gastroesophageal reflux disease (GERD), sleep bruxism (SB), eating disorders (EDs) and gambling disorder (GD). Methods: This cross-sectional observational study enrolled adults categorized into the four mutually exclusive at-risk groups and an age and sex-matched healthy control group. Demographic information, medical history, oral hygiene, diet, stress, and parafunctional habits were obtained through questionnaires. TW was assessed by a single examiner using TWES 2.0. Maximum bilateral force and salivary pH, flow and buffer capacity was measured. Correlations, multivariate linear regression, and mediation models were used to explore the relationships between the different variables and TW. Results: In total, 147 participants, divided into five groups (34 with GERD, 28 with SB 20 with GD, 20 with ED, and 45 controls) were included. The lowest resting salivary pH was observed in the GERD and ED groups (GERD: 6.63 ± 0.61; ED: 6.62 ± 0.52). The GERD group also exhibited the highest chemical (1.51 ± 0.58) and mechanical (1.08 ± 0.58) TW. Chemical and mechanical wear were strongly correlated, and mechanical wear increased with age. Risk-group status and salivary pH explained 47% of chemical wear, while age and bite force explained 54% of mechanical wear. Conclusions: Chemical TW was strongly linked to risk-group status—particularly GERD/ED—and low salivary pH, while mechanical TW related to age and bite force. Further longitudinal studies with larger samples, employing standardized methodologies and criteria are needed. Full article

Sleep bruxism (SB) is a masticatory muscle activity during sleep which can be categorized as primary, when it remains unclear whether the phenomenon is directly linked to a specific disorder, or if it only coexists, and secondary, when it is proven to be associated with a particular disorder, treatment or lifestyle and bruxism that is part of the signs of a disorder. In this way, SB is associated with various factors, including obstructive sleep apnea and gastroesophageal reflux (GER), where evidence suggests SB has a protective role in airway patency, potentially triggered by microarousals and autonomic instability, especially under hypoxia conditions. Since hypobaric hypoxia exposition—generated by high-altitude exposure—produces a decrease in the partial pressure of oxygen, it triggers alterations in cardiac rhythm and gastric function, which could be associated with physiological alterations mentioned in SB. Therefore, the aim of this review is to determine the effect of hypobaric hypoxia exposure on the physiological and molecular alterations during sleep bruxism. Method: The SANRA-guided narrative review synthesized recent human and animal studies on hypoxia’s physiological and molecular effects in sleep bruxism. In conclusion, SB is associated with GER and autonomic dysregulation, which are present in hypobaric hypoxia conditions, where respiratory disturbances, microarousals, and increased muscle activity are associated with SB. High-altitude exposure triggers oxidative stress, genetics, and sleep alteration, which exacerbate its severity. Moreover, neurophysiological and molecular mechanisms, including TRPV1 and HIF-1α activation, are implicated. Finally, polysomnography remains the gold standard for diagnosis; however, studies at high altitude are needed to confirm this association. Full article

Many individuals suffer from sleep disorders associated with chronic pain, neuroendocrine diseases, and primary sleep disorders. Although cervical manual therapy (CMT) is frequently presumed to enhance sleep quality in clinical settings, evidence regarding its effects on sleep remains inconclusive. We aimed to evaluate the therapeutic effect of CMT and clinical patterns, providing novel insights into its applicability for sleep disorders and further mechanism studies. Methods: A comprehensive literature survey was conducted by using 6 databases through February 2025, to identify randomized controlled trials (RCTs) assessing the effect of CMT on sleep quality as clinical outcome, regardless of primary diseases. Results: Among 1220 initial studies, a total of 10 RCTs involving 552 participants were included. All included RCTs assessed sleep quality using patient-reported outcome measures, while only one study utilized objective assessment via polysomnography. Among them, seven RCTs (70.0%) reported significant improvements in sleep quality that were not dependent on alleviating the primary diseases, with notable enhancements in subjective sleep depth and efficiency rather than sleep duration or latency. Sleep benefits were pronounced in primary sleep disorders, such as obstructive sleep apnea and bruxism, and in sleep disturbances secondary to other conditions, with limited effects in fibromyalgia (FM). Conclusions: With the dysregulated hypothalamic–pituitary–adrenal axis and aberrant serotonergic activity in FM, in this review, we formed a hypothesis and explored the potential effects of CMT on sleep-related serotonergic activity and HPA axis regulation. This scoping review underscores the need for further research to clarify the neuroendocrinological mechanisms underlying CMT’s role in sleep modulation and its potential applications in sleep-related disorders. Full article

Objectives: The objective of this study was to compare occlusal and articular characteristics between young adults with and without a confirmed diagnosis of sleep bruxism, through a case-control study based on polysomnography. Methods: We conducted a case–control study with probabilistic sampling, including 20 participants with a polysomnography-confirmed diagnosis of sleep bruxism and 20 age- and sex-matched controls. A clinical oral examination was conducted to identify wear facets, joint sounds, and soft tissue indentations. Occlusal relationships were analyzed using mounted models on a semi-adjustable articulator, evaluating interferences during working, balancing, and protrusive movements, premature contacts, attrition, and dental inclinations. Results: Sleep bruxism showed a higher frequency of temporomandibular joint sounds (35% vs. 5%; p = 0.017; w = 0.375) and left-side balancing interferences (p = 0.04; d = 0.723). Multivariate analysis revealed a moderate correlation between bruxism and the combination of joint sound and occlusal inclination (COR = 0.39; 95% CI: 0.19–0.57; I² = 0.0%). Joint sound showed a weak association with REM-related bruxism (COR = 0.29; 95% CI: 0.05–0.51; I² = 21.7%) and a moderate association with non-REM bruxism (COR = 0.41). The correlation with occlusal inclination was stronger during REM sleep (COR = 0.41) than during non-REM sleep (COR = 0.35; I² = 0.0%), indicating consistent and clinically relevant associations. Conclusions: Occlusal and functional characteristics associated with sleep bruxism were identified, particularly joint sounds and dental inclinations, although no direct causal relationship was established. These findings suggest the presence of specific morphofunctional patterns that may play a role in the clinical expression of sleep bruxism. Full article

Background: Sleep bruxism (SB), a sleep behavior, is one of the most common sleep pathologies. Tenascin-C (TnC) and thrombospondin-1 (TSP-1) are involved in the pathogenesis of cardiovascular disease. The aim of our study was to assess the relationship between SB and TSP-1 and TnC. Methods: A total of 80 participants, who were hospitalized in the Sleep Laboratory of the Department of Internal Medicine, Occupational Diseases, Hypertension, and Clinical Oncology at Wroclaw Medical University, were enrolled in the study. Polysomnographic examination was conducted following the standard sleep evaluation criteria set by the American Academy of Sleep Medicine, utilizing the Nox-A1 device. Serum TnC and TSP-1 concentrations were determined using Elisa Kits. Results: The study showed an increased concentration of TnC in the group of patients with a BEI (bruxism episode index) >10.3, compared to <10.3 (6786.79 ± 5655.62 vs. 1585.16 ± 2526.56). In regression analysis, higher values of phasic bruxism, smoking, and older age were independently associated with increased concentrations of TnC in the serum. Moreover, higher values of tonic bruxism, as well as smoking, were independently associated with TSP-1. Conclusions: Since tenascin-C and thrombospondin-1 levels are associated with sleep bruxism, atherosclerosis may be a potential consequence of SB. This relationship is especially noticeable in severe bruxism. Therefore, monitoring for clinical signs of atherosclerosis should be considered in patients with severe bruxism. Full article

Background: Sleep bruxism (SB) is increasingly recognized not merely as a movement disorder but as a multifactorial condition in which physiological, behavioral, and contextual factors converge. Objective: To comprehensively characterize SB in young adults, integrating polysomnography (PSG) and surface electromyography (sEMG) to describe sleep architecture, periodic limb movements (PLMs), and masticatory muscle activity; compare these parameters with matched controls; and explore clinical correlations relevant to dental practice and individualized management. Methods: Forty university adults (20 PSG-confirmed SB; 20 controls) underwent PSG assessment of total sleep time, sleep stages, arousals, apnea, oximetry, and PLMs. EMG activity of the masseter and temporalis muscles was recorded in 37 participants (18 SB, 19 controls). Statistical analyses included t-tests, Mann–Whitney U tests, and multivariate logistic regression to identify independent predictors of SB. Results: SB participants exhibited higher bruxism event counts (p ≤ 0.001; PS = 0.94), increased PLMs (p ≤ 0.01; PS = 0.75), shorter REM sleep duration (p = 0.04; d = 0.69), and higher bruxism-related arousal indices (p ≤ 0.001; PS = 83.4). Left masseter activity differed significantly (p = 0.03; d = 0.50), while other muscle measures showed no significant differences. Logistic regression identified age (OR = 0.59, p = 0.02), PLMs (OR = 0.96, p = 0.03), and REM sleep duration (OR = 0.98, p = 0.05) as independent predictors, explaining 58% of the variance. Conclusions: These findings provide a comprehensive profile of SB in young adults. Integrating PSG, sEMG, and oral assessments supports early diagnosis, personalized management, and interdisciplinary collaboration to prevent complications. Full article