The effect of intermittent use of occlusal splint devices on sleep bruxism: a 4‐week observation with a portable electromyographic recording device

Abstract

This randomised controlled study investigated the effect of intermittent use of occlusal splints on sleep bruxism compared with that of continuous use by measuring masseter muscle electromyographic activity using a portable electromyographic recording system. Twenty bruxers were randomly allocated to the continuous group and intermittent group. Subjects in the continuous group wore stabilisation splints during sleep for 29 nights continuously, whereas those in the intermittent group wore splints during sleep every other week, that is they used splints on the 1st-7th, 15th-21st and 29th nights. Electromyographic activity of the masseter muscle during sleep was recorded for the following six time points: before (baseline), immediately after, and 1, 2, 3 and 4 weeks after the insertion of a stabilisation splint. The number of nocturnal masseter electromyographic events, duration and the total activity of sleep bruxism were analysed. In the continuous group, nocturnal masseter electromyographic events were significantly reduced immediately and 1 week after the insertion of the stabilisation splint, and duration was reduced immediately after the insertion (P < 0·05, Dunnett's test), but no reduction was observed at 2, 3 and 4 weeks after insertion. In the intermittent group, nocturnal masseter electromyographic events and duration were significantly reduced immediately after and also 4 weeks after insertion of the stabilisation splint (P < 0·05, Dunnett's test). The obtained results of the present exploratory trial indicate that the intermittent use of stabilisation splints may reduce sleep bruxism activity for a longer period compared with that of continuous use.

Management of sleep bruxism in adults: a qualitative systematic literature review

“…Thus, fourteen papers were included in the review. Of them, twelve were RCTs and two were uncontrolled before–after studies .…”

“…Seven papers report on the effectiveness of oral appliances (OA), either with a before–after or with a RCT design . The latter includes comparison groups treated with gabapentin , with palatal appliances , or adopting different protocols as far as the intermittent vs continuous appliance wearing , the different vertical dimension of occlusion (VDO) and the appliance design are concerned. These papers account for 121 participants in total, with non‐homogeneous recruitment strategies as far as the SB severity and the demographic features are concerned.…”

“…Findings with respect to the effects of treatment protocols on SB parameters are variable and hard to interpret. The investigations comparing different OA designs and treatment regimens suggest that stabilisation splints are better than palatal splints ; an intermittent use is superior to continuous wearing ; a 3 mm increase in VDO is more effective than a 6 mm increase ; a mandibular advancement appliance (MAA) with a robust advancement (75%) is superior to less marked (25%) advancement devices ; and the restriction of mandibular movements with oral appliances does not have any major influence on jaw‐muscle activity during sleep . Stabilisation appliances are equally effective as the neuroleptic drug gabapentin, which is only slightly superior to reduce SB events in subjects with poor sleep quality .…”

Prevalência e fatores associados ao bruxismo em universitários: um estudo transversal piloto

“…1,10 O desgaste do dente pode não ser considerado como uma base confiável para o diagnóstico, uma vez que pode ser influenciado por vários fatores, como idade, gênero, dieta e outros hábitos parafuncionais. 11,12 Nos últimos anos, a etiologia multifatorial de desgaste dentário tem sido enfatizada, sendo que uma combinação de fatores mecânicos e químicos muitas vezes pode ser verificada, e hábitos parafuncionais são apenas um dos muitos fatores de risco. 12,13 Diante da relevância do tema, o objetivo deste estudo piloto foi identificar a prevalência de bruxismo em universitá-rios da Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), no mês de julho de 2014.…”

Splint Therapy in Temporomandibular Joint Disorders: Review

“…38,40 Stabilizasyon splintlerinin aralıklı kullanımı uyku bruksizmini sürekli kullanıma kıyasla daha uzun süreli olarak azaltmaktadır. 41 Literatürde splint tedavisi; gevşeme tedavisi, psikolojik tedavi, düşük lazer tedavisi, akupunktur, ısırma plakları, stres yönetimi, çene egzersizleri, plasebo splintleri ile karşılaştırılmıştır. 39,40,[42][43][44][45][46] Kapsamlı bir derleme çalışmasında; stabilizasyon splintinin ağız açıklığını artırma ve kas ağrısını azaltmadaki etkinliği; kontrol grubu, plasebo splinti, akupunktur, ısırma plağı ve çene egzersizi uygulamaları ile karşılaştırılmış, aralarında anlamlı bir fark bulunmadığı sonucuna varılmıştır.…”