The Role of Occlusal Appliances in Reducing Masseter Electromyographic Activity in Bruxism

Abstract

Background/Objectives: Bruxism is a masticatory muscle activity, phasic or tonic, with/without teeth contact, that appears in sleep or an awake state. An instrumental technique used to measure the surface electromyographic (sEMG) activity of the masseter muscle is used to diagnose bruxism activity during sleep and while awake. The objective of this study was to compare the variation in bruxism (sleep and awake) indices and masseter activity indices in low sleep bruxism and moderate sleep bruxism before and after wearing an occlusal appliance (OA) for 3 months each night. Methods: A clinical interventional study was designed in which subjects diagnosed with sleep bruxism were randomly selected to be included in the study. After the first sEMG recording, two groups were formed: a low sleep-bruxism group (number of sleep-bruxism events/h between 2 and 4) and a moderate sleep-bruxism group (number of sleep-bruxism events/h equal or higher than 4). All subjects received treatment with a 3D-printed occlusal appliance and wore it each night for 3 months, at which point the second sEMG recording was performed. For each participant of this study, a chart was created that included anamnestic data, clinical data, and sEMG data. The data were statistically analyzed with SPSS, using the Mann–Whitney U and Wilcoxon signed-rank tests. Results: A total of 21 participants were included in the final analysis, 18 women and 3 men, with a mean age of 24.5 ± 2.7 years. The OA lowered all bruxism indices in the whole group, but clusters analysis showed a significant reduction in sleep-bruxism indices in the moderate sleep-bruxism group, while in the low-bruxism group, the sleep and awake indices varied insignificantly, and the number of sleep-bruxism events/h remained constant. Conclusions: The 3D-printed occlusal appliances significantly lowered the sleep-bruxism indices and sleep masseter activity indices recorded with a portable sEMG device in the moderate sleep-bruxism group. The OA lowered the awake-bruxism indices and awake masseter activity indices in the moderate sleep-bruxism group.