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CC BY-NC-ND 4.0 · Eur J Dent 2011; 05(04): 441-450
DOI: 10.1055/s-0039-1698917
Original Article
Dental Investigation Society

Effect of Occlusal Splints on the Temporomandibular Disorders, Dental Wear and Anxiety of Bruxist Children

Claudia C Restrepo
a   CES University, Director CES-LPH Research Group, Medellín, Colombia.
,
Isabel Medina
b   CES University, CES-LPH Research Group, Medellín, Colombia.
,
Patiñob Isabel
b   CES University, CES-LPH Research Group, Medellín, Colombia.
› Author Affiliations
Further Information

Publication History

Publication Date:
15 October 2019 (online)

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ABSTRACT

Objectives: To evaluate the effectiveness of occlusal splints to reduce the signs and symptoms of temporomandibular disorders (TMD), dental wear and anxiety in a group of bruxist children. Methods: All of the subjects were 3 to 6 years old, had complete primary dentition, class I occlusion and were classified as bruxist according to the minimal criteria of the ICSD for bruxism. For each child, anxiety was evaluated with the Conners’ Parent Rating Scales (CPRS). The TMD were evaluated using the RDC/TMD. The dental wear was processed in digital format with Mat Lab® and Lab view® software to determine its size and form. The children were randomized into an experimental (n=19) and a control (n=17) group. The children in the experimental group used rigid bite plates for a two-year period, until mixed dentition. Afterwards, the CPRS and the RDC/TMD were applied again and dental casts were taken. Comparisons of the variables regarding dental wear, signs and symptoms of TMD and anxiety before and after treatment among the groups were analyzed using the t-test, the Wilcoxon rank sum test and the Mann-Whitney test. Results: The subjects in the experimental group showed no statistically significant difference regarding anxiety levels and dental wear when compared with the control group. The signs and symptoms of TMD were not reduced except for the deviation in mouth opening. Conclusions: The use of rigid occlusal bite plates was not efficient in reducing the signs of bruxism as a whole but did reduce the deviation in mouth opening. (Eur J Dent 2011;5:441-450)

Key words:

Bruxism - Rigid occlusal bite plates - TMD - Dental wear - Anxiety
 

  • REFERENCES

  • 1 Gunnar E, Egermark I, Magnnuson T. Predictors of bruxism, other oral parafunctions, and tooth wear over a 20- year follow up period. J Orofac Pain 2003;17:50-57.
  • 2 Restrepo CC, Alvarez E, Jaramillo C, Velez C, Valencia I. Effects of psychological techniques on bruxism in children with primary teeth. J Oral Rehabil 2001;28:354-360.
  • 3 Negoro T, Briggs J, Plesh O, Nielsen I, McNeill C, Miller AJ. Bruxing patterns in children compared to intercuspal clenching and chewing as assessed with dental models, electromyography and incisor jaw tracing: preliminary study. ASDC J Dent Child 1998;65:449-458.
  • 4 Lobbezzo F, Naeije, M. Bruxism is mainly regulated centrally, not peripherally. J Oral Rehabil 2001;28:1085-1091.
  • 5 Castelo PM, Gaviao MB, Pereira LJ, Bonjardim LR. Relationship between oral parafunctional/nutritive sucking habits and temporomandibular joint dysfunction in primary dentition. Int J Paediatr Dent 2005;15:29-36.
  • 6 Camparis CM, Siqueira JT. Sleep bruxism: clinical aspects and characteristics in patients with and without chronic orofacial pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:188-193.
  • 7 Bonjardim LR, Gaviao MB, Pereira LJ, Castelo PM, Garcia RC. Signs and symptoms of temporomandibular disorders in adolescents. Pesqui Odontol Bras 2005;19:93-98.
  • 8 Magnusson T, Egermarki I, Carlsson GE. A prospective investigation over two decades on signs and symptoms of temporomandibular disorders and associated variables. A final summary. Acta Odontol Scand 2005;63:99-109.
  • 9 Molina OF, dos Santos J, Mazzetto M, Nelson S, Nowlin T, Mainieri ET. Oral jaw behaviors in TMD and bruxism: a comparison study by severity of bruxism. Cranio 2001;19:114- 122.
  • 10 Demir A, Uysal T, Guray E, Basciftci FA. The relationship between bruxism and occlusal factors among seven- to 19-year-old Turkish children. Angle Orthod 2004;74:672- 676.
  • 11 Sari S, Sonmez H. The relationship between occlusal factors and bruxism in permanent and mixed dentition in Turkish children. J Clin Pediatr Dent 2001;25:191-194.
  • 12 Oksenberg A, Arons E. Sleep bruxism related to obstructive sleep apnea: The effect of continuous positive airway pressure. Sleep Med 2002;3:513-515.
  • 13 Lavigne G, Palla S. Transient morning headache: recognizing the role of sleep bruxism and sleep-disordered breathing. J Am Dent Assoc 2010;141:297-299.
  • 14 Manfredini D, Landi N, Fantoni F, Segù M, Bosco M. Anxiety symptoms in clinically diagnosed bruxers. J Oral Rehabil 2005;32:584-588.
  • 15 Tsai CM, Chou SL,Gale EN, Mccall JR. Human masticatory muscle activity and jaw position under experimental stress. J Oral Rehabil 2002;29:44-51.
  • 16 Giraki M, Schneider C, Schäfer R, Singh P, Franz M, Raab WH, Ommerborn MA. Correlation between stress, stresscoping and current sleep bruxism. Head Face Med 2010;6:2.
  • 17 Bayardo RE, Mejia JJ, Orozco S, Montoya K. Etiology of oral habits. ASDC J Dent Child 1996;63:350-353.
  • 18 Lobbezoo F, Soucy JP, Montplaisir JY, Lavigne GJ. Striatal d2 receptor binding in sleep Bruxism: A controlled study with iodine-123-iodobenzamide and single-photon-emission computed tomography. J Dent Res 1996;75:1804-1810.
  • 19 Lobbezoo F, Soucy JP, Hartman NG, Montplaisir JY, Lavigne GJ. Effects of the d2 receptor agonist bromocriptine on sleep bruxism of two single-patient clinical trials. J Dent Res 1997;76:1610-1614.
  • 20 Seraidarian P, Seraidarian PI, das Neves Cavalcanti B, Marchini L, Claro Neves AC. Urinary levels of catecholamines among individuals with and without sleep bruxism. Sleep Breath 2009;13:85-88.
  • 21 Hirsch C, John MT, Lobbezoo F, Setz JM, Schaller HG. Incisal tooth wear and self-reported TMD pain in children and adolescents. Int J Prosthodont 2004;17:205-210.
  • 22 Farsi NM. Symptoms and signs of temporomandibular disorders and oral parafunctions among Saudi children. J Oral Rehabil 2003;30:1200-1208.
  • 23 Carlsson GE, Egermark I, Magnusson T. Predictors of signs and symptoms of temporomandibular disorders: a 20-year follow-up study from childhood to adulthood. Acta Odontol Scand 2002;60:180-185.
  • 24 Manfredini D, Landi N, Bandettini Di Poggio A, Dell'Osso L, Bosco M. A critical review on the importance of psychological factors in temporomandibular disorders. Minerva Stomatol 2003;52:321-330.
  • 25 Michelotti A, Martina R, Russo M, Romeo R. Personality characteristics of temporomandibular disorder patients using M.M.P.I. Cranio 1998;16:119-125.
  • 26 Bader G, Lavigne G. Sleep bruxism; an overview of an oromandibular sleep movement disorder. Review article. Sleep Med Rev 2000;4:27-43.
  • 27 Nekora-Azak A, Yengin E, Evlioglu G, Ceyhan A, Ocak O, Issever H. Prevalence of bruxism awareness in Istanbul, Turkey. Cranio 2010;28:122-127.
  • 28 Carlsson GE, Egermark I, Magnusson T. Predictors of bruxism, other oral parafunctions, and tooth wear over a 20-year follow-up period. J Orofac Pain 2003;17:50-57.
  • 29 Quintero Y,Restrepo C.C, Tamayo V, Tamayo M, Vélez A.L, Gallego G, Peláez A,Effect of awareness through movement on the head posture of bruxist children. J Oral Rehabil 2009;36:18-25.
  • 30 Saletu A, Parapatics S, Saletu B, Anderer P, Prause W, Putz H, Adelbauer J, Saletu-Zyhlarz GM. On the pharmacotherapy of sleep bruxism: placebo-controlled polysomnographic and psychometric studies with clonazepam. Neuropsychobiology 2005;51:214-225.
  • 31 Raigrodski AJ, Christensen LV, Mohamed SE, Gardiner DM. The effect of four-week administration of amitriptyline on sleep bruxism. A double-blind crossover clinical study. Cranio 2001;19:21-25.
  • 32 Van der Zaag J, Lobbezoo F, Wicks DJ, Visscher CM, Hamburger HL, Naeije M. Controlled assessment of the efficacy of occlusal stabilization splints on sleep bruxism. J Orofac Pain 2005;19:151-158.
  • 33 Vann WF Jr, Dilley GJ, Nelson RM. A cephalometric analysis for the child in the primary dentition. ASDC J Dent Child 1978;45:45-52.
  • 34 Kocadereli I, Telli AE. Evaluation of Ricketts’ long-range growth prediction in Turkish children. Am J Orthod Dentofacial Orthop 1999;115:515-520.
  • 35 Buysse DJ, Young T, Edinger JD, Carroll J, Kotagal S. Clinicians' use of the International Classification of Sleep Disorders: results of a national survey. Sleep 2003;26:48-51.
  • 36 Restrepo C, Peláez A, Alvarez E, Paucar C, Abad P. Digital imaging of patterns of dental wear to diagnose bruxism in children. Int J Paediatr Dent 2006;16:278-285.
  • 37 Al-Awad AM, Sonuga-Barke EJ. The application of the Conners’ Rating Scales to a Sudanese sample: an analysis of parents' and teachers' ratings of childhood behaviour problems. Psychol Psychother 2002;75:177-187.
  • 38 Wahlund K, List T, Dworkin SF. Temporomandibular disorders in children and adolescents: reliability of a questionnaire, clinical examination, and diagnosis. J Orofac Pain 1998;12:42–51.
  • 39 Hirsch C, John MT, Lautenschlager C, List T. Mandibular jaw movement capacity in 10–17-yr-old children and adolescents: normative values and the influence of gender, age, and temporomandibular disorders. Eur J Oral Sci 2006;114:465–470.
  • 40 Nilsson IM, List T, Drangsholt M. The reliability and validity of self-reported temporomandibular disorder pain in adolescents. J Orofac Pain 2006;20:138–144.
  • 41 Bennet CG, Mahan PE. Management of a preadolescent chronic headache patient with occlusal splint therapy: case report. Pediatr Dent 1989;11:64-67.
  • 42 Okeson JP. The effects of hard and soft occlusal splints on nocturnal bruxism. J Am Dent Assoc 1987;114:788-790.
  • 43 Lundeen TF. Occlusal splint fabrication. J Prosth Dent 1979;42:588-591.
  • 44 Hachmann A, Martins EA, Araujo FB, Nunes R. Efficacy of the nocturnal bite plate in the control of bruxism for 3 to 5 year old children. J Clin Pediatr Dent 1999;24:9-15.
  • 45 Restrepo CC, Vasquez LM, Alvarez M, Valencia I. Personality traits and temporomandibular disorders in a group of children with bruxing behaviour. J Oral Rehabil 2008;35:585–593.
  • 46 Monaco A, Ciammella NM, Marci MC, Pirro R, Giannoni M. The anxiety in bruxer child. A case–control study. Minerva Stomatol 2002;51:247–250.
  • 47 Morton DL, Brown CA, Watson A, El-Deredy W, Jones AK. Cognitive changes as a result of a single exposure to placebo. Neuropsychologia 2010;48:1958-1964.
  • 48 Gorayeb MA, Gorayeb R. Association between headache and anxiety disorders indicators in a school sample from Ribeirao Preto, Brazil. Arq Neuropsiquiatr 2002;60:764–768.
  • 49 Conners CK, Sitarenios G, Parker JD, Epstein JN. The revised Conners’ Parent Rating Scale (CPRS-R): factor structure, reliability and criterion validity. J Abnorm Child Psychol 1998;26:257–268.
  • 50 Pincus H, Frances A, Wakefield Davis W, First M, Widiger T. DSM-IV and new diagnostic categories: holding the line on proliferation. Am J Psychiatry 1992;149:112–117.
  • 51 Vila G, Nollet-Clemencon C, de Blic J, Falissard B, Mouren- Simeoni MC, Scheinmann P. Assessment of anxiety disorders in asthmatic children. Psychosomatics 1999;40:404– 413.
  • 52 Serra-Negra JM, Ramos-Jorge ML, Flores-Mendoza CE, Paiva SM, Pordeus IA. Influence of psychosocial factors on the development of sleep bruxism among children. Int J Paediatr Dent 2009;19:309-317.
  • 53 Dylina TJ. A common-sense approach to splint therapy. J Prosthet Dent 2001;86:539-545.
  • 54 Klasser GD, Greene CS. Oral appliances in the management of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:212-223.
  • 55 Caiozzo VJ, Richmond H, Kaska S, Valeroso D. The mechanical behavior of activated skeletal muscle during stretch: effects of muscle unloading and MyHC isoform shifts. J Appl Physiol 2007;103:1150-1160.
  • 56 Baba K, Haketa T, Clark GT, Ohyama T. Does tooth wear status predict ongoing sleep bruxism in 30-year-old Japanese subjects? Int J Prosthodont 2004;17:39-44.
  • 57 John MT, Frank H, Lobbezoo F, Drangsholt M, Dette KE. No association between incisal tooth wear and temporomandibular disorders. J Prosthodont 2002;87:197-203.
  • 58 Pigno MA, Hatch JP, Rodrigues-Garcia RC, Sakai S, Rugh JD. Severity, distribution, and correlates of occlusal tooth wear in a sample of Mexican-American and European- American adults. Int J Prosthodont 2001;14:65-70.
  • 59 White KS. Anxiety and psychosocial stress as predictors of headache and abdominal pain in urban early adolescents. J Pediatr Psicol 2006;31:582-596.
  • 60 Carlsson GE, Egermark I, Magnusson T. Predictors of signs and symptoms of temporomandibular disorders: a 20-year follow-up study from childhood to adulthood. Acta Odontol Scand 2002;60:180-185.