Tongue pressure and volume, oral sensory and masticatory function, quality of life and sleep, and effect of intraoral appliances in bruxers

Author(s)

Mariana Barbosa Câmara Souza

• Document type: Master's Dissertation
• Press: Piracicaba, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Odontologia de Piracicaba
• Defense date: 2017-03-02

Examining board members

Renata Cunha Matheus Rodrigues Garcia; Gustavo Augusto Seabra Barbosa; Giselle Rodrigues Ribeiro

• Advisor: Renata Cunha Matheus Rodrigues Garcia

Abstract

Sleep bruxism has multifactorial etiology and deleterious effects that may lead to tooth wear, muscular pain, tongue injuries, and others. This study investigated maximum tongue pressure (MTP), oral sensory function (OSF), masticatory function, pain, sleep quality and oral health-related quality of life (OHRQoL) in bruxers. Also, tongue size (TS) and dental arch size (DAS) were evaluated in relation to MTP. Sixty volunteers were selected at Piracicaba Dental School ¿ University of Campinas (FOP/UNICAMP) and divided into two groups: subjects with (experimental) and without (control) sleep bruxism (SB). Sleep bruxers were chosen based on clinical evaluation and home recording electromyography/ electrocardiography, which accuracy and reproducibility are compared to polysomnography exam. Then, the following variables were evaluated: MTP (measured by pressure sensors), OSA (oral stereognosis), masticatory function parameters (swallowing threshold and masticatory efficiency by sieve fractionation method), TS (ultrasonography), DAS (measured from mandibular first molar from right to left), pain (Visual Analogue Scale), sleep quality (Pittsburgh Sleep Quality Index ¿ PSQI; Epworth Sleepiness Scale - ESS) and the improvement in oral health-related quality of life (OHIP-14). Then, half of the Experimental Group volunteers received stabilization splint (SS) therapy as SB management (n=15), and the other half received palatal splints (PS) as placebo (n=15). All participants used the splints at night and after thirty and sixty days of usage, all variables were re-evaluated. After data collection, an exploratory analyzes was applied. The results collected were submitted to exploratory analysis and appropriate statistical tests were applied. Data from OHIP, PSQI and ESS were analyzed by Wilcoxon signed rank test. One-way ANOVA was used to compare X50, ME and OSF means between bruxers and health subjects. After splints therapy, comparisons between groups and time were carried out with two-way ANOVA and Tukey post-hoc, and the correlation between MTP, TS the ratio TS/DAS was analyzed by Peason¿s test. Participants with SB showed greater values of OHRQoL than controls (p = 0.003), indicating that their quality of life was worst. Also, bruxers presented the highest PSQI scores (p = 0.0009), and excessive daytime sleepiness (p = 0.023), as accessed by ESS. Masticatory cycles, X50 and ME were similar in both groups (p > 0.05). Moreover, sleep bruxism did not influence the OSF (p = 0.241), and splint therapy reduced MTP and pain levels (p < 0.0001). Besides, OHRQoL and sleep quality were improved after SS and PS wearing (p < 0.001), while TS did not alter after 30 nor 60 days of usage (p = 0.464). Likewise, a weak and not significant correlation was found between MTP and TS (p = 0.326) and between MTP and ratio TS/DAS (p = 121). Thus, it might be concluded that SB impairs OHRQoL and sleep quality without affecting mastication and OSF. In addition, splint therapy reduces MTP and self-reported pain, also improving OHRQoL and sleep in bruxers (AU)

• FAPESP's process: 15/14662-0 - Maximum tongue pressure and volume, oral stereognostic ability, sleep quality and quality of life in patients with bruxism
• Grantee: Mariana Barbosa Câmara de Souza
• Support Opportunities: Scholarships in Brazil - Master