BiteStrip

Abstract: Objective This validation study compared an electromyography (EMG) device, Bitestrip, versus polysomnography in the diagnosis of sleep bruxism (SB). Study design Forty-nine consecutive patients (32 women and 17 men, 41.2 ± 12.9 years old) with a clinical history of SB were included in the study from the Orofacial Pain Clinic, Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul in Brazil. Results Initially, we compared an SB positive/negative test result for both systems (agreement 87.8%, sensitivity 84.2%, positive predictive value 100%, and crude kappa 0.71). We then compared a 4-scale test (no, light, moderate, or severe bruxism) between the 2 methods (agreement 80.27%, weighted kappa 0.51, and Kendall W coefficient 0.575). Conclusions The Bitestrip can be considered as a moderate screening method for the diagnosis of SB, because it is more precise in detecting the presence or absence of SB but less precise in detecting its intensity.

Abstract: PURPOSE A before-and-after experimental clinical study was carried out with the objective of evaluating the effect of a mandibular advancement device (MAD; 75% advancement), made of a thermoplastic material, on sleep bruxism (SB) and sleep scores MATERIALS AND METHODS After a habituation period of 1 week, SB scores were taken at baseline and after use of the MAD for 30 days Scores were compared using the newly developed BiteStrip, which registers the number of contractions of the unilateral masseter muscle after a 5-hour period, giving a severity score from 0 to 3 after the registrations To assess sleep, the Sleep Assessment Questionnaire (SAQ), a screening tool with scores ranging from 0 to 68, was used before and after use of the MAD Twenty-eight subjects (13 women, 15 men; mean age: 429 +/- 120 years) with a clinical history of SB and no spontaneous temporomandibular disorder (TMD) pain were selected The clinical diagnosis of either moderate or severe SB was further confirmed through use of the BiteStrip (scores 2 or 3) at baseline A 30-day follow-up period was used for evaluation Both methods were validated against polysomnography In addition, common signs and symptoms of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders were also evaluated before and after use to assess the side effects of the MAD RESULTS There was a statistically significant improvement in both SB and sleep scores based on the BiteStrip and the SAQ (Wilcoxon signed rank and Student paired t test, P < 05) In the signs and symptoms of TMD, there was a significant reduction in temporomandibular joint sounds as well as in masseter and temporalis tenderness to palpation None of the SB subjects experienced any breakage of the MAD CONCLUSION The MAD had a positive effect on SB and sleep scores, measured by the BiteStrip and the SAQ, respectively, and did not increase any traditional signs and symptoms of TMD in a 30-day evaluation period

Abstract: Purpose: This before and after study evaluated the effects of a mandibular advancement device (MAD) on sleep bruxism (SB) activity and its associated signs and symptoms. Materials and Methods: Nineteen young adults (39.9 ± 12.9 years, 58% women) with a clinical history of SB without sleep or neurologic disorders and no spontaneous temporomandibular disorder pain were selected. SB activity was assessed after a habituation period of 2 weeks. The results of a 3-month treatment with a thermoplastic monoblock MAD were compared to baseline using electromyogram polysomnography and the BiteStrip, a portable EMG device. Sleep disorders were assessed and validated against the polysomnography sleep assessment questionnaire (SAQ). Additionally, common signs and symptoms of SB were evaluated with the research diagnostic criteria for temporomandibular disorders. Occlusal force was compared to baseline using a cross-arch force transducer. Results: There was a significant improvement in both SB activity and sleep scores (including SB episodes per hour) according to the BiteStrip and the SAQ, respectively. There was also a significant reduction in the signs and symptoms of SB, including grinding and/or clenching, temporomandibular joint (TMJ) sounds, muscle pain, and occlusal force. None of the SB subjects experienced MAD breakage, but in 24% of patients, the MAD treatment had to be interrupted due to TMJ/muscle pain and/or discomfort. Conclusion: The MAD treatment resulted in the reduction of SB activity, SB signs and symptoms, sleep disorders, and occlusal force.

Abstract: PURPOSE Bruxism and parafunctions are potential risk factors for implant and prosthodontic treatment failure. However, the etiology of bruxism remains unknown. This study sought to clarify the relationship between bruxism behavior and a salivary stress biomarker level. MATERIALS AND METHODS Forty-six volunteers (23 men, 23 women) participated in this study. Bruxism behavior was assessed using a self-administered questionnaire, study casts, and BiteStrip, a miniature electronic screener used to detect sleep bruxism. The questionnaire consisted of six items asking about bruxism, occlusion, jaw functional limitation, and dentition. Occlusal wear was assessed from dental casts and calculated as the sum of the facets in the maxillary arch segment. Participants used BiteStrip at home for one night and the score was evaluated. Two-minute stimulated whole saliva samples were collected from participants to measure daytime levels of chromogranin A (CgA), a major salivary stress biomarker. Nonparametric tests of the relationship between variables were performed using the Spearman R and Kendall tau statistical correlation tests. RESULTS There was a positive correlation between self-reported bruxism and self-reported jaw functional limitation. Occlusal wear did not significantly correlate with occlusion, jaw functional limitation, or dentition, but it did significantly correlate with self-reported bruxism behavior, as well as the BiteStrip score. It was interesting to find that the CgA level was significantly negative in correlation with the BiteStrip score. CONCLUSION Sleep bruxism is believed to be a stress-related sleep disorder. The results suggest that daytime psychological stress level is significantly negative in correlation with sleep bruxism behavior.