软塑He垫治疗夜磨牙症的临床观察

目的 观察软塑料He垫治疗夜磨牙症的效果。方法 超硬石膏灌制患者下颌牙列印模，真空热压成形制作下颌软塑料He垫，2个月后针对磨损点调He，并统计有效率。结果 治疗总有效率为73．5％，其中，He垫有磨穿现象的有效率为58．3％，He垫无磨穿现象的有效率为77％，结论 软He垫能够有效矫治夜磨牙症，但软塑料He垫被磨穿者较难纠正夜磨牙症。     

颞下颌关节可复性盘移位的咬合治疗进展

颞下颌关节可复性盘移位的咬合治疗,尤其是作为一期治疗的咬合板在临床诊疗中应用广泛.现查阅文献,对可复性盘前移位的咬合治疗状况进行总结,结合咬合板设计原理以及患者的咬合特征指导咬合板的选择.     

夜磨牙症的肌电研究

对50例夜磨牙者和30例对照者用EM2型肌电仪测双颞肌前束、后束、嚼肌和二腹肌姿势位和ICP紧咬平均电位值。结果表明夜磨牙者各肌姿势位电位均高于对照组,说明夜磨牙者有颌面肌紧张现象;夜磨牙者嚼肌和颞肌后束ICP紧咬平均电位低于对照组P<0.05),而颞肌前束和二腹肌两组间无统计学意义(P>0.05)。     

真空成形牙合垫和普通塑料牙合垫治疗夜磨牙症的临床效果评价

目的比较真空成形牙合垫与普通塑料牙合垫治疗夜磨牙症的临床效果.方法分别用真空成形术和普通塑料制作牙合垫,嘱患者夜间休息时戴用.结果配戴普通塑料牙合垫和真空成形牙合垫1个月时停止磨牙例数之比为6∶11;6个月时为10∶17,具有显著性差异(P<0.05).结论真空成〗形牙合垫治疗夜磨牙疗效显著,配戴舒适,优于传统塑料牙合垫.     

高职大学生夜磨牙症患病情况的调查分析

目的:了解高职大学生夜磨牙症的发生情况及相关影响因素。方法:随机抽取2 562名高职大学生进行问卷调查和口腔检查,采用Excel表格和SPSS 13.0软件进行数据处理。结果:高职大学生夜磨牙症发病率为10.34%,其中男生9.72%,女生为10.93%,女生略高于男生,性别差异无统计学意义(P>0.05);口腔损害状况以颞下颌关节紊乱和牙齿磨损多见;影响因素以精神紧张因素多见。结论:高职大学生夜磨牙症发病率较高,学校应加强口腔健康宣传教育,减少夜磨牙症的发病率。     

咬合板治疗颞下颌关节盘移位的疗效评价

目的：对临床使用咬合板治疗颞下颌关节盘移位病例进行疗效评价，比较稳定性咬合板和再定位咬合板疗效。方法：使用稳定性咬合板治疗的病例66人（男19人，女47人），再定位咬合板29人（男9人，女20人）。以上病例均是通过临床检查、颞下颌关节许勒位片和关节上腔造影确诊为颞下颌关节盘前移位。研究设计与统计：分别对两组用咬合板治疗前后的关节弹响，疼痛指数，压痛的程度，以及病人对治疗的满意程度进行统计，对部分人治疗后的关节造影及许勒位进行评价，用SPSS建立数据库，用卡方检验比较两组治疗效果有无显著性差异。结果：95例患者中，经过咬合板治后，关节弹响的消失的有69例，消失为72．63％。关节弹响减轻有17例，治疗弹响的有总的效率为90．5％。两种咬合板的分组对照，在两组在弹响治疗效果上没有差异（χ^2值为0．138，P=0．719）。在治疗前有疼痛的患者41名中，经过咬合板治疗后有34名患者疼痛消失，其比率为82．96％，其它7名患者均表示疼痛较治疗前有改善，在两种咬合板治疗的分组统讲计中，疼痛的治疗效果没有显著性差异（χ^2值为0．005，P=0．967）。结论：两种咬合板治疗关节盘前移位均有疗效，当稳定性咬合板无法消除的弹响用再定位咬合板治疗也可以达到很好的疗效。     

乳牙列及混合牙列儿童夜磨牙症相关因素的分析

目的 研究夜磨牙症儿童的心理、咬合等特点,探索儿童夜磨牙症发生、发展的影响因素.方法 收集北京大学口腔医学院·口腔医院儿童口腔科门诊117例4～10岁乳牙列和混合牙列儿童,其中59例符合夜磨牙症的诊断标准,为病例组;58例未患夜磨牙症,为对照组.通过口腔检查和问卷调查,研究其口腔、颞下颌关节和心理等,分析各项因素与夜磨牙症发生的关系.结果 经Logistic回归分析得出:精神心理因素、咬合关系、特定的睡眠姿势、父母遗传和亲属遗传等因素的OR值分别为1.074、1.528、4.472、11.164和8.757.结论 精神心理因素、咬合关系、特定的睡眠姿势和遗传因素是儿童夜磨牙症发病的相关因素.     

生物反馈法治疗磨牙症的进展

磨牙症是对人类咀嚼系统及全身健康有严重影响的一种常见病、多发病,其病因和发病机制至今尚不清楚,且缺乏有效的治疗方法。生物反馈法治疗磨牙症在国外已有较多报道。该文较系统介绍生物反馈法治疗磨牙症的机制、应用方法、疗效及目前尚存在的不足之处。     

Nocturnal sleep architecture is altered by sleep bruxism

ObjectiveSleep is a complex behaviour phenomenon essential for physical and mental health and for the body to restore itself. It can be affected by structural alterations caused by sleep bruxism. The aim of this study was to verify the effects of sleep bruxism on the sleep architecture parameters proposed by the American Academy of Sleep Medicine.DesignThe sample comprised 90 individuals, between the ages of 18 and 45 years, divided into two groups: with sleep bruxism (n = 45) and without sleep bruxism (n = 45). The individuals were paired by age, gender and body mass index: a polysomnography was performed at night.ResultsStatistically significant differences were found between (P ≤ 0.05) individuals with sleep bruxism and individuals without sleep bruxism during total sleep time (P = 0.00), non-rapid eye movement (NREM) total sleep time (P = 0.03), NREM sleep time stage 3 (P = 0.03), NREM sleep latency (P = 0.05), sleep efficiency (P = 0.05), and index of microarousals (P = 0.04).ConclusionsSleep bruxism impairs the architecture of nocturnal sleep, interfering with total sleep time, NREM sleep latency, and sleep efficiency.     

Grinding patterns in migraine patients with sleep bruxism: a case-controlled study

Objectives: Details on grinding patterns and types of contact during sleep bruxism in association with migraine headache have not yet been elucidated. This study compared the characteristics of sleep bruxism between patients with migraine and controls.

Methods: The study included 80 female patients who had been diagnosed with migraine and 52 women with no history of migraine. Grinding patterns were measured using the BruxChecker® (Scheu Dental, Iserlohn, Germany).

Results: There was a significant difference between the two groups in the distribution of grinding patterns at the laterotrusive side (p < 0.001). When the anterior teeth and premolar and molar regions in the two groups were compared, the proportion of the grinding area at all sites was significantly larger in the migraine group than in the control group (p < 0.001).

Discussion: The BruxChecker® showed that there was substantial grinding over a large area among migraine patients, particularly in the molar region.     

夜磨牙症儿童患者的多导睡眠监测分析

目的 通过多导睡眠监测分析儿童夜磨牙症患者睡眠电生理及睡眠结构方面的改变,初步探讨夜磨牙症与睡眠电生理的关系.方法 分别选择12例严重夜磨牙症儿童患者(磨牙症组)及11名健康儿童(健康对照组)进行多导睡眠监测,并行统计学分析.结果 磨牙症组儿童非快速动眼睡眠Ⅱ期及Ⅳ期所占比例分别为(45.7±7.1)%和(19.2±4.9)%,而健康对照组分别为(52.9±5.8)%和(13.3±5.3)%,差异均有统计学意义(P＜0.05).磨牙症组儿童的睡眠效率[(84.0±8.0)%]及睡眠潜伏期[(39.33±28.73)min]与健康对照组相比[分别为(94.0±3.7)%和(10.27±7.57)min]差异均有统计学意义(P＜0.01).结论 夜磨牙症儿童存在睡眠结构紊乱.

Abstract：

Objective To analyze the sleep electrophysiological changes and the sleep structure changes in children with bruxism by use of the polysomnography. Methods Twelve children with severe bruxism and 11 children who had no systemic diseases or sleep disorders were selected for polysomnography.Results The proportion of nonrapid eye movements sleep(NREMS) Ⅱ and NREMS Ⅳ stages in bruxism group were (45.7 ± 7.1)% and (19.2 ± 4.9)%, while the control group were (52.9 ± 5.8)% and (13.3 ±5.3)% respectively. The sleep efficiency and the latency of sleep were (84.0 ± 8.0)% and (39.33 ± 28.73) min in bruxism group, and(94.0 ± 3.7)% and (10.27 ± 7.57) min in the control group respectively. The difference was statistically significant Conclusions The sleep structure is inordinate in bruxism children.     

Sleep bruxism associated with obstructive sleep apnea syndrome in children

Aims: Sleep bruxism (SB) and obstructive sleep apnea syndrome (OSAS) are often observed in children and may have several health implications. The aim of this paper is to evaluate their prevalence and to test for possible associations between these two conditions.

Methodology: The sample consisted of 496 children randomly selected among the preschoolers of Taubaté, Brazil; 249 (50·2%) were boys and 247 (49·8%) were girls. Diagnoses of SB and OSAS were made by clinical examinations and questionnaires filled out by the children’s parents in a cross-sectional design. Analysis of variance and Chi-square tests were applied to verify possible association among the variables in question.

Results: The average age was 4·49 years (SD: ±1·04 years). A total of 25·6% were diagnosed with SB, while 4·83% were diagnosed with OSAS, and only 2·82% presented both conditions. A statistical association was found between SB and OSAS (P<0·001; Chi-square test): 11·03% of subjects with SB also presented with OSAS, and 97·18% of subjects without SB did not present with OSAS. No association was found among children’s gender and age and the presence of SB or OSAS.

Conclusions: Within the limits of this study, SB was associated with OSAS.     

Changes in oxygen and carbon dioxide in the genesis of sleep bruxism: a mechanism study

PurposeRhythmic masticatory muscle activity (RMMA), a biomarker of sleep bruxism (SB), has been associated with mild hypoxia and/or big breaths in some adults with non-sleep-disordered breathing. The purpose of this study was to investigate that concurrent oxygen and carbon dioxide fluctuations are among the physiological variables that contribute to RMMA onset.MethodsTwelve subjects (5 female, 7 male, mean age: 43 ± 11) underwent polysomnography recording in a sleep laboratory. RMMA index and apnea-hypopnea index were calculated. Oxygen saturation (SpO₂) was estimated by finger pulse oximeter and end-tidal CO₂ (ETCO₂) by nasal airflow cannula before and after RMMA onset. Given the expected response time delay between actual arterial hypoxemia and fingertip pulse detection, we adjusted the SpO₂ desaturation onset to the onset of masseter muscle activity using a 17 s criterion based on ETCO₂ shifts.ResultsSpO₂ was slightly but significantly lower than at baseline (max: −0.6%) in the 6–4 s before RMMA onset and significantly higher in the 6–18 s after onset (0.9%; p < 0.05). Although ETCO₂ before RMMA onset did not differ from baseline, it decreased at 8–10 s after onset (−1.7 mmHg: p < 0.05). No changes in SpO₂ or ETCO₂ in relation to RMMA onset reached a critical clinical threshold.ConclusionsThe mild transient hypoxia observed before RMMA onset was not associated with a change in ETCO_2. The mild and brief oxygen fluctuations before RMMA onset may reflect a physiological response that seems to have little influence on SB genesis.     

Time-variant nature of sleep bruxism outcome variables using ambulatory polysomnography: implications for recognition and therapy evaluation

Summary  The aim of this study was to quantify the time-variant nature of sleep bruxism (SB) and to discuss its consequences. Six clinically diagnosed bruxers and six non-bruxers participated. Four ambulatory polysomnographic (PSG) recordings were obtained for every participant. As SB outcome variables, the number of episodes per hour of sleep (Epi h⁻¹), the number of bursts per hour (Bur h⁻¹) and the bruxism time index (BTI: the percentage of total sleep time spent bruxing) were established. To quantify the time-variant nature of SB, standard errors of measurement (SEMs) were calculated. For the non-bruxers, the SEMs for Epi h⁻¹, Bur h⁻¹ and BTI were 1·0, 5·7 and 0·1. For the bruxers, the respective values were 2·1, 14·9 and 0·4. In the discussion, arguments are given that because of the time-variant nature of the PSG recordings, cut-off bands around cut-off points might be useful for the recognition of SB.     

Impact of sleep bruxism on masseter and temporalis muscles and bite force

Objectives: This study aimed to analyze the impact of sleep bruxism (SB) on electromyography (EMG) activity and the thickness of the masseter and temporal and maximal molar bite force. Method: Ninety individuals, aged between 18 and 45 years, were selected and divided into two groups: Group I (case group, 45 individuals with SB) and Group II (control group, 45 individuals without SB). A diagnosis of SB was made from polysomnography. Results: The data obtained from EMG and the muscle thickness and the maximal molar bite force were tabulated (SPSS 21.0), normalized, and subjected to statistical analysis (p ≤ 0.05). Comparisons between the groups showed significant differences regarding the habitual chewing of hard food for the left temporalis muscle (p = 0.04) and the chewing of soft food for the right masseter muscle (p = 0.04), but no significant differences for the measurements of muscle thickness and maximal molar bite force. Discussion: The present data suggest that SB negatively altered the masticatory muscles’ functions. Based on the results of this research, it can be concluded that individuals with SB showed decreased EMG activity in the masticatory muscles.