Current concepts of diagnosis and treatment of bruxism

Abstract

Bruxism is the name of the action of clenching and/or grinding performed on teeth without a functional purpose such as chewing and grinding. In etiology, morphological, psychological and parafunctional factors are generally accused. However, due to its subjective nature, there is no universally recognized common opinion in the diagnosis of bruxism. Bruxism can occur during sleep or while awake. Sleep bruxism does not vary depending on sex but awake bruxism is seen mostly in women. Bruxism can cause problems such as wear and fractures in teeth, loss of periodontal support and mobility, pain in the masticatory system and orofacial region, and temporomandibular joint dysfunction. There are basically five methods for bruxism diagnosis. These are questionnaire method, clinical observation, intraoral appliances, electromyographic analysis of masticator muscles and polysomnographic evaluation (PSG). Although PSG evaluation is accepted as the gold standard among these methods, it has some limitations. Clinical observation is mainly based on tooth wear and changes in soft tissues. Abfraction, attrition, corrosion and abrasion are named according to the factors affecting the formation of tooth wear. Conditions where the degree of wear is high, the tooth is unable to perform its specific function, the cause of pain and sensitivity, and the level of loss of tooth tissue that requires restoration is called pathological tooth wear. Differences in the etiology of bruxism require different approaches on treatment.  Current bruxism treatment approaches are personal approaches (cognitive-behavioral therapy), pharmacological approaches and occlusal approaches. The aim of this study is to present current diagnosis and treatment principles of bruxism. 

Keywords

• Bruxism,etiology

Bruksizmin tanı ve tedavisinde güncel yaklaşımlar

Abstract

Bruksizm, çiğneme ve öğütme gibi fonksiyonel bir amaç olmaksızın dişlerde gerçekleştirilen sıkma ve/veya gıcırdatma hareketinin adıdır. Etiyolojide genel olarak morfolojik, psikolojik ve parafonksiyonel faktörler suçlanmaktadır. Ancak subjektif olması yönüyle bruksizm tanısında dünya genelinde kabul görmüş ortak bir görüş bulunmamaktadır. Bruksizm uyku esnasında veya uyanıkken gerçekleşebilir. Uyku bruksizmi cinsiyete bağlı farklılık göstermezken, uyanıkken gerçekleşen bruksizm daha çok kadınlarda görülmektedir. Bruksizm, dişlerde fraktür ve aşınmalar, periodontal dokularda destek kaybı ve mobilite, çiğneme sisteminde ve orofasial bölgede ağrı ile temporomandibular eklem disfonksiyonu gibi problemlere yol açabilmektedir. Bruksizm tanısında temel olarak beş yöntem uygulanmaktadır. Bunlar; anket yöntemi, klinik gözlem, ağız içi apareyleri, çiğneme kaslarının elektromyografik analizi, polisomnografi (PSG)’dir. Bu yöntemlerin içinde PSG ile değerlendirme gold standart olarak kabul edilmesine rağmen belirli limitasyonları bulunmaktadır. Klinik gözlemde temel olarak diş aşınmaları ve yumuşak dokuda görülen değişiklikler izlenmektedir. Diş aşınmaları oluşumuna etki eden faktörlere göre abfraksiyon, atrizyon, korozyon ve abrazyon olarak adlandırılmaktadır. Aşınma derecesi fazla olan, dişin spesifik fonksiyonunu yapamadığı, ağrı ve hassasiyete sebep olduğu ve diş dokusundaki kaybın restorasyon gerektirecek seviyeye geldiği durumlar patolojik diş aşınması olarak adlandırılır. Bruksizmin etiyolojisindeki farklılıklar tedavilerinde de farklı yaklaşımlar gerektirir. Günümüzde bruksizm tedavi yaklaşımları; kişiye yönelik yaklaşımlar (bilişsel-davranışsal terapi), farmakolojik yaklaşımlar ve oklüzal yaklaşımlar olarak özetlenebilir. Bu çalışmanın amacı, bruksizmin güncel tanı ve tedavi prensiplerini sunmaktır. 

Anahtar Kelimeler: Bruksizm, etiyoloji, diş aşınmaları

Keywords

• Bruksizm,etiyoloji

References

1. 1. Firestone AR. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. Jeffrey P. Okeson (Ed.). Publisher, Chicago, Quintessence Publishing Co., 1997, p: 103-4.
2. 2. Okeson JP. Management of Temporomandibular Disorders and Occlusion: Elsevier Health Sciences; 2000, p: 640.
3. 3. Koyano K, Tsukiyama Y, Ichiki R, Kuwata T. Assessment of bruxism in the clinic. J Oral Rehabil. 2008;35:495-508.
4. 4. Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K. Bruxism physiology and pathology: an overview for clinicians. J Oral Rehabil. 2008;35:476-94.
5. 5. Klasser G, Greene C. Role of Oral Appliances in the Management of Sleep Bruxism and Temporomandibular Disorders. Alpha Omegan. 2007;100:111-9.
6. 6. Seligman DA, Pullinger AG, Solberg WK. The prevalence of dental attrition and its association with factors of age, gender, occlusion, and TMJ symptomatology. J Dent Res. 1988;67:1323-33.
7. 7. Kato T, Dal-Fabbro C, Lavigne GJ. Current knowledge on awake and sleep bruxism: overview. Alpha Omegan. 2003;96:24-32.
8. 8. Winocur E, Gavish A, Voikovitch M, Emodi-Perlman A, Eli I. Drugs and bruxism: a critical review. J Orofac Pain. 2003;17:99-111.

9. 9. Glaros AG. Incidence of diurnal and nocturnal bruxism. J Prosthet Dent. 1981;45:545-9.
10. 10. Bader G, Lavigne G. Sleep bruxism; an overview of an oromandibular sleep movement disorder. Sleep Med Rev. 2000;4:27-43.
11. 11. Pierce CJ, Chrisman K, Bennett ME, Close JM. Stress, anticipatory stress, and psychologic measures related to sleep bruxism. J Orofac Pain. 1995;9:51-6.
12. 12. Johansson A, Omar R, Carlsson GE. Bruxism and prosthetic treatment: a critical review. J Prosthodont Res. 2011;55:127-36.
13. 13. Safari A, Jowkar Z, Farzin M. Evaluation of the Relationship between Bruxism and Premature Occlusal Contacts. J Contemp Dent Pract. 2013:616-21.
14. 14. Rugh JD, Solberg WK. Electromyographic studies of bruxist behavior before and during treatment. J Calif Dent Assoc. 1975;3:56-9.
15. 15. Clark GT, Beemsterboer PL, Solberg WK, Rugh JD. Nocturnal electromyographic evaluation of myofascial pain dysfunction in patients undergoing occlusal splint therapy. J Am Dent Assoc. 1979;99:607-11.
16. 16. Clark GT, Beemsterboer PL, Rugh JD. Nocturnal masseter muscle activity and the symptoms of masticatory dysfunction. J Oral Rehabil. 1981;8:279-86.
17. 17. Rugh JD, Barghi N, Drago CJ. Experimental occlusal discrepancies and nocturnal bruxism. J Prosthet Dent. 1984;51:548-53.
18. 18. Miller VJ, Yoeli Z, Barnea E, Zeltser C. The effect of parafunction on condylar asymmetry in patients with temporomandibular disorders. J Oral Rehabil. 1998;25:721-4.
19. 19. Young DV, Rinchuse DJ, Pierce CJ, Zullo T. The craniofacial morphology of bruxers versus nonbruxers. Angle Orthod. 1999;69:14-8.
20. 20. Lavigne GJ, Manzini C, Kato T. Sleep Bruxism. Principles and Practice of Sleep Medicine2005. p. 946-59.
21. 21. Lobbezoo F, Naeije M. Bruxism is mainly regulated centrally, not peripherally. J Oral Rehabil. 2001;28:1085-91.
22. 22. L'Estrange PR. Sleep medicine for dentists. A practical overview. Eur J Orthod. 2010;32:351-2.
23. 23. Sjöholm T, Lehtinen I, Helenius H. Masseter muscle activity in diagnosed sleep bruxists compared with non-symptomatic controls. J Sleep Res. 1995;4:48-55.
24. 24. Bader GG, Kampe T, Tagdae T, Karlsson S, Blomqvist M. Descriptive physiological data on a sleep bruxism population. Sleep. 1997;20:982-90.
25. 25. Macaluso GM, Guerra P, Di Giovanni G, Boselli M, Parrino L, Terzano MG. Sleep bruxism is a disorder related to periodic arousals during sleep. J Dent Res. 1998;77:565-73.
26. 26. Reding GR, Zepelin H, Robinson JE, Zimmerman SO, Smith VH. Nocturnal Teeth-Grinding: All-Night Psychophysiologic Studies. J Dent Res. 1968;47:786-97.
27. 27. Rugh JD, Harlan J. Nocturnal bruxism and temporomandibular disorders. Adv Neurol. 1988;49:329-41.
28. 28. Özen NE. Temporomandibuler Bozuklukların Psikiyatrik Yönü ve Bruksizm. Klinik Psikiyatri Dergisi. 2007;10.
29. 29. Millwood J, Fiske J. Lip-biting in patients with profound neuro-disability. Dent Update. 2001;28:105-8.
30. 30. Tan E-K, Chan L-L, Chang H-M. Severe bruxism following basal ganglia infarcts: insights into pathophysiology. J Neurol Sci. 2004;217:229-32.
31. 31. Manzano FS, Granero LM, Masiero D, Botti MT. Treatment of muscle spasticity in patients with cerebral palsy using BTX-A: a pilot study. Spec Care Dentist. 2004;24:235-9.
32. 32. Louis ED, Tampone E. Bruxism in Huntington's disease. Mov Disord. 2001;16:785-6.
33. 33. Srivastava T, Ahuja M, Srivastava M, Trivedi A. Bruxism as presenting feature of Parkinson's disease. J Assoc Physicians India. 2002;50:457.
34. 34. Magalhães MHCG, C. MH, Kawamura JY, Araújo LCA. General and oral characteristics in Rett syndrome. Spec Care Dentist. 2002;22:147-50.
35. 35. Ahlberg J, Savolainen A, Rantala M, Lindholm H, Könönen M. Reported bruxism and biopsychosocial symptoms: a longitudinal study. Community Dent Oral Epidemiol. 2004;32:307-11.
36. 36. Lobbezoo F, Van Der Zaag J, Naeije M. Bruxism: its multiple causes and its effects on dental implants - an updated review. J Oral Rehabil. 2006;33:293-300.
37. 37. 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;75:1804-10.
38. 38. Lobbezoo F, van Denderen RJ, Verheij JG, Naeije M. Reports of SSRI-associated bruxism in the family physician's office. J Orofac Pain. 2001;15:340-6.
39. 39. Dettmar DM, Shaw RM, Tilley AJ. Tooth wear and bruxism: a sleep laboratory investigation. Aust Dent J. 1987;32:421-6.
40. 40. Kato T, Thie NM, Huynh N, Miyawaki S, Lavigne GJ. Topical review: sleep bruxism and the role of peripheral sensory influences. J Orofac Pain. 2003;17:191-213.
41. 41. Reding GR, Rubright WC, Zimmerman SO. Incidence of bruxism. J Dent Res. 1966;45:1198-204.
42. 42. Hublin C, Kaprio J, Partinen M, Koskenvuo M. Sleep bruxism based on self-report in a nationwide twin cohort. J Sleep Res. 1998;7:61-7.
43. 43. Milosevic A, Agrawal N, Redfearn P, Mair L. The occurrence of toothwear in users of Ecstasy (3,4-methylenedioxymethamphetamine). Community Dent Oral Epidemiol. 1999;27:283-7.
44. 44. Nadler SC. Bruxism, a classification: critical review. J Am Dent Assoc. 1957;54:615-22.
45. 45. Pingitore G, Chrobak V, Petrie J. The social and psychologic factors of bruxism. J Prosthet Dent. 1991;65:443-6.
46. 46. Selms MKA, Lobbezoo F, Wicks DJ, Hamburger HL, Naeije M. Craniomandibular pain, oral parafunctions, and psychological stress in a longitudinal case study. J Oral Rehabil. 2004;31:738-45.
47. 47. Manfredini D, Cantini E, Romagnoli M, Bosco M. Prevalence of bruxism in patients with different research diagnostic criteria for temporomandibular disorders (RDC/TMD) diagnoses. Cranio. 2003;21:279-85.
48. 48. Harada T, Ichiki R, Tsukiyama Y, Koyano K. The effect of oral splint devices on sleep bruxism: a 6-week observation with an ambulatory electromyographic recording device. J Oral Rehabil. 2006;33:482-8.
49. 49. Lavigne GJ, Rompre PH, Montplaisir JY. Sleep Bruxism: Validity of Clinical Research Diagnostic Criteria in a Controlled Polysomnographic Study. J Dent Res. 1996;75:546-52.
50. 50. Rompré PH, Daigle-Landry D, Guitard F, Montplaisir JY, Lavigne GJ. Identification of a sleep bruxism subgroup with a higher risk of pain. J Dent Res. 2007;86:837-42.
51. 51. Lavigne GJ, Rompré PH, Poirier G, Huard H, Kato T, Montplaisir JY. Rhythmic masticatory muscle activity during sleep in humans. J Dent Res. 2001;80:443-8.
52. 52. Ikeda T, Nishigawa K, Kondo K, Takeuchi H, Clark GT. Criteria for the detection of sleep-associated bruxism in humans. J Orofac Pain. 1996;10:270-82.
53. 53. Shetty S, Pitti V, Satish Babu CL, Surendra Kumar GP, Deepthi BC. Bruxism: A Literature Review. J Indian Prosthodont Soc. 2010;10:141-8.
54. 54. Jadidi F, Castrillon E, Svensson P. Effect of conditioning electrical stimuli on temporalis electromyographic activity during sleep. J Oral Rehabil. 2008;35:171-83.
55. 55. Yamamura M, Takahashi A, Aoki H, Takeuchi N, Endo Y, Tamaki K, Sano Y, Fujiwara S, Fujita T, Kusunoki S. A study on display and accuracy of occlusal contacts by means of T-Scan System. Kanagawa shigaku The Journal of the Kanagawa Odontological Society. 1990;25:236-41.
56. 56. Bozhkova TP. The T-SCAN System in Evaluating Occlusal Contacts. Folia medica. 2016;58:122-30.
57. 57. Kara Mİ, Ertaş ET, Özen E, Atıcı M, Aksoy S, Erdoğan MS, Kelebek S. BiteStrip analysis of the effect of fluoxetine and paroxetine on sleep bruxism. Archives of oral biology. 2017;80:69-74.
58. 58. Lobbezoo F, van der Zaag J, van Selms MKA, Hamburger HL, Naeije M. Principles for the management of bruxism. J Oral Rehabil. 2008;35:509-23.
59. 59. Lavigne GJ, Guitard F, Rompré PH, Montplaisir JY. Variability in sleep bruxism activity over time. J Sleep Res. 2001;10:237-44.
60. 60. Manfredini D, Lobbezoo F. Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:e26-50.
61. 61. Bartlett D, Phillips K, Smith B. A difference in perspective--the North American and European interpretations of tooth wear. Int J Prosthodont. 1999;12:401-8.
62. 62. Knight DJ, Leroux BG, Zhu C, Almond J, Ramsay DS. A longitudinal study of tooth wear in orthodontically treated patients. Am J Orthod Dentofacial Orthop. 1997;112:194-202.
63. 63. Hugoson A, Bergendal T, Ekfeldt A, Helkimo M. Prevalence and severity of incisal and occlusal tooth wear in an adult Swedish population. Acta Odontol Scand. 1988;46:255-65.
64. 64. Çelik Ç, Özgünaltay G, Attar N. Diş aşınmaları. HÜ Diş Hek Fak Derg. 2007;31:22-30.
65. 65. Lehman ML, Meyer ML. Relationship of dental caries and stress: concentrations in teeth as revealed by photoelastic tests. J Dent Res. 1966;45:1706-14.
66. 66. Kydd WL. Maximum forces exerted on the dentition by the perioral and lingual musculature. J Am Dent Assoc. 1957;55:646-51.
67. 67. Milosevic A. Book reviewBruxism – Theory and Practice Editor: Daniel A Paesani. London: Quintessence Publishing Co Ltd, 2010.
68. 68. Smith BG, Knight JK. A comparison of patterns of tooth wear with aetiological factors. Br Dent J. 1984;157:16-9.
69. 69. Asher C, Read MJ. Early enamel erosion in children associated with the excessive consumption of citric acid. Br Dent J. 1987;162:384-7.
70. 70. ASTM. Terminology Relating to Wear and Erosion. 2002.
71. 71. ASTM. Terminology Relating to Corrosion and Corrosion Testing. 2002.
72. 72. Eisenburger M, Shellis RP, Addy M. Comparative study of wear of enamel induced by alternating and simultaneous combinations of abrasion and erosion in vitro. Caries Res. 2003;37:450-5.
73. 73. Oral K. Bruksizm: Tanı ve tedavi. İstanbul, Quintessence Yayıncılık. 2012.
74. 74. Grippo JO, Simring M, Schreiner S. Attrition, abrasion, corrosion and abfraction revisited: a new perspective on tooth surface lesions. J Am Dent Assoc. 2004;135:1109-18
75. 75. Ommerborn MA, Schneider C, Giraki M, Schafer R, Singh P, Franz M, Raab WHM. In vivo evaluation of noncarious cervical lesions in sleep bruxism subjects. J Prosthet Dent. 2007;98:150-8.
76. 76. Travell J. Temporomandibular joint pain referred from muscles of the head and neck. J Prosthet Dent. 1960;10:745-63.
77. 77. McNeill C. Management of temporomandibular disorders: Concepts and controversies. J Prosthet Dent. 1997;77:510-22.
78. 78. de Leeuw R, Klasser GD. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management, Chicago, Quintessence Publishing (IL) ,2013. 301 p.
79. 79. Long JH, Jr. A device to prevent jaw clenching. J Prosthet Dent. 1998;79:353-4.
80. 80. Clarke JH, Reynolds PJ. Suggestive Hypnotherapy for Nocturnal Bruxism: A Pilot Study. Am J Clin Hypn. 1991;33:248-53.
81. 81. Goldberg G. The psychological, physiological and hypnotic approach to bruxism in the treatment of periodontal disease. J Am Soc Psychosom Dent Med. 1973;20:75-91.
82. 82. Olkinuora M. A review of the literature on, and a discussion of studies of bruxism and its psychogenesis and some new psychological hypotheses. Suom Hammaslaak Toim. 1969;65:312-24.
83. 83. Cannistraci AJ, Friedrich JA. A multidimensional approach to bruxism and TMD. N Y State Dent J. 1987;53:31-4.
84. 84. Baş B, Ozan B, Muğlali M, Celebi N. Treatment of masseteric hypertrophy with botulinum toxin: a report of two cases. Med Oral Patol Oral Cir Bucal. 2010;15:649-52.
85. 85. Ré JP, J.-P R, Perez C, Darmouni L, Carlier JF, Orthlieb JD. The occlusal splint therapy. Int J Stomatol Occlusion Med. 2009;2:82-6.