Diagnostic accuracy of portable instrumental devices to measure sleep bruxism: a systematic literature review of polysomnographic studies

Abstract

This study systematically reviews the sleep bruxism (SB) literature published in the MEDLINE and Scopus databases to answer the following question: What is the validity of the different portable instrumental devices that have been proposed to measure SB if compared with polysomnographic (PSG) recordings assumed as the gold standard? Four clinical studies on humans, assessing the diagnostic accuracy of portable instrumental approaches (i.e. Bitestrip, electromyography (EMG)-telemetry recordings and Bruxoff) with respect to PSG, were included in the review. Methodological shortcomings were identified by QUADAS-2 quality assessment. Findings showed contrasting results and supported only in part the validity of the described diagnostic devices with respect to PSG. The positive predictive value (PPV) of the Bitestrip device was 59-100%, with a sensitivity of 71-84·2%, whilst EMG-telemetry recordings had an unacceptable rate of false-positive findings (76·9%), counterbalanced by an almost perfect sensitivity (98·8%). The Bruxoff device had the highest accuracy values, showing an excellent agreement with PSG for both manual (area under ROC = 0·98) and automatic scoring (0·96) options as well as for the simultaneous recording of events with respect to PSG (0·89-0·91). It can be concluded that the available information on the validity of portable instrumental diagnostic approaches with respect to PSG recordings is still scarce and not solid enough to support any non-PSG technique's employ as a stand-alone diagnostic method in the research setting, with the possible exception of the Bruxoff device that needs to be further confirmed with future investigations.

Sleep-associated aspects of myofascial pain in the orofacial area among Temporomandibular Disorder patients and controls

“…The advantage of these devices is that subject adherence is high and that they can be very useful for recording EMG activity over the course of several nights without added cost or complication. Another advantage of these portable EMG devices is the ability to record muscular activity in a familiar environment [20], because EMG sleep recordings are performed at home [21,22]. This is very advantageous, because it can reduce the "firstnight effect" that can occur during PSG, although this effect might be circumstantial in moderate-high frequency SBs [23].…”

Sleep bruxism in individuals with and without attrition-type tooth wear: An exploratory matched case-control electromyographic study

“…1,4,6 Therefore, portable EMG equipments have been developed to be used in SB assessment 7 , 8,9 but their validity in relation to PSG may still be questionable. 10 One of these portable equipment on the market (Grindcare Measure®, Medotech A/S, Copenhagen, Denmark) has been used in the present study as an indicator of SB diagnosis. 11-,12,13 Attrition type of tooth wear featuring matched, sharp and clearly demarcated wear facets between opposing teeth, have anecdotally been believed by many dental professionals to be associated with SB.…”

Diagnosis of Sleep Bruxism with the BruxChecker

“…Jednak ze względu na małą dostępność, duże koszty, niewygodę dla pacjenta związaną z badaniem, potrzebną aklimatyzację do warunków ambulatoryjnych oraz konieczność dysponowania personelem wykwalifikowanym w prawidłowym odczytywaniu epizodów bruksizmu, polisomnografia znajduje niewielkie zastosowanie w diagnostyce bruksizmu. Częściowo jest zastępowana obecnie miniaturowymi aparatami do elektromiografii, których kolejne typy wykazują coraz większą czułość i swoistość diagnostyczną [15]. Ich wadą jest brak podglądu audio/wideo pozwalającego na odróżnienie od bruksizmu niespecyficznych aktywności ustno-twarzowych i ruchów całego ciała w czasie badania.…”

“…Te ostatnie uzyskują bardzo dobre rezultaty w porównaniu z polisomnografią. Najbardziej precyzyjnym urządzeniem obecnie wydaje się Bruxoff ® (Spes Medica, Battipaglia, Włochy), który w wykrywaniu SB osiąga czułość na poziomie 91,6% i swoistość 84,6% [15,21]. W porównaniu z folią BruxChecker, działa jednak na zupełnie innych zasadach i nie rejestruje żadnych informacji o wzorcach zgrzytania.…”