Effects of a contingent vibratory stimulus delivered by an intra-oral device on sleep bruxism: a pilot study

Nakamura, Hirotaka; Takaba, Masayuki; Abe, Yuka; Yoshizawa, Shuichiro; Suganuma, Takeshi; Yoshida, Yuya; Nakazato, Yukari; Ono, Yasuhiro; Clark, Glenn T.

doi:10.1007/s11325-019-01782-x

Cited by 12 publications

(25 citation statements)

References 27 publications

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“…The vibratory stimuli were applied for four consecutive nights after the adaptation period. As a result, the number and the total duration of SB episodes per hour decreased significantly, which was equivalent to those in our pilot study, 20 suggesting that a vibration feedback stimulus might reduce SB even after adaptation to OA.…”

Section: Discussionsupporting

confidence: 83%

Effect of contingent vibratory stimulus via an oral appliance on sleep bruxism after the splint adaptation period

Nakazato

Takaba

Abe

et al. 2021

J of Oral Rehabilitation

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Background Contingent vibratory feedback stimuli applied by a specially designed oral appliance (OA) have been reported to be effective in reducing sleep bruxism (SB). However, the inhibitory effects of the OA, which occur immediately after OA delivery, may have confounded this finding. Objective This study sought to shed light on the effects of vibratory stimuli on SB after the OA adaptation period, when its inhibitory effects are diminished. Methods Fourteen ‘definite’ SB patients were enrolled. A force‐based bruxism detection system was utilised to trigger a vibrator attached to the OA. Masseter electromyographic activity during sleep was recorded at home using portable polysomnography. After using the OA without vibratory stimulus for 16 nights (adaptation period), intermittent vibratory stimuli were applied every other half‐hour for four nights (intervention period). Electromyographic activity over 10% of the maximum voluntary contraction was regarded as a SB episode. The number and the total duration of SB episodes per hour of sleep were calculated for the sessions with and without stimuli separately and averaged for four intervention nights. The effects of stimuli on these two variables were evaluated. Results The number and the total duration of the sessions without stimuli were 5.2 episodes/h and 35.3 s/h, respectively. These values significantly decreased to 3.9 episodes/h and 15.1 s/h (p < .05) for the sessions with vibratory stimuli. Conclusion Contingent vibratory stimulus via an OA may be effective for the management of SB even after adaptation to OA.

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Section: Discussionsupporting

confidence: 83%

Effect of contingent vibratory stimulus via an oral appliance on sleep bruxism after the splint adaptation period

Nakazato

Takaba

Abe

et al. 2021

J of Oral Rehabilitation

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“…Therefore, how to effectively combine traditional materials that require high-temperature and high-stress fabrication with chips that cannot withstand high temperature and high stress is the most basic problem that must be solved. At present time, both traditional approaches and digital methods are unable to propose an optimal strategy for embedding chips into OSS resins [10][11][12]. Although the modified OSS could be accomplished by light-curing, digital technology manufacturing and comparable resin selection may be new directions for future research.…”

Section: Embedding Challengesmentioning

confidence: 99%

“…Another kind of mini wireless biofeedback device for SB diagnosis and treatment was reported, in which a stress sensor, a button cell, and a mini monitoring circuit were embedded in the special splint and a watch style device was designed for monitoring and feedback [12]. Pilot studies found that biofeedback therapy based on occlusal force could monitor occlusal changes effectively [10][11][12].However, the occlusal force-based detection system was mainly used in SB, and the sensors were packed only in the canines or premolars regions. The existing limitations in previous studies on this topic gave rise to several questions.…”

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confidence: 99%

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confidence: 99%

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Intelligent Occlusion Stabilization Splint with Stress-Sensor System for Bruxism Diagnosis and Treatment

Gao

Liu

Gao

et al. 2019

Sensors

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Bruxism is a masticatory muscle activity characterized by high prevalence, widespread complications, and serious consequences but without specific guidelines for its diagnosis and treatment. Although occlusal force-based biofeedback therapy is proven to be safe, effective, and with few side effects in improving bruxism, its mechanism and key technologies remain unclear. The purpose of this study was to research a real-time, quantitative, intelligent, and precise force-based biofeedback detection device based on artificial intelligence (AI) algorithms for the diagnosis and treatment of bruxism. Stress sensors were integrated and embedded into a resin-based occlusion stabilization splint by using a layering technique (sandwich method). The sensor system mainly consisted of a pressure signal acquisition module, a main control module, and a server terminal. A machine learning algorithm was leveraged for occlusal force data processing and parameter configuration. This study implemented a sensor prototype system from scratch to fully evaluate each component of the intelligent splint. Experiment results showed reasonable parameter metrics for the sensors system and demonstrated the feasibility of the proposed scheme for bruxism treatment. The intelligent occlusion stabilization splint with a stress sensor system is a promising approach to bruxism diagnosis and treatment.Sensors 2020, 20, 89 2 of 15 discussion summary, the existing assessment of bruxism could also be classified into three main aspects: (1) noninstrumental approaches, (2) instrumental approaches, and (3) cut-off points grading [6]. Self-report and clinical examination are considered as noninstrumental approaches, which are also the primary choices in the clinical assessment of bruxism. However, their reliability and validity need further improvement [6]. EMG may provide good evidence of both sleep and awake bruxism, but there is also a risk of overestimating the number of true SB events [7]. PSG could be regarded as a reference standard for SB assessment; however, it is expensive and time-consuming [2]. To date, the reliability and validity of all the common techniques remain debatable, and consensus has yet to be established regarding the best method to diagnose bruxism. Therefore, exploring some new methods of bruxism diagnosis and management is a necessary and meaningful research topic.The use of biofeedback technologies (electrical, auditory, vibratory stimulus, etc.) as behavioral techniques of bruxism diagnosis and treatment has been considered a promising approach in both clinical and scientific fields in recent years [8]. Various biofeedback modalities have been reported in previous papers, and most of these are based on EMG recordings, except two studies that described force-based devices [8,9]. An intra-splint force detector (ISFD) for SB force detection was described in 2003 [10]. A detailed description of this SB inhibition system has been presented in a recently published paper [11]. This inhibition system consisted of ISFD, vibration, and co...

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“…The experiment achieved a 25% decrease in the number of SB events and a 44% decrease in SB event duration following the application of vibratory stimuli. The authors subsequently examined the immediate effects of vibratory stimulation via an OA on SB using single-night portable polysomnography (PSG) recordings of 13 patients with "definite" SB [15]. That study found a 46% reduction in the duration of SB episodes and a 25% reduction in the number of SB episodes.…”

Section: Introductionmentioning

confidence: 99%

Effects of vibratory feedback stimuli through an oral appliance on sleep bruxism: a 6-week intervention trial

et al. 2021

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Purpose Various biofeedback stimulation techniques of managing sleep bruxism (SB) have recently emerged; however, the effect of successive application of vibratory feedback stimulation has not been clarified. This study elucidated the effect of vibration feedback stimulation via an oral appliance (OA) on SB when vibration feedback was applied for 4 weeks. Methods This was a prospective, single-arm, open-label, intervention study. Ten participants diagnosed with "definite" SB wore a specially designed OA for 45 nights in a home-setting. A force-based SB detection system, including a pressuresensitive piezoelectric film placed internally in the OA, triggered a vibrator attached to the OA. Vibratory stimulation was withheld during the first 2-week adaptation period (1st-15th nights), applied during the 4-week stimulation period (16th-43rd nights), and again withheld during the post-stimulation period (44th and 45th nights). The number and duration of SB episodes/hour of sleep were calculated based on masseter electromyographic activity recorded with in-home portable polysomnography and compared between the 15th and 45th nights (without stimulation) and the 17th and 43rd nights (with stimulation). ResultsThe number and duration of SB episodes significantly decreased after vibratory stimulation (15th vs. 17th nights: p = 0.012 and p = 0.012, respectively), then significantly increased upon cessation of vibratory stimulation after the stimulation period (43rd vs. 45th nights: p = 0.023 and p = 0.023, respectively). Conclusion Contingent vibratory stimulation through an OA may suppress SB-related masticatory muscle activity continuously for 4 weeks and may be an effective alternative for the management of SB. Trial registration https:// jrct. niph. go. jp/; trial registration number: jRCTs032190225

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Effects of a contingent vibratory stimulus delivered by an intra-oral device on sleep bruxism: a pilot study

Cited by 12 publications

References 27 publications

Effect of contingent vibratory stimulus via an oral appliance on sleep bruxism after the splint adaptation period

Effect of contingent vibratory stimulus via an oral appliance on sleep bruxism after the splint adaptation period

Intelligent Occlusion Stabilization Splint with Stress-Sensor System for Bruxism Diagnosis and Treatment

Effects of vibratory feedback stimuli through an oral appliance on sleep bruxism: a 6-week intervention trial

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