Propositions for a cognitive behavioral approach to bruxism management

Orthlieb, Jean-Daniel; Tran, Thi-Nguyen-Ny; Camoin, Ariane; Mantout, B.

doi:10.1007/s12548-012-0072-5

Cited by 6 publications

(5 citation statements)

References 28 publications

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“…In the present study, 25 patients (76 %) were treated with splint- and physiotherapy, four patients (12 %) received only physiotherapy, two patients (6 %) were treated with splint therapy only, and two patients (6 %) were given no therapy at all. The fact that some patients do not require any additional therapy following detailed information is consistent with the results of Orthlieb and McNeill who postulated that rapid pain relief using medication, appropriate information on behavioral measures may be sufficient in some patients to achieve appropriate pain elimination and, thus, adequate treatment success [22, 23]. Our patients were also adequately instructed during the baseline evaluation to employ appropriate measures in the case of obvious parafunctional activity and to avoid any hard or chewy food until appropriate improvement of symptoms.…”

Section: Discussionsupporting

confidence: 74%

Magnetic resonance imaging of temporomandibular joint with anterior disk dislocation without reposition - long-term results

et al. 2016

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ObjectivesAnterior disk dislocation (ADD) without reposition in the temporomandibular joint (TMJ) may be associated with morphological changes in the retrodiscal region of the bilaminar zone presenting as pseudo-disk (PD). The present study was initiated to investigate the development of retrodiscal fibrosis in a period of 4–8 years and to assess if patients with a PD show differences in the clinical and radiologic findings versus patients without a PD.Materials and MethodsIn a retrospective follow-up study of 33 consecutive patients with ADD without reposition in one or both TMJs, a clinical and MRI-supported evaluation was conducted 4 to 8 years after baseline diagnosis.ResultsIn 45 % of the TMJs with ADD without reposition, a PD could be identified. Twenty-one of 31 patients who showed pain at the baseline examination (VAS mean 56 ± 38) were pain free. The mouth opening capacity (MO) of the mandible could be increased in 80 %. There were no statistical significant differences between patients with or without PD in these clinical features. The MRI parameters effusion and translation showed a statistical tendency for more improvement in the group with PD (p = 0.061, 0.064).ConclusionIn about half of the patients, a structure corresponding to a pseudo-disk developed during follow-up. Pain and the mouth opening capacity improved in all patients independent of the development of a PD.Clinical RelevanceDetection of a PD during follow-up of patients with ADD without spontaneous reposition does neither predict favorable nor worse therapy response and clinical course.

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Section: Discussionsupporting

confidence: 74%

Magnetic resonance imaging of temporomandibular joint with anterior disk dislocation without reposition - long-term results

et al. 2016

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“…Concerning the intensity of bruxism, 21 patients (67.74%) suffered from severe bruxism (BRUXi≥30), 9 patients (29.03%) moderate bruxism (20<BRUXi<30) and 1 patient (3.23%) mild bruxism (BRUXi<20). To quantify the intensity of bruxism, we used the BRUXi index of Orthlieb et al, which is a score obtained from elements collected during the interview (questionnaire) and clinical examination [24]. This method is used by some authors [29,30].…”

Section: Discussionmentioning

confidence: 99%

“…However, polysomnography remains the gold standard for the diagnosis of bruxism in the context of research projects [29,30], but it is not available to all researchers, and in dental practices, the most widely used method remains that based on clinical assessment. Orthlieb et al recommend combining assessment questionnaires with clinical examination for a more accurate diagnosis of bruxism [24]. Other very reliable means can also be used to quantify the intensity of bruxism namely electromyography (EMG) and polysomnography [29,30].…”

Section: Discussionmentioning

confidence: 99%

Sleep bruxism and perceived stress: assessment using salivary cortisol levels, a biomarker of stress

Lecor,

Dieng,

Soumboundou

et al. 2023

Ann Med Physiol.

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Sleep bruxism (SB) corresponds to physiologically based manducatory muscle reactions, with no identifiable neuropathic cause, in relation to anxiety disorders, respiratory disorders or behavioral "tocs". The aim of this study was to assess the relationship between SB and perceived stress by measuring salivary cortisol levels. The study included 61 consenting adult participants: 31 for the study group (bruxers) and 30 for the control group (no bruxers). The diagnosis of BS was made using a standard bruxism assessment questionnaire defined by the American Academy of Sleep Medicine (AASM). The preliminary diagnosis was confirmed by clinical assessment according to AASM criteria. The BRUXi index, a tool proposed by Orthlieb, was used to determine the intensity of bruxism. Perceived stress was measured using the Perceived Stress Scale questionnaire. Unstimulated whole saliva was collected and morning salivary cortisol levels were determined by ELISA. Non-parametric statistical methods were used to analyze the data. The bruxers (study group) had significantly high levels of mean salivary cortisol (12.3±4.2 ng/mL or 34.5±14.6 nmol/L) than the non-bruxers (control group) (5.3±1.2 ng/mL or 14.5±4.6 nmol/L) (p<0.001). The elevated salivary cortisol level was positively associated with perceived stress and SB (p<0.0001) in the study group. These results suggest that bruxing activity is associated with higher levels of perceived psychological stress and salivary cortisol. Despite the absence of polysomnographic recording for the diagnosis of SB, a positive correlation between SB and salivary cortisol levels was observed in bruxers.

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“…Bruxism, especially night bruxism, is a product of complex mechanisms and it is assumed that it will continue regardless of the use of the therapy 36 . In this study, we did not want to assume that therapy would reduce parafunctions in six months (the length of the trial) since a period of intense cognitive‐behavioural therapy is needed to overcome habits such as bruxism 37 . On the contrary, we assumed that the frequency and severity of parafunctions would affect the therapy's success.…”

Section: Discussionmentioning

confidence: 99%

Treatment responses in chronic temporomandibular patients depending on the treatment modalities and frequency of parafunctional behaviour

Gikić

Vrbanović

Zlendić

et al. 2021

J of Oral Rehabilitation

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Objectives: (i) To evaluate the effect of three different interventions on treatment outcomes and (ii) to determine how the frequency of oral parafunction influences the effectiveness of the different therapeutic modalities.Methods: Forty-five participants were randomly assigned into three treatment groups [physical therapy (PT), stabilisation splint (SS) and control therapy (CT)]. According to Oral Behavior Checklist score, participants were divided into "high-frequency parafunction" (HFP) and low-frequency parafunction" (LFP) group. Primary (spontaneous pain and characteristic pain intensity) and secondary outcomes (range of mouth opening, anxiety symptoms, quality of life, perceived stress and global functional limitation) were evaluated during six-month treatment period.Results: Participants in PT group showed a significant reduction in characteristic pain intensity (p = .047, η 2 = 0.243) when compared to SS and CT group, but significant improvement in spontaneous pain was found in all treatment groups. Patients treated with PT and SS exhibited significantly stronger improvement in pain-free mouth opening than patients in CT group (3rd month: p=.037, η2=0.258; 6th month: p = .005, η 2 = 0.383). Within-group analyses showed significant decrease of perceived stress, anxiety symptoms and global functional limitation only in PT group over a sixmonth treatment period. Participants with HFP presented significantly greater levels of anxiety (3rd month: p = .009, η 2 = 0.275; 6th month: p = .041, η 2 = 0.176) than participants with LFP. Within-group analyses, however, showed significant improvement of anxiety, but also the decrease of perceived stress and improvement of global limitation for the HFP group but not for the LFP group. Conclusion:Although no treatment can be marked as superior in terms of spontaneous pain relief, PT was more effective when observing relief of characteristic pain intensity. In HFP group the reduction of anxiety, stress and functional limitation was present regardless of the applied therapy. Trial registration: ClinicalTrials.gov NCT04694274. Registered on 01/04/2021.

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Propositions for a cognitive behavioral approach to bruxism management

Cited by 6 publications

References 28 publications

Magnetic resonance imaging of temporomandibular joint with anterior disk dislocation without reposition - long-term results

Magnetic resonance imaging of temporomandibular joint with anterior disk dislocation without reposition - long-term results

Sleep bruxism and perceived stress: assessment using salivary cortisol levels, a biomarker of stress

Treatment responses in chronic temporomandibular patients depending on the treatment modalities and frequency of parafunctional behaviour

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