Evaluation of various treatment modalities in sleep bruxism

Abstract

Statement of problem: Sleep bruxism (SB) is an oral condition that is associated with tooth wear, orofacial pain, and interference with sleep. The most recommended management technique is the use of an occlusal splint. Although the mandibular advancement device (MAD) has shown good results, few well-designed randomized controlled trials are available with which to compare these treatment options. Therefore, an evaluation of the effect of these 2 appliances on SB is needed.

Purpose: The purpose of this study was to evaluate the effect of a MAD and a maxillary occlusal splint (MOS) on the sleep quality and SB activity of participants with SB.

Material and methods: In this randomized controlled trial, 28 participants were randomly supplied with either a MAD or MOS. The sleep quality of the participants was evaluated with the Pittsburgh Sleep Quality Index (PSQI) and their SB activity with electromyographic activity of the masseter with polysomnography. These variables were measured at baseline, 1 month, and 3 months.

Results: Of 32 participants, 28 had data available for statistical analysis, as 4 participants did not return for follow-up examination. Both the MOS and MAD significantly reduced the PSQI and SB episodes and bursts in participants after 3 months (P<.05). The MAD provided greater reduction in SB episodes per hour after 3 months compared to the MOS. Participants supplied with a MAD reported more discomfort in their feedback form than participants using a MOS.

Conclusions: Both the MAD and MOS provided significantly improved sleep quality and a decrease in SB episodes at 3 months.