Frequency of awake bruxism behaviour in orthodontic patients: Randomised clinical trial: Awake bruxism behaviour in orthodontic patients

J Oral Rehabil. 2021 Apr;48(4):422-429. doi: 10.1111/joor.13130. Epub 2020 Dec 19.


Introduction: The influence of aligners on the activity of the masticatory muscles is still controversial, especially regarding the behaviour associated with awake bruxism (AB).

Objective: To compare the frequency of AB behaviours between patients treated with aligners and fixed appliances.

Methods: The sample comprised 38 Class I patients (mean age 22.08 years), divided by simple randomisation into two groups: OA group; orthodontic aligners (n 19) and FA group; fixed appliance (n 19). The frequency of AB was investigated by the ecological momentary assessment using an online device (mentimeter), during 7 following days at different timepoints, before and after appliance placement and in the 2nd, 3rd, 4th and 6th months of orthodontic treatment. These variables were also evaluated: level of anxiety by the State-Trait Anxiety Inventory, stress by the Perceived Stress Scale, catastrophising related to pain and degree of hypervigilance by the Pain Vigilance and Awareness Questionnaire, and the presence of facial pain evaluated by the DC/TMD.

Results: There was no difference between groups in the frequency of AB behaviours, with mean of 53.5% for group OA and 51.3% for FA. The most frequent behaviour was slightly touching the teeth, and in FA group, there was a significant reduction in this behaviour soon after appliance placement. The groups did not differ concerning the degree of anxiety, stress, catastrophising, hypervigilance and facial pain.

Conclusion: The orthodontic treatment performed with aligners or fixed appliances did not influence the frequency of AB during the 6 months of treatment. REGISTRY OF CLINICAL TRIALS: (REBEC): RBR-9zytwf.

Keywords: Aligners; Awake bruxism; Fixed appliance; Orthodontics.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anxiety
  • Bruxism* / therapy
  • Humans
  • Masticatory Muscles
  • Orthodontic Appliances, Fixed
  • Wakefulness
  • Young Adult