Zeng Xiao, Wang Yong, Dong Qiang, Ma Min-Xian, Liu Qin, Tan Jian-Guo
Dept. of Prosthodontics and Implant, Stomatological Hospital of Guizhou Medical University, Guiyang 550002, China.
Dept. of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2020 Feb 1;38(1):54-58. doi: 10.7518/hxkq.2020.01.010.
To investigate the correlation between the clinical diagnostic criteria of sleep bruxism and the frequency of mandibular movements during sleep.
Video polysomnography was used to record 20 healthy adults with at least one of the following clinical symptoms and signs: 1) report of frequent tooth grinding; 2) tooth wear and dentin exposure with at least three occlusal surfaces; 3) masticatory muscle symptoms in the morning; 4) masseter muscle hypertrophy. The rhythmic masticatory muscle activity (RMMA) and isolated tonic activity were scored to compare the correlations with clinical symptoms and signs. Finally, the incidence of temporomandibular disorders (TMD) was investigated in patients with isolated tonic and RMMA subjects.
Among the 20 subjects, RMMA events were observed (5.8±3.1) times·h⁻¹ and isolated tonic episodes were observed (2.1±0.9) times·h⁻¹. The frequency of RMMA events was significantly greater in the patients with acoustic molars than in those without (P<0.05). Similarly, the frequency of RMMA events was significantly greater in the patients with tooth attrition than in those without (P<0.05). However, no difference was observed between the occurrence of RMMA and the symptoms of masticatory muscles or masseter hypertrophy in the morning. The incidence of TMD was significantly higher in the patients with RMMA than in the isolated tonic patients.
The clinical symptoms and signs often used to diagnose sleep bruxism are different clinical and physiological mandibular movements during sleep. RMMA during sleep can reflect the occurrence of tooth attrition and the high risk of TMD.
探讨磨牙症的临床诊断标准与睡眠期间下颌运动频率之间的相关性。
采用视频多导睡眠图记录20名健康成年人，这些成年人至少具有以下临床症状和体征之一：1）频繁磨牙的报告；2）至少三个咬合面出现牙齿磨损和牙本质暴露；3）早晨咀嚼肌症状；4）咬肌肥大。对节律性咀嚼肌活动（RMMA）和孤立性强直性活动进行评分，以比较其与临床症状和体征的相关性。最后，对孤立性强直性活动和RMMA受试者的颞下颌关节紊乱病（TMD）发病率进行调查。
20名受试者中，观察到RMMA事件为（5.8±3.1）次·小时⁻¹，孤立性强直性发作次数为（2.1±0.9）次·小时⁻¹。有磨牙声音的患者中RMMA事件的频率显著高于无磨牙声音的患者（P<0.05）。同样，有牙齿磨损的患者中RMMA事件的频率显著高于无牙齿磨损的患者（P<0.05）。然而，RMMA的发生与早晨咀嚼肌症状或咬肌肥大之间未观察到差异。RMMA患者的TMD发病率显著高于孤立性强直性活动患者。
常用于诊断磨牙症的临床症状和体征是睡眠期间不同的临床和生理性下颌运动。睡眠期间的RMMA可反映牙齿磨损的发生情况以及TMD的高风险。
