Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan.
Division of Temporomandibular Disorders and Orofacial Pain, Department of Special Needs Dentistry, School of Dentistry, Showa University, Tokyo, Japan.
J Oral Rehabil. 2021 Aug;48(8):901-908. doi: 10.1111/joor.13182. Epub 2021 May 25.
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.
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.
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.
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.
Contingent vibratory stimulus via an OA may be effective for the management of SB even after adaptation to OA.
应用特制口腔矫治器(OA)产生的随发振动反馈刺激已被证实可有效减少睡眠磨牙症(SB)。然而,OA 即时产生的抑制作用可能会影响这一发现。
本研究旨在探究 OA 适应期后,当 OA 的抑制作用减弱时,振动刺激对 SB 的影响。
本研究纳入 14 名“确诊”的 SB 患者。采用基于力的磨牙检测系统触发附着于 OA 的振动器。使用便携式多导睡眠图在家中记录睡眠时的咬肌肌电图活动。在使用无振动刺激的 OA 16 晚(适应期)后,每半小时施加间歇性振动刺激 4 晚(干预期)。将肌电活动超过最大随意收缩的 10%定义为磨牙事件。分别计算有和无刺激时每小时睡眠中磨牙事件的数量和总持续时间,并对 4 个干预夜晚进行平均。评估刺激对这两个变量的影响。
无刺激时的磨牙事件数量和总持续时间分别为 5.2 次/小时和 35.3 秒/小时。这些值在有振动刺激时显著降低至 3.9 次/小时和 15.1 秒/小时(p<.05)。
即使 OA 适应后,通过 OA 施加随发振动刺激也可能对 SB 的管理有效。