Grossi Márcio Lima, Castillo Lourenço Oliveira, Pattussi Marcos Pascoal, Pinto Georgia Meneghini, Filho Ruy Teichert
DDS, MS, PhD, Professor, Post-Graduate Program in Dentistry (Prosthodontics), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Professor, Porto Alegre, Brazil.
DDS, MS, PhD. Post-Graduate Program in Dentistry (Prosthodontics), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Professor, Porto Alegre, Brazil.
J Clin Exp Dent. 2024 Nov 1;16(11):e1354-e1360. doi: 10.4317/jced.61720. eCollection 2024 Nov.
Sleep bruxism is a major research area in dentistry today and needs valid clinical means of diagnosis against valid instrumental methods. Purpose: To assess the validity of the most commonly reported sleep bruxism (SB) signs and symptoms in the literature against a polysomnography (PSG) validated portable electromyographic (EMG) device (BiteStrip®).
Fifty young adults (40 women & 10 men, 18-30 years old) volunteered for the sequential and simultaneous administration of the SB signs and symptoms questionnaire versus the BiteStrip®. The SB signs and symptoms questionnaire was comprised of 19 items divided in 5 areas: a) Area 1: self-awareness of tooth grinding, clenching, and/or tooth sounds/noises, b) Area 2: headaches and/or facial pain, c) Area 3: muscle fatigue and/or hypertrophy, d) Area 4: clicking, crepitation and/or locking in the TMJ, and e) Area 5: tooth sensitivity, tooth wear/breaking, and/or cheek/tongue indentations. A cross-tabulation between the dichotomic test results (positive = 1, negative = 0) between the all five SB areas separately using quartiles (positive test result=75th percentile or higher, negative test result=50th percentile or lower) versus a positive test result of the BiteStrip® (score=1 or higher) was performed.
Area 1 presented the highest sensitivity for SB screening (80.0%), but with low specificity (51.4%), diagnosing most SB cases, but with a high number of false positives. All other four areas had low sensitivity (range=37.9% to 58.6%) and screening capacity and are only useful if Area 1 is positive.
Commonly reported SB signs and symptoms are not valid diagnostic measurements and can only be used as a screening method for either 'possible' or 'probable' SB diagnosis. Sleep bruxism, electromyography, validation study, polysomnographies.
睡眠磨牙症是当今牙科领域的一个主要研究方向，需要有效的临床诊断方法来与有效的仪器检测方法相抗衡。目的：根据经多导睡眠监测（PSG）验证的便携式肌电图（EMG）设备（BiteStrip®），评估文献中最常报道的睡眠磨牙症（SB）体征和症状的有效性。
五十名年轻成年人（40名女性和10名男性，年龄在18至30岁之间）自愿接受SB体征和症状问卷调查与BiteStrip®的顺序及同步检测。SB体征和症状问卷由19个项目组成，分为5个方面：a）方面1：对磨牙、紧咬牙和/或牙齿声音/噪音的自我感知；b）方面2：头痛和/或面部疼痛；c）方面3：肌肉疲劳和/或肥大；d）方面4：颞下颌关节弹响、摩擦音和/或绞锁；e）方面5：牙齿敏感、牙齿磨损/折断和/或脸颊/舌头压痕。使用四分位数（阳性检测结果=第75百分位数或更高，阴性检测结果=第50百分位数或更低）分别对所有五个SB方面的二分测试结果（阳性=1，阴性=0）与BiteStrip®的阳性检测结果（分数=1或更高）进行交叉制表。
方面1对SB筛查的敏感性最高（80.0%），但特异性较低（51.4%），能诊断出大多数SB病例，但假阳性数量较多。其他四个方面的敏感性较低（范围为37.9%至58.6%）且筛查能力有限，仅在方面1为阳性时才有用。
常见报道的SB体征和症状并非有效的诊断指标，仅可作为“可能”或“疑似”SB诊断的筛查方法。睡眠磨牙症、肌电图、验证研究、多导睡眠监测。
