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Introduction Bruxism is a parafunction characterized by excessive chewing muscle activity involving grinding or clenching of the teeth. Bruxism has become a significant challenge in the field of pediatric dentistry. Aim of the study The aim of this comprehensive review is to provide an overview of bruxism in children, focusing on etiology, symptoms, diagnosis, and current treatment options. To draw attention to the prevalence of the disorder and to raise awareness of the importance of early recognition and intervention for bruxism in children. Materials and methods An analysis of scientific articles available in the PubMed and Google Scholar databases was conducted. Our research is supported by all relevant publications from recent years. The etiology, diagnosis, and treatment of bruxism in children were of particular interest in the study. This process involved the use of the following keywords: ‘bruxism’, ‘children’, ‘sleep bruxism’, ‘tooth wear’, ‘bruxism diagnosis’, ‘bruxism etiology’, ‘bruxism treatment’. Conclusions We evaluated 31 relevant publications. The results of the study indicate a variation in the prevalence of bruxism in children, oscillating between 13-49%. The etiology of this disorder is multidimensional and remains incompletely elucidated. The primary methods of diagnosing bruxism in younger patients include observation by parents or caregivers, a thorough health history and intraoral and extraoral dental examination. Physiotherapy and psychotherapy are recommended for the treatment of nocturnal bruxism in children. Prompt recognition of the disorder and implementation of appropriate therapy can help to halt the progression of motor dysfunction of the masticatory apparatus in children.

Abstract: The co-occurrence of bruxism, temporomandibular disorders (TMDs), and headache is common in patients. However, there is conflicting evidence regarding whether this association is simply a result of their high prevalence or whether there are indeed causal relationships. This review provides an overview of the current state of research while taking into account the controversies surrounding research methods, particularly in definitions and diagnostic standards. Bruxism-defined as repetitive jaw muscle activity during sleep or wakefulness-is not a painful disorder but may-particularly in co-occurrence with TMD-worsen pre-existing headache. It seems important to differentiate between sleep and awake bruxism because of different impact on pathophysiological processes in different primary headache disorders such as migraine and tension-type headache. Temporomandibular disorder is a heterogenous entity with both myofascial and arthrogenous types of pain in addition to nonpainful disorders. Research suggests a correlation between TMD pain and migraine, as well as between awake bruxism and tension-type headache. However, psychosocial factors may act as confounders in these relationships. Determining causality is challenging because of the limited number of experimental and clinical studies conducted on this topic. The main finding is an apparent lack of consensus on the definition and assessment criteria for bruxism. Treatment wise, it is important to differentiate all 3 conditions because treatment of one condition may have an effect on the other 2 without proving causality. For future research, it is crucial to establish greater consistency and applicability in diagnostic procedures and definitions. In addition, more experimental and clinical studies investigating the question of causality are needed., (Copyright © 2024 International Association for the Study of Pain.)

Bruxism is a centrally mediated neurological para-functional movement disorder encompassing clenching, and grinding of teeth, or thrusting and bracing of mandible, which may be performed without conscious awareness. Diagnosis of bruxism can be done with instrumental and non-instrumental tools. Non-instrumental tools include self-reporting, questionnaires, history, and clinical diagnostic criteria. Instrumental tools include the use of intra-oral bite appliances, electromyography, and polysomnography. Polysomnography is considered as the gold standard to diagnose bruxism requiring the presence of special equipment and / or access to a sleep laboratory. The purpose of this study was to evaluate the evidence available for the validity (ability to identify those who have the disease versus those who do not) of non-instrumental tools in the diagnosis of bruxism. The research question for this study was whether non-instrumental tools are sufficient for confirmatory diagnosis of bruxism. PICO was described as 'P'opulation = adults, 'I'ntervention = diagnostic tools, 'Comparison' = non-instrumental tools compared with instrumental tools, and 'O'utcome as results of the intervention. The study was conducted from May 2020 to November 2021. Out of 3,687 reviewed articles, eight articles were selected for final review and reviewed for quality appraisal. It was found that non-instrumental tools or questionnaires are not sufficient for confirmatory diagnosing of bruxism independently. Correlating instrumental recordings with non-instrumental tools such as clinical findings may be a good practice to diagnose bruxism definitely and precisely. Key Words: Diagnosis, Bruxism, History, Electromyography, Polysomnography.

Objectives: Bruxism is a parafunctional orofacial behavior. For diagnosis, wearable devices that use sounds as biomarkers can be applied to provide the necessary information. Human beings emit various verbal and nonverbal sounds, making it challenging to identify bruxism-induced sounds. We wanted to investigate whether the acoustic emissions of different oral behaviors have distinctive characteristics and if the placement of the transducer has an impact on recording the sound signals., Material and Methods: Sounds from five oral behaviors were investigated: jaw clenching, teeth grinding, reading, eating, and drinking. Eight transducers were used; six were attached to the temporal, frontal, and zygomatic bones with the aid of medical tape, and two were integrated into two commercial earphones. The data from 15 participants were analyzed using time-domain energy, spectral flux, and zero crossing rate (ZCR)., Results: In summary, all oral behaviors showed distinct characteristic features except jaw clenching, though there was a peak in the recording, possibly due to tooth tapping, before its expected onset. For teeth grinding, the transducer placement did not have a significant impact (p > 0.05) based on energy, spectral flux, and ZCR. For jaw clenching, the transducer placement had an impact with regard to spectral flux (p < 0.01). For reading and eating, the transducer placement had a significant impact with regard to energy (p < 0.05 for reading, p < 0.01 for eating), spectral flux (p < 0.001 for reading, p < 0.01 for eating), and ZCR (p < 0.001 for both reading and eating). For drinking, the transducer placement only had a significant impact with regard to ZCR (p < 0.01)., Conclusions: We were able to record the sounds of various oral behaviors from different locations on the head. However, the ears were an advantageous location to place the transducer, since they could compensate for various head movements and ear devices are socially tolerable., (© 2024 The Author(s). Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Background: The noteworthy correlation between bite force and masticatory performance emphasizes its significance as a meaningful and objective method for assessing oral function. Furthermore, in the study of bruxism, the measurement of intraoral bite force assumes critical importance. Given the importance of assessing occlusal forces and bite force, this systematic review aims to assess the efficacy of wireless sensors in measuring these forces., Methods: The search methodology employed in this systematic review adhered to the guidelines outlined by PRISMA. The strategy involved the exploration of various databases, including PubMed/MEDLINE, SCOPUS and SCIELO. An assessment tool was employed to evaluate the bias risk and study quality., Results: This systematic review encompassed six prospective clinical studies involving a total of 89 participants. Wireless sensors for measuring occlusal forces and bite forces were predominantly employed in healthy adults or individuals with bruxism, along with children undergoing orthodontic treatment. All wireless sensors employed in the studies underwent validation and reproducibility assessments, affirming their reliability. The findings indicated that all wireless sensors exhibited efficacy in detecting occlusal forces and bite forces., Conclusion: Wireless sensors offer real-time monitoring of occlusal and bite forces, aiding in understanding force distribution and identifying bruxism patterns. Despite limited studies on their application, these sensors contribute to evolving insights. Integration into clinical practice requires careful consideration of factors like calibration and patient compliance. Ongoing research is crucial to address limitations and enhance the efficacy of wireless sensors in measuring occlusal and bite forces and managing bruxism., (© 2024 John Wiley & Sons Ltd.)

Temporomandibular disorders (TMDs) and headache disorders are highly prevalent in the population. TMDs can present headache symptoms as a secondary headache and, in addition, be comorbid with primary headache disorders. This overlap has significant clinical implications for which it is essential for the physician to be aware, and they should screen for the potential presence of TMDs in a headache patient. Bruxism is a parafunctional behavior also prevalent in the population which has a role in TMDs and may influence headache symptomatology, but it is still necessary to clarify this relationship., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Bruxism is a spectrum of masticatory muscles activities. According to the recent evidence and international consensus, there is no indication to treat bruxism unless clinical consequences are present. The aim of the present study was to investigate the approach of Italian dentists to bruxism in their clinical practice., Methods: An anonymous online survey was developed, composed by 26 items grouped into five sections: (1) Characteristics of the respondent (Q1-Q6); (2) Bruxism frequencies (Q7-Q11); (3) Bruxism assessment (Q12-Q15); (4) Bruxism management (Q16-Q20); (5) Occlusal splints therapy (Q21-Q26)., Results: A total of 384 practitioners, including specialists and non-specialists, participated in this survey. The majority of the respondents reported that 1-3 out of ten patients presented with bruxism. The diagnosis is mainly performed with non-instrumental methods, and facial pain and dental wear are the major clinical consequence associated with bruxism. Almost the entire sample of respondents report to offer occlusal splints to bruxism patients, and 41% refer to perform occlusal adjustments. Almost half of the respondents have never proposed any form of cognitive-behavioural therapy., Conclusion: The results of the current survey highlighted several inconsistencies in Italian dentists' approaches to bruxism, suggesting the need for better education of practitioners and for the development of a standardized protocol to assess and manage bruxism in dental practices., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The recently proposed shortened screening tools for temporomandibular disorders (TMD) and bruxism should enable a better assessment of these conditions by the general dentist.

Objective: The present study aimed to investigate the association between self-reported awake/sleep bruxism, and orofacial pain with post-traumatic stress disorder (PTSD)., Methods: A case-control study with a convenience sample was designed. Participants were recruited from a university-based Trauma Ambulatory. The diagnosis of PTSD was established through a clinical interview and the Structured Clinical Interview (SCID-I/P). Thirty-eight PTSD patients and 38 controls completed the Research Diagnostic Criteria for Temporomandibular Disorders Axis-II to categorize awake/sleep bruxism and orofacial pain. Following this, we performed a short clinical examination of the temporomandibular joint and extraoral muscles., Results: Adjusted logistic regression analysis showed that awake bruxism was associated with PTSD (OR = 3.38, 95% CI = 1.01-11.27, p = 0.047). Sleep bruxism was not associated with any covariate included in the model. In a Poisson regression model, PTSD (IRR = 3.01, 95% CI = 1.38-6.55, p = 0.005) and the muscle pain/discomfort (IRR = 5.12, 95% CI = 2.80-9.36, p < 0.001) were significant predictors for current orofacial pain., Conclusions: PTSD was associated with self-reported awake bruxism and low-intensity orofacial pain. These conditions were frequent outcomes in patients previously exposed to traumatic events., Clinical Relevance: We suggest including a two-question screening for bruxism in psychiatry/psychology interviews to improve under-identification and to prevent harmful consequences at the orofacial level., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: No consensus exists regarding the examination methods and assessment criteria for awake bruxism (AB). In this study, masticatory muscle activity measured using electromyography (EMG) was recorded simultaneously with the ecological momentary assessment (EMA) of bruxism events. Data were collected to identify distinctive EMG parameters in AB., Methods: A total of 104 individuals were classified into the bruxism (BR) or control (CO) groups based on clinical findings. The participants recorded EMA on a tablet device under continuous EMG recording using a data log-type wireless EMG device. For EMA recording, a warning was randomly provided three times each hour for five hours. A receiver operating characteristic (ROC) curve was obtained based on EMA and EMG events. Maximum voluntary contraction (MVC) at the time of maximum bite force was set at 100%. The muscle activity was assessed as a relative value., Results: Based on discriminant analysis, analysis of participants who had four or more positive clenching EMA responses was appropriate. The assessed parameters for the EMG cutoff value determination procedure, which combined EMG and EMA, resulted in a cutoff value that enabled the distinction between the BR and CO groups. The area under the ROC curve was 0.77 and the cut-off value was 3.2 events/hour under the EMG of 20% MVC with a duration of ≥1 s., Conclusions: This is the first study to report a combined analysis of the EMA and EMG. These results suggest its effectiveness as a cutoff value for AB screening.

Background: Recently, the Standardized Tool for the Assessment of Bruxism (STAB) and the bruxism screener (BruxScreen) have been developed for use in research and clinical settings., Objective: As to ascertain high-quality use of both instruments worldwide, it was our aim to develop a guideline for the translation and cultural adaptation of the STAB and the BruxScreen., Methods and Results: This paper describes a 12-step guideline for the translation and cultural adaptation of the STAB and the BruxScreen. A format of a translation log is provided as well. Besides, a website has been created for the guidance of translation teams., Conclusion: Following the 12 steps, new language versions of the STAB and the BruxScreen will be ready for further testing (reliability, validity, responsiveness and interpretability) and, ultimately, application in research and clinics around the world., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Background: Bruxism is a masticatory muscle activity occurring during sleep or wakefulness, involving grinding and clenching of teeth and/or jaw bracing. As yet, the aetiology, epidemiology and consequences of awake bruxism (AB) are largely unknown., Objectives: The aims of the study were to AB behaviours using a novel bruxism screener (BruxScreen) questionnaire part and Ecological Momentary Assessment (EMA; BruxApp©) on AB behaviours, and to investigate AB's prevalence among masticatory muscle myalgia patients and non-patients., Methods: Altogether, 115 participants (masticatory myalgia patients referred to a specialist clinic (n = 67) and non-patients (n = 46)) filled in a bruxism screener questionnaire to report bruxism behaviours and jaw symptoms. A selection of both groups did a week-long EMA (patients n = 12, non-patients n = 11) to report AB behaviours. The chi-squared test was used to determine group differences in categorical variables. A logistic regression model was fitted to study the probability of AB., Results: According to BruxScreen, bruxism behaviours and jaw symptoms were more frequent in patients than in non-patients (p < .001). Based on EMA, 14.6% of the behaviour in patients was tooth clenching; for non-patients, this was 0.5% (p < .000). Relaxed muscles were reported by patients and non-patients at 20.6% and 56.4%, respectively (p < .021). Logistic regression, adjusted by age and sex, revealed that patients reported AB 5 times more often than non-patients (OR 4.8, 95% CI 2.1-11.2)., Conclusion: Awake bruxism behaviours are significantly more frequent in masticatory muscle myalgia patients than non-patients and associate with frequent bruxism-related symptoms. Self-reported teeth clenching seems to be the most significant sign of AB behaviour., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Background: With time, due to the poor knowledge on it epidemiology, the need to focus on awake bruxism as a complement of sleep studies emerged., Objective: In line with a similar recent proposal for sleep bruxism (SB), defining clinically oriented research routes to implement knowledge on awake bruxism (AB) metrics is important for an enhanced comprehension of the full bruxism spectrum, that is better assessment and more efficient management., Methods: We summarised current strategies for AB assessment and proposed a research route for improving its metrics., Results: Most of the literature focuses on bruxism in general or SB in particular, whilst knowledge on AB is generally fragmental. Assessment can be based on non-instrumental or instrumental approaches. The former include self-report (questionnaires, oral history) and clinical examination, whilst the latter include electromyography (EMG) of jaw muscles during wakefulness as well as the technology-enhanced ecological momentary assesment (EMA). Phenotyping of different AB activities should be the target of a research task force. In the absence of available data on the frequency and intensity of wake-time bruxism-type masticatory muscle activity, any speculation about the identification of thresholds and criteria to identify bruxers is premature. Research routes in the field must focus on the improvement of data reliability and validity., Conclusions: Probing deeper into the study of AB metrics is a fundamental step to assist clinicians in preventing and managing the putative consequences at the individual level. The present manuscript proposes some possible research routes to advance current knowledge. At different levels, instrumentally based and subject-based information must be gathered in a universally accepted standardised approach., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Background: To assess awake and sleep bruxism, the Standardised Tool for the Assessment of Bruxism (STAB) is currently being developed. The STAB will be a comprehensive tool for the detailed assessment of bruxism behaviour itself as well as of its possible consequences, causes, and comorbid conditions., Objective: Since the STAB cannot fully meet the 'A4 principle' for a bruxism assessment tool, i.e., being Accurate (reliable and valid), Applicable (feasible), Affordable (cost-effective), and Accessible (suitable for everyday clinical use), the Bruxism Screener (BruxScreen) has been developed to be used in large-scale epidemiological research projects and, especially, in general, dental practices., Methods: The BruxScreen consists of two parts: a questionnaire (BruxScreen-Q) to be completed by patients, and a clinical assessment form (BruxScreen-C) to be completed by dentists., Results: This paper describes the development of the BruxScreen and provides the outcomes of the pilot testing phase and the face validity assessment (i.e. that the first impressions of the tool indicate that it adequately reflects the construct to be measured)., Conclusion: The resulting BruxScreen is considered ready for more profound psychometric testing in the general dental setting., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Objective: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences., Methods: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications., Results: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration., Conclusions: The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Background: It is assumed that other factors than masticatory muscle activity awareness could drive the self-report of awake bruxism., Objectives: To investigate the extent to which the report of awake bruxism is associated with psychological distress, and with the belief that oral behaviours put a strain on the masticatory system among TMD-pain patients., Materials and Methods: The study sample consisted of 1830 adult patients with reported function-dependent TMD pain. Awake bruxism was assessed through six items of the Oral Behaviors Checklist. Psychological distress was assessed by means of somatic symptoms, depression and anxiety. Causal attribution belief was measured with the question 'Do you think these behaviours put a strain on your jaws, jaw muscles, and/or teeth?', Results: Mean age of all participants was 42.8 (±15.2) years, 78.2% being female. Controlled for sex, positive, yet weak, correlations were found between awake bruxism and somatic symptom severity (r s  = 0.258; p < .001), depression (r s  = 0.272; p < .001) and anxiety (r s  = 0.314; p < .001): patients with the highest scores reported approximately twice as much awake bruxism compared to those with minimal scores. Controlled for age and sex, a positive, moderate correlation was found between awake bruxism and causal attribution belief (r s  = 0.538; p < .001). Patients who believed that performing awake oral behaviours put 'very much' a strain on the masticatory system reported four times more awake bruxism than patients who did not believe that these behaviours are harmful., Conclusions: Based on the results and relevant scientific literature, the theoretical background mechanisms of our findings are discussed in four scenarios that are either in favour of the use of self-report of awake bruxism being a representation of masticatory muscle activity awareness, or against it., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Background: Bruxism is defined as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism can occur during sleep (sleep bruxism, SB) or during wakefulness (awake bruxism, AB). To date, the effect of AB on the purported negative consequences of bruxism has remained unclear., Objectives: The assessment of AB, its relation to temporomandibular disorders (TMD) treatment modalities, and their possible outcomes were investigated among TMD patients resistant to treatment in primary care and referred to a tertiary care clinic., Methods: The records of 115 patients were studied. Patients were referred to the Head and Neck Centre, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, for TMD treatment between 2017 and 2020. The data derived from the eligible patients' records included the following: background data (age and sex), referral data (reason and previous treatment), medical background (somatic and psychiatric), clinical and possible radiological diagnoses at a tertiary care clinic, treatment modalities for masticatory muscle myalgia, bruxism assessment, its possible treatment modalities and their outcomes, and overall management outcome. We analysed the outcomes of single treatment modalities and combined groups of modalities. For the demographic data, the Chi-squared test and Fischer's Exact test were used to determine the associations between the categorical variables. A Sankey-diagram was used to describe the flow of treatment., Results: Temporomandibular joint-pain-dysfunction syndrome (K07.60) was the most frequent single reason to refer a patient to tertiary care (17.4%). At referral, men had myalgia (M79.1) significantly more often (p = .034) than women. Similarly, men had depression (p = .002) more often and other psychiatric diagnoses (p = .034). At tertiary care, the presence of AB was assessed in 53.9%, and self-reported AB was recorded in 48.7%. In patients with possible AB, those who were prescribed neuropathic pain medication showed significantly less improvement in symptoms (p = .021) than those who underwent splint therapy (p = .009). Overall, half of the patients showed overall improvement in their TMD symptoms from the treatment combinations., Conclusion: Despite several treatment modalities, only half of the patients showed improvement in their symptoms in the present study. A standardised assessment method encompassing all factors contributing to bruxism behaviours and their consequences is suggested., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Objective: To investigate the association of the severity of temporomandibular disorders (TMD) pain and dysfunction with the frequency of self-reported awake bruxism (AB), sleep bruxism (SB), and stress in an adult TMD-patient population., Materials and Methods: This cross-sectional study included 237 TMD patients based on the Diagnostic Criteria for TMD. Age, sex, frequency of self-reported AB and SB, and stress were included as independent variables. TMD pain and TMD dysfunction were included as dependent variables in regression analyses. Univariate and multivariable linear regression analyses were used to predict TMD pain and TMD dysfunction in two separate models. Finally, network analysis was performed to investigate the associations between all variables., Results: In the univariate analyses, TMD pain was significantly associated with self-reported AB-frequent (unstandardized coefficient (B) = 3.196, 95%CI 1.198-5.195, p = 0.002). TMD dysfunction was significantly associated with AB-frequent (B = 2.208, 95%CI 0.177-4.238, p = 0.033) and SB-sometimes (B = 1.698, 95%CI 0.001-3.394, p = 0.050). In the multivariable analyses, TMD pain was significantly associated with TMD dysfunction (B = 0.370, p < 0.001), stress (B=0.102, p < 0.001). TMD dysfunction was significantly associated with TMD pain (B = 0.410, p < 0.001) only. Network analysis showed that TMD pain is a bridge factor between AB, stress, and TMD dysfunction., Conclusions: TMD pain is directly associated with AB, stress, and TMD dysfunction, while TMD dysfunction is only associated with TMD pain., Clinical Relevance: Reducing pain may improve pain-related dysfunction, and the management of AB and stress may improve TMD pain and dysfunction, and vice versa., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Bruxism is a repetitive masticatory muscles activity whose definition is being thoroughly reviewed in recent years. As in adults, two different forms of bruxism exist in children, namely awake and sleep bruxism. Scarcity of data, however,still persists about paediatric bruxism and no clear consensus has been developed. Therefore, the current review overviews the literature on bruxism in children tries to outline the state of art about this condition METHODS: Bruxism affects from 5% to 50% of the worldwide paediatric population. Sleep disturbances, parafunctional habits and psycho-social factors emerged to be the most likely associated factors with paediatric bruxism. Bruxism is characterised by several signs and symptoms variously combined, such as tooth wear and fractures, teeth impressions on soft tissues, temporomandibular disorders, headaches, behavioural and sleep disorders. About diagnosis, the most reliable tool in children remains the report of teeth grinding by parents or caregivers which must be accompanied by oral interview and accurate clinical examination. Electromyography and sleep polysomnography, albeit suitable in the diagnostic process, are not easy-to-use in children and are not strongly recommended. Currently, no evidence exists to support any kind of therapeutic options for bruxism in children. Management should be based on the identification of the underlying condition and conservative approaches are recommendable., Conclusion: Notwithstanding the high prevalence, several aspects need to be further assessed in paediatric bruxism. Parental reports are still the most suitable diagnostic tool and conservative approaches are recommended in the management. Bruxism should be considered through a biopsychosocial model, and sleep, personality traits, stress and headaches are the factors towards whom research questions must be addressed to improve diagnosis and management.

Background: Oral mucosa indentations can be signs of awake bruxism (AB) in adults, but this association has not yet been verified in adolescents., Objectives: To evaluate the frequency of AB in adolescents and determine whether there is an association between AB and oral mucosa indentation., Methods: This study enrolled 66 high school students, mean age of 16.9 (±0.54) years. Clinical inspection was performed to assess the presence or absence of tongue, cheek and lip mucosa indentation. AB was assessed by the Ecological Momentary Assessment method using the WhatsApp mobile app. Messages were sent 15 times a day, 7 days, between 8:00 AM and 7:00 PM at random times to choose one of the five oral behaviours: teeth contact, teeth clenching, teeth grinding, mandible bracing and relaxed jaw muscles. The non-parametric Mann-Whitney U-test for independent samples, Friedman test for paired samples, Friedman pairwise multiple comparisons non-parametric test, Pearson's chi-squared tests, and z-test of comparisons between two proportions were performed (p < .05)., Results: During the week the frequency of AB behaviours was 56.20%, teeth contact was the most frequent (37.68% ± 22.26%), significantly more frequent than other AB behaviours; there was a greater frequency of cheek indentation (27.27%) and no difference between genders in oral behaviours and indentations (p > .05). A higher frequency of AB behaviours was observed in individuals with a greater frequency of cheek indentation (p < .05)., Conclusions: Teeth contact and cheek indentation were the most frequent conditions among adolescents and AB behaviours are associated with this indentation., (© 2023 John Wiley & Sons Ltd.)

Background: Information on the prevalence of temporomandibular disorders (TMD) or possible/probable bruxism in seniors is heterogeneous and sparse., Objectives: To elucidate the prevalence of TMD and possible/probable bruxism in German adults aged 60 years and older., Methods: Participants of the Interdisciplinary Longitudinal Study of Adult Development and Aging (ILSE) born between 1950-1952 (C1) and 1930-1932 (C2) were examined in 2014-2016 (fourth wave). The participants were surveyed and clinically examined by one calibrated examiner. Two questions of the Patient Health Questionnaire (PHQ) were utilised to evaluate self-reported bruxism. The clinical examination included signs of probable bruxism and the RDC/TMD examination protocol., Results: Data from 191 participants were available. No RDC/TMD diagnosis was made in 83.2%. Of the participants, 15.2% received a single diagnosis and 1.6% multiple diagnoses that included disc displacements (9.4%) and degenerative joint diseases (8.9%). A total of 24.7% reported bruxism that included self-reported awake bruxism in 11.9% and sleep bruxism in 16.2%. Wear was clinically identified in 27.2% of the participants. No sex-related differences were observed. Significant differences were detected for probable bruxism between C1 (14.1%) and C2 (54.3%)., Conclusion: In the German population aged 60 years and older, the prevalence of TMD is 16.8%. TMD is characterised by temporomandibular joint disorders, including disc displacements and degenerative joint disorders. Bruxism was observed in a quarter of the old population., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

Objective: To investigate the prevalence of self-reported bruxism and its association with temporomandibular disorders (TMD). The hypothesis of the study was that self-reported bruxism is associated with TMD., Methods: The data were gathered from 1962 subjects who participated in a field study in 2012-2013, including a questionnaire concerning bruxism and TMD symptoms as well as clinical sub-diagnoses of TMD using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Statistical method was chi-square test. Bonferroni correction was made, and a p -value of <0.003 was considered as significant., Results: The prevalence of self-reported bruxism was 39.6%: 34.0% in men and 44.5% in women. Those who reported sleep bruxism (SB) or awake bruxism (AB) had significantly more pain-related TMD symptoms and signs compared to those not reporting bruxism., Conclusion: The prevalence of self-reported bruxism is high among middle-aged adults and is associated with TMD pain-related symptoms and signs, as well as TMD diagnoses.

The aims of this study were to perform an exploratory analysis of probable awake (AB) and sleep bruxism (SB) prevalence using of different diagnosis criteria based on the International Consensus; evaluate the associations between self-report and clinical signs/symptoms in adolescents. Participated in this cross-sectional study 403 adolescents aged 12- to 19-years-old enrolled in public and private schools from Belo Horizonte, Brazil. Parents/caregivers answered a questionnaire about sociodemographic status and adolescents' health status. Adolescents answered a questionnaire evaluating AB (e.g., grinding and clenching) and SB (e.g., grinding, bracing, and thrusting) activities and frequent headaches. A clinical examination was performed on adolescents to evaluate bruxism clinical signs/symptoms (pain upon palpation on masseter and temporal, linea alba, indentation on the tongue and attrition wear severity). Descriptive statistics and Pearson's Qui-square test were performed (P≤0.05). Adolescents mean age was 14.3±1.5 years, and 58.1% were female. Self-report of SB was identified in 31% of participants and self-report of AB in 51.6%. Almost all adolescents (99%) presented at least one tooth with attrition wear (98.5% on enamel and 0.5% on dentin), with a mean number of 12.4±5.7 teeth. Depending on the diagnosis criteria, the prevalence of probable SB and AB varied from 0- 99% and 0.2- 99%, respectively. A high inconsistency was found for the prevalence of probable AB and SB in adolescents, which were influenced by the different clinical sings/symptoms used as diagnosis criteria. Frequent headaches and pain upon palpation on masseter and temporal muscle were associated to self-report of AB and SB among adolescents.

This article will provide an overview of the diagnosis of common temporomandibular disorders (TMDs) and bruxism, along with their relevance in management of tooth wear. When assessing and managing a tooth wear case, the teeth should not be considered in isolation, but as part of the articulatory system, which has three inter-related elements: the teeth, the temporomandibular joints and the masticatory muscles. The presence/absence of bruxism and TMD are highly relevant, although there may not be a causal relationship between these. A consideration of TMD and bruxism, together with the potential impact these may have on the patient during and after any management of tooth wear, will form part of patient education and the informed consent process., (© 2023. The Author(s), under exclusive licence to the British Dental Association.)

Objective: The current state of portable/wearable electromyographic (EMG) devices for assessment of bruxism was reviewed., Methods: A search of full-text articles relevant to portable/wearable EMG devices capable of being used at home was performed. The data source used was MEDLINE via PubMed from January 1970 to July 2019., Results: There were nine kinds of wearable EMG devices capable of being used under unrestrained conditions. Ultra-miniaturized wearable EMG devices with a level of performance equivalent to that of conventional stationary EMG devices have been developed and are being used during sleep and in the daytime. The devices have a high level of diagnostic accuracy for sleep bruxism. A definite cut-off value for awake bruxism has not been established., Discussion: Assessment of sleep bruxism with a high level of accuracy can be performed using a portable/wearable EMG device. However, a definite cut-off value is required for assessment of awake bruxism.

Statement of Problem: The definition of bruxism has evolved, and the dental profession needs to align with the terminologies adopted in the current literature of sleep and orofacial pain medicine., Purpose: The purpose of this review was to discuss the recent evolution of bruxism concepts and the implications for changing the definition that is currently used by the prosthodontic community., Material and Methods: A historical perspective on the evolution of the definition of bruxism, as well as a systematic literature review on the validity of polysomnography (PSG)-based criteria for sleep bruxism diagnosis to detect the presence of clinical consequences, is presented. Selected articles were read in a structured Population, Intervention, Comparison, Outcome (PICO) format to answer the question "If a target population with conditions such as tooth wear, dental implant complications, and temporomandibular disorders (P) is diagnosed with sleep bruxism by means of PSG (I) and compared with a population of nonbruxers (C), is the occurrence of the condition under investigation (that is, the possible pathologic consequences of sleep bruxism) be different between the 2 groups (O)?", Results: Eight studies were eligible for the review, 6 of which assessed the relationship between PSG-diagnosed sleep bruxism and temporomandibular disorder pain, while the other 2 articles evaluated the predictive value of tooth wear for ongoing PSG-diagnosed sleep bruxism and the potential role of sleep bruxism in a population of patients with failed dental implants. Findings were contradictory and not supportive of a clear-cut relationship between sleep bruxism assessed based on available PSG criteria and any clinical consequence. The literature providing definitions of bruxism as a motor behavior and not pathology has been discussed., Conclusions: The bruxism construct has shifted from pathology to motor activity with possibly even physiological or protective relevance. An expert panel including professionals from different medical fields published 2 consecutive articles focusing on the definition of bruxism, as well as an overview article presenting the ongoing work to prepare a Standardized Tool for the Assessment of Bruxism (STAB) to reflect the current bruxism paradigm shift from pathology to behavior (that is, muscle activity). As such, dental practitioners working in the field of restorative dentistry and prosthodontics are encouraged to appraise this evolution., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: Bruxism is a repetitive masticatory muscle activity characterized by clenching or grinding of the teeth, or by bracing or thrusting of the mandible, or both., Objectives: To investigate whether bruxism in awake dogs could be associated with brain lesions., Animals: Four dogs with episodic bruxism in the awake state., Methods: Observational retrospective single-center case series. Inclusion criteria were dogs examined between 2010 and 2021 with episodic bruxism as a presenting complaint or observed during the examination or hospitalization, complete medical records and magnetic resonance imaging or computed tomography of the brain. Bruxism during epileptic seizures as oroalimentary automatism was an exclusion criterion., Results: Four dogs met the inclusion criteria. Two dogs had bruxism while awake as a presenting complaint, whereas in the remaining 2 it was a clinical finding. All dogs had neuroanatomical localization consistent with a forebrain lesion, with diencephalic involvement in 3/4. The diagnostic evaluation was consistent with neoplasia (n = 2) and meningoencephalitis of unknown origin (n = 2), in 1 case accompanied by corpus callosum abnormality affecting the forebrain, in 3 dogs advanced imaging findings were suggestive of increased intracranial pressure. All dogs were euthanized., Conclusions and Clinical Importance: Our results suggest that the presence of bruxism in the awake state associated with other neurological deficits might indicate a forebrain lesion., (© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Introduction: Bruxism is defined as a repetitive activity of masticatory muscles, characterized by the clenching or grinding of the teeth, which can occur during wakefulness (awake bruxism) or during sleep (sleep bruxism)., Objectives: The objectives of the present study were to determine the prevalence of awake bruxism and its associated factors., Methods: Sample was composed by 50 participants of both genders, aged between 18 and 60 years, submitted to a clinical examination - to observe the presence of tooth wear, marks on the mucosa, or masseter muscles hypertrophy - and self-applied questionnaires, which evaluated the presence of TMD signs and symptoms, oral behaviors, lifestyles, anxiety level and sleep quality., Results: The prevalence of awake bruxism was 48%. Its presence was statistically and significantly associated with the presence of signs and symptoms of TMD (p= 0.002), poor sleep quality (p = 0.032), buccal mucosa indentations (p < 0.001) and tongue (p = 0.011). Age, gender, social characteristics, habits (such as coffee ingestion, smoking, alcoholism and physical activity) and tooth wear were variables that had no significant association with awake bruxism., Conclusions: It was concluded that awake bruxism shows a high prevalence and a positive association with signs and symptoms of TMD and worst sleep quality. In addition, awake bruxism is more likely to occur in individuals who have buccal mucosa indentation and who present high rates of oral habits and oral behaviors.

Objective : Assessments of diurnal awake bruxism (d-AB) using masseteric electromyogram (EMG) during various lengths of measurement time within a day were examined as the first step of research to clarify the minimum measurement time required for assessment of d-AB by subject. Methods : Subjects were 33 outpatients. Assessment of d-AB by EMG during partial measurement time (PMT) with durations ranging from 30 minutes to 6 hours was compared with that during total measurement time (TMT) used as the reference standard. Results : No significant difference was found between TMT data and PMT data. There were significant correlations in all combinations between TMT data and PMT data. Accuracy was 0.909 or more for 2.5 hours or longer. Discussion : The results suggest that the tendency of daytime muscle activity in 1 day can be assessed even by using masseteric EMG data obtained during a relatively short measurement time.

(1) Background: Bruxism, a condition characterized by grinding and involuntary clenching of the teeth, is a risk factor for the development of masticatory dysfunction. It can occur together with sleep disturbances and may be associated with abnormal body movements, breathing difficulties, increased muscle activity, and heart rate disturbances. This disorder is becoming an important dental concern in children. (2) Methods: A literature review was carried out based on a search in PubMed and Google Scholar databases for articles on bruxism in children, published between 2014 and 2021. The etiology, diagnosis, and treatment of bruxism in children were of particular interest in the study. (3) Results: A total of 40 articles were included in the review. The analyzed studies indicated that the prevalence rates of bruxism in children vary widely from 13% to 49%. The etiology of bruxism is complex and incomprehensible, and the main diagnostic criteria for this condition in children are subjective observation, clinical history, and clinical examination. The recommended therapy for sleep bruxism in children is physiotherapy and psychotherapy. (4) Conclusions: Dentists and primary care physicians should correctly diagnose bruxism in children, educate parents, prevent potential consequences for oral health, and identify possible comorbidities. Appropriate clinical guidelines for the treatment and prophylaxis of bruxism in children should also be developed.

Objective : The Evaluation of Clinical Practice (ECP) conducted with a sample of French general dental practitioners aimed to measure the methods used to diagnose and manage bruxism. Methods : The ECP was performed using a declarative online questionnaire-based anonymous survey (SurveyMonkey) of 1388 practitioners. Twenty-two questions were grouped in 5 categories: (1) Sociodemographic characteristics (Q1-6); (2) Knowledge of the prevalence and definition of bruxism (Q7-9); (3) Diagnostic approach (Q10-11) and management (Q12-Q13); (4) The use of occlusal splints (Q14-21); (5) Oral rehabilitation (Q22). Results : The answers obtained (233; 16.8%) revealed a wide disparity and insufficient diagnosis (e.g. only 41% looked for sleep disorders, 22.3% for consumption of stimulants, 3% for upper airway obstruction) and management of bruxism (e.g. only 21.9% of participants proposed cognitive-behavioral therapy). Discussion : The discrepancies detected, such as the use of inappropriate splints (30 to 70%), emphasize the need for more prompt research-to-practice transfer of new knowledge.

Diurnal bruxism among individuals with intellectual disabilities is often measured on the basis of its auditory products, thereby precluding the contingent presentation of stimuli during silent bruxism events. Electromyography (EMG) offers a technological solution to the identification of all bruxism events. EMG has not been previously evaluated in nonvocal clients with intellectual disabilities in the context of functional analysis and treatment. In the current series of analyses, we suggest a set of methods to implement EMG technology with this population. In Analysis 1, we propose a strategy for systematically identifying bruxism events. In Analysis 2 we evaluate an EMG staff-training package with naïve interventionists without past experience with EMG technology. Finally, Analysis 3 presents a practical example of this method during the functional analysis and treatment of a client with frequent diurnal bruxism., (© 2021 The Authors. Journal of Applied Behavior Analysis published by Wiley Periodicals LLC on behalf of Society for the Experimental Analysis of Behavior (SEAB).)

Objectives: The aim of the study was to compare the prevalence of parafunctions and signs and symptoms of TMD in a population group of children with and without ADHD., Methods: The study included all 5th grade children of all public primary schools in Sopot (untreated, unguided children). The reporting rate was 91%. At the first stage of the psychological-psychiatric study both parents and children filled in the CBCLand YSR questionnaires. At the next stage, in the group of children selected during the screening, aqualified child psychiatrist conducted asemi-structured diagnostic interview K-SADS-PLand diagnosed ADHD. Parafunctions, signs and symptoms of TMD were assessed by conducting a direct interview with a child and a clinical examination by a dentist., Results: There were significant differences (p < 0.05) between children with ADHD and without ADHD associated with parafunctions such as chewing gum (76.47% vs. 46.07%), nail biting (70.59% vs. 40.45%) and bruxism (52.54% vs. 26.22%), the number of signs and symptoms of TMD (1 sign or symptom 0.0% vs. 32.21%; 4-7 signs or symptoms 17.65% vs. 3.75%)., Conclusions: In children with ADHD, symptoms of temporomandibular joint disorders and parafunctions were significantly more frequent. These studies suggest that children with ADHD constitute agroup of increased risk for TMD in the future. Interdisciplinary treatment of an ADHD patient by a psychiatrist and a dentist is necessary.

One of the common causes of ear pain (Otalgia) in children is the pain felt in the temporomandibular region due to bruxism, usually accompanied by stress and anxiety. The diagnosis and treatment of anxiety at an early age will affect the future lives of children. Our aim in the study was to investigate the presence and subtypes of anxiety in children with otalgia due to bruxism. In our study, 86 children aged between 6 and 16 years old who had ear pain and whose pain and tenderness were detected in the temporomandibular joint area and 40 healthy children were included as the control group. The children in both study groups were administered the Spence Children's Anxiety Scale (SCAS) test by the clinical psychologist. There was no statistical correlation between the children with bruxism and normal children (p > 0.05). While anxiety rate was 82% in children with bruxism, this rate was found to be 12.5% in normal children, this result was also statistically significant (p < 0.01). According to the SCAS test, when the subscales of anxiety detected in children with bruxism were evaluated, According to the SCAS test, when the subscales of anxiety detected in children with bruxism were evaluated, it was observed that the performance anxiety was high in the 6-12 and 12-16 age group. However, obsessive symptoms were mostly observed in the 12-16 age group while separation anxiety was detected in children in the 6-12 age group., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: The relationship of bidirectional comorbidity between chronic migraine and pain in the cephalic segment led us to evaluate the improvement in reducing the pain in patients diagnosed with chronic migraine headache and awake bruxism, when undergoing treatment with a partial posterior interocclusal device designed for the management and control of awake bruxism through biofeedback., Methods: Seventy-four patients were evaluated during the following periods: pretreatment, seven, thirty, ninety, one hundred and eighty days, and one year. The evaluation was carried out by measuring the pain in the pretreatment period and pain reduction after awake bruxism treatment, using clinical evaluation and numerical scales for pain., Results: Most of the patients who complained of headache migraine pain, masticatory myofascial pain, temporomandibular joint and neck pain experienced a significant reduction in overall pain, including headaches, between t0 and t30 (p<0.0001). After 30 days of using the device, it was observed that the improvement remained at the same level without any recurrence of pain up to t90. At t180 and t360, it was observed that even with the device withdrawal (at t90) the improvement remained at the same level., Conclusion: The utilization of a posterior interocclusal device designed for the management and control of awake bruxism through biofeedback seems to contribute to the reduction of pain (including migraine headache) in the majority of patients, and, even with the device withdrawal (at t90), the improvement remained at the same level, suggesting the patients succeeded in controlling their awake bruxism and consequently the pains.

Objective: A smartphone-based ecological momentary assessment (EMA) strategy to collect real time data on awake bruxism (AB) has been recently introduced. The aim of this study was to assess the compliance with its use over 1 week in a sample of healthy young adults., Method: Sixty (N = 60) healthy young adults (mean age 24.2 ± 4.1 years) used a dedicated smartphone application that sent 20 alerts at random times throughout the day. Upon alert receipt, the subjects had to report in real time their condition among five possible options: relaxed jaw muscles, teeth contact, teeth clenching, teeth grinding, and mandible bracing. Compliance rate with the app was assessed at the individual and group level in terms of percentage of answered alerts as well as number of days that were needed to reach the targeted observation period of 7 days with a compliance of at least 60%., Results: The mean compliance recorded with the smartphone application was 67.8% of the total alerts. On average, 9.8 ± 3.2 days (range 7-19) have been necessary to achieve the targeted goal of 7 days with a minimum of 60% alerts/day. No gender differences were detected in any compliance data. Response rate was not different during weekdays or weekends., Conclusions: This investigation is the first attempt to assess individual compliance with EMA for reporting awake bruxism. Results suggest that a smartphone-based strategy can have interesting potential. The compliance rate reported in this study will serve as a comparison standpoint for future investigations., Clinical Significance: Based on the recent multidisciplinary focus on the study of awake bruxism, EMA has emerged as a potential approach for use in the clinical and research settings. This investigation suggests that compliance with such strategy is good, thus making it worthy of adoption for the assessment of AB and its clinical implications.

Aims : Systemic Lupus Erythematosus (SLE) is a connective tissue disease characterized by a wide range of pleomorphic pictures, including mucocutaneous, renal, musculoskeletal and neurological symptoms. It involves oral tissues, with hyposalivation, tooth decay, gingivitis, angular cheilitis, ulcers and glossitis. Temporomandibular disorders represent a heterogeneous group of inflammatory or degenerative diseases of the stomatognatic system, with algic and/or dysfunctional clinical features involving temporomandibular joint (TMJ) and related masticatory muscles. The aim of this study was to investigate the prevalence of oral manifestations and temporomandibular disorders (TMD) in SLE patients (Lp) compared with a control group. Methods : Fifty-five patients (9 men and 46 women) with diagnosed Lupus were recruited in the study group. A randomly selected group of 55 patients, matched by sex and age, served as control group. The examination for TMD symptoms and signs was based on the standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a questionnaire and clinical examination. Results : Lupus patients complained more frequently (95.8%) of oral and TMJ symptoms (dysgeusia, stomatodynia, masticatory muscle pain during function, neck and shoulder muscles pain and presence of tinnitus) but only xerostomia (χ 2 =4,1548 p =0,0415), temple headache (χ 2 =4,4542 p =0,035) and the sensation of a stuck jaw (Mid-p-test p =0,043) were significant. About signs, cheilitis ( p =0,0284) oral ulcers (χ 2 =4,0104 p =0,045) and fissured tongue are significantly more frequent in study group. The salivary flow was significantly decreased in the study group respect to the control one (p<0.0001). As regard to the oral kinematics, restricted movements (RM) in protrusion and left lateral movement were significantly different between study group and controls. In particular, 85,2% of Lp showed limited protrusion versus 56,4% of controls (χ 2 = 10,91 p <0,001); 59,3% of Lp had also a limitation during left lateral movement versus 47,3% of controls (T=2,225 p =0,0282). About bruxism, only the indentations on the lateral edges of the tongue were found in Lp group (72,7%), with a significant difference respect to controls (χ 2 =7,37 p =0,007). Conclusions: While masticatory muscles have an overlapping behavior in both groups, the findings collected show a more severe TMJ kinematic impairment in Lp than in controls, with protrusion and left lateral movements significantly different. In addition, a remarkable reduction of salivary flow has been detected in Lp compared to controls. In conclusion, this autoimmune disease seems to play a role in oral manifestations and TMJ disorders, causing an increase in orofacial pain and an altered chewing function., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Bruxism is a masticatory muscle activity characterized by high prevalence, widespread complications, and serious consequences but without specific guidelines for its diagnosis and treatment. Although occlusal force-based biofeedback therapy is proven to be safe, effective, and with few side effects in improving bruxism, its mechanism and key technologies remain unclear. The purpose of this study was to research a real-time, quantitative, intelligent, and precise force-based biofeedback detection device based on artificial intelligence (AI) algorithms for the diagnosis and treatment of bruxism. Stress sensors were integrated and embedded into a resin-based occlusion stabilization splint by using a layering technique (sandwich method). The sensor system mainly consisted of a pressure signal acquisition module, a main control module, and a server terminal. A machine learning algorithm was leveraged for occlusal force data processing and parameter configuration. This study implemented a sensor prototype system from scratch to fully evaluate each component of the intelligent splint. Experiment results showed reasonable parameter metrics for the sensors system and demonstrated the feasibility of the proposed scheme for bruxism treatment. The intelligent occlusion stabilization splint with a stress sensor system is a promising approach to bruxism diagnosis and treatment.

Background: Bruxism is among the habits considered generally as contributory factors for temporomandibular joint (TMJ) disorders and its etiology is still controversial., Methods: Three-dimensional models of maxilla and mandible and teeth of 37 patients and 36 control subjects were created using in-vivo image data. The maximum values of stress and deformation were calculated in 21 patients six months after using a splint and compared with those in the initial conditions., Results: The maximum stresses in the jaw bone and head of mandible were respectively 4.4 and 4.1 times higher in patients than in control subjects. Similar values for deformation were 5.8 and 4.9, respectively. The maximum stress in the jaw bone and head of mandible decreased six months after splint application by up to 71.0 and 72.8%, respectively. Similar values for the maximum deformation were 80.7 and 78.7%, respectively. Following the occlusal splint therapy, the approximation of maximum deformation to the relevant values in control subjects was about 2.6 times the approximation of maximum stress to the relevant values in control subjects. The maximum stress and maximum deformation occurred in all cases in the head of the mandible and the splint had the highest effectiveness in jaw bone adjacent to the molar teeth., Conclusions: Splint acts as a stress relaxer and dissipates the extra stresses generated as well as the TMJ deformation and deviations due to bruxism. The splint also makes the bilateral and simultaneous loading possible and helps with the treatment of this disorder through regulation of bruxism by creating a biomechanical equilibrium between the physiological loading and the generated stress.

Objective: To assess the presence of bruxism and anxiety among military firefighters with frequent episodic tension-type headache and painful temporomandibular disorders (TMDs)., Methods: The sample consisted of 162 individuals aged 18 to 55 years divided into four groups. Headache was diagnosed in accordance with the International Classification of Headache Disorders-III. The Research Diagnostic Criteria for Temporomandibular Disorders questionnaire was used to classify TMDs and awake bruxism; sleep bruxism was diagnosed in accordance with the International Classification of Sleep Disorders-3; and anxiety was classified using the Beck Anxiety Inventory. In statistical models, a significance level of 95% was used. The chi-square test was used to assess anxiety., Results: Associations were found among frequent episodic tension-type headache, painful TMDs, awake bruxism and anxiety (p < 0.0005). Sleep bruxism was not a risk factor (p = 0.119) except when associated with awake bruxism (p = 0.011)., Conclusion: Anxiety and awake bruxism were independent risk factors for developing frequent episodic tension-type headache associated with painful TMDs; only awake bruxism was a risk factor for frequent episodic tension-type headache with non-painful TMDs.

The electronic advances of the last hundred years have made enormous contributions to medical research and the development of new therapeutic methods. In recent years in particular, it has been demonstrated that intelligent sensors, with appropriate radio interfaces, will soon allow diagnostic and therapeutic processes in medicine to be linked to one another - this will enable the development of completely new forms of therapy [1]. This new "Medicine 4.0" was the subject of a first article in the series, which presented the progress achieved through the merging of microsensor technology, microelectronics, information and communication technologies, with a particular focus on the case of personalized chemotherapy. The purpose of this new article is to present more practical applications of these new therapeutic methods., (© 2018 médecine/sciences – Inserm.)

In 2013, consensus was obtained on a definition of bruxism as repetitive masticatory muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible and specified as either sleep bruxism or awake bruxism. In addition, a grading system was proposed to determine the likelihood that a certain assessment of bruxism actually yields a valid outcome. This study discusses the need for an updated consensus and has the following aims: (i) to further clarify the 2013 definition and to develop separate definitions for sleep and awake bruxism; (ii) to determine whether bruxism is a disorder rather than a behaviour that can be a risk factor for certain clinical conditions; (iii) to re-examine the 2013 grading system; and (iv) to develop a research agenda. It was concluded that: (i) sleep and awake bruxism are masticatory muscle activities that occur during sleep (characterised as rhythmic or non-rhythmic) and wakefulness (characterised by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible), respectively; (ii) in otherwise healthy individuals, bruxism should not be considered as a disorder, but rather as a behaviour that can be a risk (and/or protective) factor for certain clinical consequences; (iii) both non-instrumental approaches (notably self-report) and instrumental approaches (notably electromyography) can be employed to assess bruxism; and (iv) standard cut-off points for establishing the presence or absence of bruxism should not be used in otherwise healthy individuals; rather, bruxism-related masticatory muscle activities should be assessed in the behaviour's continuum., (© 2018 The Authors. Journal of Oral Rehabilitation Published by John Wiley & Sons Ltd.)