Analysis of the Influence of a Mandibular Advancement Device on Sleep and Sleep Bruxism Scores by Means of the BiteStrip and the Sleep Assessment Questionnaire

作者：Saueressig Aline C; Mainieri Vivian C; Grossi Patricia K; Fagondes Simone C; Shinkai Rosemary S A; Lima Eduardo M; Teixeira Eduardo R; Grossi Marcio L^*

来源：International Journal of Prosthodontics, 2010, 23(3): 204-213.

Purpose: A before-and-after experimental clinical study was carried out with the objective of evaluating the effect of a mandibular advancement device (MAD; 75% advancement), made of a thermoplastic material, on sleep bruxism (SB) and sleep scores. Materials and Methods: After a habituation period of 1 week, SB scores were taken at baseline and after use of the MAD for 30 days. Scores were compared using the newly developed Bite Strip, which registers the number of contractions of the unilateral masseter muscle after a 5-hour period, giving a severity score from 0 to 3 after the registrations. To assess sleep, the Sleep Assessment Questionnaire (SAC), a screening tool with scores ranging from 0 to 68, was used before and after use of the MAD. Twenty-eight subjects (13 women, 15 men; mean age: 42.9 +/- 12.0 years) with a clinical history of SB and no spontaneous temporomandibular disorder (TMD) pain were selected. The clinical diagnosis of either moderate or severe SB was further confirmed through use of the Bite Strip (scores 2 or 3) at baseline. A 30-day follow-up period was used for evaluation. Both methods were validated against polysomnography. In addition, common signs and symptoms of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders were also evaluated before and after use to assess the side effects of the MAD. Results: There was a statistically significant improvement in both SB and sleep scores based on the Bite Strip and the SAC (Wilcoxon signed rank and Student paired t test, P < .05). In the signs and symptoms of TMD, there was a significant reduction in temporomandibular joint sounds as well as in masseter and temporalis tenderness to palpation. None of the SB subjects experienced any breakage of the MAD. Conclusion: The MAD had a positive effect on SB and sleep scores, measured by the BiteStrip and the SAC, respectively, and did not increase any traditional signs and symptoms of TMD in a 30-day evaluation period. Int J Prosthodont 2010;23:204-213.

• 出版日期2010-6