Reduction of sleep bruxism using a mandibular advancement device: an experimental controlled study.
Reduction of sleep bruxism using a mandibular advancement device: an experimental controlled study.
复制标题
使用下颌前移装置减少睡眠磨牙症：一项实验对照研究。
DOI：
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发表时间：
2006
影响因子：
2.3
通讯作者：
G. Lavigne
中科院分区：
文献类型：
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作者：
M. Landry;P. Rompré;C. Manzini;F. Guitard;P. de Grandmont;G. Lavigne
目的
本实验研究的目的是比较双弓临时定制适合下颌前移装置（MAD）和单一的上颌牙合垫（MOS）对睡眠磨牙症和磨牙活动的影响。
材料和方法
13名剧烈和频繁的磨牙者参加了这项短期随机交叉对照研究。所有的多导记录和分析都在睡眠实验室进行。以MOS为主动控制条件，以MAD为实验处理条件。MAD旨在暂时管理打鼾和睡眠呼吸暂停，有3种不同的配置：（1）在拱之间没有保持销（完全运动自由度），（2）保持销处于下牙弓的略微前移位置（<40%），和（3）保持销处于下牙弓的更前移位置（> 75%）。主观报告（疼痛、舒适度、口腔流涎和睡眠质量）采用方差分析和Friedman检验进行分析。
结果
使用MOS观察到每小时睡眠磨牙症发作次数显著减少（减少42%，P <0.001）。与MOS相比，主动MAD（有进展）也显示睡眠磨牙症运动活动显着减少。然而，13例患者中有8例报告疼痛（位于下颌牙龈和/或前牙）伴活动性MAD。
结论
短期使用临时定制的MAD与睡眠磨牙症运动活动的显着减少有关。在较小程度上，MOS也减少了睡眠磨牙症。然而，支持这种减少的确切机制仍有待解释。假设针对以下方面：器械的尺寸和配置、疼痛的存在、运动自由度降低或上气道通畅性改变。
PURPOSE
The objective of this experimental study was to compare the effect on sleep bruxism and tooth-grinding activity of a double-arch temporary custom-fit mandibular advancement device (MAD) and a single maxillary occlusal splint (MOS).
MATERIALS AND METHODS
Thirteen intense and frequent bruxors participated in this short-term randomized crossover controlled study. All polygraphic recordings and analyses were made in a sleep laboratory. The MOS was used as the active control condition and the MAD was used as the experimental treatment condition. Designed to temporarily manage snoring and sleep apnea, the MAD was used in 3 different configurations: (1) without the retention pin between the arches (full freedom of movement), (2) with the retention pin in a slightly advanced position (< 40%), and (3) with the retention pin in a more advanced position (> 75%) of the lower arch. Sleep variables, bruxism-related motor activity, and subjective reports (pain, comfort, oral salivation, and quality of sleep) were analyzed with analysis of variance and the Friedman test.
RESULTS
A significant reduction in the number of sleep bruxism episodes per hour (decrease of 42%, P < .001) was observed with the MOS. Compared to the MOS, active MADs (with advancement) also revealed a significant reduction in sleep bruxism motor activity. However, 8 of 13 patients reported pain (localized on mandibular gums and/or anterior teeth) with active MADs.
CONCLUSIONS
Short-term use of a temporary custom-fit MAD is associated with a remarkable reduction in sleep bruxism motor activity. To a smaller extent, the MOS also reduces sleep bruxism. However, the exact mechanism supporting this reduction remains to be explained. Hypotheses are oriented toward the following: dimension and configuration of the appliance, presence of pain, reduced freedom of movement, or change in the upper airway patency.