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Epidemiological and clinical research by a miniature bruxism detection device - Verify the prevalence, proportionate contribution for TMD and efficacy of oral appliance therapy -

通过微型磨牙症检测装置进行流行病学和临床研究 - 验证 TMD 的患病率、比例贡献以及口腔矫治器治疗的功效 -

基本信息

批准号：
16591949
负责人：
MINAKUCHI Hajime
金额：
$ 2.3万
依托单位：
OKAYAMA UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2004
资助国家：
日本
起止时间：
2004 至 2005
项目状态：
已结题

项目摘要

Objective : Sleep bruxism (SB) has been assessed by a self-estimated questionnaire and/or degree of tooth attrition. However these reliabilities were recognized insufficient to detect on-going SB events. One solution can be a miniature self-contained EMG detector-analyzer (BiteStrip○!R, S.L.P. Israel) that can be applied directly to the masseter muscle. Our previous study demonstrated this device has sufficient reliability to detect bruxism events with polysomnography as a golden standard (sensitivity : 0.92, specificity : 0.91); however, this device occasionally showed error message when applied in Asian subjects. This would be potentially due to skin resistance difference between Asian and Caucasians. In response, the version-up model has been developed recently to solve this problem. This study verified the improvement of this device. SB also has been hypothesized as a precipitating/perpetuating factor in TMD signs and symptoms. However, the direct relationship between the SB level … More and prevalence of the TMD signs and symptoms were still unclear, because of the difficulty in measuring the SB severity epidemiologically. Therefore, the aim of this study was to investigate the relationship in an adolescent population by using a miniature SB detection device (BiteStrip○!R, S.L.P. Israel).Methods : Six healthy volunteers (1 female and 5 males, mean age 24.5+/-0.55) who had been diagnosed as bruxisers by means of portable electromyography assessment and concomitant video recording and participated continuous 10-nights BiteStrip recordings. Each subject was applied both conventional and version-up BiteStrip on their bilateral buccal skin surface individually during continuous 5-nights. The incidence rates of error message were compared. The 1st degree students of a high school were exhaustively recruited, and 195 students (male/female : 86/109, mean age 15.4±0.5 yr) among them participated in this survey. They received clinical examination and were explained the usage of BiteStrip. Bruxism episodes were detected at their 30% MVC threshold, and total number of SB episodes was classified into 0-3 (<40, 41-74, 75-124 and ≦ 125, respectively). Relationship between their SB levels and presence/absence of the TMD signs and symptoms (clicking, limitation of mouth opening (LMO), headache, shoulder stiffness) were calculated, and odd-ratio and confidence interval (CI) were estimated by a simple regression analysis.Results : The incidence (rates) of error message in the conventional and version-up systems were 14/30 (46.7%) and 1/30 (3.3%) and the incidence in the version-up system was significantly lower than that in the conventional systems (p<0.01, Chi-square test). Of which 195 responders, 29 subjects didn't return BiteStrip and 40 BiteStrip showed error or no indication. Severe bruxier (≧score 3) had 3.58 times higher prevalence of TMJ clicking (95% CI : 1.21-10.39, P=0.02), whereas other signs and symptoms showed no significant relation.Conclusion : This modification made in the version-up BiteStrip was able to reduce the incidence of the error message in this system. The device appears to be clinically applicable even for Asian population. These results supported TMJ clicking can be associated with severe bruxism. However this study measured SB in one night, multiple SB recordings should be included in a further research. Less

目的：通过自我评估问卷和/或牙齿磨损程度来评估睡眠磨牙症（SB）。然而，这些可靠性被认为不足以检测正在进行的SB事件。一种解决方案可以是微型独立EMG检测分析仪（BiteStrip○！R，S. L. P.以色列），可以直接应用于咬肌。我们之前的研究表明，该设备具有足够的可靠性，可以检测磨牙症事件，并将多导睡眠图作为金标准（灵敏度：0.92，特异性：0.91）;然而，该设备在亚洲受试者中应用时偶尔会显示错误消息。这可能是由于亚洲人和高加索人之间的皮肤电阻差异。作为回应，最近开发了版本升级模型来解决这个问题。本研究验证了该装置的改进。SB也被假设为TMD体征和症状的促发/持续因素。然而，SB水平之间的直接关系 ...更多信息由于难以从流行病学上衡量SB的严重程度，TMD症状和体征的患病率仍不清楚。因此，本研究的目的是通过使用微型SB检测设备（BiteStrip○！方法：6名健康志愿者（1名女性和5名男性，平均年龄24.5+/-0.55），他们通过便携式肌电图评估和伴随的视频记录被诊断为磨牙症，并参与连续10晚的BiteStrip记录。每名受试者在连续5个晚上期间分别在其双侧颊部皮肤表面上应用常规和升级版BiteStrip。比较两组错误信息的发生率。本研究以某高中一年级学生为研究对象，共195名学生（男/女：86/109，平均年龄15.4±0.5岁）参加了本次调查。他们接受了临床检查，并被解释了BiteStrip的用法。磨牙症发作在其30%MVC阈值下检测，SB发作的总数被分类为0-3（分别为<40、41-74、75-124和> 125）。他们的SB水平与TMD体征和症状的存在/不存在之间的关系结果：（1）两组患者的临床症状（喀喇音、张口受限（LMO）、头痛、肩关节僵硬）差异均有统计学意义（P < 0. 05），并通过简单回归分析估计比值比和可信区间（CI）。传统系统和版本升级系统的错误信息发生率为14/30（46.7%）和1/30（3.3%），升级系统的发生率明显低于常规系统（P<0.01，卡方检验）。在195例应答者中，29例受试者未返回BiteStrip，40例BiteStrip显示错误或无指示。严重磨牙者（BVI评分3）的颞下颌关节咔嗒声发生率高3.58倍（95%CI：1.21-10.39，P=0.02），而其他体征和症状无显著相关性。该器械似乎在临床上适用于亚洲人群。这些结果支持颞下颌关节敲击声可能与严重磨牙症有关。然而，这项研究测量了一个晚上的SB，多个SB记录应包括在进一步的研究。少