Vivian Chiada Mainieri

Validation of the Bitestrip versus polysomnography in the diagnosis of patients with a clinical history of sleep bruxism

OBJECTIVE This validation study compared an electromyography (EMG) device, Bitestrip, versus polysomnography in the diagnosis of sleep bruxism (SB). STUDY DESIGN Forty-nine consecutive patients (32 women and 17 men, 41.2 ± 12.9 years old) with a clinical history of SB were included in the study from the Orofacial Pain Clinic, Faculty of Dentistry, Pontifical Catholic University of Rio Grande do Sul in Brazil. RESULTS Initially, we compared an SB positive/negative test result for both systems (agreement 87.8%, sensitivity 84.2%, positive predictive value 100%, and crude kappa 0.71). We then compared a 4-scale test (no, light, moderate, or severe bruxism) between the 2 methods (agreement 80.27%, weighted kappa 0.51, and Kendall W coefficient 0.575). CONCLUSIONS The Bitestrip can be considered as a moderate screening method for the diagnosis of SB, because it is more precise in detecting the presence or absence of SB but less precise in detecting its intensity.

Analysis of the effects of a mandibular advancement device on sleep bruxism using polysomnography, the BiteStrip, the sleep assessment questionnaire, and occlusal force.

PURPOSE This before and after study evaluated the effects of a mandibular advancement device (MAD) on sleep bruxism (SB) activity and its associated signs and symptoms. MATERIALS AND METHODS Nineteen young adults (39.9 ± 12.9 years, 58% women) with a clinical history of SB without sleep or neurologic disorders and no spontaneous temporomandibular disorder pain were selected. SB activity was assessed after a habituation period of 2 weeks. The results of a 3-month treatment with a thermoplastic monoblock MAD were compared to baseline using electromyogram polysomnography and the BiteStrip, a portable EMG device. Sleep disorders were assessed and validated against the polysomnography sleep assessment questionnaire (SAQ). Additionally, common signs and symptoms of SB were evaluated with the research diagnostic criteria for temporomandibular disorders. Occlusal force was compared to baseline using a cross-arch force transducer. RESULTS There was a significant improvement in both SB activity and sleep scores (including SB episodes per hour) according to the BiteStrip and the SAQ, respectively. There was also a significant reduction in the signs and symptoms of SB, including grinding and/or clenching, temporomandibular joint (TMJ) sounds, muscle pain, and occlusal force. None of the SB subjects experienced MAD breakage, but in 24% of patients, the MAD treatment had to be interrupted due to TMJ/muscle pain and/or discomfort. CONCLUSION The MAD treatment resulted in the reduction of SB activity, SB signs and symptoms, sleep disorders, and occlusal force.

Surface changes in denture soft liners with and without sealer coating following abrasion with mechanical brushing.

AIM To evaluate the surface alterations of soft liners with or without sealer coating following abrasion with mechanical brushing. METHODS Thirty specimens were made of a methacrylate- (Coe-Soft) and a siloxane-based material (Ufi-Gel SC), and 15 received two coatings of surface sealer. The specimens were submitted to a mechanical brushing-dentifrice assay under 200g of force at 250 cycles/min. Mechanical brushing was simulated for a period of 1 (1250 cycles) and 6 months (5000 cycles). Surface roughness (Ra parameter) was measured, and scanning electron microscopy (SEM) images were obtained. Ra data were analysed by anova for repeated measures and Bonferronis test (alpha=0.05). RESULTS Ra increased from baseline to 6 months regardless of sealer coating. At baseline, only Coe-Soft without sealer had a higher Ra than the other groups. After 1 month, the Ra of Coe-Soft with sealer was three-fold higher than the Ra at baseline; the other groups showed no significant increase of Ra. SEM images showed degradation of the soft liners over time, except for the Ufi-Gel SC with sealer, which displayed minimum alteration of surface texture. CONCLUSION Sealer coating reduced the surface degradation of the tested soft liners, but the protective effect was more pronounced for the siloxane-based material.

Surface changes in denture soft liners with and without sealer coating after mechanical brushing abrasion

AIM To evaluate the surface alterations of soft liners with or without sealer coating following abrasion with mechanical brushing. METHODS Thirty specimens were made of a methacrylate- (Coe-Soft) and a siloxane-based material (Ufi-Gel SC), and 15 received two coatings of surface sealer. The specimens were submitted to a mechanical brushing-dentifrice assay under 200g of force at 250 cycles/min. Mechanical brushing was simulated for a period of 1 (1250 cycles) and 6 months (5000 cycles). Surface roughness (Ra parameter) was measured, and scanning electron microscopy (SEM) images were obtained. Ra data were analysed by anova for repeated measures and Bonferronis test (alpha=0.05). RESULTS Ra increased from baseline to 6 months regardless of sealer coating. At baseline, only Coe-Soft without sealer had a higher Ra than the other groups. After 1 month, the Ra of Coe-Soft with sealer was three-fold higher than the Ra at baseline; the other groups showed no significant increase of Ra. SEM images showed degradation of the soft liners over time, except for the Ufi-Gel SC with sealer, which displayed minimum alteration of surface texture. CONCLUSION Sealer coating reduced the surface degradation of the tested soft liners, but the protective effect was more pronounced for the siloxane-based material.

Effects of the bite splint 15-day treatment termination in patients with temporomandibular disorder with a clinical history of sleep bruxism: a longitudinal single-cohort study

OBJECTIVE The aim of this study was to assess the effects of bite splint (BS) treatment termination in patients treated for temporomandibular disorder (TMD) and sleep bruxism (SB). STUDY DESIGN This longitudinal single-cohort study assessed 30 patients (29.5 ± 7.8 years old, 86.7% women) who were successfully treated with BS for SB and TMD for 30 days to 6 months prior to termination of the use of BS. The Research Diagnostic Criteria for TMD Axes I and II, Sleep Assessment Questionnaire, Beck Depression Inventory, and BiteStrip were used to assess TMD signs and symptoms, sleep disorders, depression, and SB at baseline and after 15 days of BS disuse. RESULTS TMD symptoms, including the disability points, characteristic pain intensity, and present pain at rest, increased significantly (P < 0.05). After 15 days of BS termination, there were no significant differences in SB and depression levels, sleep quality, and TMD signs. CONCLUSIONS In patients with TMD and SB, BS treatment cessation is not recommended.

Influence of ultrasound and diamond burs treatments on microtensile bond strength

OBJECTIVE To compare surface treatments with CVDentUS ultrasound tips (UT) and KGSorensen diamond burs (DB) on etched (e) and non-etched (n/e) dentin. The microtensile bond strength (μTBS) was measured and fractography was assessed by scanning electron microscope (SEM). MATERIALS AND METHODS Sixteen molars were divided into four groups of four teeth each according to treatment (DB-n/e; DB-e; UT-n/e; UT-e). The teeth were restored, sectioned into samples for μTBS (n=40) and tested on a EMIC DL-2000 universal machine (0.5 mm/min) and analyzed by SEM for fracture classification. STATISTICAL ANALYSIS For analysis of the data on μTBS, the two-way ANOVA, using treatment and acid etching as fixed factor, and the Tukey test were used (α=0.05). To failures classification in cohesive in dentin (CD); cohesive in composite resin (CC); cohesive interfacial on base or top of hybrid layer (CBT); cohesive in adhesive (CA); mixed (M); interfacial on smear layer (S) the Fishers exact test (α=0.05) was performed. RESULTS The mean values of μTBS (in MPa) in the different groups were as follows: UT-e: 45.31 ± 8.16; DB-e: 34.04 ± 9.29; UT-n/e: 15.17 ± 3.71; and DB-n/e: 9.86 ± 3.80. On analysis of the SEM micrographs, the DB-n/e group showed total obstruction of dentinal tubules; the UT-n/e group showed partial desobstruction of dentinal tubules and irregular surface; the DB-e group showed complete desobstruction of dentinal tubules; and the UT-e group showed complete desobstruction of dentinal tubules and irregular surface. CONCLUSION The combination of ultrasound treatment and acid etching provides high values of μTBS. An association exists between CA/CC failures and the UT method, CBT failure and the DB method, CBT/CC failures and etching, S failure and non-etching.