Abstract
ObjectivesTo validate a new diagnostic method (DIABRUX) for quantifying sleep bruxism (SB) activity using the current gold standard, polysomnography (PSG), as a criterion in an adequate sample size investigation.Materials and methodsFor SB diagnosis, each participant received a two-night ambulatory PSG including audio–video recordings. The 0.5-mm-thick sheet is produced in a thermoforming process. After diagnosis via PSG, each subject wore the diagnostic sheet for five consecutive nights. The resulting total abrasion on the surface was automatically quantified in pixels by a software specially designed for this purpose.ResultsForty-five participants (10 SB and 35 non-SB subjects) were included. The difference of the mean pixel score between the SB (M = 1,306, SD = 913) and the non-SB group (M = 381, SD = 483; 3.4 times higher for SB) was statistically significant (p < 0.001). The receiver operator characteristic (ROC) analysis revealed a value of 507 pixels as the most appropriate cut-off criterion with a sensitivity of 1.0, a specificity to 0.8, and an area under the curve (AUC) of 0.88. The positive and negative predictive value accounted for 0.59 and 1.0.ConclusionsThe present data confirm that the new diagnostic method is valid and user-friendly that may be used for therapeutic evaluation, and for the acquisition of larger sample sizes within sophisticated study designs.Clinical relevanceThe verified properties of the new diagnostic method allow estimating SB activity before damages occur due to long-standing bruxism activity. Therefore, it might be utilized for preventive dentistry.Trial registration numberNC T03325920 (September 22, 2017).
Highlights
Sleep bruxism (SB) has been defined as a masticatory muscle activity during sleep which is characterized as rhythmic or non-rhythmic and is not a movement disorder or a sleep disorder in otherwise healthy individuals
It is sufficiently known that the PSG in combination with audio–video recordings is characterized by good to very good validity parameters and represents the gold standard for SB diagnosis [2, 3]
The present study revealed a good to very good agreement between the new diagnostic method for quantifying SB activity and an ambulatory PSG including audio–video recording in a likewise large sample
Summary
Sleep bruxism (SB) has been defined as a masticatory muscle activity during sleep which is characterized as rhythmic (phasic) or non-rhythmic (tonic) and is not a movement disorder or a sleep disorder in otherwise healthy individuals. For the diagnosis of SB, it has been suggested that “possible” SB should be based on a positive self-report, by means of questionnaires and/or the anamnestic part of a clinical examination. As discussed elsewhere, the PSG is concomitantly associated with disadvantages such as the technical complexity, time effort, and cost intensity. This limits its use for clinical practice or evaluation of larger sample sizes for scientific purposes, especially in sophisticated study designs with repeated measures [4,5,6,7,8]
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