Oral Parafunctions Research Articles

Research progress and clinical application of veneer materials for implant-fixed restoration in edentulous jaws

Commonly used materials for fixed restorations in edentulous jaws include acrylic resins, polymerized ceramics, ceramics and zirconia, which have distinct physicochemical properties and clinical application features. The selection of these materials in clinical practice is related to the prosthodontic space, oral soft and hard tissue conditions, occlusal force, lifestyle habits, oral parafunctions, opposing dentition materials, and expectations of patients. Common mechanical complications associated with fixed restorations in edentulous jaws are cracking/chipping and abrasion of the facing materials, which can be avoided through occlusal adjustment, restoration design and processing, and the selection of appropriate restorative materials. This article reviews the characteristics, selection, and design considerations of commonly used materials for fixed restorations in edentulous jaws, as well as the causes and management of common clinical complications related to restorative materials, aiming to provide references for the selection of appropriate materials in fixed restorations for edentulous jaws in clinical practice.

The Role of Malocclusion and Oral Parafunctions in Predicting Signs and Symptoms of Temporomandibular Disorders-A Cross-Sectional Study.

The aim of this study was to examine to what extent malocclusion and parafunctional habits contribute to the development of signs and symptoms associated with temporomandibular disorders (TMD) in schoolchildren with mixed dentition in Croatia in a sample of 338 children, aged 9 to 15 years. TMD signs and symptoms assessed by the clinician were joint function and pain, masticatory muscles tenderness, range of mandibular motion, and joint sounds. To evaluate subjective symptoms and parafunctions, children and parents were asked about the presence of headaches, jaw locking, temporomandibular joint (TMJ) sounds, pain during mouth opening, or bruxism, as well as parafunctions like biting pencils or nails, chewing hard candies or ice, daily gum chewing, opening bottles with teeth, engaging in jaw play, thumb-sucking, and clenching/grinding teeth. At least one symptom of a TMD was pronounced in 142 participants (42.0%). The most commonly reported parafunction was pencil or nail biting, present in 25.1% of participants. Class II malocclusion increased the likelihood by 2.6 times, pencil or nail biting by 2.34 times, and clenching/grinding teeth by 8.9 times that the subject would exhibit at least one TMD symptom. Every child with mixed dentition should undergo a brief examination of the TMJ, especially in cases of Class II malocclusion, pencil or nail biting, and teeth clenching or grinding, as these have all been identified as significant risk factors that increase the likelihood of experiencing TMD symptoms. This highlights the need for proactive screening and assessment by healthcare providers to reduce the risk and prevalence of TMDs in affected children and ensure timely diagnosis and treatment.

0605 Temporomandibular and Oral Parafunction as Risk Factors for Jaw Pain Related to Oral Appliance Therapy

0605 Temporomandibular and Oral Parafunction as Risk Factors for Jaw Pain Related to Oral Appliance Therapy

Etiologic Factors of Temporomandibular Disorders: A Systematic Review of Literature Containing Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) from 2018 to 2022.

This study aims to conduct a systematic analysis of literature published between 1 January 2018 and 1 September 2022, exploring factors influencing the progression or development of temporomandibular disorders (TMD), diagnosed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Three electronic databases were reviewed to identify papers that examined TMD factors using DC/TMD or RDC/TMD. Inclusion criteria encompassed original research published in English between 1 January 2018 and 1 October 2022, online, and complete DC/TMD or RDC/TMD studies on human participants aged 18 or older. Two authors independently assessed the risk of bias using The Joanna Briggs Institute (JBI) Analytical cross-sectional studies' Critical Appraisal Tool. Of 1478 articles, 11 were included. The studies revealed strong associations between TMD and factors such as female, poor sleep quality, depression, oral parafunction, anxiety, somatization, and anatomical features. However, variables such as education, living conditions, socioeconomic status, marital status, chronic pain, and stress did not exhibit statistically significant correlations. Based on the obtained data, it can be concluded that the causes of TMD are largely related to psychological factors, which supports the biopsychosocial theory of the disorder.

The prevalence of bruxism and oral parafunction activities among Israeli juveniles with autism spectrum disorder: A preliminary study during the COVID-19 pandemic

ABSTRACT Objective To evaluate the prevalence of oral habits, bruxism, and Temporomandibular Disorders (TMD) injuvenileswithautisticspectrumdisorder(ASD). Methods Data included 165 juveniles diagnosed with ASD, allocated to younger group aged 6 21 (n=86) and older group aged 13-21 (n=79). Results Sleep bruxism was reported by 26.7% in the younger group and by 5% in the older group. Awake bruxism was reported by 22% and 17.7%, respectively. Oral habits were reported by 43% of all participants, with similar rate in both groups. TMD related p ain was low in both groups (6.3% and 7% respectively). The influence of the COVID 19 pandemic on oral parafunction was moderate in the younger group (17.4%) and mild in the older group (8.6%), influence on bruxism was mild in both groups (5.8% and 2.5%, respectively). Conclusion The prevalence of bruxism and oral parafunctions was similar to the reported in the literature for the general population.

Outcome of chairside CAD/CAM ceramic restorations on endodontically treated posterior teeth: a prospective study

ObjectiveThe aim of this study was to evaluate the outcome and risk factors for chairside CAD/CAM full cusp coverage restorations on endodontically treated posterior teeth after 3 years of follow-up.MethodsA total of 245 endodontically treated posterior teeth of 224 patients were included and restored with CAD/CAM full cusp coverage all-ceramic restorations according to a standardized protocol. Patients were recalled after treatments 1 to 3 years and underwent clinical and radiological examinations. At recall, modified FDI criteria were used to determine treatment outcomes by 2 evaluators. Success was determined when FDI scores were 1–2, and failure was indicated when FDI scores were 5. Logistic regression analysis was performed to evaluate potential risk factors.ResultsA total of 183 patients presented at recall, and the clinical outcomes of 201 teeth were analyzed with a recall rate of 82.0% for teeth and 81.7% for patients after 1–3 years of follow-up.185 of 201 teeth were found to have FDI scores of 1–2, and the success rate was 92%. No teeth were extracted during the follow-up period. Fourteen failed cases with an FDI score of 5 presented restoration dislocation, fracture of restoration or/and tooth. Logistic regression analysis revealed that oral parafunction (OR 2.281, 95% CI 2.2 ~ 47.5, P value 0.01) was a risk factor for success rate.ConclusionChairside CAD/CAM all-ceramic full cusp coverage restoration was (could be) a promising alternative for restoring endodontically treated posterior teeth.

Factors Influencing Mandibular Deviation: A Retrospective Clinical Study.

This study aimed to investigate the correlation between mandibular deviation (MD) and possible clinical factors in patients with anterior disc displacement (ADD). This retrospective clinical study enrolled 296 patients with ADD, diagnosed using magnetic resonance imaging, from 2015 to 2018. The clinical symptoms and medical histories of these patients were carefully examined and recorded. Mandibular deviation was the primary outcome variable confirmed by a combination of clinical examination and facial photographs or posteroanterior cephalograms. The primary predictor variable was ADD staging. Secondary predictor variables included condylar height and distance of disc displacement. Other predictor variables were age, sex, disease course, oral parafunctions, depression, and bone mineral density. We used logistic regression to examine the correlation between the MD and all predictor variables. The χ2 test and analysis of variance were used to exclude the correlation between the predictor variables. In this study, the prevalence of MD was 77% among 278 patients with ADD. Bilateral ADD staging significantly contributed to MD on both sides. The odds ratio increased with the deterioration of disc displacement. The present study demonstrated that the ADD staging influences the condylar height and MD, and that articular disk position should be considered while treating MD.

Implant Supported Fixed Prostheses and Bruxism: An Overview

The bruxism is an oral parafunction characterized by occlusal overload contacts. The global management of bruxism patients may require a prosthetic rehabilitation whether it is fixed, removable or more recently implant-supported prostheses. The aim of our literature review is to evaluate the survival rate of implant-supported prostheses in patients with bruxism, to detail the different types of complications, and to develop recommendations to ensure the longevity of this type of prosthesis in this type of patient.

The effect of passive clear aligners on masticatory muscle activity in adults with different levels of oral parafunction.

There is limited knowledge of the possible side-effects of clear aligners on jaw function. To determine the short-term effect of passive clear aligners (PCAs) on masticatory muscle activity (MMA), occlusal discomfort (OD) and temporomandibular disorder (TMD) symptoms in adults with different levels of self-reported oral parafunction. Participants were screened for oral parafunctional behaviours using the oral behavioural checklist. Respondents in ≥85th and ≤15th percentiles were invited to participate and allocated to a high (HPF: N = 15) or low (lower parafunction [LPF]: N = 16) parafunction group. Participants underwent a TMD clinical examination; somatisation and somatosensory amplification were assessed by questionnaires; OD and stress were assessed by visual analogue scales. While wearing PCAs, awake-time MMA was assessed three times over 9 days using a wearable electromyography device, along with OD, stress and TMD symptoms. The wearing of PCAs was associated with a significant decrease in mean contraction episode amplitude in both groups (p = 0.003). OD levels increased and remained raised in all participants after insertion of the PCAs (p < 0.001), more so in the HPF group (p = 0.048). The HPF group had higher somatisation scores (p = 0.006) and reported more TMD symptoms at all time points (p ≤ 0.004). No significant changes in stress or TMD symptoms were found in either group during the study period. PCAs were associated with a decrease in MMA in all participants. HPF individuals had greater somatisation and reported greater discomfort when wearing PCAs than LPF individuals.

Arsyeshmëria e përdorimit të pyetësorit Fonseka në identifikimin e ç’rregullimit të nyjes temporomandibulare

Temporomandibular disorders (TMD) and their impact on orofacial health is a highly debated topic in dentistry in re- cent years. The aim of this paper is intended to summarize up-to-date and evaluate the reliability of subjective data obtained from Fonseka questionnaires in assessing the prevalence and severity of signs and symptoms of tem- poromandibular disorders and oral parafunction habits and to compare the findings with other studies. It is gen- erally accepted that the etiology of TMJ is multifactorial related to a variety of dental and medical conditions such as occlusal changes, body posture, pre-functional habits, restorative treatments, orthodontic treatments, emotion- al stress, trauma, disc anatomy, muscle pathophysiology, genetic conditions and psycho-social, age and gender. Since TMD are a heterogeneous group of pathologies that affect the temporomandibular joint, masticatory muscles or both. The multifactorial etiology and the lack of stan- dardized criteria in the evaluation of Temporomandibu- lar disorders (TMD), despite voluminous literature makes comparison between different studies difficult and even today is a unsolved issue. Nonetheless, in consideration of the psychosocial impact that TMD have in terms of de- creased patients’ quality of life and socio-economical costs an improvement in the standardization of the diagnostic process for these disorders is strongly requested to avoid unnec- essary delays in the pathways to diagnosis and, ultimately, man- agement of TMD.

Oral behaviors in young adults: a multidimensional evaluation of the influence of personality, coping, and distress.

This study explored the relationship of oral parafunction to the psychological variables of personality, coping, and distress. Correlates of sleeping/waking-state oral activities with the different psychological factors were also examined, along with psychological predictors for high parafunction. Young adults from a large private university were enrolled. The frequency of oral behaviors was appraised with the oral behavior checklist (OBC), and participants were stratified into low and high parafunction (LP/HP) groups following the DC/TMD. Personality traits, coping styles, and psychological distress were assessed with the Big Five Personality Inventory-10 (BFI-10), brief-COPE Inventory (BCI), and Depression, Anxiety, Stress Scales-21 (DASS-21) correspondingly. Statistical evaluations were performed using the chi-square/Mann-Whitney U tests, Spearman's correlation, and logistic regression analyses (α = 0.05). Among the 507 participants (mean age 22.2 ± 1.5years), 84.6% and 15.4% had low and high parafunction respectively. While personality profiles did not vary substantially, the HP group exhibited significantly greater emotion-focused/dysfunctional coping, general distress, depression, anxiety, and stress scores than the LP group. Associations between OBC and the various psychological variables were weak when significant or insignificant. Neuroticism and dysfunctional coping were moderately correlated to general distress, depression, anxiety, and stress (rs = 0.44-0.60/0.45-0.51). Multivariate analyses indicated that high parafunction was predicted by dysfunctional coping style (OR = 2.55) and anxiety (OR = 1.33). Dysfunctional coping was the main risk factor for high parafunction, increasing its odds by about 2.5 times. Oral parafunction appears to be a dysfunctional coping response to psychological distress.

Common therapeutic approaches in sleep and awake bruxism - an overview.

Bruxism, a common medical condition characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible, can occur during sleep, when it is known as sleep bruxism (SB), or during wakefulness, when it is known as awake bruxism (AB). Although bruxism often causes headaches, temporomandibular joint pain, masticatory muscle pain, mechanical tooth wear, prosthodontic complications and cracked teeth, there is still not enough data to define and support a standardised approach to its treatment. The aim of this review was to present the pathophysiology, consequences, types and treatment methods of bruxism in order to increase readers' knowledge of this topic. Differences between awake and nocturnal bruxism are included, as well as risk factors and indicators visible during the clinical examination of affected patients. Among the causes we consider are genetics, stress, oral parafunctions and changes in the Central Nervous System (CNS). Potential and common methods of treatment are presented, along with suggested guidelines that should be followed when determining an appropriate treatment method. We draw attention to the notably dynamic development of bruxism in today's society and the importance of informational and preventive projects, especially those targeted at high-risk patients as well as those targeted at specialists, in order to better tackle the bruxism 'epidemic'.

Temporomandibular Disorders and Bruxism among Sex Workers-A Cross Sectional Study.

Sex workers are a highly underprivileged population which is present all around the world. Sex work is associated with negative social stigma which affects all aspects of the sex workers' lives including healthcare, service providers and police. The stigma may result in increased stress, mental health problems, feelings of isolation and social exclusion. In the present study, 36 sex workers (SW) and 304 subjects from the general population in Israel (GP) were evaluated for the presence of bruxism and Temporomandibular disorders (TMD), with the use of Diagnostic Criteria for Temporomandibular Disorders (DC/TMD- Axis I). When compared to the general population, sex workers presented larger maximal assisted mouth opening and higher prevalence of the following TMD diagnoses: Disc displacement with reduction, Myalgia, Myofascial pain with referral, Arthralgia (left and right) and Headache attributed to TMD. The odds of sex workers suffering from one of these diagnoses were twice to five times higher than those of the general population. The study shows that health problems of sex workers go beyond venereal diseases, HIV and mental disorders which are commonly studied. Oral health, TMD and oral parafunctions are some of the additional health issues that should be addressed and explored in this population.

Dental implant failure and factors associated with treatment outcome: A retrospective study

PurposeThe purpose of the present study was to retrospectively 1) investigate the association between implant-, patient- and bone-related parameters with the risk of implant failure; 2) analyze the survival rates of dental implants placed in a university clinical setting. MethodsData were retrieved from patient charts from the University of Minnesota School of Dentistry to identify patients older than 18 years of age who received dental implant treatment by faculty, residents or students in the university dental clinics. Implant-, patient- and bone-related parameters such as implant system, length, diameter, jaw, region, installation protocol, gender, smoking, medical history, history of periodontal disease, self-reported oral parafunctions, type of bone, and operator were manually retrieved and analyzed. ResultsFive hundred and fifty-three implants were randomly selected from a total of 4,424. Of these 553 implants, 440 (79.6%) were associated with a >10 mm length, 371 (67.1%) with a >4 mm diameter and 431 (77.9%) had replaced a single tooth. Submerged healing mode was followed in 363 (65.6%) of the implants with the mean healing time being 3.2 months. History of periodontal disease was identified in 294 (53.2%) of these cases. A total of 17 implants failed after a mean time of 6.29 ± 6.75 months, resulting in an overall survival rate of 96.9%. Based on a univariate analysis, implant system, operator, time between extraction and implant surgery, time between bone grafting and implant placement, tobacco use as well as clenching and grinding were considered potential implant failure predictors and were further included in the multivariate logistic regression analysis. Tobacco use (p < 0.001) was significantly associated with implant failure. ConclusionWithin the limitations of this retrospective randomly selected university-treated sample tobacco use increased the risk for implant failure. Failure occurred in 17 implants representing a 3.1% failure rate.

Investigation of the presence and relationship between temporomandibular disorder and oral parafunctions in dental assistant students: A cross‐sectional study

AbstractAimIn this cross‐sectional descriptive study, it was aimed to determine the relationship between the prevalence of temporomandibular disorder (TMD) and oral parafunctions in dental assistant students and to evaluate the effects of gender and education years.MethodsThe results of 105 individuals (mean age: 20.72 ± 3.51 years; 75 females, 30 males) were analyzed in this descriptive cross‐sectional study, which included student participants who received dental assistant education program from Erciyes University Vocational Health College. The Fonseca Anamnestic Index (FAI) questionnaire was used to define the presence and symptoms of TMD, and the Oral Behavior Checklist (OBC) questionnaire was used to determine the oral parafunctions of individuals. Fisher's exact, Mann–Whitney U, Kendall tau‐b, and Spearman correlation and linear regression analyses were used to evaluate the data.ResultsAny level of TMD was detected in 64.8% of all individuals included in the study, and most of these patients were women (74.3%). No significant difference was found between the TMD prevalence of the first‐ and second‐grade students based on the years of education of the participants (p = 0.614). Considering the sex and class parameters, statistically significant weak (r = 0.378 for females; r = 0.375 for the first grade) and middle (r = 0.418 for males; r = 0.478 for the second grade) degree positive correlation was determined (p &lt; 0.01) between the OBC and TMD scores for both parameters.ConclusionThe prevalence of TMD is higher in dental assistant students, especially females, and this is associated with certain degrees of oral parafunctions.

PREVALENCE OF TEMPOROMANDIBULAR DISORDERS AMONG ORTHODONTIC PATIENTS (CROSS-SECTIONAL CLINICAL SURVEY)

Orthodontic treatment as a risk factor for the development of temporomandibular disorders (TMD) has been a controversy in literature. The aim of this study was to evaluate the prevalence of TMD, as defined in the Diagnostic Criteria (DC)/TMD Axis II, among orthodontic patients. A cross-sectional study (N=180) consisted of 3 groups: 60 control patients seeking orthodontic consultation, 60 patients undergoing orthodontic treatment for 3-5 months, 60 patients undergoing orthodontic treatment for 10-14 months. Patients answered a structured questionnaire that rated their oral parafunctions according to the Oral Behavior Checklist (OBC), pain intensity levels according to the Graded Chronic Pain Scale (GCPS), jaw functional limitations according to the Jaw Functional Limitation Scale 20 (JFLS-20), psychosocial factors (PHQ-9) and somatization levels (PHQ-15). The Chi Square test showed a statistically significant difference p-value=0.001 among both active orthodontic groups (3-5 months/10-14 months) regarding masticatory limitation (53.3%), vertical mobility limitation (41.7% for 3-5 months and 55.0% 10-14 months) and verbal &amp; emotional expression limitation (53.3% 3-5 months and 66.7% 10-14 months). The findings revealed that as orthodontic treatment progresses, the limitation increases. Moreover, no statistical significance was observed between the three groups regarding oral parafunctional habits, chronic pain levels, psychosocial status and somatization. Orthodontic treatment is not a major factor associated with the symptoms of the TMD. Further prospective studies are needed to evaluate the true role of orthodontic treatment in the development of TMD.

Sleep bruxism in children: An overview and current update

Sleep bruxism (SB) is an oral parafunction characterized by grinding or clenching the teeth during sleep. Objective: To analyze the most recent literature about sleep bruxism in children, about its diagnosis, signs, and symptoms, as well as its relationship with anxiety, stress, behavior problems and its treatment. Methodology: Articles on sleep bruxism in children were analyzed in the PubMed, ScienceDirect and Google academic databases with an emphasis on the last 5 years. It was carried out with the words

Painful Temporomandibular Disorders, Bruxism and Oral Parafunctions before and during the COVID-19 Pandemic Era: A Sex Comparison among Dental Patients.

Aim: To evaluate the effect of the current coronavirus pandemic on the prevalence of bruxism, oral parafunctions and painful Temporo-Mandibular Disorders (TMDs) and to evaluate the influence of the pandemic on both sexes. Methods: This retrospective study included 288 dental patients who underwent complete anamnesis and examination according to the Diagnostic Criteria for TMD. The study evaluated two patient populations according to the date of examination: (a) pre-COVID-19 pandemic era (108 patients); (b) COVID 19 pandemic era, where 180 patients were examined during the pandemic. Results: A significant increase in parafunction activity was found in both men and women (p < 0.001) during the COVID-19 pandemic. Awake bruxism (AB) and sleep bruxism (SB) was more prevalent during the COVID-19 pandemic solely in women (AB-p < 0.001; SB-p = 0.014). Conclusions: Men and women were affected by the ongoing stress due to the COVID-19 pandemic, yet women showed a higher influence as compared to men. The long-term exposure to elevated levels of anxiety and stress may aggravate or trigger stomatognathic detrimental conditions. Dentists should be aware and regularly monitor their patients regarding the possible existence and consequences of bruxism and TMD.

Pediatric Bruxism and Sleep Disorders Early Detection

Oral parafunction and sleep disorder parasomnia, bruxism involves the dentist and particularly the pediatric dentist to detect in additionto masticatory and occlusal problems, sleep disorders. It is a question of characterizing bruxism in connection with not only dental problems but also sleep disorders. The etiology of bruxism is not formally elucidated, there is however a strong consensus on its multifactorial origin. Bruxism would be caused by central factors (neuropathic or psycho-emotional) involving the central nervous system (CNS) and autonomic (ANS) modulated among other things by sleep and the psychic state. In addition, certain local factors can maintain the parafunction: breathing disorders and sleep parasomnia in particular revealing a pattern of intricate cause-consequences. The aim of this study was to describe the relationship between dental and sleep disorder by the same symptom bruxism in children. Bruxism was the reason for consultation of 98 children aged 3-6 years with more or less extensive loss of dental material evolving over several months and repeatedly. The search for self-reported information on behavioral and attention disorders as well as the daytime and nocturnal signs reported by parents suggesting sleep disorders. A polysomnography made, it was possible to confirm the diagnosis and to indicate the severity of the sleep disorder, namelyinsomnia (2%), hypersomnia (4%) circadian rhythm disorders (8%), other parasomnias (16%), and 70% had OSAS with an average AHI of 4.4/h. A statistical association was found between bruxism and OSAS (P&lt;0·001; Chi-square test).

Changes in incisor relationship over the life course - Findings from a cohort study

ObjectiveThe aim of this longitudinal cohort study was to investigate the changes in incisor relationship over three decades from adolescence to mid-adulthood. Materials and MethodsThe sample included 1,037 children (48.4% female) born between April 1972 and March 1973 from the longitudinal birth cohort Dunedin Multidisciplinary Health and Development Study. Overjet and overbite values were assessed at age 15 and 45 years and entered in a regression model as outcome variables. Baseline occlusal variables, sex, history of orthodontic treatment, periodontal data recorded at age 38, and self-reported oral parafunction and orthodontic treatment history recorded at age 45 were entered as covariates in the regression analysis. ResultsRegression modelling showed that overjet/overbite category (high or low) at age 15 tends to predict overjet/overbite category at age 45, with overjet become slightly larger (around +0.5 mm) and overbite slightly lower (-0.5 mm) over time. Study members with self-reported tooth clenching had a slighter greater overbite (+0.3 mm) at age 45 than those who did not. Additionally, those with signs of periodontal disease at age 38 had a slightly larger overjet (+0.5 mm) at age 45 than those without disease. Sex differences were demonstrated with females having 0.6 mm larger overjet, and 0.4 mm overbite at age 45. ConclusionsOverall, overjet values tend to be higher during mid-adulthood than during adolescence, while the converse is true for overbite. There appears to be a degree of sexual dimorphism in overjet and overbite values later in life. Clinical SignificanceIncisor relationships change during the life course and are related to ageing, sex, periodontal health, and parafunctional habits. Clinicians and educators should be aware of these changes when making treatment decisions that alter incisor relationship.