Search Results (238)

A total of 304 patients with bruxism (206 women, 98 men; mean age: 52.5 years) received 25 units of botulinum toxin injected into the bilateral masseter muscles; the changes in various clinical symptoms and their contributing factors were analyzed 2 months after treatment. The mean masseter muscle electromyographic amplitude (189 μV) and maximal bite force (618.4 N) significantly decreased after botulinum toxin therapy compared to that at baseline (55.4 μV, 527.3 N, respectively; p < 0.001). Maximal mouth opening (44 mm), sleep quality (visual analog scale: 5.3), shoulder and neck stiffness (6.7), and headache (5.4) significantly improved after the injection (47.3 mm, 6.6, 4.7, and 2.6, respectively; p < 0.001). Multivariate analysis revealed that the mean masseter electromyographic amplitude reduction rate was significantly affected by age, sex, and baseline amplitude (all p < 0.001); the maximal bite force reduction rate was influenced by age (p < 0.001), sex (p = 0.007), and baseline bite force (p = 0.008). Age, sex, and muscle activity may affect the therapeutic effects. A more effective outcome for bruxism can be achieved using a tailored approach involving dose adjustment, thereby preventing the side effects attributed to excessive dosage. Full article

Many headaches at night arise due to primary headache disorders, which occur independently of other symptoms and are not caused by another medical condition. Primary headache disorders with nighttime attacks can include tension-type headaches, migraines, hypnic headaches, and cluster headaches. A hypnic headache is sometimes called an “alarm clock headache” because symptoms tend to arise at the same time of night. Apart from considering primary headaches, secondary causes of nighttime headaches should be considered and ruled out, in particular headaches secondary to intracranial hypertension, temporomandibular joint issues (like bruxism) and sleep apnea. Treatments vary based on headache type but often include a combination of medications and prevention strategies. This review article covers the basics of nighttime primary headaches in children, including pathophysiology, etiology, clinical features of the different forms and their treatment. It will also discuss the differences in headache features between children and adults. Full article

Background: Temporomandibular disorders (TMD) are common musculoskeletal conditions affecting the temporomandibular joints, masticatory muscles, and associated structures. Their etiology is complex and multifactorial, involving anatomical, behavioral, and psychosocial contributors. Parafunctional habits such as clenching, grinding, and abnormal jaw positioning have been proposed as contributing factors, yet their individual and cumulative contributions remain unclear. This exploratory cross-sectional study aimed to evaluate the prevalence and severity of parafunctional habits and their association with TMD in medical students—a group exposed to elevated stress levels. Subjects were examined in Krakow, Poland, using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol. Methods: Participants completed a 21-item Oral Behavior Checklist (OBC) assessing the frequency of oral behaviors on a 0–4 scale. A self-reported total parafunction load was calculated by summing individual item scores (range: 0–84). Logistic regression was used to evaluate associations between individual and total parafunction severity scores and TMD presence. Results: The study included 66 individuals aged 19–30. TMD was diagnosed in 55 participants (83.3%). The most commonly reported habits were resting the chin on the hand (90.9%) and sleeping in a jaw-compressing position (86.4%). Notably, jaw tension (OR = 14.5; p = 0.002) and daytime clenching (OR = 4.7; p = 0.027) showed significant associations with TMD in the tested population. Each additional point in the total parafunction score increased TMD odds by 13.6% (p = 0.004). Conclusions: These findings suggest that parafunctional behaviors—especially those involving chronic muscle tension or abnormal mandibular positioning—may meaningfully contribute to the risk of TMD in high-stress student populations. Moreover, the cumulative burden of multiple low-intensity habits was also significantly associated with increased TMD risk. Early screening for these behaviors may support prevention strategies, particularly among young adults exposed to elevated levels of stress. Full article

Background: Gum chewing is a common habit among young adults, often promoted for its oral health and psychological benefits. However, as a repetitive and non-functional activity, it is also considered a potential risk factor for temporomandibular disorder (TMD), particularly when practiced chronically. The aim of this study was to evaluate whether excessive gum chewing is associated with a higher prevalence of TMD among young adults presumed to be under elevated academic stress based on their demographic characteristics. Methods: Participants were examined in Krakow, Poland, using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol. Participants completed a structured questionnaire assessing gum-chewing frequency, duration, and chronicity. Associations between chewing behaviors and TMD presence were analyzed using univariate logistic regression (α = 0.05). Results: This study included young adults 66 participants aged 19–30. TMD was diagnosed in 55 participants (83.3%), including muscular disorders (n = 9; 16.4%), articular disorders (n = 10; 18.2%), and combined muscular–articular disorders (n = 38; 57.6%). More than 70% of participants reported chewing gum for over five years. No statistically significant associations were found between TMD occurrence and the frequency, duration, or chronicity of gum chewing (p > 0.05). Conclusions: These findings suggest that, in the absence of other contributing factors, gum chewing may not independently contribute to TMD development. The elevated TMD prevalence may reflect confounding variables such as high academic stress, narrow age distribution, or female predominance. However, the limited sample size limits statistical power, particularly for detecting subtle effects potentially distorted by other variables. Additionally, the cross-sectional nature of this study precludes causal interpretation. Further studies in larger and more heterogeneous populations are recommended. Full article

Background/Objectives: Migraine affects approximately 3–10% of school-aged children and up to 28% of adolescents, with prevalence increasing during adolescence. For pediatric specialty providers, increased awareness of this condition may influence patient care. This study examined pediatric dentists’ education, clinical exposure, and perceived knowledge gaps related to pediatric migraine, with the goal of identifying barriers to recognition and referral, as well as informing future training to support accurate diagnosis and interdisciplinary care. Methods: A 28-item electronic questionnaire was distributed to all members of the American Academy of Pediatric Dentistry, including pediatric dentists and postgraduate pediatric dental residents, assessing knowledge, beliefs, clinical experience, and interest in further training regarding pediatric headache/migraine management. Respondents with and without previous training were compared in terms of general understanding using t-tests; a linear regression model analyzed predictors of provider awareness regarding links between oral conditions and headache/migraine. Results: Among 315 respondents, the mean self-perceived awareness score was 2.7 ± 1.3 (on a 0–5 scale). The most frequently identified contributing factors were clenching (73.7%), bruxism (72.4%), and temporomandibular disorders (65.7%). Nearly all respondents (95.2%) reported no formal education on headache/migraine prevention, yet 78.1% agreed on the importance of understanding the relationship between oral health and headache/migraine. Respondents with prior training were significantly more aware (p < 0.001) than those without prior training. Educating families (p < 0.001), frequency of patient encounters with headache (p = 0.032), coordination with healthcare providers (p = 0.002), and access to appropriate management resources (p < 0.001) were significant predictors of providers’ awareness. Conclusions: Pediatric dental providers expressed strong interest in enhancing their knowledge of headache/migraine management, highlighting the value of integrating headache/migraine-related education into training programs and promoting greater interdisciplinary collaboration. Full article

Background: Cannabidiol (CBD) has demonstrated potential as a therapeutic agent for muscle tension, pain, and sleep bruxism, yet its broader impact on comorbid conditions such as sleep disturbance and migraine disability remains underexplored. This study aimed to assess the effects of topical CBD on sleep quality and migraine-related disability in patients with bruxism-associated muscular pain. Methods: In a randomized, double-blind clinical trial, 60 participants with bruxism were allocated equally into three groups: control (placebo gel), 5% CBD gel, and 10% CBD gel. Participants applied the gel intraorally to the masseter muscles nightly for 30 days. Sleep quality and migraine-related disability were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Migraine Disability Assessment Scale (MIDAS), respectively. Surface electromyography (sEMG) and the Bruxoff^® device were used for objective evaluation of muscle tension and bruxism intensity. Results: Both CBD treatment groups demonstrated statistically significant improvements in PSQI and MIDAS scores compared to the control group (p < 0.001). No significant differences were observed between the 5% and 10% CBD groups, suggesting comparable efficacy. The sEMG findings corroborated a reduction in muscle tension. Improvements in sleep and migraine outcomes were positively correlated with reductions in muscle activity and pain. Conclusions: Topical CBD gel significantly improved sleep quality and reduced migraine-related disability in patients with bruxism-associated muscular pain, supporting its role as a multifaceted therapeutic option in the management of TMD and related comorbidities. Further research is needed to confirm long-term benefits and determine optimal dosing strategies. Full article

Background/Objectives: Bruxism has been associated with dysregulation of the autonomic nervous system (ANS). Visceral manual therapy (VMT) has shown beneficial effects on the vagal tone and modulation of ANS activity. This study aimed to evaluate the immediate and short-term effects of VMT in individuals with clinically based bruxism. Methods: A single-blind randomized controlled trial was conducted including 24 individuals with clinically based bruxism. Participants received two sessions of either VMT or a sham placebo technique. Outcome measures included heart rate variability (HRV), both normal-to-normal intervals (HRV-SDNN), and the root mean square of successive normal-to-normal intervals (HRV-RMSSD), as well as muscle tone and stiffness and pressure pain thresholds (PPTs). Measurements were made at T1 (baseline), T2 (post-first intervention), T3 (pre-second intervention), T4 (post-second intervention), and T5 (4-week follow-up). Results: A significant time*group interaction was observed for HRV-SDNN (p = 0.04, η² = 0.12). No significant changes were found for muscle tone or stiffness. PPTs significantly increased at C4 after the second session (p = 0.049, η² = 0.16) and at the left temporalis muscle after the first session (p = 0.01, η² = 0.07). Conclusions: The findings suggest that two sessions of VMT may lead to significant improvements in HRV-SDNN compared to the placebo, suggesting a modulatory effect on autonomic function. No consistent changes were observed for the viscoelastic properties of the masticatory muscles. Isolated improvements in pressure pain sensitivity were found at C4 and the left temporalis muscle. Further research with larger sample sizes and long-term follow-up is needed to determine the clinical relevance of VMT in the management of signs and symptoms in individuals with bruxism. Full article

Background and objectives: The interest in studying the relationship between bruxism and sleep apnea has increased over the past decade, given its prevalence and its implications for both oral and overall health. Bruxism occurs in a significant portion of the population, with an overall incidence ranging between 8 and 31%. Obstructive sleep apnea affects 4–6% of middle-aged men and 2–4% of middle-aged women, and it is associated with diminished quality of life, hypertension, increased cardiovascular risks, traffic accidents, and a higher mortality rate. Although a possible association has been suggested, the causal relationship remains unclear. This review aimed to systematically evaluate the available evidence on the association between SB and OSA, focusing on potential shared risk factors and underlying mechanisms. Methods: An electronic literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library for studies published between 2020 and 2025. Inclusion criteria encompassed observational studies and clinical trials involving adults with SB and/or OSA. Risk of bias was assessed using ROBINS-I, and the certainty of evidence was evaluated using GRADE. The review protocol was not registered. Results: A total of 11 studies met the inclusion criteria. The prevalence of SB was consistently higher in individuals with OSA compared to the general population. Several studies suggest a potential link through autonomic arousals and neurotransmitter dysregulation. However, inconsistencies in diagnostic criteria and moderate methodological quality limited the strength of the findings. Conclusions: There is a notable prevalence of bruxism in patients with OSA, suggesting possible shared pathophysiological mechanisms; however, it is necessary to standardize diagnostic criteria and conduct larger, more standardized studies to clarify the relationship. No funding was received, and the authors declare no conflicts of interest. Full article

Three-dimensional (3D) printing has emerged as a transformative technology in dental splint fabrication, offering significant advancements in customization, production speed, material efficiency, and patient comfort. This comprehensive review synthesizes the current literature on the clinical use, benefits, limitations, and future directions of 3D-printed dental splints across various disciplines, including prosthodontics, orthodontics, oral surgery, and restorative dentistry. Key 3D printing technologies such as stereolithography (SLA), digital light processing (DLP), and material jetting are discussed, along with the properties of contemporary photopolymer resins used in splint fabrication. Evidence indicates that while 3D-printed splints generally meet ISO standards for flexural strength and wear resistance, their mechanical properties are often 15–30% lower than those of heat-cured PMMA in head-to-head tests (flexural strength range 50–100 MPa vs. PMMA 100–130 MPa), and study-to-study variability is high. Some reports even show significantly reduced hardness and fatigue resistance in certain resins, underscoring material-specific heterogeneity. Clinical applications reviewed include occlusal stabilization for bruxism and temporomandibular disorders, surgical wafers for orthognathic procedures, orthodontic retainers, and endodontic guides. While current limitations include material aging, post-processing complexity, and variability in long-term outcomes, ongoing innovations—such as flexible resins, multi-material printing, and AI-driven design—hold promise for broader adoption. The review concludes with evidence-based clinical recommendations and identifies critical research gaps, particularly regarding long-term durability, pediatric applications, and quality control standards. This review supports the growing role of 3D printing as an efficient and versatile tool for delivering high-quality splint therapy in modern dental practice. Full article

Rett syndrome (RTT) is an X-linked neurodevelopmental disorder marked by neurological regression, autonomic dysfunction, seizures, and significant sleep and breathing abnormalities. About 80% of affected individuals, especially young children, experience sleep disturbances such as insomnia, sleep-disordered breathing, nocturnal vocalizations, bruxism, and seizures. Breathing irregularities during sleep—like apnea, alternating hyperventilation, and hypoventilation—are common, with both obstructive and central sleep apnea identified through polysomnography. This review focuses on the prevalent sleep disorders in children with Rett syndrome and highlights current recommendations for the management of sleep disorders. Full article

Awake Bruxism (AB) is defined as masticatory muscle activity during wakefulness, characterized by repetitive or sustained tooth contact and/or the bracing or thrusting of the mandible. AB remains less understood than Sleep Bruxism (SB), and its identification remains a methodological challenge. The aim of this study was to introduce the Awake Bruxism Identification Tool (ABIT), developed for children and adolescents aged 8 to 12 years, to facilitate the identification of AB. The tool integrates data from self-reports, clinical examinations, and the Ecological Momentary Assessment (EMA). It comprises questionnaires using a five-point Likert scale, an analog EMA component involving color-based responses, and a clinical inspection. The tool adopts the concept of an “AB Spectrum”, as it generates individualized scores based on the combined outcomes of these multiple assessment components. The ABIT was piloted with ten families to evaluate its comprehensibility, applicability, and reliability. The results demonstrated that the participants found the questions understandable, that the tool had a minimal impact on daily family routines, and that it required approximately 5–10 min to complete. Additionally, the test–retest reliability indicated temporal stability. In terms of identification, four children were classified within the “AB identified by report and self-report,” while three were identified through the “report, self-report, and EMA.” Based on participant feedback, adjustments were made to the instrument, including the addition of an item addressing Sleep Bruxism. Although the ABIT is being applied for the first time in a research setting, it presents a promising, clinically relevant approach grounded in the self-perception of children and their caregivers. Full article

Background and Objectives: This study aimed to evaluate the effects of hard, soft, and semi-soft splints on TMJ vibrations in bruxers with JVA and to compare them with data obtained from asymptomatic individuals. Materials and Methods: A total of 64 individuals were divided into four subgroups: control (n = 15); and hard (n = 17), soft (n = 16), and semi-soft (n = 16) splints. Electrovibratography records from all individuals included in the study before and after the 3-month splint treatment were obtained with the Biopak^® System. Joint vibration analysis was used to evaluate TMJ sounds. Data normality was examined with the Kolmogorov–Smirnov and Levene tests. The significance of the differences was investigated by One-Way ANOVA and by the Kruskal–Wallis test. Conover’s multiple comparison test was used in post hoc tests. (ClinicalTrials.gov identifier: NCT06893744, on 24 March 2025, titled; Effects of Different Occlusal Splints). Results: After 3 months of treatment, for I < 300 Hz right opening, the control group was statistically lower than both semi-soft (p < 0.001) and hard (p < 0.001) splint groups. The difference between semi-soft and hard splints in post-treatment I < 300 Hz right opening is not statistically significant. After 3 months of treatment compared with the beginning, the increases in left-opening Ti (p = 0.004), I < 300 Hz (p = 0.004), and PA (p = 0.007) values in the soft splint group were statistically significant. Conclusions: All three kinds of splints improved clinical symptoms and complaints of bruxers. For joint vibrations in bruxers, hard and semi-soft splints are more beneficial than soft splints. Full article

Background: Cannabidiol (CBD), a non-intoxicating phytocannabinoid, has garnered interest as a potential therapeutic agent for managing pain and inflammation associated with upper-quarter disorders, including temporomandibular disorders (TMDs), orofacial pain, myofascial dysfunction, and postoperative dental pain. Methods: This systematic review critically evaluated clinical, preclinical, and mechanistic studies on the efficacy and safety of CBD in the management of such conditions. A total of 10 studies, comprising randomized clinical trials and animal models, met the inclusion criteria and were assessed for methodological quality and risk of bias. Results: The findings suggest that CBD demonstrates analgesic, anti-inflammatory, and muscle-relaxant effects in chronic myofascial TMDs and bruxism, particularly when applied topically or intraorally. In contrast, studies on acute nociceptive pain (e.g., pulpitis, third molar surgery) yielded inconsistent results. Notably, CBD enhanced the effects of conventional analgesics such as opioids and NSAIDs in several preclinical models, indicating synergistic potential. However, substantial heterogeneity in CBD dosage, formulation, administration routes, and outcome measures limited comparability across studies. Adverse effects were minimal in clinical trials, yet underreported. Conclusions: While early evidence supports CBD’s potential as an adjunctive treatment for certain upper-quarter conditions, especially those involving chronic myofascial pain, further high-quality, condition-specific trials are required to establish standardized dosing, delivery methods, and long-term safety. Full article

Stomatognathic dysfunctions, particularly bruxism, orofacial pain, and temporomandibular joint (TMJ) disorders, are frequently associated with anxiety and depression. However, the reverse hypothesis that these dysfunctions may act as peripheral stressors contributing to neuropsychological imbalance by activating the hypothalamic–pituitary–adrenal (HPA) axis remains underexplored. Objective: To assess the relationship between the severity of stomatognathic symptoms and both physiological and psychological stress markers to determine whether such dysfunctions may influence or exacerbate anxiety and depressive disorders. Methods: A cross-sectional observational study was conducted on 120 adult patients. Clinical assessment was included evaluation of TMJ function, bruxism, and orofacial pain. Psychological screening was performed using validated questionnaires (GAD-7 for anxiety and PHQ-9 for depression). Electromyographic (EMG) analysis of the masseter and temporalis muscles was conducted, along with the quantification of salivary cortisol using an enzyme-linked immunosorbent assay (ELISA). Multiple regression models were applied to identify statistically significant correlations (p < 0.05). Results: A positive correlation was found between the severity of stomatognathic dysfunction and scores on anxiety and depression measures, along with elevated salivary cortisol levels and increased masticatory muscle activity. Conclusions: These findings suggest a bidirectional relationship between stomatognathic dysfunctions and neuropsychological status, underscoring the potential value of integrated therapeutic approaches that combine dental care with psychological support. Full article

Aim: This study aimed to determine the oral health profile of children with autism spectrum disorder and to analyze the impact of their oral health status on their personal quality of life and the quality of life of their families. Materials and Methods: A cross-sectional online study was conducted on 121 parents. A self-structured questionnaire was used to collect data on sociodemographic characteristics, parents’ perceptions of their child’s oral health, oral hygiene practices, and access to dental care. Additionally, the Parental–Caregiver Perceptions Questionnaire (P-CPQ-16, 16 items) and the Family Impact Scale (FIS-8, 8 items) were employed. The data were analyzed descriptively and using the Mann–Whitney U test and the Kruskal–Wallis H test. Results: No significant differences were found in FIS-8 and P-CPQ-16 scores between parents and children based on their sociodemographic characteristics. However, a significant association was observed between P-CPQ-16 and FIS-8 total scores and the type of used dental care (general dental practice vs. adapted practice and general anesthesia, p ≤ 0.001), dental visit frequency (regular vs. occasional, p < 0.05), child cooperation level during dental visits (cooperative vs. uncooperative, p ≤ 0.001), and dental care access challenges (p < 0.05). Parents reported a high prevalence of poor oral health in their children: the experience of tooth decay (48.1%), malocclusion (47.1%), bruxism (38.8%), bad breath (34.7%), and toothache (28.8%) in the previous 12 months. Most children brushed their teeth daily (89.3%), often with the help of their parents (44.6%). The most frequently reported difficulty in maintaining oral hygiene was the children’s unwillingness to cooperate (62.8%). Conclusions: Poor perceived oral health in children with autism spectrum disorder is significantly linked to a lower quality of life for both them and their families, especially when access to dental care is difficult and there is a lack of cooperation. Addressing these barriers and the high prevalence of oral health problems through tailored strategies is critical to improving children’s well-being. Full article