Short-term effects of a Rigid Interocclusal Appliance and Hypnosis on individuals with bruxism: a feasibility study for a randomized clinical trial
DOI:
https://doi.org/10.70597/vozes.v12i26.999Keywords:
Temporomandibular disorders, Bruxism, Hypnosis, Interocclusal SplintsAbstract
This study had the aim of evaluate the feasibility of a randomized clinical trial to compare the effects of a Rigid Interocclusal Appliance and Hypnosis on the quality of life and muscle pain in individuals with bruxism. Forty-two patients with self- report bruxism and clinical examination were randomly assigned to three groups: Rigid Interocclusal Appliance (G1), Hypnosis (G2), and a Control Group (G3). Data collection occurred at baseline and 40 days after the interventions using the Oral Health Impact Profile (OHIP-14), Lip’s Inventory of Stress Symptoms (ISSL) and muscle and joint palpation. P-value < 0.05 was considered significant. The G1 showed a greater reduction in pain in the masseter’s portions and in the temporalis tendon insertion (p<0.05). No significant differences were observed in the quality of life (OHIP-14). From this pilot study it was possible to verify the feasibility of a clinical trial with a larger sample size and follow-up time.
References
Lobbezoo F, Ahlberg J, Raphael KG, Wetselaar P, Glaros AG, Kato T, Santiago V, Winocur E, De Laat A, De Leeuw R, Koyano K, Lavigne GJ, Svensson P, Manfredini D. International consensus on the assessment of bruxism: Report of a work in progress. J Oral Rehabil. 2018 Nov;45(11):837-844. DOI: 10.1111/joor.12663.
Bracci A, Djukic G, Favero L, Salmaso L, Guarda-Nardini L, Manfredini D. Frequency of awake bruxism behaviours in the natural environment. A 7-day, multiple-point observation of real-time report in healthy young adults. J Oral Rehabil. 2018 Jun;45(6):423-429. DOI: 10.1111/joor.12627.
Bracci A, Lobbezoo F, Colonna A, Bender S, Conti PCR, Emodi-Perlman A, Häggman-Henrikson B, Klasser GD, Michelotti A, Lavigne GJ, Svensson P, Ahlberg J, Manfredini D. Research routes on awake bruxism metrics: Implications of the updated bruxism definition and evaluation strategies. J Oral Rehabil. 2024 Jan;51(1):150-161. DOI: 10.1111/joor.13514.
Mesko ME, Hutton B, Skupien JA, Sarkis-Onofre R, Moher D, Pereira-Cenci T. Therapies for bruxism: a systematic review and network meta-analysis (protocol). Syst Rev. 2017 Jan 13;6(1):4. DOI: 10.1186/s13643-016-0397-z.
Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F. Epidemiology of bruxism in adults: a systematic review of the literature. J Orofac Pain. 2013 Spring;27(2):99-110. DOI: 10.11607/jop.921.
Manfredini D, Restrepo C, Diaz-Serrano K, Winocur E, Lobbezoo F. Prevalence of sleep bruxism in children: a systematic review of the literature. J Oral Rehabil. 2013 Aug;40(8):631-42. DOI: 10.1111/joor.12069.
Manfredini D, Ahlberg J, Wetselaar P, Svensson P, Lobbezoo F. The bruxism construct: from cut-off points to a continuum spectrum. J Oral Rehabil. 2019; 46:991- 997. DOI: https://doi.org/10.1111/joor.12833.
Manfredini D, Ahlberg J, Aarab G, Bracci A, Durham J, Emodi-Perlman A, Ettlin D, Gallo LM, Häggman-Henrikson B, Koutris M, Peroz I, Svensson P, Wetselaar P, Lobbezoo F. The development of the Standardised Tool for the Assessment of Bruxism (STAB): An international road map. J Oral Rehabil. 2024 Jan;51(1):15-28. doi: 10.1111/joor.13380.
Svensson P, Arima T, Lavigne G, Castrillon E. Sleep bruxism: definition, prevalence, classification, etiology and consequences. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine, 6th ed. Philadelphia, PA: Elsevier; 2016:1423-1426.
Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ, de Leeuw R, Manfredini D, Svensson P, Winocur E. Bruxism defined and graded: an international consensus. J Oral Rehabil. 2013 Jan;40(1):2-4. DOI: 10.1111/joor.12011.
Johansson A, Omar R, Carlsson GE. Bruxism and prosthetic treatment: a critical review. J Prosthodont Res. 2011 Jul;55(3):127-36. DOI: 10.1016/j.jpor.2011.02.004.
Needham R, Davies SJ. Use of the Grindcare® device in the management of nocturnal bruxism: a pilot study. Br Dent J. 2013 Jul;215(1):E1. DOI: 10.1038/sj.bdj.2013.653.
Soares LG, Costa IR, Brum Júnior JDS, et al. Prevalence of bruxism in undergraduate students. Cranio. 2017 Sep;35(5):298-303. DOI: 10.1080/08869634.2016.1218671.
Hara ES, Witzel AL, Minakuchi H, de Pitta CE, Gallo RT, Okada M, Matsumoto T, Kuboki T, Bolzan MC. Vibratory splint therapy for decreasing sleep clenching: A pilot study. Cranio. 2020 Jan;38(1):15-21. DOI: 10.1080/08869634.2018.1488652.
Garbelotti TO, Turci AM, Serigato JMVA, Pizzol KEDC, Franco-Micheloni AL. Effectiveness of acupuncture for temporomandibular disorders and associated symptoms. Rev. dor. 2016;17(3):223-7.
Connelly ST, Myung J, Gupta R, Tartaglia GM, Gizdulich A, Yang J, Silva R. Clinical outcomes of Botox injections for chronic temporomandibular disorders: do we understand how Botox works on muscle, pain, and the brain? Int J Oral Maxillofac Surg. 2017 Mar;46(3):322-327. DOI: 10.1016/j.ijom.2016.11.004.
Johansson A, Omar R, Carlsson GE. Bruxism and prosthetic treatment: a critical review. J Prosthodont Res. 2011 Jul;55(3):127-36. DOI: 10.1016/j.jpor.2011.02.004.
Ainoosah S, Farghal AE, Alzemei MS, et al. Comparative analysis of different types of occlusal splints for the management of sleep bruxism: a systematic review. BMC Oral Health. 2024 Jan 5;24(1):29. DOI: 10.1186/s12903-023-03782-6.
Dowd ET. Nocturnal bruxism and hypnotherapy: a case study. Int J Clin Exp Hypn. 2013;61(2):205-18. DOI: 10.1080/00207144.2013.753832.
Griffiths MJ. The role of hypnotherapy in evidence-based clinical practice. Oral Dis. 2017 May;23(4):420-423. DOI: 10.1111/odi.12532.
Truelove E, Huggins KH, Mancl L, Dworkin SF. The efficacy of traditional, low- cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial. J Am Dent Assoc. 2006 Aug;137(8):1099-107; quiz 1169. DOI: 10.14219/jada.archive.2006.0348.
Abrahamsen R, Zachariae R, Svensson P. Effect of hypnosis on oral function and psychological factors in temporomandibular disorders patients. J Oral Rehabil. 2009 Aug;36(8):556-70. DOI: 10.1111/j.1365-2842.2009.01974.x.
Roark AL, Glaros AG, O'Mahony AM. Effects of interocclusal appliances on EMG activity during parafunctional tooth contact. J Oral Rehabil. 2003 Jun;30(6):573-7. DOI: 10.1046/j.1365-2842.2003.01139.x.
Ram HK, Shah DN. Comparative evaluation of occlusal splint therapy and muscle energy technique in the management of temporomandibular disorders: A randomized controlled clinical trial. J Indian Prosthodont Soc. 2021 Oct- Dec;21(4):356-365. DOI: 10.4103/jips.jips_332_21.
Silva JJ, Da Silva J, Souza LF, Sá-Caputo D, Cortez CM, Paineiras-Domingos LL, Bernardo-Filho M. Effectiveness of hypnosis on pain and anxiety in dentistry: Narrative review. Am J Clin Hypn. 2022 Oct;65(2):87-98. doi: 10.1080/00029157.2021.2005528.
Simon EP, Lewis DM. Medical hypnosis for temporomandibular disorders: treatment efficacy and medical utilization outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Jul;90(1):54-63. DOI: 10.1067/moe.2000.106692.
Dillworth T, Mendoza ME, Jensen MP. Neurophysiology of pain and hypnosis for chronic pain. Transl Behav Med. 2012 Mar;2(1):65-72. DOI: 10.1007/s13142-011- 0084-5.
Venkiteswaran A, Tandon S. Role of Hypnosis in Dental Treatment: A Narrative Review. J Int Soc Prev Community Dent. 2021 Apr 15;11(2):115-124. DOI: 10.4103/jispcd.JISPCD_320_20.
Ommerborn MA, Schneider C, Giraki M, Schäfer R, Handschel J, Franz M, Raab WH. Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activity. Eur J Oral Sci. 2007 Feb;115(1):7-14. DOI: 10.1111/j.1600- 0722.2007.00417.x.
Rodrigues Garcia RC, Faot F, Cury AA. Effect of interocclusal appliance on masticatory performance of patients with bruxism. Cranio. 2005 Oct;23(4):264-8. DOI: 10.1179/crn.2005.037.
Karakis D, Dogan A, Bek B. Evaluation of the effect of two different occlusal splints on maximum occlusal force in patients with sleep bruxism: a pilot study. J Adv Prosthodont. 2014 Apr;6(2):103-8. DOI: 10.4047/jap.2014.6.2.103.
Gomes CAFP, El-Hage Y, Amaral AP, et al. Effects of Massage Therapy and Occlusal Splint Usage on Quality of Life and Pain in Individuals with Sleep Bruxism: A Randomized Controlled Trial. J Jpn Phys Ther Assoc. 2015;18(1):1-6. DOI: 10.1298/jjpta.Vol18_001.
Amin A, Meshramkar R, Lekha K. Comparative evaluation of clinical performance of different kind of occlusal splint in management of myofascial pain. J Indian Prosthodont Soc. 2016 Apr-Jun;16(2):176-81. DOI: 10.4103/0972- 4052.176521.
Rosar JV, Barbosa TS, Dias IOV, Kobayashi FY, Costa YM, Gavião MBD, Bonjardim LR, Castelo PM. Effect of interocclusal appliance on bite force, sleep quality, salivary cortisol levels and signs and symptoms of temporomandibular dysfunction in adults with sleep bruxism. Arch Oral Biol. 2017 Oct;82:62-70. DOI: 10.1016/j.archoralbio.2017.05.018.
Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010 Mar 23;340:c332. DOI: 10.1136/bmj.c332.
Kunselman AR. A brief overview of pilot studies and their sample size justification. Fertil Steril. 2024 Jun;121(6):899-901. DOI: 10.1016/j.fertnstert.2024.01.040.
Moore CG, Carter RE, Nietert PJ, Stewart PW. Recommendations for planning pilot studies in clinical and translational research. Clin Transl Sci. 2011 Oct;4(5):332-
DOI: 10.1111/j.1752-8062.2011.00347.x.
Julious SA. Sample size of 12 per group rule of thumb for a pilot study. Pharmaceut. Statist. 2005; 4: 287-291. DOI: https://doi.org/10.1002/pst.185.
Hyde S, Satariano WA, Weintraub JA. Welfare dental intervention improves employment and quality of life. J Dent Res. 2006 Jan;85(1):79-84. DOI: 10.1177/154405910608500114.
Lipp MN, Lipp LMN. Proposal for a Four- Phase Stress Model. Psychology; 2019; 10:1435-1443.
Okeson JP. Management of temporomandibular disorders and occlusion. 6th ed. St. Louis, MO: Elsevier/ Mosby; 2008. p. 468–497.
Lima DG, Oliveira DWD, Oliveira ES, Gonçalves PF, Flecha OD. Stabilization splints in patients with Temporomandibular Disorders: report of two cases. Rev. Bras. Odontol. 2016; 73(3): 261-264. LINK:
http://revodonto.bvsalud.org/pdf/rbo/v73n3/a16v73n3.pdf.
Simon EP, Lewis DM. Medical hypnosis for temporomandibular disorders: treatment efficacy and medical utilization outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Jul;90(1):54-63. doi: 10.1067/moe.2000.106692.
Manfredini D, Ahlberg J, Lobbezoo F. Bruxism definition: Past, present, and future - What should a prosthodontist know? J Prosthet Dent. 2022 Nov;128(5):905- 912. DOI: 10.1016/j.prosdent.2021.01.026.
McGuire MK, Nunn ME. Prognosis versus actual outcome. III. The effectiveness of clinical parameters in accurately predicting tooth survival. J Periodontol. 1996 Jul;67(7):666-74. DOI: 10.1902/jop.1996.67.7.666.
Jiménez-Silva A, Peña-Durán C, Tobar-Reyes J, Frugone-Zambra R. Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: A systematic review from 2003 to 2014. Acta Odontol Scand. 2017 Jan;75(1):36-58. DOI: 10.1080/00016357.2016.1247465.
Solis ACO, Corchs F, Duran ÉP, Silva C, Del Real N, Araújo ÁC, Wang YP, Lotufo-Neto F. Self-reported bruxism in patients with post-traumatic stress disorder. Clin Oral Investig. 2024 Feb 16;28(2):152. DOI: 10.1007/s00784-024-05534-4.
Sutinen S, Lahti S, Nuttall NM, et al. Effect of a 1-month vs. a 12-month reference period on responses to the 14-item Oral Health Impact Profile. Eur J Oral Sci. 2007 Jun;115(3):246-9. DOI: 10.1111/j.1600-0722.2007.00442.x.
Zhang SH, He KX, Lin CJ, et al. Efficacy of occlusal splints in the treatment of temporomandibular disorders: a systematic review of randomized controlled trials. Acta Odontol Scand. 2020 Nov;78(8):580-589. DOI: 10.1080/00016357.2020.1759818.
Al-Moraissi EA, Farea R, Qasem KA, Al-Wadeai MS, Al-Sabahi ME, Al-Iryani GM. Effectiveness of occlusal splint therapy in the management of temporomandibular disorders: network meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg. 2020 Aug;49(8):1042-1056. DOI: 10.1016/j.ijom.2020.01.004.
Lobbezoo F, van der Glas HW, van Kampen FM, Bosman F. The effect of an occlusal stabilization splint and the mode of visual feedback on the activity balance between jaw-elevator muscles during isometric contraction. J Dent Res. 1993 May;72(5):876-82. DOI: 10.1177/00220345930720050801.
Almeida FL, Silva AMT, Correa ECR, Busanello AR. Relation between pain and electric activity in the presence of bruxism. Rev. Cefac. 2011;13:399-406.
Kraemer HC, Mintz J, Noda A, Tinklenberg J, Yesavage JA. Caution regarding the use of pilot studies to guide power calculations for study proposals. Arch Gen Psychiatry. 2006 May;63(5):484-9. DOI: 10.1001/archpsyc.63.5.484.
Thabane L, Ma J, Chu R, Cheng J, et al. A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol. 2010 Jan 6;10:1. DOI: 10.1186/1471-2288-10-1. Erratum in: BMC Med Res Methodol. 2023 Mar 11;23(1):59. DOI: 10.1186/s12874- 023-01880-1.
Wang P, Chow SC. Sample size re-estimation in clinical trials. Stat Med. 2021 Nov 30;40(27):6133-6149. DOI: 10.1002/sim.9175.
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