Santos Miotto Amorim C1, Fioranelli Vieira G2, Ferreira Osses Firsoff E2, Puliti E2, Pasqual Marques A1
1University of Sao Paulo, Physical Therapy, Speech and Occupational Therapy of the School of Medicine, Sao Paulo, Brazil, 2University of Sao Paulo, Operative Dentistry of the School of Dentistry, Sao Paulo, Brazil
Background: Bruxism is repetitive activity of the masticatory muscles characterized by the clenching and/or grinding of teeth while asleep and/or when awake. Study demonstrates that 85% to 90% of the population will experience bruxism episodes at some point in their lives. Moreover, it has been considered the most harmful non-functional activity to the stomatognathic system and related with muscle pain, symptoms, mandibular opening limitation, anxiety, stress, depression, poor oral health and sleep quality. Therefore, since there is not a definitive treatment for bruxism, it is a challenge for health professionals.
Purpose: To compare the efficacy of dental treatment and two different physical therapy interventions in individuals with bruxism.
Methods: A total of 72 individuals with bruxism were randomly allocated to the massage (massage with stretching exercises), relaxation (relaxation with imagination therapy) groups (n = 24 each; biweekly 40-min sessions over 6 weeks) or the dental group (n = 24; direct restoration; two 2-h sessions 1 week apart). Primary outcomes included muscle pain and symptoms, and mandibular opening. Secondary outcomes included anxiety, stress, depression, oral health and sleep quality. Outcomes were evaluated at baseline, 6 weeks and 2 months post-initial intervention by a blinded assessor. Physical therapy interventions included individual sessions that lasted 40 min biweekly for 6 weeks and dental treatment, two 2-h individual sessions conducted a week apart. The level of significance established was α=5%.
Results: After 6 weeks, the improvement with difference among massage and relaxation groups and dental group was observed in muscle pain, symptoms, anxiety, stress, depression and sleep quality (p 0.001). Relaxation group exhibited significantly greater improvement in oral health than dental group (p 0.001). These effects were sustained for up to 2 months.
Conclusion(s): Therefore, two physical therapy interventions are superior to dental treatment in the improvement of muscle pain, symptoms, anxiety, stress, depression and sleep quality in individuals with bruxism. Oral health improves more with relaxation with imagination therapy than with dental treatment.
Implications: The positive effect of physical therapy on different outcomes suggests that the best therapeutic approach to ensure maximum improvement of the clinical manifestations of bruxism is physical therapy interventions based on biobehavioral approaches. Therefore, it is important that an interdisciplinary team comprising physiotherapists and dentists evaluates the symptoms of bruxism in individuals in order to provide better recommendations regarding management and treatment.
Keywords: Bruxism, Dentistry, Physical Therapy Modalities
Funding acknowledgements: Coordination for the Improvement of Higher Education Personnel (CAPES) and National Council of Technological and Scientific Development (CNPq), Brazil.
Purpose: To compare the efficacy of dental treatment and two different physical therapy interventions in individuals with bruxism.
Methods: A total of 72 individuals with bruxism were randomly allocated to the massage (massage with stretching exercises), relaxation (relaxation with imagination therapy) groups (n = 24 each; biweekly 40-min sessions over 6 weeks) or the dental group (n = 24; direct restoration; two 2-h sessions 1 week apart). Primary outcomes included muscle pain and symptoms, and mandibular opening. Secondary outcomes included anxiety, stress, depression, oral health and sleep quality. Outcomes were evaluated at baseline, 6 weeks and 2 months post-initial intervention by a blinded assessor. Physical therapy interventions included individual sessions that lasted 40 min biweekly for 6 weeks and dental treatment, two 2-h individual sessions conducted a week apart. The level of significance established was α=5%.
Results: After 6 weeks, the improvement with difference among massage and relaxation groups and dental group was observed in muscle pain, symptoms, anxiety, stress, depression and sleep quality (p 0.001). Relaxation group exhibited significantly greater improvement in oral health than dental group (p 0.001). These effects were sustained for up to 2 months.
Conclusion(s): Therefore, two physical therapy interventions are superior to dental treatment in the improvement of muscle pain, symptoms, anxiety, stress, depression and sleep quality in individuals with bruxism. Oral health improves more with relaxation with imagination therapy than with dental treatment.
Implications: The positive effect of physical therapy on different outcomes suggests that the best therapeutic approach to ensure maximum improvement of the clinical manifestations of bruxism is physical therapy interventions based on biobehavioral approaches. Therefore, it is important that an interdisciplinary team comprising physiotherapists and dentists evaluates the symptoms of bruxism in individuals in order to provide better recommendations regarding management and treatment.
Keywords: Bruxism, Dentistry, Physical Therapy Modalities
Funding acknowledgements: Coordination for the Improvement of Higher Education Personnel (CAPES) and National Council of Technological and Scientific Development (CNPq), Brazil.
Topic: Pain & pain management; Musculoskeletal; Pain & pain management
Ethics approval required: Yes
Institution: University of Sao Paulo, Brazil.
Ethics committee: Ethics Committee of the School of Medicine
Ethics number: Protocol 209369/2013
All authors, affiliations and abstracts have been published as submitted.
