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 a repetitive jaw-muscle activity characterized by the clenching and/or grinding of the teeth, which can occur during the day and/or while sleeping. Although the prevalence of sleep and awake bruxism in the adults is approximately 8% and 20%, respectively, studies have indicated that between 85% and 90% of the population have possibly succumbed to episodes of bruxism throughout their lives. It can be associated with morphological, pathophysiological and psychosocial features. Consequently, bruxism can cause orofacial and cervical muscle pain; decrease pain thresholds and mandibular opening; change sleep quality and oral health; and increase anxiety, stress and depression. Physical therapy modalities as massage, therapeutic exercises and relaxation techniques are used for bruxism. However, little is known about the effect of these isolated or combined physical therapy interventions. The literature is unclear on the use of these physical therapy interventions for individuals with bruxism and more randomized trials with high methodological quality are needed to clarity these issues.
Purpose: To compare massage and stretching exercises; relaxation and imagination therapy; and combination of these two interventions in bruxism.
Methods: Seventy-two participants were randomly assigned to Group 1 (massage with stretching exercises, n = 24), Group 2 (relaxation with imagination therapy, n = 24) or Group 3 (two interventions combinate, n = 24). The treatment lasted 6-week. Assessments were made: before, after 6-week and two-months. Muscle pain, pain threshold, maximum mandibular opening, sleep, oral health, anxiety, stress, depression were established as outcome variables. Significance level considered was 5%.
Results: After six weeks and two-month, significant improvements were observed in muscle pain, state anxiety, stress, depression and sleep for three groups (p 0.05). In the comparison among three groups, there were significant differences for the most outcomes with higher improvement of Group 3 after 6-week and two-month (p 0.05).
Conclusion(s): The data suggests that there is superior and positive effect of massage, exercises, relaxation and imagination therapy relative to these isolated physical therapy interventions in bruxism.
Implications: Consequences of bruxism including muscle pain, mandibular opening limited, sleep disorder, poor oral health, anxiety, stress and depression can be associated with the increasing and significant number of seek for treatment for bruxism. It indicates the need for health services, such as physiotherapeutic interventions with the objectives of preventing and/or controlling bruxism and its symptoms. Thus, this study is very important for physiotherapists' daily practice in treatment of individuals with bruxism.
Keywords: Bruxism, Physical Therapy Modalities, Massage
Funding acknowledgements: Coordination for the Improvement of Higher Education Personnel (CAPES) and National Council of Technological and Scientific Development (CNPq), Brazil.
Purpose: To compare massage and stretching exercises; relaxation and imagination therapy; and combination of these two interventions in bruxism.
Methods: Seventy-two participants were randomly assigned to Group 1 (massage with stretching exercises, n = 24), Group 2 (relaxation with imagination therapy, n = 24) or Group 3 (two interventions combinate, n = 24). The treatment lasted 6-week. Assessments were made: before, after 6-week and two-months. Muscle pain, pain threshold, maximum mandibular opening, sleep, oral health, anxiety, stress, depression were established as outcome variables. Significance level considered was 5%.
Results: After six weeks and two-month, significant improvements were observed in muscle pain, state anxiety, stress, depression and sleep for three groups (p 0.05). In the comparison among three groups, there were significant differences for the most outcomes with higher improvement of Group 3 after 6-week and two-month (p 0.05).
Conclusion(s): The data suggests that there is superior and positive effect of massage, exercises, relaxation and imagination therapy relative to these isolated physical therapy interventions in bruxism.
Implications: Consequences of bruxism including muscle pain, mandibular opening limited, sleep disorder, poor oral health, anxiety, stress and depression can be associated with the increasing and significant number of seek for treatment for bruxism. It indicates the need for health services, such as physiotherapeutic interventions with the objectives of preventing and/or controlling bruxism and its symptoms. Thus, this study is very important for physiotherapists' daily practice in treatment of individuals with bruxism.
Keywords: Bruxism, Physical Therapy Modalities, Massage
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.
