Associação entre provável bruxismo do sono e o uso de aparelhos ortodônticos fixos

Abstract

The aim of this study was to evaluate the association between probable sleep bruxism and orthodontic fixed appliances' wearing, sleep characteristics and intra and extra oral characteristics among adolescents. This transversal study was carried out in Brumadinho,southeast of Brazil. A total of 239 12-year-old adolescents enrolled in private and public schools and their parents were invited to participate in the study. Adolescents included in the study needed to be literate and had normal development, with no syndromes and/or neurological alterations. Parents received an informed consent form, containing informationregarding the objectives, risks of the study and examination procedures. Confidentiality was assured. They also received approval, the adolescents also signed an assent form and answered a questionnaire regarding their habits, sleep characteristics, history of muscle pain and history of sleep and awake bruxism. A clinical examination was performed after their answer. Extra and intra-oral examination was performed to identify clinical alterations, such as presence of left and rightside facial disparity, absent of lip competence, mouth breathing, presence of clicks/deflection in the temporomandibular joint, presence of fixed orthodontic appliances, pain in the masseter muscle upon palpation and presence of tooth wear. Presence of probable sleep bruxism wasdetermined by parents report plus presence of tooth wear and/or pain in the masseter muscle upon palpation. The statistical analysis was performed using descriptive statistics, chi-square test and logistic regression. A total of 231 adolescents participated in the study, with a loss of 3,34% from total sample. Most adolescents were female (54,10%). The prevalence of probable sleep bruxism found among the adolescents was 16,90%. Awake bruxism was reported by 23,90% of adolescents. Adolescents who drool on the pillow (p=0,034) andsnored during sleep (p=0,003) were associated to probable sleep bruxism. Adolescents who snored during sleep (Prevalence Ratio [PR] = 3,05; 95% Confidence Interval [CI] = 1,42 6,52), who did not have clicks/deflection in temporomandibular joint (PR = 3,52; 95% CI =1,16 10,62) and who used orthodontic appliances (PR=2,71; 95% CI = 1,03 7,13) had more chance to be in the group with probable sleep bruxism. This study concludes that 12- year-old adolescents wearing fixed orthodontic appliances, who snored during sleep and without clicks/deflection on temporomandibular joint were more likely to present probable sleep bruxism.