• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.1
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• pp.13-19
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• 2010

Bruxism is nonfunctional jaw movement that includes clenching, grinding and gnashing of teeth. It usually occurs during sleep, but with functional abnormality of brain, it can be seen during consciousness. Oromandibular dystonia (OMD) can involve the masticatory, lower facial, and tongue muscles and may result in trismus, bruxism, involuntary jaw opening or closure, and involuntary tongue movement. Its prevalence in the general population is 21%, but its incidence after brain injury is unknown, Untreated, bruxism and OMD cause masseter hypertrophy, headache, temporomandibular joint destruction and total dental wear. We report a case of successful treatment of bruxism and OMD after brain injury treated with botulinum toxin A and occlusal appliance. The patient was a 59-year-old man with operation history of frontal craniotomy and removal of malformed vessel secondary to cerebral arteriovenous malfomation. We injected with a total 60 units of botulinum toxin A each masseteric muscle and took impression for occlusal appliance fabrication under general anesthesia. On follow up 2 weeks and 2 months, the patient remained almost free of bruxism. We propose that botulinum toxin A and occlusal appliances be considered as a treatment for bruxism and OMD after brain injury.

• Journal of Oral Medicine and Pain
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• v.30 no.1
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• pp.69-77
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• 2005

The purposes of this study were to develop and introduce a novel intraoral appliance for bruxism composed of power switch and biofeedback device and further to examine inter- and intra-reliability of the appliance prior to clinical tests. The newly-developed appliance consisted of detection sensors, a central processing unit (CPU), a reactor and a storage unit and a displayer. Compact-sized, waterproof switches were selected as bruxism detection sensor and any sensor activation by clenching or grinding event was processed at the CPU and transmitted, by radio wave, to the reactor and storage unit and triggered auditory or vibratory signal, subsequently producing biofeedback to the patient with bruxism. The data on bruxing event in the storage unit can be displayed on the computer, making it possible analyzing frequency, duration and nature of bruxism. Cast models were obtained from ten volunteers with normal occlusion to evaluate reliability of the appliances. For inter-operator reliability on the intraoral appliances, each operator of the two fabricated the appliance for the same subject and compared the minimal contact forces provoking auditory biofeedback reaction in vertical, lateral and central directions. Intra-operator reliability was also investigated on the appliances made by a single operator at two separate times with an interval of two days. Conclusively, the newly-developed appliance is compact and safe to use in oral circumstance and easy to make. Furthermore, it had to be proven reliability excellent enough to apply in clinical settings. Thus, it is assumed that this appliance with the processor and the storage of data and auditory or vibratory biofeedback function is available and useful to analyze and control bruxism.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.1
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• pp.87-101
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• 2012

Bruxism is extensively defined as a diurnal or nocturnal parafunctional habit of tooth clenching or grinding. The etiology of bruxism may be categorized as central factors or peripheral factors and according to previous research results, central factors are assumed to be the main cause. Bruxism may cause tooth attrition, cervical abfraction, masseter hypertrophy, masseter or temporalis muscle pain, temporomandibular joint arthralgia, trismus, tooth or restoration fracture, pulpitis, trauma from occlusion and clenching in particularly may cause linea alba, buccal mucosa or tongue ridging. An oral appliance, electromyogram or polysomnogram is used as a tool for diagnosis and the American Sleep Disorders Association has proposed a clinical criteria. However the exact etiology of bruxism is yet controversial and the selection of treatment should be done with caution. When the rate of bruxism is moderate or greater and is accompanied with clinical symptoms and signs, treatment such as control of dangerous factors, use of an oral appliance, botulinum toxin injection, pharmacologic therapy and biofeedback therapy may be considered. So far, oral appliance treatment is known to be the most rational choice for bruxism treatment. For patients in need of esthetic correction of hypertrophic masseters, as well as bruxism treatment, botulinum toxin injection may be a choice.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.1
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• pp.71-80
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• 2021

Background: The options for stabilization appliance therapy for masticatory muscle pain include soft occlusal and hard stabilization appliances. A previous study suggested that hard stabilization appliance therapy was effective for patients with local myalgia who developed long facets on their occlusal appliances. The objective of this study was to identify patients in whom a soft occlusal appliance should be used to treat masticatory muscle pain by analyzing the type of muscle pain present and patient factors that influenced the effectiveness of this treatment. Methods: The study included 42 patients diagnosed with local myalgia or myofascial pain according to the Diagnostic Criteria for Temporomandibular Disorders Diagnostic Decision Tree. The analysis of patient factors included variables believed to be associated with temporomandibular disorders. First, a temporary screening appliance was used for 2 weeks to assess each patient for bruxism during sleep. Soft appliance therapy was then started. For each patient, the effectiveness of the appliance was evaluated according to the intensity of tenderness during muscle palpation and the treatment satisfaction score at one month after starting treatment. Results: Data from 37 of the 42 patients were available for analysis. Twenty-five patients reported satisfaction with the appliance. In logistic regression analysis, the odds ratio for reduction of facet length was 1.998. Nineteen patients showed at least a 30% improvement in the visual analog scale score. The odds ratio for local myalgia was 18.148. Conclusion: Soft appliance therapy may be used in patients with local myalgia. Moreover, patients who develop short facets on the appliance surface are likely to be satisfied with soft appliance therapy. Soft appliance therapy may be appropriate for patients with local myalgia who develop short facets on their occlusal appliance.

• Journal of TMJ Balancing Medicine
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• v.4 no.1
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• pp.8-11
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• 2014

A 27 year-old male patient with sleep bruxism-induced temporomandibular pain was managed by appliance of FCST with 3 weeks of duration, combined with acupuncture. After being treats for 3 weeks, the patient's pain was improved. Assessment was made by self assessment (Numerical Rating Scale, NRS; Korean Oral Health Impact Profile, KOHIP) and clinical observation. An impressive effect was observed and further clinical and biological research on FCST is expected.

• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.110-117
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• 2016

Purpose: The purpose of this study is to determine factors influencing the duration of occlusal appliance (OA) treatment for patients with temporomandibular joint (TMJ) internal derangement. Methods: Ninety patients were included for this study, who satisfied the following including criteria: (i) those who were diagnosed as disc displacement of TMJ by taking magnetic resonance imaging (MRI) and (ii) those who were finished OA treatment. The subjects were classified into three groups according to the period of OA treatment: (i) early response group (<6 months), (ii) moderate response group (6 months-1 year), and (iii) delayed response group (>1 year). Demographic data, data from chief complaints and past history of temporomandibular disorder, data from clinical examination and diagnostic imaging including panoramic view and TMJ MRI were compared among groups. One-way ANOVA and chi-square analysis were used to test statistical significance. Results: There were no significant differences in demographic data, data from chief complaints and TMJ imaging. However, only the prevalence of oral parafunctional habits including bruxism, clenching, and unilateral chewing showed significant differences among groups. Conclusions: Oral parafunctional habits could be factors to influence the duration of OA treatment in the patients with TMJ internal derangement.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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• pp.539-544
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• 1998

Thermoformed appliance, which has been recently introduced for dental usage, is an appliance made of thermoformed sheets and formed with positive or negative pressure under heat. Thermoplastic material is a kind of plastics and can be repeatedly softened by heat. It is classified into hard elastic foil, hard/soft compound foil and soft elastic foil, including BIOPLAST, BIOCRYL, IMPRELON, etc. It has been developed in 1969 and is available in various thickness, shape and color. There are two types of Vacuum former for thermoplastic materials; the pressure type and suction type. The former is much better than the latter for fabrication of various appliances due to its higher pressure. The authors have applied these appliances to some cases - chin cap, active retainer, individual Fluoride tray, mouth protector, bracket transfer mask, bruxism splint(night guard), Essix appliance - by pressure type Vacuum former($Biostar^{(R)}$). The thermoplastic appliances have numerous advantages such as simple procedure, short working time, clean and transparent product, less objectionable taste. But its outstanding advantage would be its excellent biocompatibility bacause it has no monomer and hence no tissue irritation. Although there is some limitations in its usage, it can be used widely for various purposes especaily for pediatric dentistry.

• Journal of Oral Medicine and Pain
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• v.47 no.2
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• pp.95-101
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• 2022

Temporomandibular joint osteoarthritis (TMJ OA) causes destruction of the temporomandibular joint (TMJ) and can lead to occlusal changes such as anterior open bite in some patients. Consequently, these patients may experience difficulty in chewing food items and exhibit abnormal functional habits such as bruxism, preventing healing of the TMJ condyles. Treatment protocols include the use of traction appliances to reduce stress on the condyles. Unstable occlusions can lead to weakness of the masticatory muscles which, in turn, worsen the occlusal changes and complicate pain management. Therefore, the current study evaluated the condition of the masseter muscle using ultrasonography and educated patients on the execution of gum-chewing exercises for muscle strengthening. It also aimed to assess the effects of traction appliances and strengthening exercises on the masticatory muscles of patients with occlusal changes caused by TMJ OA.

• Journal of Oral Medicine and Pain
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• v.32 no.3
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• pp.337-346
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• 2007

This study aimed to evaluate a relation of bruxism with clinical effects of botulinum toxin type A(BTX-A) injection. 5 bruxers and 5 nonbruxers with bilateral masseter hypertrophy were participated in this study. After injecting 25 unit of BTX-A(Allergen Inc, $Botox^{(R)}$) into each masseter muscle, the thickness of masseter(Mm) and anterior temporalis(Ta) muscles was measured by ultrasonography and the maximum bite force was evaluated during a 9-month period. Self-estimation on the recovery of occlusal force during mastication was done as well. Regardless of presence of bruxsim, all subjects showed significantly reduced Ms thickness(p<0.001) and maximum bite force at $1^{st}$ molars(p=0.027) with their peak at 3 months after injection, which then started to return. No significant difference was observed in Ta thickness and the bite force at the central incisors. While self-estimated occlusal force was the least at 2 weeks after injection and then rapidly returned to the baseline level with full recovery at the time of 6 to 9 months after injection, the maximum bite force measured by bite force recorder did not recover the original value, particularly in the nonbruxer group. It is assumed that nocturnal bruxism can influence recovery of atrophic masseter and decreased occlusal force due to BTX-A injection. These findings suggest a need of occlusal appliance to control bruxism or clenching habit for longer clinical effect of BTX-A injection.

• Journal of Oral Medicine and Pain
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• v.35 no.1
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• pp.75-81
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• 2010

By repeating nocturnal bruxism occlusal appliance's wearing condition that is used to cure temporomandibular disorders into the vitro experiment, research aims to find out how moisture infiltrated and drying cycle process affects on the surface microhardness of the resin for occlusal appliance and flexural strength. By utilizing resin for occlusal appliance which is the main component of poly methyl methacrylate, bar shaped sample was produced. For the resin sample utilized as the controlled group 1, the sample was infiltrated in the moisture for 7 days in the temperature of 37C. Then, the resin sample of the controlled group 2 was maintained in a dry condition for 7 days in the normal temperature. After that, each sample's surface microhardness and flexural strength were measured. For the resin sample that is utilized as the experimental sample, the sample was infiltrated in the moisture for 7 days in the temperature of 37C. Then, it was inundated for 8 hours a day and dried in the normal temperature for 16 hours with the continuous process of moisture infiltration and dry cycle process for 30 days. During this cycle process, sample's surface and flexural strength were measured in the 1st day, 7th day, and 30th day. Then, it was statistically analyzed to find out the difference of controlled and experiment group's surface microhardness and flexural strength. Results are 1. For the experimental and controlled group's surface microhardness of the resin for the occlusal appliance, it did not show any significant differences after moisture infiltration and dry cycle process repetition. 2. In case of the flexural strength for resin for the occlusal appliance, experimental group with moisture infiltration and dry cycle for 30 day process had greater effect than the experimental group at the 1st day and controlled group These results can be considered to be utilized from the patients of the temporomandibular disorders towards occlusal appliance used and maintained method.