Efficiency of mixed and rigid occlusal stabilization splints: Randomized clinical trial

Abstract Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student's t-test, Mann-Whitney U test, non-parametric Friedman's analysis of variance for paired samples and pairwise multiple comparisons, Pearson's chi-square test, two-proportion z-test, non-parametric McNemar's and Cochran's Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism.

Bruxismo y su asociación con la disfunción temporomandibular en niños. Revisión de literatura / Bruxism and its association with temporomandibular disorders in children. Literature review

Resumen Introducción: El bruxismo está definido como una actividad oral motora que consiste en el apretamiento o rechinamiento involuntario (rítmico o espasmódico no funcional) de los dientes, con una prevalencia de 5,9% a 49,6% en niños. Lo que podría contribuir a problemas clínicos asociados con la articulación temporomandibular. La asociación entre la disfunción temporomandibular (DTM) y el bruxismo en niños aún no está totalmente establecida. Objetivo: El objetivo de esta revisión de literatura es recopilar información actualizada de estudios que hayan abordado la asociación entre el bruxismo y la disfunción temporomandibular en niños de 3 a 12 años. Metodología: Se realizó una búsqueda en las bases de datos de Scopus, Pubmed y Scielo usando los descriptores "Niño", "Niños", "Preescolar", "Bruxismo", "Bruxismo del sueño", "Disfunción Temporomandibular"; y, "Síndrome de la Disfunción de Articulación Temporomandibular". Fueron incluidos artículos publicados en los últimos 15 años en idiomas español, inglés y portugués. Fueron incluidos estudios transversales, de cohorte, casos controles y ensayos clínicos aleatorizados. Resultados: Se evaluaron 242 artículos, de los cuales solo 11 fueron incluidos de acuerdo a los criterios de inclusión. Entre los estudios incluidos, dos de ellos no encontraron asociación entre DTM y bruxismo, tres encontraron una tendencia o probable asociación y seis encontraron una asociación positiva. Conclusiones: Existen estudios que relatan asociación entre el bruxismo y las disfunciones temporomandibulares en niños de 3 a 12 años, relacionando la presencia de signos y síntomas de la DTM con el bruxismo, pudiendo ser este último, un factor de riesgo para la presencia de DTM.

ABSTRACT Introduction: Bruxism is defined as an oral motor activity that consists of involuntary clenching or grinding (non-functional rhythmic or spasmodic) of the teeth, with a prevalence rate ranging from 5.9% to 49.6% in children, which could contribute to clinical problems associated with the temporomandibular joint. The association between bruxism in children and temporomandibular dysfunction (TMD) is not yet fully established. Objective: The objective of this literature review is to collect up-to-date information on studies that have addressed the association between bruxism and temporomandibular dysfunction in children ranging 3 - 12 years of age. Methods: A search was performed in the Scopus, PubMed and SciELO databases using the descriptors "Child", "Children", "Child, Preschool", "Bruxism", "Sleep Bruxism", "Temporomandibular Dysfunction" and "Temporomandibular Joint Dysfunction Syndrome." Articles published in the last 15 years in the Spanish, English and Portuguese languages were included. Results: A total of seventy-two articles were assessed. Only 11 articles were included according to the inclusion criteria. Among the included studies, two of them found no association between TMD and bruxism, three found a trend or probable association, and six found a positive association. Conclusion: There are studies that report an association between bruxism and temporomandibular dysfunctions in children ranging 3 - 12 years old, relating the presence of signs and symptoms of TMD with bruxism.

Impact of dental bullying on bruxism associated with poor sleep quality among adolescents

Abstract This study aimed to investigate the impact of school bullying and oral health-related verbal bullying on the occurrence of bruxism associated with poor sleep quality among adolescents. This cross-sectional study was nested in a cohort study performed with a sample of children from southern Brazil. Possible sleep bruxism was determined by the question: "Has anyone told you that you grind your teeth in your sleep?" Sleep quality was determined by answering the following question: "How would you classify the quality of your sleep?". The outcome was created by combining occurrence of sleep bruxism and poor sleep quality. The Sense of Coherence (SOC) was assessed using the SOC-13 scale. Bullying was investigated using the victim scale of the Olweus Bullying Questionnaire and oral health-related verbal bullying using an item from the Child Perceptions Questionnaire-11-14. Demographic, socioeconomic, psychosocial, and clinical data were also collected. Poisson regression models with robust variance were used. Results were expressed as prevalence ratio (PR) and 95% confidence intervals (95% CI). A total of 429 adolescents with a mean age of 12.6 (standard deviation 1.3) years were evaluated. The prevalence of bruxism associated with poor sleep quality was 23.7%. Victims of school bullying (PR 2.06; 95%CI: 1.01-4.22) and oral health-related verbal bullying (PR 1.87; 95%CI: 1.18-2.95) presented higher prevalence of bruxism associated with poor sleep quality. Factors such as skin color and SOC were also associated with the outcome. These findings suggest an association between episodes of bullying and bruxism related to poor sleep quality.

Prevalence and Risk Factors of Bruxism in a Selected Population of Iranian Children

ABSTRACT Objective: To investigate the prevalence of bruxism in Iranian children aged 6 to 12 years. Material and Methods: This cross-sectional study was conducted on 600 schoolchildren aged 6-12 years. The questionnaire consisted of two sections: the first section included demographic information, while the second evaluated the occurrence of bruxism. Kruskal-Wallis, Chi-Square, Fisher and Multinomial logistic regression were used. A level of p<0.05 was considered statistically significant. Results: 698 questionnaires were distributed, of which 600 participants were returned. According to Multinomial logistic regression, awake bruxism was associated significantly with the following variables: age, sequence of birth, recurrent headache, gastrointestinal disease, nasal obstruction, neurological disorder, easy child crying, sleep disorders, talking in a dream and snoring and jaw disorder. Sleep bruxism was associated significantly with age, premature birth, allergy, gastrointestinal disease, drooling, mouth breathing, nasal obstruction, oral habit, nail biting, sleep disorder, jaw disorders, and family history. Conclusion: Pre-birth and post-birth factors play an important role in the prevalence of bruxism in society. It is possible to prevent complications of bruxism by informing parents and making a timely diagnosis. Parents should be aware of this occurrence to reduce possible related factors to teeth and the masticatory system.

Associated factors and treatment options for sleep bruxism in children: an umbrella review

Abstract Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.

Sleep disorders are associated with both morning temporal and jaw pain among adults and elderly: a population-based study in Brazil / Distúrbios do sono estão associados à dor temporal matinal e à dor na mandíbula em adultos e idosos: um estudo de base populacional

Objective Purpose: To assess the influence of sleep disorders on temporal and jaw pain in the morning in adults and elderly people. Methods: Population-based study with representative individuals aged 18 years or over. Individuals were selected using a multistage sampling procedure. The outcomes of morning jaw pain and morning temporal pain were assessed. Sleep bruxism, obstructive sleep apnea, and sleep quality were evaluated as exposure variables. Adjusted analysis was conducted using Poisson regression. All analysis was sex stratified. Results: 820 individuals were studied. Female with sleep bruxism were 1.37 times more likely to have morning temporal pain (p=0.041). Male and female with bruxism had a prevalence 160% and 97%, respectively, higher of morning jaw pain (male: p=0.003; female: p<0.001). Women with obstructive sleep apnea were 1.52 times more likely to have morning temporal pain (p=0.023). Men with poor sleep quality had a prevalence 190% higher of morning temporal pain (p=0.005). Conclusion: Morning craniofacial pain is more frequent in individuals with sleep disorders, and there are differences between sexes. Since more than one sleep disorder can be present in the same individual, studies that adjust the analyses for possible confounders are important to avoiding possible overlap between them.

RESUMO Objetivo: Avaliar a influência dos distúrbios do sono nas dores temporais e mandibulares pela manhã em adultos e idosos. Métodos: Estudo de base populacional realizado com uma amostra representativa de indivíduos com 18 anos ou mais. Os participantes foram selecionados por meio de um processo amostral com múltiplos estágios. Os desfechos avaliados foram a dor matinal na mandíbula e a dor temporal matinal. Apneia obstrutiva do sono, bruxismo do sono e qualidade do sono foram as variáveis de exposição avaliadas. Análise ajustada foi realizada através da Regressão de Poisson e todas as análises foram estratificadas por sexo. Resultados: Foram estudados 820 indivíduos. Mulheres com bruxismo do sono tiveram 1,37 vezes mais chance de ter dor temporal matinal (p=0,041). Homens e mulheres com bruxismo tiveram uma prevalência 160% e 97%, respectivamente, maior de dor matinal na mandíbula (homens: p=0,003; mulheres: p<0,001). Mulheres com apneia obstrutiva do sono tiveram 1,52 vezes mais chance de ter dor temporal matinal (p=0,023). Homens com má qualidade do sono tiveram prevalência 190% maior de dor temporal matinal (p=0,005). Conclusão: Dor craniofacial matinal é mais frequente em indivíduos com distúrbios do sono e há diferenças entre os sexos. Uma vez que mais de um distúrbio do sono pode estar presente no mesmo indivíduo, estudos que ajustem as análises para possíveis confundidores são importantes para evitar uma possível sobreposição entre eles.

An investigation of the sleep quality status of adolescent patients with temporomandibular joint anterior disc displacement and its influencing factors / 口腔疾病防治

Objective @# To survey the current situation and analyze the relevant influencing factors of sleep quality in adolescent patients with temporomandibular joint anterior disc displacement. @*Methods@#This study has been reviewed and approved by the Ethics Committee, and informed consent has been obtained from patients. A convenience sampling method was used to investigate 120 adolescent patients with temporomandibular joint anterior disc displacement in the outpatient department of stomatology in a grade A tertiary hospital in Shanghai using the general data questionnaire, the Pittsburgh sleep quality index scale (PSQI), the Chinese middle school student mental health scale (MMHI-60) and the pain visual analog scale (VAS). Descriptive analysis, single factor analysis, correlation analysis and multiple regression analysis were used to explore the relevant influencing factors. @* Results@#The PSQI score of adolescent patients with temporomandibular joint anterior disc displacement in this study was 7.77 ± 4.63. There was a statistically significant difference in sleep quality among patients with different academic pressures and levels of sleep bruxism (P<0.05). The sleep quality score was positively correlated with the pain score (r = 0.45, P<0.001) and positively correlated with the psychological score (r = 0.74, P<0.001). The degree of pain can affect the patient's sleep quality, and those with good mental health have better sleep quality. The results of regression analysis showed that academic stress (OR = 2.511, 95% CI =1.307 ~ 4.828), bruxism (OR = 3.694, 95% CI = 1.394 ~ 9.791), pain score (OR = 2.104, 95% CI =1.095 ~ 4.041) and psychological score (OR = 1.039, 95% CI = 1.021 ~ 1.058) were statistically significant.@*Conclusion @#The sleep quality of adolescent patients with temporomandibular joint anterior disc displacement is generally poor. Academic pressure, sleep bruxism, pain and mental health are the influencing factors of sleep quality.

Factores de riesgo relacionados al bruxismo del sueño en niños de 3 a 12 años: revisión de literatura / Risk factors related to sleep bruxism in children: literature review

Resumen Introducción: El bruxismo del sueño (BS) es una actividad del músculo masticatorio durante el sueño que se caracteriza por ser rítmica o no rítmica que no debe ser considerada un trastorno del sueño o movimiento por sí sola. Objetivo: Revisar información de artículos relacionados a los factores de riesgo del bruxismo del sueño en niños de 3 a 12 años. Metodología: La estrategia de búsqueda de artículos fue realizada en las siguientes bases de datos electrónicos: PubMed, Ebsco, Web of Science y Scielo. Los descriptores: niños, pre-escolares, bruxismo, factores de riesgo y bruxismo del sueño fueron utilizados en la búsqueda. Los criterios de selección incluyeron artículos publicados desde el 2009 al 2020 en idioma inglés y español. Estudios transversales, estudios de cohorte, casos controles y ensayos clínicos aleatorizados que reportaron factores de riesgo del BS en niños de 3 a 12 años de edad fueron incluidos. Dos revisores examinaron de forma independiente los títulos y los resúmenes. Luego, los resúmenes considerados relevantes se programaron para la revisión del texto completo. En esta revisión, no existió discrepancias entre los dos revisores. Resultados: Después de aplicar los criterios de inclusión, se incluyeron veintidós artículos. Entre los artículos seleccionados, no hubo asociación entre edad y SB en niños. Conclusiones: De acuerdo con la información disponible, se considera que la genética, sexo masculino, ansiedad, desordenes psicológicos y emocionales, hábitos orales nocivos, el cronotipo del sueño, problemas y/o características del sueño y problemas respiratorios son factores de riesgo relacionados al bruxismo del sueño en niños de 3 a 12 años. Sin embargo, la asociación con maloclusiones aún necesita más estudios.

Abstract Introduction: Sleep bruxism (SB) is an activity of the masticatory muscle during sleep that could be rhythmic or non-rhythmic. Also, SB should not be considered a sleep or movement disorder by itself. Objective: To review information from studies related to risk factors of sleep bruxism in children aged 3 to 12 years old. Methods: The search for literature was performed in the following electronic databases: PubMed, Ebsco, Web of Science and Scielo. The terms children, pre-school, bruxism, risk factors, and sleep bruxism were used to search. The selection criteria included articles published from 2009 to 2020 in English and Spanish languages. Cross-sectional studies, cohort studies, case controls and randomized clinical trials which reported risk factors related to sleep bruxism in children aged 3 to 12 years-old were included. Two reviewers independently screened titles and abstracts. Then, abstracts considered relevant were scheduled for full-text review. In this review, there was no discrepancias between the two reviewers. Results: After applying the inclusion criteria, twenty-two articles were included. Among selected articles, there were no association between age and SB in children. Conclusions: According to the available information, genetics, male gender, anxiety, psychological and emotional disorders, chronotype sleep profiles, oral habits, characteristics and/or sleep problems; and respiratory difficulties are considered as risk factors related to sleep bruxism in children aged 3 to 12 years old. However, the association with malocclusions needs further studies.

Toxina Botulínica tipo A para el bruxismo del sueño en adultos

RESUMEN: Introducción: El bruxismo del sueño es un comportamiento que se caracteriza por la actividad repetitiva de los músculos masticadores. Varias terapias para el manejo del bruxismo del sueño se centran en la relajación de los músculos involucrados, incluyendo la inyección intramuscular de Toxina Botulínica tipo A (BoNTA). A pesar de que se ha comprobado la efectividad de esta terapia frente al dolor subjetivo, cuando se asocia a bruxismo del sueño, es necesario determinarla frente a desenlaces objetivos, tanto a nivel craneofacial como sistémico. Además, se debe evaluar también la seguridad de esta intervención frente a eventos adversos tales como afecciones estéticas, debilidad masticatoria y pérdida ósea mandibular, entre otros. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un meta-análisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Identificamos 11 revisiones sistemáticas que en conjunto incluyeron 9 estudios primarios, de los cuales, 8 corresponden a ensayos aleatorizados. Concluimos que la inyección intramuscular de toxina botulínica tipo A podría disminuir el dolor en reposo, presentar poca o nula diferencia en dolor durante la masticación y mejorar la autoevaluación del bruxismo, pero la certeza de la evidencia es baja. Por otra parte, no es posible establecer con claridad si el uso de Toxina Botulínica Tipo A disminuye el número de eventos de bruxismo, ya que la certeza de la evidencia ha sido evaluada como muy baja. Finalmente y a pesar de la evidencia existente respecto de los potenciales eventos adversos producto de la intervención con Toxina Botulínica Tipo A en los músculos masticatorios, los ensayos clínicos fallan en evaluarlos y reportarlos.

ABSTRACT: Introduction: The sleep bruxism is a behavior that impacts the craniofacial musculoskeletal system characterized by repetitive activity of the masticatory muscles. Several management strategies for sleep bruxism are focused of the relaxation of the involved masticatory muscles, including the intramuscular injection of botulinum toxin type A (BoNTA). Although the effectiveness of BoNTA for myofascial pain, when related with the sleep bruxism in adult patients, it is necessary to determine its effectiveness using objective outcomes at both craniofacial and systemic levels. In addition, it is necessary to determine the safety of this intervention in the context of adverse events such as aesthetic alterations, reduced masticatory function, mandibular bone loss among others. Methods: A search was performed using Epistemonikos, the biggest database for systematic reviews in health, with is maintained by screening of multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. Data from systematic reviews were extracted, and analysis of the primary studies was performed, including a meta-analysis and a summary of findings table using GRADE assessment. Results and conclusions: 11 systematic reviews were identified, and 9 primary studies were included. 8 out of these 9 studies corresponded to randomized clinical trials. We conclude that the intramuscular injection of BoNTA may reduce the pain during rest and results in either little or none difference in pain during mastication, when pain is associated with sleep bruxism in adult patients. Also, low evidence is determined for auto-report and subjective evaluation of sleep bruxism among adult patients. Additionally, it is not possible to determine if the BoNTA intervention is effective to reduce the bruxism events due to the low evidence. Finally, although evidence regarding adverse events such as mandibular bone loss after BoNTA intervention in masticatory muscles has been published at preclinical and clinical levels, the clinical trials fail to consider and to report these outcomes.

Bruxismo do sono e em vigília em adolescentes: prevalência, fatores associados e análise de caminhos / Sleep and awake bruxism in adolescents: prevalence, associated factors and pathways to occurrence

O Bruxismo é um comportamento, com atividade muscular mastigatória, que pode apresentar-se como bruxismo do sono (BS) e bruxismo em vigília (BV). Possui etiologia multifatorial, sendo pouco explorado entre adolescente. Essa tese é composta por dois artigos que avaliam a prevalência, fatores associados e análise de caminhos. O objetivo do artigo 1 (n=403) foi reconhecer os caminhos que influenciam a ocorrência de provável bruxismo do sono (PBS) e provável bruxismo em vigília (PBV) em adolescentes. O artigo 2 (n=342) objetivou avaliar a associação entre PBV e hábitos de morder, satisfação de vida, caracteristicas do sono e perfil cronotipo em adolescentes, por meio de um estudo caso-controle. Com aprovação do comitê de ética institucional, participaram do estudo adolescentes de 12 a 19 anos de idade, regularmente matriculados em escolas públicas e privadas de Belo Horizonte. Os pais/cuidadores responderam a um questionário sobre características do sono de seus filhos. Os adolescentes responderam aos seguintes instrumentos: questionário sobre hábitos de morder, características do sono e relato de bruxismo; a escala "The Circadian Energy Scale" (CIRENS), para mensurar o perfil cronotipo; e o dominio self da versão brasileira da Escala Multidimensional de Satisfação de Vida para Adolescentes (EMSVA). O PBS e PBV foram mensurados considerando o auto relato positivo, somado à presença de desgaste dentário por atrição aferido em exame clinico feito pela pesquisadora previamente calibrada. A análise descritiva foi incluida nos artigos 1 e 2. O artigo 1 usou a análise de caminhos, tecnica que descreve as dependências direcionadas entre um conjunto de variáveis. No artigo 2 foi feita regressão logistica condicional (OR) (p<0,05). Como resultados no artigo 1, verificou-se que 22,3% dos adolescentes apresentaram PBS e 51,1% PBV. As duas manifestações de bruxismo apresentaram associação entre si, com uma correlação moderada e positiva (ß= 0,390). Qualidade do sono e renda familiar tiveram um efeito direto sobre PBS (ß= - 0,138; ß=0,123; respectivamente) e em PBV (ß= - 0,155; ß=0,116; respectivamente), de modo que aqueles com maior renda e com má qualidade do sono tenderam a apresentar provável bruxismo tanto BS, quanto BV. Cronotipo teve efeito direto sobre o PBS, de modo que adolescentes com cronotipo matutino tenderam a ter o comportamento (ß= -0,102). Adolescentes que relataram babar no travesseiro enquanto dormiam (ß= 0,184) e/ou que tinham sono agitado (ß= 0,104) tenderam a apresentar PBS. Já no artgido 2 verificou-se que má qualidade do sono (OR=1,731, IC95% 1,054-2,842, p=0,030), hábito de morder objetos muitas vezes (OR=3,303, IC95% 1,631-6,690, p=0,001), hábito de morder ou apertar os lábios algumas vezes (OR=2,134, IC95% 1,230-3,702, p=0,007) e hábito de morder ou apertar os lábios muitas vezes nas duas semanas anteriores à avaliação (OR=2,355, IC95% 1,203- 4,608, p=0,012) foram associados à ocorrencia de PBV. Concluiu-se com o artigo 1 que o perfil cronotipo, renda familiar e caracteristicas do sono influenciaram no caminho percorrido pelo PBS, enquanto renda e qualidade do sono influenciam o PBV. Enquato atraves do artigo 2, concluiu- se que adolescentes com má qualidade do sono e que apresentam habitos de morder tiveram mais chance de apresentar PBV.

Bruxism is a behavior, with masticatory muscle activity, which can present itself as sleep bruxism (SB) and awake bruxism (AB). It has a multifactorial etiology, and is little explored among adolescents. This thesis is composed of two articles assessing prevalence, associated factors, and path analysis. The objective of article 1 (n=403) was to recognize the pathways influencing the occurrence of probable sleep bruxism (PSB) and probable awake bruxism (PAB) in adolescents. Paper 2 (n=342) aimed to evaluate the association between PSB and biting habits, life satisfaction, sleep characteristics and chronotype profile in adolescents by means of a case-control study. After approval by the institutional ethics committee, adolescents aged 12 to 19 years, regularly enrolled in public and private schools in Belo Horizonte, Brazil, participated in the study. Parents/caregivers answered a questionnaire about their children's sleep characteristics. The adolescents answered the following instruments: a questionnaire about biting habits, sleep characteristics and bruxism report; the Circadian Energy Scale (CIRENS), to measure the chronotype profile; and the self domain of the Brazilian version of the Multidimensional Life Satisfaction Scale for Adolescents (MLSSA). The PSB and PAB were measured considering the positive self-report, added to the presence of attrition dental wear measured in a clinical examination performed by a previously calibrated researcher. Descriptive analysis was included in articles 1 and 2. Article 1 used path analysis, a technique that describes the directed dependencies among a set of variables. In article 2, conditional logistic regression (OR) was performed (p<0.05). As results in article 1, it was found that 22.3% of the adolescents presented PSB and 51.1% PAB. The two manifestations of bruxism showed an association with each other, with a moderate and positive correlation (ß= 0.390). Sleep quality and family income had a direct effect on PSB (ß= - 0.138; ß=0.123; respectively) and on PAB (ß= -0.155; ß=0.116; respectively), so that those with higher income and poor sleep quality tended to show likely bruxism in both SB and AB. Chronotype had a direct effect on PSB, such that adolescents with morning chronotype tended to have the behavior (ß= -0.102). Adolescents who reported drooling on the pillow while sleeping (ß= 0.184) and/or who had restless sleep (ß= 0.104) tended to present PSB. In artgid 2, on the other hand, it was found that poor sleep quality (OR=1.731, 95%CI 1.054-2.842, p=0.030), habit of biting objects often (OR=3.303, 95%CI 1.631-6.690, p=0.001), habit of biting or tightening lips sometimes (OR=2, 134, 95%CI 1.230-3.702, p=0.007) and biting or lip-squeezing often in the two weeks prior to evaluation (OR=2.355, 95%CI 1.203- 4.608, p=0.012) were associated with the occurrence of PAB. It was concluded with article 1 that the chronotype profile, family income and sleep characteristics influence the path taken by PSB, while income and quality of sleep influence PAB. In article 2, it was concluded that adolescents with poor sleep quality and those with biting habits were more likely to present PAB.

Sleep bruxism in children and its association with clinical and sleep characteristics: cross-sectional study / Bruxismo do sono em crianças e sua relação com características clínicas e do sono: estudo transversal

ABSTRACT Objective: The aim of the present study was to evaluate the prevalence of bruxism in children and its association with clinical and sleep characteristics. Methods: The study sample composed of 239 children aged 7 to 10 years enrolled in a public and a private school in the city of São Luís (MA). Bruxism was investigated based on parental reports of teeth grinding at night, sleep quality, and both intraoral and extraoral clinical aspects related to the condition. Data analysis involved descriptive statistics, Pearson's chi-squared (c2) test, the linear trend c2 test, and Fisher's exact test with a 5% significance level. Results: The prevalence of bruxism was 19.7%. Among the children with bruxism, 17% had poor sleep quality, 44.1% slept up to nine hours per night, 82.2% had daytime sleepiness, and 17.9% felt tiredness or pain in the facial muscles upon waking. Conclusions: Based on the present findings, the prevalence of sleep bruxism was significant. No significant associations were observed with the factors investigated, although daytime sleepiness was found to be the most prevalent characteristic of bruxism.

RESUMO Objetivo: Este estudo avaliou a prevalência do bruxismo em crianças e sua associação a características clínicas e do sono. Métodos: A amostra foi constituída por 239 crianças, de 7 a 10 anos de idade, provenientes de uma escola pública e uma privada de São Luís (MA). O bruxismo foi investigado por meio do relato dos pais quanto a sons de ranger de dentes durante o sono, qualidade do sono e aspectos clínicos intra e extrabucais relacionados ao agravo. Foi realizada análise descritiva e aplicado os testes c2 de Pearson, c2 de Tendência Linear e Exato de Fisher, ao nível de significância de 5%. Resultados: A prevalência de bruxismo foi de 19,7%. Das crianças que apresentaram bruxismo, 17% tinham qualidade do sono ruim, 44,1% dormiam até 9 horas por noite, 82,2% tinham sonolência diurna e 17,9% se sentiam cansadas ou com dor nos músculos da face ao acordar. Conclusão: Com base nos achados, a prevalência de bruxismo do sono foi significativa. Não foi observada associação com os fatores investigados, embora a sonolência diurna tenha sido a característica mais prevalente.

Neurofeedback therapy used to treat sleep bruxism in adult subjects: a scoping review protocol

ABSTRACT Purpose: to identify evidence regarding the treatment of sleep bruxism with neurofeedback, as well as gaps in such evidence, through mapping studies, and how treatment protocols were performed. Methods: the proposed review will be conducted in accordance with the JBI methodology for scope reviews. The search strategy will aim to locate published and unpublished studies. The main databases to search include MEDLINE, Embase, LILACS, PsycINFO, Web of Science and Scopus. Gray literature and relevant materials will be included. Two independent reviewers will select titles and abstracts for evaluation, according to the inclusion criteria for the review. The search results will be reported and presented in a PRISMA flowchart. Data will be extracted from materials included in the scoping review using a data extraction tool. The results found will be presented in an organized table with the variables, with data being presented through diagrams, narratives and tables. Conclusion: a narrative summary will be performed that will accompany the tabulated results and describe the relationship of these results with the objectives and questions of this scoping review, that may lead to encouraging further research on this topic, bringing a new clinical approach evidence to the management of sleep bruxism.

Caracterización de lesiones cervicales no cariosas en pacientes bruxópatas / Characterization of non-carious cervical lesions in bruxopathic patients

RESUMEN 20. Fundamento: las lesiones cervicales no cariosas son la pérdida patológica del tejido dentario, donde el bruxismo juega un rol importante como factor de riesgo que al transmitir fuerzas lesivas provoca la fractura de los tejidos dentarios y la posterior afectación estética. Objetivo: caracterizar las lesiones cervicales no cariosas en pacientes bruxópatas. Métodos: se realizó un estudio descriptivo, transversal en los pacientes atendidos en la consulta de Prótesis Estomatológica del municipio Nuevitas, provincia Camagüey en el período de enero a julio de 2019, el universo lo constituyeron los 157 pacientes diagnosticados con bruxismo, que presentaran al menos un tipo de las lesiones cervicales no cariosas, la muestra fue de tipo probabilístico por el método aleatorio simple y quedó constituida por 97 pacientes. Resultados: de los pacientes bruxópatas examinados con lesiones cervicales no cariosas predominó el sexo femenino y el grupo de edad entre 34 a 48 años. La principal lesión cervical no cariosa de forma general en los pacientes con bruxismo fue la abfracción y se relacionó con mayor frecuencia en los pacientes con bruxismo de rechinamiento. El grupo dentario de premolares superiores fueron los más afectados. Conclusiones: durante la caracterización de las lesiones cervicales no cariosas en el paciente con bruxismo, predominó el sexo femenino y entre la tercera y cuarta década de vida, la abfracción fue la principal lesión cervical no cariosa, de mayor frecuencia en el bruxismo por rechinamiento y el grupo dentario premolar el más afectado.

ABSTRACT 27. Background: non-carious cervical lesions are the pathological loss of dental tissue, where bruxism plays an important role as a risk factor that, by transmitting damaging forces, causes the fracture of dental tissues and subsequent aesthetic involvement. Objective: to characterize non-carious cervical lesions in bruxopathic patients. Methods: a descriptive, cross-sectional study was carried out in the patients treated at the dental prosthesis consultation of the Nuevitas municipality, Camagüey province in the period from January to July 2019, the universe was made up of 157 patients diagnosed with bruxism, who presented at least a type of non-carious cervical lesions, the sample was probabilistic by the simple random method, and consisted of 97 patients. Results: of the bruxopathic patients examined with non-carious cervical lesions, the female sex and the age group between 34 and 48 years predominated. The main non-carious cervical lesion in general in patients with bruxism was abfraction and was more frequently associated in patients with grinding bruxism. The dental group of upper premolars were the most affected. Conclusions: during the characterization of non-carious cervical lesions in the patient with bruxism, the female sex predominated and between the third and fourth decade of life, abfraction was the main non-carious cervical lesion, with the highest frequency in grinding bruxism and the premolar dental group the most affected.

Auriculotherapy for sleep bruxism in children: a series of cases

Sleep bruxism is defined as a behavior that causes masticatory muscle activities during sleep. Sleep bruxism in childhood leads to consequences, which may vary from teeth wear in deciduous dentition to temporomandibular disfunction symptoms. There's no data that demonstrates improvement of children with sleep bruxism during and after auricular acupuncture treatment. Objective: Therefore, this case report series aimed to evaluate the effect of auriculotherapy on children presenting sleep bruxism. Methods: Twelve patients were included in this study, in the mean age of 6,9. The diagnosis was evaluated by the question: "Does your kid grind their teeth while sleeping?". Treatment was performed by an acupuncture specialist in a standardized way. The therapy was given for three weeks and the effect was evaluated through a sleep diary, in which the parents noted whether or not their child grinded teeth while sleeping before (baseline) and during therapy (T1 to T3). Sleep bruxism was categorized as presence or absence of nocturnal teeth grinding and the frequency varied from 0 to 7 (baseline), 0 to 5 (T1), 0 to 7 (T2) and 0 to 4 (T3) between patients. The intensity of the reported sleep bruxism was compared according to the periods by pared T-test ( =0.05). Results: It was observed that the frequency of reports decreased significantly from baseline to T3. Conclusion: These results suggest that ear acupuncture may be an alternative therapy for sleep bruxism in childhood, once it demonstrated to reduce its frequency in this study, although patients may present different effects to therapy due to biological variability.

Introdução: Bruxismo do sono é definido como um comportamento que causa atividades musculares durante o sono. Na infância, leva a consequências que podem variar de desgaste dentário na dentição decídua a sintomas de disfunção temporomandibular. Não há estudos que demonstrem melhora de casos de crianças com bruxismo do sono durante e após tratamento com auriculoterapia. Objetivo: portanto, esta série de casos visou avaliar o efeito da auriculoterapia em crianças apresentando este quadro. Métodos: Doze pacientes foram inclusos neste estudo, com a media de idade de 6,9. O diagnóstico foi avaliado pela pergunta "Seu filho range os dentes quando dorme?". O tratamento foi executado por um especialista em acupuntura de forma padronizada. A terapia foi feita por três semanas e o efeito foi avaliado através de um diário do sono, no qual os pais anotavam se a criança rangeu os dentes enquanto dormia antes (baseline) e durante a terapia (T1 a T3). Bruxismo do sono foi categorizado como presença ou ausência de ranger de dentes e a frequência variou de 0 a 7 (baseline), 0 a 5 (T1), 0 a 7 (T2) e 0 a 4 (T3) entre os pacientes. A intensidade foi comparada de acordo com os períodos pelo teste-T pareado (=0,05). Resultados: Foi observado que a frequência de relatos diminuiu significativamente de baseline a T3. Conclusão: Estes resultados sugerem que auriculoterapia pode ser uma terapia alternativa para o bruxismo do sono na infância, uma vez que demonstrou reduzir sua frequência neste estudo, embora os pacientes possam apresentar efeitos diferentes devido à variabilidade biológica.

Bruxismo en niños y adolescentes: Revisión de la literatura / Bruxism in Children and Adolescents: A Review of the Literature

Resumen: El bruxismo se define como una actividad repetitiva de los músculos masticatorios caracterizada por apretar o rechinar los dientes y/o por golpear y balancear la mandíbula. Es de etiología multifactorial y se considera que existe un bruxismo fisiológico necesario para el desarrollo de la cara de los niños. Estos dos aspectos hacen complicado el diagnóstico que se basa fundamentalmente en un cuestionario a los padres y en el examen clínico del niño. Cuando el desgaste fisiológico no se diferencia a tiempo del desgaste parafuncional, trae consecuencias negativas en el niño que alteran su calidad de vida, necesitando un manejo multidisciplinario adecuado. Considerando que es necesario conocer características fundamentales del bruxismo infantil, el objetivo del presente artículo de revisión es realizar una actualización sobre sus manifestaciones circadianas, clasificaciones, prevalencia, etiología, factores de riesgo, diagnóstico y tratamiento que servirá al odontólogo para una temprana identificación y tratamiento.

Abstract: Bruxism is defined as a repetitive activity of the chewing muscles characterized by clenching or grinding of the teeth and/or by striking and swinging the jaw. It is of multifactorial etiology and it is considered that there is a physiological bruxism necessary for the development of the face of children. These two aspects complicate the diagnosis that is fundamentally based on a questionnaire to the parents and on the clinical examination of the child. When the physiological wear does not differentiate in time from the parafunctional wear, it has negative consequences in the child that alter their quality of life, requiring an adequate multidisciplinary management. Considering that it is necessary to know the fundamental characteristics of bruxism in children and adolescents, the objective of this review article is to update its circadian manifestations, classifications, prevalence, etiology, risk factors, diagnosis and treatment that will serve the dentist for the early identification and treatment.

Bruxismo nocturno y síndrome de dolor miofascial / Sleep bruxism and myofascial pain syndrome

El bruxismo es un factor iniciador y coadyuvante de alteraciones de la región temporomandibular, entre las que se incluye el síndrome de dolor miofascial. Sin embargo, en los diversos estudios realizados en la literatura científica no hay homogeneidad en los métodos diagnósticos, en la clasificación de bruxismo o en las alteraciones temporomandibulares, lo que no permite asegurar que existe una relación causa-efecto entre el bruxismo y los diferentes desórdenes temporomandibulares. Para intentar aclarar la relación entre el bruxismo y el síndrome de dolor miofascial se realizó una revisión sistemática de la literatura sobre estudios que hayan buscado identificar la asociación entre las dos condiciones. Los estudios que han sugerido una relación causal entre bruxismo nocturno y dolor miofascial han utilizado métodos diagnósticos variables, apoyándose, principalmente, en encuestas de corte transversal, lo cual ha limitado la posibilidad de lograr conclusiones firmes; mientras que aquéllos que usan métodos objetivos, como polisomnografía, no han encontrado una concluyente relación causal (AU)

Bruxism is an initiating and coadjuvant factor of temporomandibular disorders, including myofascial pain syndrome. However, in the various studies conducted in the scientific literature, there is a lack of consistency in diagnostic methods, the classification of bruxism, or temporomandibular disorders, which has prevented to ensure that there are a cause and effect relationship between bruxism and the different temporomandibular disorders. To try to clarify the relationship between bruxism and myofascial pain syndrome, a systematic review of the literature was carried out on studies that have sought an association about these two conditions. Studies that have found a causal relationship between nocturnal bruxism and myofascial pain have used variable diagnostic methods, relying mainly on surveys, which has limited the possibility of reaching firm conclusions; while those who used objective methods, such as polysomnography, have not found a conclusive causal relationship (AU)

Comparison between sleep disorders and polysomnographic records of young adults with and without sleep bruxism: a cross-sectional study / Comparación entre trastornos del sueño y registros polisomnográficos de adultos jóvenes con y sin bruxismo del sueño: un estudio transversal

Objectives: To compare sleep disorders and polysomnographic records among a group of young adults with sleep bruxism (SB) and a control group (C). Material and methods: This cross-sectional study considered a consecutive sampling of students from the target population, searching for cases of SB until 20 individuals with and without SB were obtained. Sleep disorders were determined by applying both medical records and physiological records during sleep which were gathered from a polysomnography exam. To establish the difference of the means according to SB, the T-Student or Mann-Whitney U tests were used, depending on the data. A Logistic Regression analysis was also applied. Results: The study found differences (p-value<0.05) in the variables related to the sleep disorder: the possibility of major depressive episode (SB: 30% - C: 5%), degree of nasal airway obstruction (SB: 20% - C: 10%) and in polysomnographic registers: sleep time stage 1 (SB: 9 min - C: 18 min), Rapid Eye Movement (REM) stage (SB: 123 min C: 93 min ), number of periodic movement of the limbs (SB: 84.2 - C: 49.7), bruxism index (SB: 40.2 - C: 10.1) and average of total arousals (SB: 71.9 - C: 57.5). According to the logistic regression model, the Odds Ratio (OR) of SB, in relation to the periodic movement of the limbs and the degree of airway obstruction, it showed a statistically significant relationship (p-value<0.05). Conclusion: There were significant differences recorded in two sleep disorders between the two groups: the degree of airway obstruction and the possibility of having a major depressive episode. Differences were found in sleep and REM time stages, periodic movement of limbs and bruxism events.

Objetivo: Comparar los trastornos del sueño y los registros polisomnográficos entre un grupo de adultos jóvenes con bruxismo del sueño (BS) y un grupo control (C). Material y Métodos: Este estudio transversal consideró una muestra consecutiva de estudiantes de la población objetivo, buscando casos de BS hasta obtener 20 individuos con y sin BS. Los trastornos del sueño se determinaron aplicando registros médicos y fisiológicos durante el sueño que se obtuvieron de un examen de polisomnografía. Para establecer la diferencia de las medias según BS se utilizaron las pruebas t-Student o U de Mann-Whitney, según los datos. También se aplicó un análisis de regresión logística. Resultados: El estudio encontró diferencias (p<0,05) en las variables relacionadas con el trastorno del sueño: posibilidad de episodio depresivo mayor (BS: 30% - C: 5%), grado de obstrucción de la vía aérea nasal (BS: 20% - C: 10%) y en registros polisomnográficos: tiempo de sueño etapa 1 (BS: 9 min - C: 18 min), etapa de Movimiento Ocular Rápido (REM) (SB: 123 min C: 93 min), número de movimientos periódicos del extremidades (BS: 84.2 - C: 49.7), índice de bruxismo (BS: 40.2 - C: 10.1) y promedio de despertares totales (BS: 71.9 - C: 57.5). Según el modelo de regresión logística, el Odds Ratio (OR) del BS, en relación al movimiento periódico de las extremidades y al grado de obstrucción de la vía aérea, mostró una relación estadísticamente significativa (p<0,05). Conclusión: Se registraron diferencias significativas en dos trastornos del sueño entre los dos grupos: el grado de obstrucción de la vía aérea y la posibilidad de tener un episodio depresivo mayor. Se encontraron diferencias en las etapas de sueño y tiempo REM, movimiento periódico de extremidades y eventos de bruxismo.

CONTROLE DO BRUXISMO DO SONO NA INFÂNCIA: REVISÃO DE LITERATURA / CONTROL OF SLEEPING BRUXISM IN CHILDHOOD: LITERATURE REVIEW

O bruxismo em crianças tem se tornado uma preocupação crescente nos últimos anos. É definido como uma atividade involuntária dos músculos mastigatórios caracterizada por apertar ou ranger os dentes e pode ser de dois tipos, do sono (BS) ou da vigília (BV). A prevalência do BS na população infantil varia de 5,9% a 49,6%.Fatores funcionais, estruturais e psicológicos podem estar envolvidos com a presença do bruxismo. O diagnóstico é feito por meio de questionários, exame clínico e exame de polissonografia, que é o padrão ouro. Por ser uma desordem de origem central e não periférica, o BS não tem cura. Logo, faz-se o controle, que abrange prevenção, abordagem e gerenciamento de consequências. Atualmente, são citadas na literatura inúmeras técnicas de manejo para oBS. Este trabalho tem o objetivo de revisar a literatura atual referente ao controle do BS em crianças e confeccionar uma cartilha informativa direcionada aos pais, expondo os benefícios da higiene do sono como controle basal do BS. Conclui-se que a higiene do sono, apesar de baixa evidência científica, é considerada a primeira linha de abordagem para o bruxismo do sono infantil.

Children bruxism has become a growing worry in the last years. It is defined as an involuntary activity of masticatory muscles characterized by tightening or gritting the teeth and can be of two types, sleep (SB) or wake (WB). The prevalence of SB in infant population varies from 5,9% to 49,6%. Functional, structural and psychological factors may be involved in the presence of bruxism. The diagnosis is made through questionnaires, clinical examination and polysomnography, which is the gold standard. Because it is a central and non-peripheral origin disorder, SB has no cure. Therefore, control is made, which includes prevention, approach and consequence management. Currently, numerous management techniques for SB are cited in the literature. This work aims to review the current literature regarding the control of SB in children and to make an informative booklet directed to parents, exposing the benefits of sleep hygiene as basal control of BS. It is concluded that sleep hygiene, despite low scientific evidence, is considered the first line of approach for children sleep bruxism.

Oximetría, Frecuencia Cardíaca, Apnea y Actividad de los Músculos Masticatorios en Sujetos con BS / Oximetry, Heart Rate, Apnea and Mastication Muscle Activity in Subjects with Sleep Bruxism

RESUMEN: El objectivo de este estudio fue describir los valores promedio de oximetría, frecuencia cardíaca y eventos de apnea durante la noche y la actividad de los músculos maseteros y temporales en un grupo de adultos jóvenes con BS. Estudio observacional descriptivo de serie de casos que consideró una muestra 20 jóvenes entre 21 y 25 años diagnosticados con BS mediante polisomnografía. Se describieron las condiciones de actividad de los músculos maseteros y temporales mediante electromiografía y los valores e los signos vitales mediante polisomnografía. El análisis estadístico fue de tipo descriptivo, se aplicaron medidas de tendencia central, frecuencias absolutas y relativas. El promedio de la actividad muscular durante la masticación de los maseteros fue (D: 86) (I: 520). El promedio de la actividad muscular durante la masticación de los temporales fue (D: 340) (I: 510). El promedio en los episodios de hipopnea fue de (28,9). El promedio de oximetría fue (NMOR: 93,5) (MOR: 93,8). El promedio de la tasa cardiaca fue (NMOR: 65,4) (MOR: 66,8) latidos/minuto. El promedio de eventos de bruxismo fue (NREM: 135,4) (REM: 120,2).y el índice (eventos BS/hora) (40,60). Las características de las musculares masticatorias y los signos vitales durante el sueño de los sujetos con BS pueden ayudar al entendimiento y a la toma de decisiones en el tratamiento.

ABSTRACT: The objective of the study was to describe the average oximetry, heart rate, and apnea events values during sleep, and the activity of masseter and temporal muscles in a group of young adults with SB (Sleep Bruxism). This serial case and observational descriptive study comprised of a sample of 20 young people between 21 and 25 years of age, who were diagnosed with SB through a polysomnography test. Electromyography recordings served to describe the activity conditions of masseter and temporal muscles, while polysomnography was used to obtain measurement values and vital signs. A descriptive statistical analysis accounting for measures of central tendency, absolute and relative frequencies was performed. During mastication, the average masseter and temporal muscle activity values registered at (D: 86) (I: 520), and (D: 340) (I: 510) respectively. While, the average value for hypopnea episodes was (28.9), and (NREM: 93.5) (REM: 93.8) for oximetry. The average heart rate exhibited a value of (NREM: 65.4) (REM: 66.8) beats / minute, while the values for bruxism events registered at (NREM: 135.4) (REM: 120.2) with an index value of (SB events / hour) (40.60). Muscles of mastication characteristics, and vital signs during sleep for subjects with SB can aid in understanding and decision making in treatment.

Evaluación interdisciplinaria del sistema estomatognático y de la postura en un sujeto diagnosticado con bruxismo del sueño: Reporte de caso / Interdisciplinary evaluation of the stomatognathic and posture systems in patients with sleep bruxism: case report

Resumen Introducción: Según la literatura científica el bruxismo del sueño (BS) podría producir alteraciones musculares orofaciales, dentales, cefaleas temporales y alteraciones posturales. Objetivo: Evaluar interdisciplinariamente el sistema estomatognático y la postura de un sujeto diagnosticado con bruxismo del sueño. (BS). Materiales y métodos: Estudio descriptivo de reporte de caso de un sujeto de sexo femenino con BS que se diagnosticó mediante polisomnografía. Las relaciones inter-oclusales estáticas y dinámicas se analizaron mediante montaje de modelos en un articulador semi-ajustable. Se realizó evaluación orofacial aplicando mioescanografía, dinamometría y electromiografía y, evaluación de la alineación postural y la estabilidad mediante el índice de Romberg y las presiones plantares con baropodometría. Resultados: En la polisomnografía se registraron 56 eventos de BS/hora, 86 micro-despertares, 11 hipopneas, una tasa cardíaca de 67 l/min y una oximetría de 95%. En la masticación hubo actividad marcada en maseteros (Der: 330 uV Izq: 452 uV) y temporal (Der:418 uV, Izq:221uV) y asimetría en temporales de 34% y en orbiculares de 33%. Hubo disminución de la fuerza contráctil del masetero (0.3 lb) y compresiva del orbicular (2.0 lb). Se registró miositis en los músculos orofaciales y del cuello. Hubo compromiso postural del hemicuerpo izquierdo, estabilidad durante la posición bípeda estática con índice de Romberg de 0.99 y presión plantar mayor en el pie izquierdo de 68,5% que en el derecho de 31,5%. Conclusiones: En un caso de BS diagnosticado por polisomnografía hubo alteraciones del sistema estomatognático a nivel dental, de ATM y muscular con alteraciones posturales y de la presión plantar.

Abstract Introduction: According to the scientific literature, sleep bruxism (SB) could produce orofacial muscle, dental, and temporary headaches as well as postural alterations. Objective: To evaluate the stomatognathic system and the posture of an individual diagnosed with sleep bruxism (SB) from an interdisciplinary approach. Materials and methods: Descriptive study of a case report of a female individual. The SB was determined by polysomnography. Static and dynamic inter-occlusal relationships were analyzed by assembling models in a semi-adjustable articulator. An orofacial evaluation was performed by applying myoscanoplasty, dynamometry, and electromyography, and an evaluation of postural alignment and stability was performed using the Romberg index and plantar pressures with baropodometry. Results: In the polysomnography, 132 minutes of MOR stage and 265 of NMOR, 56 events of SB / hour, 86 micro-awakenings, 11 hypopneas, a cardiac rate of 67 l / min, and an oximetry of 95% were recorded. In the mastication, there was activity marked in masseters (Right: 330 uV Left: 452 uV) and temporary Right: 418 uV and asymmetry of temporal (34%) and orbicular (33%). There was a decrease in the contractile force of the masseter (0.3 lb) and compressive force of the orbicular (2.0 lb). Myositis was registered in the orofacial and neck muscles. There was postural involvement of left hemibody, stability during static bipedal position with Romberg Index of 0.99, and greater plantar pressure in the left foot of 68.5% than in the right foot of 31.5. Conclusions: In a case of SB diagnosed by polysomnography, there were alterations of the stomatognathic system at the dental, TMJ, and muscular levels with postural alterations and plantar pressure.