Objetivos: Comparar o efeito de três intervenções de fisioterapia com tratamento odontológico na dor e sintomas, abertura mandibular, ansiedade, estresse, depressão, qualidade de saúde bucal e sono em indivíduos com bruxismo. Métodos: Noventa e seis indivíduos com dor e bruxismo do sono e vigília entre 18 e 60 anos de idade foram randomizados em quatro grupos: Grupo 1 (n=24) massoterapia e exercícios de alongamento muscular; Grupo 2 (n=24) terapia de relaxamento e imaginação; Grupo 3 (n=24) massoterapia, exercícios, relaxamento e imaginação e Grupo 4 (n=24) tratamento odontológico pela restauração direta. As variáveis primárias foram dor e sintomas, sendo a intensidade avaliada pela escala visual analógica e limiar de dor com dolorímetro; e abertura mandibular com paquímetro digital. As variáveis secundárias foram ansiedade avaliada com Inventário de Ansiedade Traço-Estado; estresse com Escala de Estresse Percebido; depressão com Inventário de Depressão de Beck; qualidade de saúde bucal com Perfil de Impacto de Saúde Bucal e sono com Índice de Qualidade de Sono de Pittsburgh. Todos os participantes foram avaliados antes, após seis semanas e dois meses das intervenções por avaliador cego. As intervenções de fisioterapia foram individualizadas por 40 minutos, duas vezes por semana, por seis semanas; e o tratamento odontológico incluiu duas sessões individuais, com intervalo de uma semana e duração de aproximadamente duas horas. O nível de significância estabelecido foi alfa=5%. Resultados: Após seis semanas, houve melhora com diferença significativa entre os Grupos 1, 2 e 3 e o Grupo 4 na dor muscular do masseter [Média da Diferença=2,3 / 2,7 / 5,5 (IC95%=0,2 a 4,4 / 0,9 a 4,4 / 3,8 a 7,2)], temporal anterior [Média da Diferença=2,6 / 2,1 / 5 (IC95%=0,5 a 4,7 / 0,1 a 4,1 / 3,2 a 6,7)], esternocleidomastóideo [Média da Diferença=3,3 / 4,2 / 6,1 (IC95%=1,6 a 4,9 / 2,6 a 5,8 / 4,6 a 7,5)] e trapézio superior [Média da Diferença=3,8 / 4,1 / 6,6 (IC95% = 2,1 a 5,5 / 2,3 a 5,5 / 5,4 a 7,7)]. Melhora similar foi encontrada nos sintomas de cefaleia, apertamento dentário e dificuldade de dormir, bem como no estado de ansiedade, estresse, depressão e qualidade de sono (p < 0,001). Os Grupos 2 e 3 melhoraram o traço de ansiedade e qualidade de saúde bucal e o Grupo 3 melhorou o limiar de dor do músculo trapézio superior e abertura mandibular, com diferença significativa comparados ao Grupo 4 (p < 0,05). Houve manutenção destas melhoras dois meses após as intervenções (p < 0,05), porém a melhora na qualidade de saúde bucal e aumento na abertura mandibular não se mantiveram nos Grupos 2 e 3 (p > 0,05), respectivamente. Conclusão: Os dados sugerem que as três intervenções de fisioterapia comparadas a tratamento odontológico reduzem a dor e sintomas e indicam melhora da ansiedade, estresse, depressão e qualidade de sono. Os resultados apontam que as intervenções de fisioterapia: isolada (terapia de relaxamento e imaginação) e combinada (massoterapia, exercícios, relaxamento e imaginação) melhoram a qualidade de saúde bucal; e somente a combinada aumenta o limiar de dor no músculo trapézio superior e abertura mandibular em indivíduos com bruxismo / Objectives: To compare the effects of three different physical therapy interventions with dental treatment in the pain and symptoms, mandibular opening, anxiety, stress, depression, oral health and sleep in individuals with bruxism. Methods: Ninety-six individuals with pain and awake and sleep bruxism and 18-60 years old were allocated to the one of four groups: Group 1: massage and stretching exercises (n=24), Group 2: relaxation therapy and imagination (n=24), Group 3: massage, exercises, relaxation and imagination (n=24) or Group 4: dental treatment by the direct restoration (n=24). Primary outcomes included muscle pain and symptoms (intensity measured using a visual analogue scale and pain threshold with algometry) and mandibular opening (measured using a digital pachymeter). Secondary outcomes included anxiety (state-trait anxiety inventory), stress (perceived stress scale), depression (Beck depression inventory), oral health (oral health impact profile-14), and sleep quality (Pittsburgh sleep quality index). Outcomes were evaluated at baseline, 6 weeks and 2 months post-initial intervention by the 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 alfa=5%. Results: At 6 weeks after, the improvement with difference among Groups 1, 2, 3 and Group 4 was observed in masseter muscle pain [Mean Difference=2.3 / 2.7 / 5.5 (95%CI=0.2 to 4.4 / 0.9 to 4.4 / 3.8 to 7.2)], anterior temporalis [Mean Difference=2.6 / 2.1 / 5 (95%CI=0.5 to 4.7 / 0.1 to 4.1 / 3.2 to 6.7)], sternocleidomastoid [Mean Difference=3.3 / 4.2 / 6.1 (95%CI=1.6 to 4.9 / 2.6 to 5.8 / 4.6 to 7.5)] and upper trapezius [Mean Difference=3.8 / 4.1 /6.6 (95%CI=2.1 to 5.5 / 2.3 to 5.5 / 5.4 to7.7)] as well as in symptoms of headache, teeth clenching and sleep difficulties, anxiety state, stress, depression and sleep quality (p < 0.001). Both Group 2 as Group 3 improved oral health and anxiety trait and the Group 3 increased the pain threshold of upper trapezius muscle and mandibular opening with significant difference relative to Group 4 (p < 0.05). These results were sustained for up to 2 months (p < 0.05), however the improvements of oral health and mandibular opening were not maintained in Groups 2 and 3(p > 0.05), respectively. Conclusions: The results suggest that three physical therapy interventions compared to dental treatment reduce the pain and symptoms and indicate improvement of anxiety, stress, depression and sleep quality. Moreover, the date demonstrate that both combined physical therapy interventions (massage, exercises, relaxation and imagination) as isolated (relaxation therapy and imagination) improve the oral health and only the combined increases the mandibular opening and pain threshold of upper trapezius muscle in individuals with bruxism

Made available in DSpace on 2016-03-15T19:40:44Z (GMT). No. of bitstreams: 1 Erika Miti Yasui.pdf: 439112 bytes, checksum: 64788c447a4bd122f64e6e366477885f (MD5) Previous issue date: 2006-08-03 / Fundo Mackenzie de Pesquisa / To study the oral manifestations of Rett syndrome and the oral health conditions of female patients with Rett syndrome diagnosis and to evaluate the necessity of specific preventive and therapeutic dental treatment. Clinical evaluation of 21 patients from Associação Brasileira de Síndrome de Rett (ABRE-TE) classified according to the syndrome stage. The collected data came from a questionnaire about general and oral health for the caretakers and clinical and radiographic examination (panoramic radiography). These data were loaded and analysed statiscally in the EPI6 6.04d, 2001 program. The used indexes for the oral health conditions evaluation were: carie experience index (DMFT), simplified hygiene index (IHO-S) and dental treatment needs index (INTO). The diurnal excentric bruxism was observed in 17 patients (80,9%) and it was the main reason for the dental visits. Alterations in shape, size or chronological eruption of the teeth were not detected. Only 7,6% of the dental surfaces were plaque free and 12 patients presented gingival bleeding (57,1%). The person responsible for the oral hygiene of the patients, in most cases was the mother (n=17), who presented high level of education and reported have not been given professional advice to performed it. Although 14 patients did not show dental treatment needs, it increases with age. In the present study clinical and radiographic oral alterations specific to the Rett syndrome were not detected, and the diurnal excentric bruxism was the main oral manifestation. The oral hygiene conditions were not satisfactory and the clinical characteristics presented by the patients with Rett syndrome make the oral hygiene performance by the caretakers difficult. This fact stresses the necessity of the implementation of a preventive and therapeutic dental program as well the education and training of professionals capable to work in a multidisciplinary way and then, to provide dental treatment according to the patients needs. / A síndrome de Rett é uma condição neurobiológica, que afeta quase que exclusivamente o sexo feminino, ocorrendo em uma diversidade de grupos raciais e étnicos no mundo inteiro. Desde que foi descrita pela primeira vez, por Andreas Rett em 1966, grandes avanços das pesquisas sobre diversos aspectos da síndrome foram realizados. Porém, na área odontológica, pouco se conhece a respeito de suas manifestações bucais. Esse desconhecimento dificulta a detecção da necessidade de elaboração de tratamento odontológico preventivo e terapêutico específico. O objetivo desse estudo foi detectar as manifestações bucais da síndrome de Rett e as condições de saúde bucal apresentadas por 21 portadoras da síndrome de Rett e avaliar a necessidade de tratamento odontológico preventivo e terapêutico específico. Foram estudadas 21 pacientes atendidas na Associação Brasileira de Síndrome de Rett de São Paulo, classificadas de acordo com o estágio de evolução da síndrome. A coleta de dados utilizou questionário sobre as condições de saúde geral e bucal das pacientes, dirigido aos responsáveis; avaliação das condições saúde bucal realizada por meio de exame de inspeção com a utilização de espelho clínico, sonda periodontal CPI (OMS) e corante para evidenciação de biofilme dental e exame radiológico (radiografia panorâmica) para detecção de eventuais alterações ósseas e dentárias. Os dados coletados foram armazenados e analisados em banco de dados do programa Epi6, versão 6.04d, 2001. Os índices utilizados para análise das condições de saúde bucal foram: índice de experiência de cárie (CPOD), índice de higiene oral simplificado (IHO-S) e índice de necessidade de tratamento (INTO). O bruxismo excêntrico diurno foi observado em 17 pacientes (80,9%), sendo o principal motivo para consultas odontológicas. Não foram observadas alterações de forma, tamanho ou cronologia de erupção dos dentes ou das estruturas ósseas das pacientes examinadas. Somente 7,6% das superfícies dentárias examinadas apresentavam-se isentas de biofilme dental e 12 pacientes apresentaram sangramento gengival (57,1%). O responsável pela higiene bucal das portadoras de síndrome de Rett é, na maioria dos casos, a mãe (n=17), que apresenta nível de escolaridade elevada e relata não ter recebido orientação profissional para realizar a higiene bucal de sua filha. Apesar de 14 pacientes não apresentarem necessidades de tratamento odontológico (índice INTO=0), essa necessidade aumenta de acordo com a idade das pacientes. Conclui-se que no presente estudo não foram detectadas alterações clínicas ou radiográficas específicas, relacionadas com a síndrome de Rett, sendo o bruxismo excêntrico diurno a principal manifestação bucal observada, devendo sofrer intervenção sempre que possível. As pacientes com síndrome de Rett não apresentaram condições de higiene bucal satisfatórias, independente da idade e estágio de evolução da síndrome. As características clínicas apresentadas por essas pacientes dificultam a realização da higiene bucal por seus responsáveis, evidenciando a necessidade de implementação de programas odontológicos preventivos e terapêuticos para essas pacientes, além da necessidade de formação e treinamento de profissionais capazes de trabalhar de forma multidisciplinar, com uma visão integral de seus pacientes e de suas necessidades odontológicas.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2018-09-27T17:56:21Z No. of bitstreams: 1 larissadeoliveirareis.pdf: 7026883 bytes, checksum: ed47575eca8cad23157546a9c709e3c8 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-10-16T12:14:27Z (GMT) No. of bitstreams: 1 larissadeoliveirareis.pdf: 7026883 bytes, checksum: ed47575eca8cad23157546a9c709e3c8 (MD5) / Made available in DSpace on 2018-10-16T12:14:27Z (GMT). No. of bitstreams: 1 larissadeoliveirareis.pdf: 7026883 bytes, checksum: ed47575eca8cad23157546a9c709e3c8 (MD5) Previous issue date: 2018-08-03 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O bruxismo em crianças e sua relação com o desenvolvimento das disfunções temporomandibulares (DTM) ainda não foram claramente definidos. O objetivo desta revisão sistemática foi avaliar a possível associação entre bruxismo e DTM em crianças. Sete bases de dados foram pesquisadas e 497 artigos foram avaliados. A qualidade metodológica foi avaliada através da Escala de Newcastle-Ottawa. A meta-análise foi realizada com os artigos em que a extração de dados foi possível e o efeito sumário foi medido por meio do odds ratio (OR) e respectivos intervalos de confiança de 95% (IC). A classificação de recomendações, avaliação, desenvolvimento e avaliação (GRADE) foi usada para avaliar a certeza da evidência. Dez estudos transversais foram incluídos na revisão sistemática. Destes, 8 apresentaram associação estatisticamente significante entre bruxismo e DTM. No entanto, 7 apresentaram alto risco de viés. A meta-análise foi realizada com 3 artigos e obteve OR de 2,97 (IC 95% variando de 1,72 a 5,15), indicando que crianças com bruxismo têm 2,97 vezes mais chances de apresentar DTM, com nível de certeza muito baixo definido pelo GRADE. Embora os estudos mostrem alto risco de viés, a análise qualitativa de estudos individuais mostrou que as crianças com bruxismo têm maior chance de desenvolver DTM. / Bruxism in children and its relation to the development of temporomandibular disorders (TMD) has not been clearly determined yet. The objective of this systematic review was to evaluate the possible association between bruxism and TMD in children. Seven databases were searched and 497 articles were assessed. Methodological quality was assessed through Newcastle-Ottawa Scale. The meta analysis was performed with the articles in which extraction of data was possible and the summary effect measure through odds ratio (OR) and respective 95% confidence intervals (CI). Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the certainty of evidence. Ten cross sectional studies were included in the systematic review. Of these, 8 showed a statistically significant association between bruxism and TMD. However, 7 presented a high risk of bias. The meta-analysis was performed with 3 articles and obtained an OR of 2.97 (95% CI ranging from 1.72 - 5.15), indicating that children with bruxism are 2.97 times more likely to present TMD, with very low level of certainty defined by GRADE. Although the studies showed high risk of bias, the qualitative analysis of individual studies showed that the children with bruxism have greater chance of developing TMD.

El desgaste dentario patológico es el atípico para la edad del paciente, provocando dolor o malestar, problemas funcionales o deterioro del aspecto estético que, de progresar, puede dar lugar a complicaciones indeseables de complejidad creciente. El objetivo de este artículo es presentar un caso clínico de una rehabilitación oral, restaurando las estructuras dentarias desgastadas y restauraciones perdidas mediante el uso de diferentes materiales adhesivos. Se propuso rehabilitación con prótesis fija arcada inferior y superior que se realizó en tres fases: Restauraciones directas de resina en sector anteroinferior y carillas palatinas de resina indirectas anterosuperior; provisionalización de sectores postero inferior y posterosuperior; preparación y cementación de restauraciones indirecta. Para finalizar la confección de férula miorelajante junto a instrucción de guía de hábitos alimenticios. / Pathological tooth wear is atypical for the age of the patient, causing pain or discomfort, functional problems or deterioration of the aesthetic appearance that, if it progresses, can lead to undesirable complications of increasing complexity. The objective of this article is to present a clinical case of an oral rehabilitation, restoring worn tooth structures and lost restorations through the use of different adhesive materials. Rehabilitation with a fixed lower and upper arch prosthesis was proposed, which was performed in three phases: direct resin restorations in the anteroinferior sector and indirect anterosuperior resin palatal veneers; provisionalization of the posterior inferior and posterior superior sectors; preparation and cementation of indirect restorations. All in all, the preparation of myorelaxing splint together with instruction on the guide on eating habits. / Trabajo académico

Introduction : L'apnée obstructive du sommeil (AOS) et ses comorbidités (tel le bruxisme du sommeil (BS)) sont associées à des fluctuations du système nerveux autonome (SNA) chez les adultes et les enfants. La variabilité de la fréquence cardiaque (VFC), qui concerne, entre autres, la fluctuation des intervalles de temps entre les battements cardiaques adjacents, est une méthode non invasive et reproductible d'évaluation de la modulation du SNA. Objectif : Évaluer l'effet individuel et potentiellement cumulatif de ces conditions sur la VFC de la population pédiatrique. Méthodes : Des questionnaires dentaires et de bruxisme ont été remplis par les parents. Les enfants ont subi une évaluation dentaire et un enregistrement polysomnographique. La VFC a été analysée dans une fenêtre de référence de 5 minutes ainsi que dans des fenêtres de 4x3 minutes avant et après les événements d’AOS ou de BS. Résultats : Un total de 41 enfants ont été classés en sous-groupes : BS, contrôle et AOS+BS. Le rapport de puissance spectrale Basse Fréquence/Haute Fréquence (BF/HF), qui est connu pour utiliser les transformations de Fourier rapide, était plus élevé dans le groupe AOS + BS que dans le groupe contrôle (p = 0,01) et le groupe BS (p = 0,04) pour toutes les fenêtres d’analyse combinées (B0-B8). Dans le domaine temporel de la VFC, l'écart type des intervalles RR (SDNN) des fenêtres était plus élevé après chaque événement (B5 à B8) que la ligne de base (B0) pour les 3 groupes (p < 0,05). Conclusion : La VFC est différente entre les trois groupes. / Introduction: Obstructive sleep apnea (OSA) and its comorbid conditions (such as sleep bruxism (SB)) are associated with an autonomic nervous system (ANS) fluctuation in adults and children. Heart rate variability (HRV), which is concerned with, among other things, the fluctuation of the time intervals between adjacent heartbeats, is a non-invasive and reproducible method of assessing the modulation of the ANS. Aim: To assess the individual and potentially cumulative effect of these conditions on HRV in the pediatric population. Methods: Dental and bruxism questionnaires were completed by the parents. Children underwent a dental assessment and polysomnographic recording. HRV was analyzed in a 5-minute baseline windows as well as in 4x3-minute windows before and after OSA or SB events. Results: A total of 41 children were classified into subgroups: SB, control and OSA+SB. The Low Frequency/High Frequency (LF/HF) power ratio, which is known to use Fast Fourier Transforms, was higher in the AOS + SB group than in the control group (p = 0.01) and the SB group (p=0.04) for all analysis windows combined (B0-B8). In the time domain of the HRV, the standard deviation of the RR intervals (SDNN) of the windows was higher after each event (B5 to B8) than the baseline (B0) for the 3 groups (p < 0.05). Conclusion: HRV is different between the three groups.

Introduction : Le bruxisme du sommeil est un désordre du mouvement décrit comme un mouvement involontaire de la mastication durant le sommeil. Cette parafonction est observée dans 14-38% de la population pédiatrique. Un lien a été trouvé entre les événements respiratoires et les épisodes de bruxisme. L’expansion palatine rapide (EPR) est un traitement orthopédique effectué chez les enfants en croissance pour régler un manque transverse squelettique du maxillaire supérieur. Quelques études ont observé que l’apnée obstructive du sommeil a été diminuée par un traitement d’expansion palatine rapide. Objectifs : Étant donné que le bruxisme est en lien avec des événements respiratoires et que l’expansion palatine rapide augmente la dimension des cavités nasales, l’objectif de la présente étude est d’évaluer la possible réduction du bruxisme après le traitement d’expansion rapide. Méthodes : Ce projet pilote est une étude clinique randomisée contrôlée de patients consécutifs qui a inclus 27 enfants (8-14 ans, 8 garçons et 19 filles) avec ou sans bruxisme du sommeil. Tous ces patients sont venus à la clinique d’orthodontie de l’Université de Montréal et présentaient un manque transverse du maxillaire supérieur (au moins 5 mm). Dans le cadre de l’étude, les patients devaient passer un enregistrement polysomnographique ambulatoire avant le traitement d’expansion palatine (T0) et après l’activation de l’appareil d’expansion (T1). Résultats : Les résultats démontrent une diminution du bruxisme chez 60% (9 patients) de nos patients bruxeurs. L’interaction entre le traitement et les groupes (Br et Ctl) s’est avérée significative (p=0,05 ANOVA mesures répétées), et démontre une diminution du bruxisme chez les bruxeurs (p=0,04, t-test paire). Les médianes (min, max) du groupe avec bruxisme sont passées de 3,11 (2,06; 7,68) à 2,85 (0,00; 9,51). Les paramètres de sommeil sont restés stables (Stade N1/N2/N3, REM, efficacité du sommeil), ainsi que les paramètres respiratoires et le ronflement. Conclusion : Une réduction du bruxisme a été observée lors de cette étude, mais un échantillonnage plus grand est nécessaire pour conclure. / Introduction: Sleep bruxism (SB) is a movement disorder described as an involuntary mastication movement during sleep. This parafunction is observed in 14-38% of the child population. A link was found between respiratory events and episodes of bruxism. Rapid palatal expansion (RPE) in children is an orthopedic treatment that is effective in correcting maxillary transverse deficiency and in reducing obstructive apnea syndrome (OAS) by increasing airway capacity. Objectives : Since bruxism is related to respiratory events and RPE increases respiratory capacity, the objective of this study is to evaluate the possible reduction of bruxism after RPE therapy. Material and Methods : This prospective randomized controlled clinical pilot study recruited 27 children (8-14 years old, 8 boys, 19 girls) with or without sleep bruxism. These patients were seeking treatment for transverse maxillary deficiency (5 mm or more) at the orthodontics department of the University of Montreal. Patients underwent an ambulatory polysomnography before (T0) and after expansion (T1). Sleep parameters, rhythmic muscular masticatory activity index were evaluated. Results : The results show a reduction of bruxism in 60% of bruxer patients (9 participants). The interaction between the treatment and the groups (Br and ctl) was significant (p=0,05, repeated measures ANOVA). A reduction of bruxism is shown for bruxers (p=0,04, paired t-test). The sleep parameters stayed stable after RPE (Stage N1/N2/N3, REM, sleep efficiency) as well as the breathing parameters and snoring data. The medians (min, max) of bruxism group went from 3,11 (2,06; 7,68) to 2,85 (0,00; 9,51). Conclusion : During this study, a reduction of bruxism was observed but a larger sample size is needed to conclude on the subject.

Introduction : Le bruxisme du sommeil est un désordre du mouvement décrit comme un mouvement involontaire de la mastication durant le sommeil. Cette parafonction est observée dans 14-38% de la population pédiatrique. Un lien a été trouvé entre les événements respiratoires et les épisodes de bruxisme. L’expansion palatine rapide (EPR) est un traitement orthopédique effectué chez les enfants en croissance pour régler un manque transverse squelettique du maxillaire supérieur. Quelques études ont observé que l’apnée obstructive du sommeil a été diminuée par un traitement d’expansion palatine rapide. Objectifs : Étant donné que le bruxisme est en lien avec des événements respiratoires et que l’expansion palatine rapide augmente la dimension des cavités nasales, l’objectif de la présente étude est d’évaluer la possible réduction du bruxisme après le traitement d’expansion rapide. Méthodes : Ce projet pilote est une étude clinique randomisée contrôlée de patients consécutifs qui a inclus 27 enfants (8-14 ans, 8 garçons et 19 filles) avec ou sans bruxisme du sommeil. Tous ces patients sont venus à la clinique d’orthodontie de l’Université de Montréal et présentaient un manque transverse du maxillaire supérieur (au moins 5 mm). Dans le cadre de l’étude, les patients devaient passer un enregistrement polysomnographique ambulatoire avant le traitement d’expansion palatine (T0) et après l’activation de l’appareil d’expansion (T1). Résultats : Les résultats démontrent une diminution du bruxisme chez 60% (9 patients) de nos patients bruxeurs. L’interaction entre le traitement et les groupes (Br et Ctl) s’est avérée significative (p=0,05 ANOVA mesures répétées), et démontre une diminution du bruxisme chez les bruxeurs (p=0,04, t-test paire). Les médianes (min, max) du groupe avec bruxisme sont passées de 3,11 (2,06; 7,68) à 2,85 (0,00; 9,51). Les paramètres de sommeil sont restés stables (Stade N1/N2/N3, REM, efficacité du sommeil), ainsi que les paramètres respiratoires et le ronflement. Conclusion : Une réduction du bruxisme a été observée lors de cette étude, mais un échantillonnage plus grand est nécessaire pour conclure. / Introduction: Sleep bruxism (SB) is a movement disorder described as an involuntary mastication movement during sleep. This parafunction is observed in 14-38% of the child population. A link was found between respiratory events and episodes of bruxism. Rapid palatal expansion (RPE) in children is an orthopedic treatment that is effective in correcting maxillary transverse deficiency and in reducing obstructive apnea syndrome (OAS) by increasing airway capacity. Objectives : Since bruxism is related to respiratory events and RPE increases respiratory capacity, the objective of this study is to evaluate the possible reduction of bruxism after RPE therapy. Material and Methods : This prospective randomized controlled clinical pilot study recruited 27 children (8-14 years old, 8 boys, 19 girls) with or without sleep bruxism. These patients were seeking treatment for transverse maxillary deficiency (5 mm or more) at the orthodontics department of the University of Montreal. Patients underwent an ambulatory polysomnography before (T0) and after expansion (T1). Sleep parameters, rhythmic muscular masticatory activity index were evaluated. Results : The results show a reduction of bruxism in 60% of bruxer patients (9 participants). The interaction between the treatment and the groups (Br and ctl) was significant (p=0,05, repeated measures ANOVA). A reduction of bruxism is shown for bruxers (p=0,04, paired t-test). The sleep parameters stayed stable after RPE (Stage N1/N2/N3, REM, sleep efficiency) as well as the breathing parameters and snoring data. The medians (min, max) of bruxism group went from 3,11 (2,06; 7,68) to 2,85 (0,00; 9,51). Conclusion : During this study, a reduction of bruxism was observed but a larger sample size is needed to conclude on the subject.

Syfte: Det saknas kunskap om samband mellan vaginism och bruxism. Syftet med studien var att studera förekomst av orala parafunktioner och bruxism hos kvinnor med vaginism i jämförelse med kvinnor utan vaginism. Studien syftar även till att undersöka eventuella skillnader kring smärta, stress och somatiska besvär mellan grupperna. Metod: En enkätstudie där en modifierad version av DC/TMD axel II, delades ut till patienter som sökt barnmorska. Resultat: Bland de 26 svarande fanns en tendens till ökade dagliga parafunktioner som att pressa tänder under vaken tid, vilket kunde ses i deltagargruppen med vaginism i jämförelse med kontrollgruppen. Smärta som skulle kunna relateras till TMD och parafunktioner var mer frekventa samt mer uttalade i deltagargruppen med vaginism. Deltagargruppen med vaginism hade även en antydan till mer stress, oro samt somatiska besvär.Konklusion: Den viktigaste slutsatsen utifrån utförd studie är att det inte tydligt skiljer sig mellan en grupp individer med vaginism och en kontrollgrupp avseende bruxism. Deltagargruppen med vaginism har en tendens till mer förekommande orala parafunktioner. TMD smärta är mer förekommande i deltagargruppen med vaginism vilket eventuellt kan vara en orsak av ökade parafunktioner. Båda grupperna hade förekomst av psykosociala riskfaktorer för bruxism, dock var de något mer frekventa i experimentgruppen. Det finns ingen tidigare forskning kring sambandet mellan vaginism och bruxism varvid denna studie med endast ett fåtal deltagare skulle kunna ses som en pilotstudie, vilken kan bidra till att öppna upp för interdisciplinär forskning i ämnet. / Aim: There is a lack of knowledge regarding the relationship between vaginismus and bruxism. The purpose of the study was to investigate the occurrence of bruxism and oral parafunctions in women with vaginismus in comparison to women without vaginismus. The study also aimed to investigate possible differences in pain, stress and somatic disorders between the groups.Method: The survey was executed with a modified version of DC/TMD Axis II, and was distributed to patients seeking care from a midwife.Results: Among the 26 respondents, there was a tendency for increased parafunctions, such as clenching teeth during awake time in the vaginismus group of participants. Pain that could be related to TMD and parafunctions were more frequent and more apparent in the group with vaginismus. The group with vaginismus also had a hint of more stress, anxiety and somatic problems.Conclusion: The most important conclusion from the study is that there is no clear difference between a group of individuals with vaginismus and a control group regarding TMD. The group with vaginismus had a tendency of more oral parafunctions. TMD pain is more common in the group with vaginismus, which might be caused by increased parafunctions. Both groups had psychosocial risk factors for bruxism, however, they were somewhat more frequent in the experimental group. There is no previous research on the relationship between vaginismus and bruxism, this study with only a few participants could be seen as a pilot study, which could help open up interdisciplinary research on the subject.