Effect of Two Interventions of Physical Therapy Compared to Dental Treatment in Individuals With Bruxism
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Purpose
Introduction: Bruxism is an oral parafunctional habit of clenching and / or grinding of teeth, which can occur during daytime (diurnal bruxism) and / or during sleep (nocturnal bruxism), whose prevalence in adults is 20% and 8% respectively. The peripheral, psychosocial and centers factors are associated with the origin of bruxism, which can trigger masticatory muscle pain, neck pain, headache, low threshold of pain sensitivity, limited jaw opening, negatively influence sleep quality and oral health and be related to affective disorders (anxiety, stress and depression). The objective of this study is to compare two physiotherapy interventions with dental treatment in pain, limited jaw opening, sleep quality, anxiety, stress and depression and oral health quality in individuals with bruxism. Methods: Participants will be randomly assigned to three groups: Group 1 (n = 20) will perform massage techniques and muscle stretching exercises, Group 2 (n = 20) relaxation therapy and imagination and Group 3 (n = 20)dental treatment. All participants will perform the same assessment procedures (pre, post and two months after intervention). The intensity of the pain will be assessed by visual analog scale (VAS), pain threshold by algometer, mandibular depression by paquimeter, sleep quality by Pittsburgh Sleep Quality Index, anxiety by State-Trait Anxiety Inventory, stress by Perceived Stress Scale, depression by Beck Depression Inventory and oral health quality by Oral Health Impact Profile (OHIP-14). Significance is considered 5%.
| Condition | Intervention |
|---|---|
|
Bruxism |
Other: Massage therapy and muscle stretching exercises Other: Relaxation therapy and imagination Other: Dental treatment |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Effect of Two Interventions of Physical Therapy Compared to Dental Treatment in Individuals With Bruxism: a Randomized Clinical Trial |
- Pain / Mandibular depression [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]Visual Analogue Scale (VAS) and Algometer (pain threshold)/Paquimeter
- Sleep Quality [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]Pittsburgh Sleep Quality Index (PSQI)
- Anxiety [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]State-Trait Anxiety Inventory (STAI)
- Stress [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]Perceived Stress Scale (PSS)
- Depression [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]Beck Depression Inventory (BDI)
- Oral Health Quality [ Time Frame: 6 weeks ] [ Designated as safety issue: Yes ]Oral Health Impact Profile (OHIP-14)
| Estimated Enrollment: | 60 |
| Study Start Date: | March 2013 |
| Estimated Study Completion Date: | September 2015 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Massage and muscle stretching exercises
Intra and extra oral massage therapy and muscle stretching exercises (mastigatory and head/neck muscles)
|
Other: Massage therapy and muscle stretching exercises
The group will perform intra and extra oral massage and muscle stretching exercises (mastigatory and head/neck muscles).
|
|
Active Comparator: Relaxation therapy and imagination
Relaxation therapy (progressive muscle relaxation) and imagination (guided imagery)
|
Other: Relaxation therapy and imagination
The group will perform relaxation therapy (progressive muscle relaxation) and imagination (guided imagery).
|
|
Active Comparator: Dental treatment
Restorative treatment
|
Other: Dental treatment
The group will perform restorative treatment.
|
Detailed Description:
Objetive: To compare two interventions of physical therapy with dental treatment in individuals with bruxism.
Design: Sixty individuals will be randomized into three group: Group 1 (n=20) massage therapy and muscle stretching exercises, Group 2 (n=20) relaxation therapy and imagination and Group 3 (n=20) dental treatment. The primary clinical outcomes will be pain, assessed with the Visual Analogue Scale (VAS) and Algometer (pain threshold) and mandibular depression asseded with paquimeter. Secondary outcomes will be sleep quality (Pittsburgh Sleep Quality Index -PSQI), anxiety (State-Trait Anxiety Inventory - STAI), stress(Perceived Stress Scale -PSS), depression (Beck Depression Inventory (BDI) and oral health quality (Oral Health Impact Profile -OHIP-14). Evaluations will be performed before(baseline), after (6 weeks) and with a follow-up 2 months after treatment. Data will be collected by a blinded examiner. Individuals of physiotherapy intervention groups will hold 12 individual sessions, lasting 40 minutes each, twice a week, by the same therapist, duly qualified. Will be requested to carry out specific exercises at home. Individuals of dental treatment group will be two sessions of individual restoration, with an interval of one week and will last two hours. Participants will be reassessed 30, 60 and 90 days after treatment ended. Significance level is established at 5%.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of sleep bruxism according to the International Classification of Sleep Disorders of the American Academy of Sleep Medicine
- Self-reported diagnosis of diurnal bruxism
Exclusion Criteria:
- Individuals with more than five dental flaws
- Systemic and/or degenerative disease
- Arthrogenic or mixed temporomandibular dysfunction
- Neurological and/or psychiatric disorders (except anxiety and depression)
- Medications with possible effects on sleep and motor behavior
- Periodontal disease
- Abuse of alcohol and/or drugs
- Complete removable denture
- Direct trauma and/or surgery in orofacial region and
- Being under physical therapy, dental, speech therapy, psychological and others
Contacts and Locations| Contact: Cinthia SM Amorim, MSc | +55 11 98228-3699 | ci_miotto@yahoo.com.br |
| Brazil | |
| Medicine School of the University Of São Paulo | Not yet recruiting |
| São Paulo, SP, Brazil, 01246903 | |
| Contact: Cinthia SM Amorim, MSc +55 11 98228-3699 ci_miotto@yahoo.com.br | |
| Study Director: | Amélia P Marques, PhD | University of Sao Paulo |
| Principal Investigator: | Cinthia SM Amorim, MSc | University of Sao Paulo |
More Information
No publications provided
| Responsible Party: | University of Sao Paulo General Hospital |
| ClinicalTrials.gov Identifier: | NCT01778881 History of Changes |
| Other Study ID Numbers: | cinthiamiotto |
| Study First Received: | January 24, 2013 |
| Last Updated: | January 28, 2013 |
| Health Authority: | Brazil: National Committee of Ethics in Research |
Keywords provided by University of Sao Paulo General Hospital:
|
Bruxism Physical Therapy Massage |
Muscle Stretching Exercises Relaxation therapy Imagination |
Additional relevant MeSH terms:
|
Bruxism Tooth Diseases Stomatognathic Diseases |
ClinicalTrials.gov processed this record on May 19, 2013