Physiotherapy on the Airway of Bruxist Children

Study Description

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Brief Summary:

Objective: to evaluate the effects of physiotherapy on the anteroposterior airway size in a group of bruxist children

Question: Is a physiotherapeutic technique aiming at changing the head posture, effective to increase the anteroposterior dimensions of the upper airway in bruxist children?

Hypothesis: The bruxist children treated with physiotherapy will present higher airway dimensions

Design: randomized clinical trial with allocation and blinding of the examiners.

Participants: 3 to 6 year old children with complete primary dentition, dental and skeletal class I occlusion. The participants were classified as bruxist according to the minimal criteria of the ICSD for bruxism. The children were randomized in an experimental (n=13) and a control (n=13) group.

Intervention: A physiotherapeutic intervention using the Awareness through movement technique was applied to the children of the experimental group once a week, until 10 sessions were completed.

Outcome measures: anteroposterior measurements of the nasopharynx, oropharynx and hypopharynx taken in a lateral cephalogram with standardized techniques.

Condition or disease	Intervention/treatment	Phase
Sleep Bruxism; Airway Remodeling; Physical Therapy Modalities	Other: Physiotherapy	Phase 1; Phase 2

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Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	26 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Single (Outcomes Assessor)
Primary Purpose:	Treatment
Official Title:	AWARNESS THROUGH MOVEMENT PHYSIOTERAPEUTIC TECHNIQUE INCREASED THE AIRWAY DIMENSIONS OF BRUXIST CHILDREN: A SINGLE BLIND RANDOMIZED CLINICAL TRIAL.
Study Start Date :	January 2006
Actual Primary Completion Date :	June 2007
Study Completion Date :	November 2007

Arms and Interventions

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Arm	Intervention/treatment
Experimental: Physiotherapy; group of bruxist children that received physiotherapy to change the head posture	Other: Physiotherapy; The physiotherapeutic intervention was based on the Awareness through Movement technique. Ten sessions were planed. Each session lasted three hours. The children of the experimental group and their parents were guided by two physiotherapist and the sessions took place in a room rounded by mirrors. Each session developed as follows: presentation to the parents of the somatic awareness technique for each day; movements, games, motor tales and exercises performed by the children; in each session, a guide book with cartoons was given to the children and their parents to reinforce the exercises at home to keep a long-term result. All the children assisted together to all the sessions and the instructions and instruments given to the children and their parents were the same for all of them.; Other Name: Awareness through movement
No Intervention: Control; Group of bruxist children that did not receive treatment

Outcome Measures

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Primary Outcome Measures :

1. ad1 [ Time Frame: After 10 sessions of physiotherapy ]
   ad1: Distance between the posterior nasal spine (PNS) and basion (Ba) along the line which intersects the anterior and posterior pharyngeal wall.
2. ad2 [ Time Frame: After the 10 sessions of physiotherapy ]
   ad2: Distance between the anterior and posterior pharyngeal wall traced perpendicular to the plane sella (S) Ba plane and passing through PNS.
3. Angle ad1-ad2 [ Time Frame: After 10 sessions of physiotherapy ]
   Angle ad1-ad2: angle formed by ad1 and ad2.
4. OAW1 [ Time Frame: After 10 sessions of physiotherapy ]
   OAW1: the distance between the points where the functional occlusal plane intersects the anterior and posterior pharyngeal walls.
5. OAW2 [ Time Frame: After 10 sessions of physiotherapy ]
   OAW2: the distance between points where a line passing through hyoid (hy) and C2 i intersects the anterior and posterior pharyngeal walls.
6. OAW3 [ Time Frame: After 10 sessions of physiotherapy ]
   OAW3: the distance between the points where a line passing through hy and C4 i intersects the anterior and posterior pharyngeal walls.
7. Angle OAW2-OAW3 [ Time Frame: After 10 sessions of physiotherapy ]
   Angle OAW2-OAW3: angle formed by OAW2 and OAW3.
8. SPPS [ Time Frame: After 10 sessions of physiotherapy ]
   SPPS: anteroposterior dimension of the pharynx measured between the posterior pharyngeal wall and the dorsum of the soft palate on a line parallel to the Frankfort horizontal (FH) plane that runs through the middle of a line from PNS to the distal extreme of the soft palate (P).
9. IPS [ Time Frame: after 10 sessions of physiotherapy ]
   IPS: anteroposterior dimension of the pharynx measured between the posterior pharyngeal wall and the dorsum of the tongue on a line parallel to the FH plane that runs through C2i

Eligibility Criteria

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Ages Eligible for Study:	3 Years to 6 Years (Child)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• All the children accomplished the minimal criteria of the International Classification of Sleep Disorders (ICSD) for sleep bruxism.
• High anxiety level according to the Conners' Parents' Rating Scales.
• Three to six year old.

Exclusion Criteria:

• Skeletal malocclusions confirmed with cephalometric x-rays
• Dental malocclusions confirmed with dental casts.
• The reports of respiratory diseases.
• Presence of mouth breathing.
• Functional alterations in the body posture, due to any illness

Contacts and Locations

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Locations

Colombia
CES Sabaneta Physiotheray Center
Sabaneta, Antioquia, Colombia

Sponsors and Collaborators

CES University

Investigators

Principal Investigator:	Claudia Restrepo, DDS	Director CES-LPH Research Group

More Information

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Responsible Party:	Claudia Restrepo, Director CES-LPH Research Group. CES University
ClinicalTrials.gov Identifier:	NCT01178229 History of Changes
Other Study ID Numbers:	via aerea 01
First Posted:	August 10, 2010
Last Update Posted:	August 10, 2010
Last Verified:	July 2006

Keywords provided by CES University:

Sleep bruxism; Airway remodeling; Physical therapy modalities; Child preschool.

Additional relevant MeSH terms:

Bruxism; Sleep Bruxism; Airway Remodeling; Tooth Diseases; Stomatognathic Diseases	Parasomnias; Sleep Wake Disorders; Nervous System Diseases; Mental Disorders; Pathological Conditions, Anatomical