Bruxism, Cervical Stabilization Exercise, Sleep Quality
Conditions
Brief summary
Bruxism and temporomandibular joint dysfunction are common conditions today. The applications in the treatment of these disorders are limited. When the literature is examined, it has been determined that cervical stabilization exercises, which are frequently applied in physical therapy clinics for neck problems, have not been applied to bruxism before. For this reason, in this study, we will examine the effects of cervical stabilization exercises targeting deep cervical muscles on bruxism.
Detailed description
Bruxism is the grinding or clenching of teeth, which is characterized by the fixed or forward movement of the mandible that occurs repeatedly during the day, including muscles such as the masseter and temporal muscles. Correct determination of the etiology plays a key role in the treatment of bruxism. There are many suggestions in the literature for the treatment of bruxism. The most preferred of these are: providing training for the person to quit harmful habits, physiotherapy applications for muscle relaxation, botox applications, drug treatments, giving the patient an occlusal splint, etc. Since bruxism is a functional problem of muscular origin, it is possible to talk about muscle-oriented exercise applications in its treatment. As a result of studies in which exercises are frequently prescribed for the chewing muscles and temporomandibular muscles, it has been determined that bruxism symptoms are relieved and functional gains are achieved. It has also been stated that muscle pain and activity, mouth opening, oral health, anxiety, stress, depression and head posture can be improved in individuals with bruxism with physiotherapy approaches. When the literature is examined; There are studies investigating the effects of physiotherapy applications in bruxism. In addition, although it is known that the neck region is affected in bruxism, causing the head to tilt forward and increased muscle activation in the neck region, no study has been found investigating the effects of specific cervical region stabilization exercises. This study was planned considering the effects of cervical stabilization exercises on correcting cervical posture and providing muscle activation balance.
Interventions
The cervical region is one of the most affected regions of the musculoskeletal system due to the intensive proprioceptors. Studies have shown that many position sense proprioceptors are over the deep group cervical muscles such as longus colitis and longus capitis. The deep group cervical muscles, which perform a dynamic ligament function, have an important role in maintaining the stability of the spine as well as the proprioceptive sense. In particular, proprioceptive receptors, which are commonly found in the deep suboccipital muscles; There are cervical and reflex connections with vestibular, visual and postural control systems.
Sponsors
Necmettin Erbakan University
Hacettepe University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 30 Years
Healthy volunteers
Yes
Inclusion criteria
* Patients with full dentition including 2nd molars * Patients without facial asymmetry
Exclusion criteria
* Patients with systemic and/or neuromuscular diseases * Patients with orofacial pain not caused by bruxism * History of temporomandibular joint (TMJ) surgery or injection * Use of any medical drugs affecting the muscular system * Patients with developmental deformities or a history of surgery in the maxillofacial region (facial trauma history, resection history, etc.) * TMJ pathologies (major condylar changes seen on panoramic radiographs) * History of radiotherapy and/or chemotherapy * Ongoing orthodontic treatment * Use of removable prosthesis * Inflammatory connective tissue diseases * Pregnancy * Obstructive sleep apnea * Local skin infection over the myofascial area * Patients who have undergone root canal treatment * Reluctance to take responsibility for the work
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Muscle Activation Evaluation | At baseline, after 6 weeks of treatment, 4 weeks after the end of treatment | Participants' Masseter, Temporal and Trapezius muscle activation will be evaluated with Superficial Electromyography. (Number of Participants estimated 28 individuals) |
| Tongue Pressure Evaluation | At baseline, after 6 weeks of treatment, 4 weeks after the end of treatment | Tongue pressure will be done by oral muscle measurement. (Number of Participants estimated 28 individuals) |
| Evaluation of Sleep Quality | At baseline, after 6 weeks of treatment, 4 weeks after the end of treatment | Since bruxism affects the sleep quality of patients, the Pittsburg Sleep Quality Index will be used to evaluate sleep quality. (Number of Participants estimated 28 individuals) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mouth Opening Evaluation | At baseline, after 6 weeks of treatment, 4 weeks after the end of treatment | The amount of mouth opening will be evaluated by adding the vertical coverage amounts of the lower and upper incisors to the distance between the incisal edges of the lower and upper incisors at maximum mouth opening, using a ruler, for pre-treatment, post-treatment and 1 month later follow-up purposes. (Number of Participants estimated 28 individuals) |
| Tongue Range of Motion Ratio Assessment | At baseline, after 6 weeks of treatment, 4 weeks after the end of treatment | In the functional tongue tie classification published by Ferrés-Amat et al., the mouth opening with tongue tip to maxillary incisive papillae at roof of mouth (MOTTIP) and the maximum interincisal mouth opening (MIO) ratio (MOTTIP/MIO ratio is defined as Tongue range of motion ratio - TRMR) will be used to measure functional tongue limitation. In this classification system, it is stated as Grade 1: tongue range of motion ratio \>% 80, Grade 2: 50-80, Grade 3: \<% 50, Grade 4: \<% 25. (Number of Participants estimated 28 individuals) |
Countries
Turkey (Türkiye)
Outcome results
None listed