Current treatments for sleep bruxism include dental nightguards or occlusal splints, which are often provided without upper airway or sleep assessments. In this case report, they used biomimetic oral appliance therapy by redeveloping the maxilla and repositioning the mandible. This particular case report represents a patient who followed all treatment recommendations conscientiously, and her progress and results appear to reflect her pursuit of health. It is thought that preventive therapy cannot effectively cure sleep bruxism but various treatment protocols for its management are available.
This particular case report tracks a patient who followed all treatment recommendations conscientiously, and her progress and results appear to reflect her pursuit of health. However, a major limitation of this case report is the lack of a PSG study to document bruxism and OSA at both the baseline and post-treatment phases. However, psychometric measures, such as an Epworth Sleepiness Scale questionnaire were used to confirm the presence of bruxism, its severity and daytime sleepiness. In addition, the patient admitted to grinding her teeth, had worn holes through her night-guard, and the flattened cusps of her posterior teeth were indicative of sleep bruxism. As a result of biomimetic oral appliance therapy, her upper airway was developed so that mouth breathing was corrected and she could revert back to nasal breathing. This change in function appears to have resolved her chief concern of sleep bruxism. In addition, the nasal mode of breathing allowed her lips to contact gently while at rest.
A multi-disciplinary approach may be appropriate for patients that present to a dental office with issues relating to sleep bruxism. The protocol described in this article may also be applicable to cases of posterior open bite associated with mandibular advancement appliance therapy for the management of OSA. That premise remains as the basis for future studies. We conclude that dentists and orthodontists can help in the recognition and treatment of both sleep bruxism and malocclusion, thereby preventing systemic co-morbidities associated with obstructive sleep apnea.
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