Non-Instrumental and Instrumental Tools Validity in Bruxism Diagnostics

Area of Science:

• Dentistry
• Neurology
• Sleep Medicine

Background:

• Bruxism diagnosis often relies on subjective patient reports and clinical signs.
• Validated diagnostic tools are needed to differentiate between sleep bruxism (SB) and awake bruxism (AB).
• The Standardized Tool for the Assessment of Bruxism (STAB) system requires validation against instrumental measures.

Purpose of the Study:

• To validate the STAB diagnostic system by comparing questionnaire and clinical examination results with instrumental (sEMG) findings.
• To assess the diagnostic accuracy of non-instrumental and instrumental methods for SB and AB.
• To evaluate the correlation between dental wear and bruxism diagnosis.

Main Methods:

• A three-stage study involving questionnaires, clinical examinations (including oral mucosal signs and BEWE index for dental wear), and surface electromyography (sEMG).
• Subjects were grouped based on questionnaire/clinical results (SB, AB, SB AB, no B) before sEMG.
• Diagnostic accuracy metrics (sensitivity, specificity) were calculated for various bruxism indicators.

Main Results:

• Non-instrumental methods showed higher sensitivity and specificity for SB compared to AB.
• Awake bruxism (AB) diagnosis had lower sensitivity (55%) due to lack of patient awareness.
• Dental wear assessment had low sensitivity (15%) but high specificity (83%), indicating wear does not always confirm bruxism.

Conclusions:

• Questionnaires and clinical exams are useful for bruxism assessment, especially for identifying sleep bruxism (SB).
• Surface electromyography (sEMG) remains the gold standard for definitive bruxism diagnosis.
• Further research may be needed to improve AB detection rates due to low patient awareness.