18 May 2023

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Evaluating the reliability of a new portable device to diagnose nocturnal bruxism

Lara Figini

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Bruxism can lead to various clinical problems such as wear of the teeth, their fracture, failure of conservative and prosthetic restorations, irritation of the tongue and cheeks, muscle hypertrophy and even orofacial pain.

The diagnosis of nocturnal or sleep bruxism (SB) is demanding and the current methods to arrive at it are not easily accessible for dentists. Hence the need to develop a reliable method capable of assessing SB in a simple and easily accessible way, with acceptable sensitivity and specificity.

Based on current knowledge, the gold standard for the diagnosis of SB is laboratory polysomnography (PSG), but it is costly, with limited availability and long waiting times for evaluation, all of which are limiting factors.

Therefore, alternative approaches have been developed for the purpose of diagnosing SB including self-report questionnaires, clinical examination of the masticatory muscles and portable devices.

Bruxoff is a portable SB assessment device that combines electromyography and heart rate assessment.

Materials and methods

In a study published in the April issue of the Journal of Oral Rehabilitation, the authors investigated the reliability and validity of the Bruxoff device for the diagnosis of nocturnal bruxism-SB in comparison with polysomnography (PSG). Forty-nine subjects underwent a full-night polysomnographic study with simultaneous recording using the Bruxoff device.

The rhythmic masticatory muscle activity index (RMMA) was evaluated according to the pre-established criteria. Pearson correlation, Bland-Altman results, and receiver operating characteristics (ROC) curve were used to quantify the agreement between the two methods.

Results

Analysis of receiver operating characteristics showed acceptable accuracy for Bruxoff with sensitivity of 83.3% and specificity of 72% when the cut-off was set at two events per hour.

Pearson's analysis showed a nearly significant correlation between PSG and Bruxoff by RMMA index (r = .282 p = .071) and by total SB episodes per night (r = .295 p = .058). Furthermore, the Bland-Altman plot revealed a consistent and systematic difference in event measurement between the two methods.

Conclusions

From the data of this study, researchers concluded that the Bruxoff device appears to be a promising diagnostic method for clinical use. The team also said additional studies should be conducted. 

For more information, see "Diagnostic accuracy of a portable device (Bruxoff®) to measure sleep bruxism."