title: Effect of an adjustable mandibular advancement appliance on sleep bruxism: a crossover sleep laboratory study.
abstract: OBJECTIVE
  The objective of this experimental study was to assess the efficacy and safety of a reinforced adjustable mandibular advancement appliance (MAA) on sleep bruxism (SB) activity compared to baseline and to a mandibular occlusal splint (MOS) in order to offer an alternative to patients with both tooth grinding and respiratory disorders during sleep.
  
  
  METHODS
  Twelve subjects (mean age: 26.0 +/- 1.5 years) with frequent SB participated in a short-term (three blocks of 2 weeks each) randomized crossover controlled study. Both brain and muscle activities were quantified based on polygraphic and audio/video recordings made over 5 nights in a sleep laboratory. After habituation and baseline nights, 3 more nights were spent with an MAA in either a slight (25%) or pronounced (75%) mandibular protrusion position or with an MOS (control). Analysis of variance and Friedman and Wilcoxon signed-rank tests were used for statistical analysis.
  
  
  RESULTS
  The mean number of SB episodes per hour was reduced by 39% and 47% from baseline with the MAA at a protrusion of 25% and 75%, respectively (P < .04). No difference between the two MAA positions was noted. The MOS slightly reduced the number of SB episodes per hour without reaching statistical significance (34%, P = .07). None of the SB subjects experienced any MAA breakage.
  
  
  CONCLUSIONS
  Short-term use of an MAA is associated with a significant reduction in SB motor activity without any appliance breakage. A reinforced MAA design may be an alternative for patients with concomitant tooth grinding and snoring or apnea during sleep.
authors: Department of Prosthodontics, Faculty of Dental Medicine, Université de Montréal, Canada.
authors: Anaïs
authors: A
authors: Landry-Schönbeck
authors: Pierre
authors: P
authors: de Grandmont
authors: Pierre H
authors: PH
authors: Rompré
authors: Gilles J
authors: GJ
authors: Lavigne
mesh_terms: D000328:Adult; D016302:Centric Relation; D018592:Cross-Over Studies; D004576:Electromyography; D005260:Female; D006801:Humans; D007574:Jaw Relation Record; D008297:Male; D019186:Mandibular Advancement / Q000295:instrumentation*; D008406:Masseter Muscle / Q000502:physiology; D017090:Occlusal Splints; D016382:Orthodontic Appliance Design; D017286:Polysomnography; D012449:Safety; D012891:Sleep Apnea Syndromes / Q000628:therapy; D020186:Sleep Bruxism / Q000628:therapy*; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000628:therapy; D016896:Treatment Outcome