title: Comparative Capabilities of Clinical Assessment, Diagnostic Criteria, and Polysomnography in Detecting Sleep Bruxism.
abstract: OBJECTIVE
  To evaluate the diagnostic capability of signs and symptoms of sleep bruxism (SB) as per the American Academy of Sleep Medicine (AASM) criteria and a diagnostic grading system proposed by international experts for assessing SB.
  
  
  METHODS
  The study was conducted in three phases (interview, physical examination, and sleep studies). Subjects were asked about self-reported tooth grinding sounds occurring during sleep, muscle fatigue, temporal headaches, jaw muscle pain, and jaw locking. A visual examination was conducted to check for presence of abnormal tooth wear. A full-night polysomnography (PSG) was performed. After three phases, the subjects were divided into two groups matched by age and gender: Case Group, 45 SB subjects, and Control Group, 45 non-SB subjects. Diagnostic accuracy measurements were calculated for each sign or symptom individually and for the two diagnostic criteria analyzed.
  
  
  RESULTS
  Muscle fatigue, temporal headaches, and AASM criteria were associated with highest sensitivity (78%, 67%, 58%, respectively) and also with highest diagnostic odds ratio (OR = 9.63, 9.25, 6.33, respectively). Jaw locking, muscle pain, and the criterion of "probable SB" were associated with the worst sensitivity (16%, 18%, 22%, respectively).
  
  
  CONCLUSIONS
  Presence of muscle fatigue and temporal headaches can be considered good tools to screen SB patients. None of the diagnostic criteria evaluated was able to accurately identify patients with SB. AASM criteria had the strongest diagnostic capabilities and--although they do not attain diagnostic values high enough to replace the current gold standard (PSG)--should be used as a screening tool to identify SB.
authors.affiliation: Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Palinkas
authors.affiliation: Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil.|Department of Dentistry, University of Alberta, Edmonton, Canada.
authors.forename: Graziela
authors.initials: G
authors.lastname: De Luca Canto
authors.affiliation: Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Laíse Angélica Mendes
authors.initials: LA
authors.lastname: Rodrigues
authors.affiliation: Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: César
authors.initials: C
authors.lastname: Bataglion
authors.affiliation: Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Selma
authors.initials: S
authors.lastname: Siéssere
authors.affiliation: Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Marisa
authors.initials: M
authors.lastname: Semprini
authors.affiliation: Department of Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Simone Cecilio Hallak
authors.initials: SC
authors.lastname: Regalo
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006261:Headache / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008406:Masseter Muscle / Q000503:physiopathology*; D008875:Middle Aged; D018763:Muscle Fatigue / Q000502:physiology*; D017286:Polysomnography / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020186:Sleep Bruxism / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D055815:Young Adult
keywords: bruxism; diagnostic grading system; polysomnography; sleep bruxism