title: Agreement of the International Classification of Sleep Disorders Criteria with polysomnography for sleep bruxism diagnosis: A preliminary study.
abstract: BACKGROUND
  Validated questionnaires and guidelines for assessing sleep bruxism (SB) that can be administered by dentists in clinical practice are still lacking.
  
  
  OBJECTIVE
  The purpose of this preliminary study was to compare the third edition of the International Classification of Sleep Disorders (ICSD-3) criteria for diagnosing SB with the results of the gold standard polysomnography (PSG) examination.
  
  
  METHODS
  Twenty consecutive postgraduate students and staff at Bauru School of Dentistry, University of São Paulo, Bauru, Brazil, participated. Each participant underwent interview, clinical assessment, and a PSG evaluation. Bruxers and nonbruxers were identified based only on the PSG analysis. The validity of the ICSD-3 criteria was assessed by receiver operating characteristics curve analysis, area under the curve (AUC), likelihood ratios (LR), and the diagnostic odds ratio (DOR).
  
  
  RESULTS
  The ICSD-3 diagnostic criteria items for SB had fair to moderate concordance with the PSG diagnosis, with AUC ranging from 0.55 to 0.75. The best value of agreement was the association of SB more than once a week with transient morning jaw muscle pain or fatigue with a moderate but significant agreement with the PSG diagnosis of SB (AUC=0.75), with 90% specificity, positive LR=6, and DOR=13.5. When the frequency of self-reported SB increased to more than 4 times a week, the combination of this finding with tooth wear also had high values of agreement with the PSG diagnosis of SB (AUC= 0.75, +LR=6, DOR=13.6).
  
  
  CONCLUSIONS
  The report of regular or frequent SB and the presence of (1) incident of abnormal tooth wear or (2) incidents of transient morning jaw muscle pain or fatigue were the best discriminatory items of ICSD-3 for SB diagnosis.
authors.affiliation: Doctoral student, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil. Electronic address: juliana.dentista@gmail.com.
authors.forename: Juliana
authors.initials: J
authors.lastname: Stuginski-Barbosa
authors.affiliation: Doctoral student, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: André Luís
authors.initials: AL
authors.lastname: Porporatti
authors.affiliation: Doctoral student, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: Yuri Martins
authors.initials: YM
authors.lastname: Costa
authors.affiliation: Professor, Section of Clinical Oral Physiology, School of Dentistry, Aarhus University, Aarhus, Denmark; Guest Professor, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden; and Member, Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus University, Aarhus, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Svensson
authors.affiliation: Professor, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: Paulo César Rodrigues
authors.initials: PC
authors.lastname: Conti
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D015203:Reproducibility of Results; D020186:Sleep Bruxism / Q000175:diagnosis*; D012893:Sleep Wake Disorders / Q000145:classification*; D011795:Surveys and Questionnaires