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Órgano Oficial de la Asociación Dental Mexicana

2015, Number 2

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Rev ADM 2015; 72 (2)

The dento-skeletal factors and nocturnal bruxism.

Chávez PR, Castellanos JL, Pacheco RA

Language: Spanish
References: 34
Page: 85-91
PDF size: 347.32 Kb.


ABSTRACT

Nocturnal or sleep bruxism is an oromandibular movement disorder that occurs during sleep. It is characterized by induced phasic and tonic contractions of the central autonomous system of the jaw elevator muscles, which frequently lead to teeth grinding. In dentistry and medicine alike, its etiology and diagnostic criteria are characterized by a lack of knowledge, confusion, and debate. In an attempt to systematically organize available, though sometimes contradictory information, we performed a review of the literature found in the Medline and Pubmed databases in order to reexamine the possible etiologic factors, manifestations, and significance of eccentric bruxism, paying particular attention to morphological or dento-skeletal causes. Among the causes of nocturnal bruxism mentioned in the literature are: neurochemical alterations (related to neurotransmitters), genetic and psychosocial factors, sleep-related breathing disorders, and exogenous factors. Dento-skeletal factors (e.g., occlusion and the anatomy of the maxillae) are also listed as a source of nocturnal bruxism, both in isolation and in combination with those already mentioned. Nocturnal bruxism is currently regarded as a sleep disorder, known as parasomnia, an alteration of the autonomic nervous system that manifests itself in the form of an increase in micro-arousals accompanied by increased activity of the masticatory muscles and cardiac system. Respiratory sleep disorders caused by dento-skeletal alterations such as apnea (a type of dyssomnia) also seem to play an important role in the incidence of nocturnal bruxism, given that micro-arousals and increased masticatory muscle activity have also been observed in those disorders. The review of the information available revealed that dento-skeletal factors play a major role in the etiology of nocturnal bruxism, given that when someone lacks anatomical and occlusal stability, the likelihood of their exhibiting rhythmic jaw movements during sleep, teeth grinding, and tooth wear increases secondarily to functional and occlusal alterations that disturb the sufferer’s sleep, as they attempt to find a comfortable physiological position. Osseous disharmony was also found to be part of the etiology of sleep-related breathing disorders, which have been associated with micro-arousals and nocturnal bruxism.


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