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The International Journal of Prosthodontics
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Int J Prosthodont 22 (2009), No. 3     15. May 2009
Int J Prosthodont 22 (2009), No. 3  (15.05.2009)

Page 251-259, PubMed:19548407


Effect of an Adjustable Mandibular Advancement Appliance on Sleep Bruxism: A Crossover Sleep Laboratory Study
Landry-Schönbeck, Anaïs / de Grandmont, Pierre / Rompré, Pierre H. / Lavigne, Gilles J.
Purpose: 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.
Materials and 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 signedrank 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.
Conclusion: 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.