Clinical signs of awake bruxism are higher in psychiatric patients: a controlled study Caroline Vidal Paseto, Antonio Adilson Soares de Lima, Ricardo Ramussen Petterle, Priscila Brenner Hilgenberg-Sidney Brazilian Journal of Oral Sciences, 2026 Bruxism is a masticatory muscle activity that can occur during sleep and/or wakefulness, characterized by repetitive or sustained tooth contact and/or by bracing or thrusting of the mandible. Aim: Evaluate the prevalence of probable awake bruxism (PAB) and its association with signs and symptoms of temporomandibular disorders (TMD) in psychiatric patients. Methods: The sample was comprised of 123 participants of both genders, between 18 and 65 years old. Of these 73 were inpatients at 3 psychiatric hospitals (experimental group) and 50 healthy individuals (control group). All of them were evaluated through a clinical inspection, to observe the presence of clinical signs of bruxism (tooth wear, buccal and labial mucosa and/or tongue indentations, masseter muscle hypertrophy) and a questionnaire to assess the presence of TMD signs and symptoms. Information about current use of medication and reason for hospitalization were also collected. Results: There was no statistical difference regarding the prevalence of probable awake bruxism between experimental (85%) and control (74%) groups. However, a higher prevalence of clinical signs of bruxism and TMD signs and symptoms was observed in psychiatric patients diagnosed with probable awake bruxism. For the experimental group, the association of PAB with the reason for hospitalization and the use of psychotropic drugs were not statistically significant. The presence of masseter hypertrophy, tongue indentation, buccal mucosa indentation, tooth wear and TMD signs and symptoms appears to be associated with the presence of PAB and psychiatric disorders. Conclusions: The prevalence of awake bruxism in psychiatric patients about 85%. The presence of TMD signs and symptoms appears to be associated with the presence of PAB in psychiatric patients.
Frequency of Oral Behaviors as a Risk Factor for Somatosensory Tinnitus Ana Carolina de Oliveira Garcia D'Amato, Thaís Spisila, Gabriela Schumacher de Camargo, Priscila Brenner Hilgenberg-Sydney International Archives of Otorhinolaryngology, 2025 Introduction Somatosensory tinnitus is a type of tinnitus that can be modified by somatosensory stimuli from the cervical spine and temporomandibular area. Temporomandibular disorders and oral behaviors are associated with a higher prevalence of somatosensory tinnitus, and this association is described in the literature as part of the diagnosis of this condition. Objective To verify the association between somatosensory tinnitus and oral behaviors. Methods Patients were recruited from an Orofacial Pain outpatient clinic and from Head and Neck Unit. All participants underwent anamnesis, physical examination and completed the Oral Behaviors Checklist questionnaire. Forty-six patients were divided into 2 groups, each consisting of 23 patients: somatosensory tinnitus group (STG) and a comparison group (CG), with subjective tinnitus. Data were gathered and analyzed using the Jamovi software (open source) and a significance level of 5% was adopted. Somatosensory tinnitus was associated with dizziness and neck and temporomandibular joint pain. Results There was an association between a higher Oral Behaviors Checklist score and the presence of somatosensory tinnitus. For each point marked on Oral Behaviors Checklist, there was an 8.2% greater chance of having somatosensory tinnitus. Tinnitus modulation through somatic maneuvers and palpation of masticatory and cervical muscles was significantly associated with somatosensory tinnitus. Conclusion Dizziness and neck and temporomandibular joint pain are associated with the presence of somatosensory tinnitus. Probable sleep and awake bruxism are not exclusive behaviors of somatosensory tinnitus patients. However, their frequency may impact its presence.
Conservative Management of Tourette Syndrome Tics Using Intraoral Occlusal Devices: Report of Two Cases Andrea Hoette Stahlke, Daniel Bonotto, Danielle Veiga Bonotto, Priscila Brenner Hilgenberg‐Sydney Special Care in Dentistry, 2025 AimsThe aim of this study is to present and discuss two cases of patients with Tourette syndrome controlled with intraoral occlusal devices.Methods and ResultsThis paper presents two case reports: one of a 10‐year‐old male patient and another of a 17‐year‐old male patient who underwent treatment using a conservative approach that has garnered increasing clinical interest: the use of an occlusal device. This device is placed over the lower teeth, creating a space between the mandible and maxilla. Patients reported improvements in tic frequency as well as enhancements in their ability to focus and concentrate on academic activities following the installation of the occlusal device.ConclusionsThe use of these occlusal devices demonstrates promising success in managing tics associated with Tourette syndrome.
Phenotyping of somatosensory tinnitus and its associations: An observational cross-sectional study Thaís Spisila, Luana Carolina Fontana, Rogério Hamerschmidt, Rita de Cássia Cassou Guimarães, Priscila Brenner Hilgenberg‐Sydney Journal of Oral Rehabilitation, 2024 BackgroundSomatosensory tinnitus (ST) is associated with activation of the auditory pathway by trigeminal or cervical afferents.ObjectiveThis is a cross‐sectional observational study that aims to verify the association of ST with TMD, bruxism, migraine and psychosocial aspects.MethodsThis study was conducted at the Tinnitus Outpatient Clinic of the Clinical Hospital Complex of the Federal University of Paraná. Specific ST characteristics, were evaluated according to the last consensus for the diagnosis of ST. Two groups with 39 individuals each one were formed, the ST group (STG) and the comparison group (CG). TMD was classified according to the Diagnostic Criteria for Temporomandibular Disorders and migraine by the International Classification of Headaches. The presence of probable sleep and awake bruxism was associated with individual's reports and clinical inspections. The applied questionnaires investigated oral behaviours (OB), sleep quality (SQ), psychosocial aspects (PA), central sensitization (CS), tinnitus impact on quality of life (TIQF), and graded chronic pain scale (GCPS).ResultsThe STG showed a significant association with modulation manoeuvres and trigger points; myalgias and arthralgia; disc displacement with and without reduction; subluxation; bruxism; and presence of migraine. For the same group, we found a significant association with OB, PA, CS, TIQF and GCPS. There was no significant difference between groups regarding SQ.ConclusionThere is a significant association between the presence of ST and the occurrence of TMD, probable sleep and awake bruxism, and migraine. There is also a greater impairment of OB, PA, CS and TIQF.
Telediagnosis as an effective tool for assessment temporomandibular disorders Amanda Rossi Corelhano, Priscila Brenner Hilgenberg‐Sydney, Daniel Bonotto, Cassius Carvalho Torres‐Pereira Journal of Oral Rehabilitation, 2024 BackgroundThe use of communication technologies has allowed a substantial improvement in telediagnosis.ObjectivesTo evaluate the feasibility and diagnostic agreement of synchronous teleconsultation compared to physical standard examination for temporomandibular disorders (TMD) and orofacial pain.MethodsSixty‐one patients (50 women, 11 men) with a mean age of 46.07 years referred to the Orofacial Pain Ambulatory Service (SAMDOF —UFPR) were evaluated remotely. They were then examined in person by another evaluator, blinded for the first evaluation. Data on the experience and level of satisfaction with the teleconsultation were also collected.ResultsFor each type and subtype of TMD, diagnostic agreement values, sensitivity, specificity, positive predictive values and negative predictive values were calculated with a 95% confidence interval. ‘Almost perfect’ agreement was found for Myalgia (k = 0.915), Arthralgia (k = 0.863), disc displacement without reduction without limited opening (k = 0.955) and no TMD (k = 1.00). ‘Substantial’ agreement for the subtypes headache attributed to TMD (k = 0.761), disc displacement without reduction with limited opening (k = 0.659) and subluxation (k = 7.82). The diagnoses of local myalgia (k = 0.573), myofascial pain with referral (k = 0.524) and disc displacement with reduction (k = 0.563) obtained ‘moderate’ agreement. Degenerative joint disease (k = 0.170) and disc displacement with reduction with intermittent locking (k = 0.000) obtained ‘weak’ and ‘no agreement’, respectively. More than 90% of the participants were satisfied and reported no discomfort during the assessment, agreeing to participate in another teleconsultation.ConclusionSynchronous teleconsultation proved to be feasible and presented adequate diagnostic agreement for the main painful TMDs, especially for the diagnosis of myalgia and arthralgia. This format was also well accepted among patients.
Prevalence of clinical signs and diagnosis of temporomandibular disorders in adults with intellectual disability Yasmine Mendes PUPO, Giselle Emilãine da Silva REIS, Jullyana Mayara Preizner DEZANETTI, Marina FANDERUFF, Thábata Louise SCHOSSLER, et al. Revista De Odontologia Da UNESP, 2024 Introduction Temporomandibular Pain among individuals with intellectual disabilities has been explored in only a few studies. Nevertheless, it is noted that pain in this population often remains undetected and inadequately treated. Objective To evaluate and compare, signs and diagnosis of temporomandibular disfunction (TMD) in adults with and without intellectual disability (ID). Material and method A cross-sectional study with comparison group was conducted. Data regarding gender and age of ID group were collected from medical records available in the institutions of special education. These data from the comparison group were collected in the dental clinics of the Federal University of Parana (UFPR). We using the RDC/TMD I axis, with the help of the UPAT. The clinical examination evaluated muscle and joint pain, mouth opening pattern, extension of mandibular movement and joint noise. The Chi-squared test, Fisher's test, and Bonferroni's post-test were used with significance level of 5%. Result Two homogeneous groups by gender (P = 0.08) and age (P = 0.419) were evaluated, of which 97 adults with intellectual disability and another 96 did not have intellectual disability. No significant difference was observed between groups on TMD signs (p>0.05). The comparison group had significantly more disc displacement with reduction (DDWR) (P=0.011). When we compare the differences with respect to gender. Overall, women in the comparison group had higher prevalence for TMD diagnoses (p<0.05), but these differences were not found in the ID group (p>0.05). Regarding age, only the comparison group showed statistical significance, with the diagnosis of myofascial pain with limited opening being more diagnosed in young individuals (p=0.009). Conclusion Adults with ID have similar prevalence of TMD signs and symptoms to adults without ID. Gender differences are not significant in the ID group.
Childhood and Adolescents Sleep Bruxism Treatment: A Systematic Review Jordana Senff, Danielle Veiga Bonotto, Priscila Brenner Hilgenberg-Sydney, Aline Sebastiani, Rafaela Scariot, et al. Sleep Science, 2023 Introduction Sleep Bruxism (SB) is a common condition in childhood that can cause multiple consequences such as abnormal tooth wear, tensional headaches, masticatory muscle pain, or fatigue. The literature reports some interventions, however the treatment for SB in children is not well-established. Objectives A systematic review was performed to investigate the effectiveness of the treatments described for SB in children and adolescents: pharmacological and psychological treatments; behavioral guidelines; and dental approaches. Materials and methods Randomized clinical trials comparing different SB treatments with a control group were searched in the electronic databases PubMed, Scopus, Web of Science, Cochrane Library, and VHL until August 04, 2021. Two independent reviewers selected the studies, extracted the data, and assessed the risk of bias. After a two-phase selection process, 07 articles were selected. The methodology of the selected studies was analyzed using the Cochrane Risk of Bias Tool. The criteria used to qualify the studies were based on randomization, allocation, blinding of participants and evaluators, and analysis of results. Results The signs and symptoms of SB were reduced with pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts (M. Officinalis), but with occlusal splints and physiotherapy, this improvement was not statistically significant when compared to control groups. Conclusion Some evidence of the efficacy of pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts (M. Officinalis) was found. However, this systematic review is not enough to establish a protocol for the treatment of SB. Besides, the individualized management of SB in this population should be considered, emphasizing the management of risk factors.
Are temporomandibular disorders and tinnitus associated? Aline Dantas Diógenes Saldanha, Priscila Brenner Hilgenberg, Lívia Maria Sales Pinto, Paulo Cesar Rodrigues Conti Cranio Journal of Craniomandibular and Sleep Practice, 2012
