Impact of Orthodontic Treatment on Awakening Bruxism Individuals: Longitudinal Study

Objectives: The objective of this longitudinal study is to evaluate the impact of the installation of orthodontic apparatus on the pressure pain threshold (PPT) of masticatory muscles and Temporomandibular joint (TMJ), symptoms of depression and anxiety, and oral health related quality of life in self-reported awakening bruxism (AB) patients
Methods: 111 patients (59 women) initiating orthodontic treatment were selected and divided according the presence of self-reported AB in two groups: AB group (n=56) and control group (n=55). Patients were examined in 3 sessions: t1 (immediately before the orthodontic apparatus installation), t2 (two months after installation), and t3 (six months after the beginning of the treatment). TMJ, anterior temporalis and masseter muscles PPT were obtained in the three sessions. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Oral Health Impact Profile (OHIP-14) were also recorded. Log transformation were done as most of the variables showed non-normal distribution. For PPT, comparisons were made considering the three phases of evaluation, site (3 levels), and group (2 levels) and, for BDI, BAI and OHIP-14, comparisons were made considering the three phases of evaluation, and group (2 levels). All comparisons were made through a multi-way analysis of variance (ANOVA).
Results: TMJ and/or muscle pain was not a complaint for both groups. The presence (or absence) of AB was stable overtime. Regardless of the moment analyzed, self-reported AB patients reported more anxiety (F=6.90,p=0.009) and depression symptoms (F=9.25,p=0.002) . OHIP-14 scores were higher in AB group in baseline (Tukey:p=0.001) and after 6 months of orthodontic treatment (Tukey:p=0.004) comparing with control group. PPT figures did not change over time for both groups.
Conclusions: Authors concluded that for a period of six months, orthodontic treatment did not change TMJ/muscles PPT, anxiety and depression symptoms and oral quality of life in self-report AB patients, when compared to controls.