Difference between revisions of "Bruxism"

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[[File:IMG0103.jpg|left|225x225px]]Bruxism is a complex phenomenon often reduced to dental and occlusal factors in medical discussions. However, these traditional perspectives frequently overlook a crucial aspect: the functionality of the trigeminal nervous system. This omission exemplifies the broader issue in medical diagnostics where conventional terms, such as bruxism, may not adequately represent the underlying complexities of the conditions they describe.
[[File:IMG0103.jpg|left|225x225px]]Bruxism is often reduced to dental and occlusal factors, but this overlooks the crucial role of the trigeminal nervous system. This chapter emphasizes that conventional terms like bruxism may not adequately represent the complexities of the conditions they describe.


Bruxism is characterized as a non-functional oral activity, distinct from necessary functions like eating or speaking. Despite its prevalence, reported as ranging from 8% to 31% in the general population, bruxism often remains unnoticed until significant dental wear occurs. This raises questions about the inevitability of dental wear and whether it can occur even without bruxism.
Bruxism is characterized as a non-functional oral activity, distinct from eating or speaking. Despite its prevalence, it often goes unnoticed until significant dental wear occurs. This raises questions about whether dental wear can occur without bruxism.


The concept of 'Thegosis' suggests that bruxism might actually serve a physiological function to increase masticatory efficiency and muscular strength, challenging the distinction between physiological and pathological states. This perspective necessitates a deeper reassessment of how bruxism is perceived and managed in clinical settings.
The concept of 'Thegosis' suggests that bruxism might serve a physiological function to increase masticatory efficiency and muscular strength, challenging the distinction between physiological and pathological states. This perspective necessitates a reassessment of how bruxism is perceived and managed in clinical settings.


The complexity of bruxism is evident in its diverse etiologies, which include psychological stress, physiological anomalies, and especially the involvement of the trigeminal nervous system. Traditional views of bruxism as primarily a dental or occlusal issue do not account for its neurological dimensions, which are critical for effective management.
Bruxism has diverse etiologies, including psychological stress, physiological anomalies, and especially the involvement of the trigeminal nervous system. Traditional views of bruxism as primarily a dental or occlusal issue do not account for its neurological dimensions, which are critical for effective management.


Recent studies focusing on the trigeminal motoneurons have begun to reveal the neurological basis of bruxism, suggesting that it may be linked to decreased inhibitory control within the trigeminal network. This emerging understanding opens new avenues for comprehending and treating bruxism beyond conventional dental interventions, emphasizing the importance of integrating neurobiological research into clinical practice.
Recent studies on trigeminal motoneurons suggest that bruxism may be linked to decreased inhibitory control within the trigeminal network. This emerging understanding opens new avenues for comprehending and treating bruxism beyond conventional dental interventions, emphasizing the importance of integrating neurobiological research into clinical practice.


Bruxism may involve complex neurophysiological processes that include the activation and modulation of trigeminal motoneurons. Studies have indicated that bruxism could be related to specific neuronal discharges in areas such as the raphe nuclei and the locus coeruleus, which play roles in the modulation of sleep and arousal states that impact muscle activity.
Bruxism may involve complex neurophysiological processes, including the activation and modulation of trigeminal motoneurons. Studies indicate that bruxism could be related to specific neuronal discharges in areas like the raphe nuclei and the locus coeruleus, which modulate sleep and arousal states that impact muscle activity.


These findings suggest that bruxism could be more than just a response to dental misalignment or stress, but also a manifestation of broader neurophysiological activities. Understanding these processes could lead to more targeted therapies that address the neurological components of bruxism, potentially offering relief for patients who do not respond to conventional treatments.
These findings suggest that bruxism could be more than a response to dental misalignment or stress but also a manifestation of broader neurophysiological activities. Understanding these processes could lead to more targeted therapies addressing the neurological components of bruxism, offering relief for patients unresponsive to conventional treatments.


The management of bruxism is poised to benefit greatly from the integration of these neurophysiological insights. Instead of relying solely on dental guards and stress management, treatment protocols could include neuromodulatory approaches that address the central nervous system's role in bruxism.
Integrating neurophysiological insights into bruxism management can significantly benefit treatment protocols. Future research should explore the interactions between neuronal circuits and bruxism behavior to develop effective interventions. Integrating neurobiological insights with clinical practice is expected to improve patient outcomes, providing a holistic treatment approach.


Future research should continue to explore the complex interactions between neuronal circuits and bruxism behavior to develop more effective interventions. As the field advances, the integration of neurobiological insights with clinical practice is expected to improve outcomes for patients with bruxism, providing a more holistic approach to treatment.
Reevaluating bruxism through neurology underscores the need for a nuanced understanding. It challenges traditional boundaries between physiological and pathological states, suggesting bruxism is a complex neurophysiological phenomenon requiring a comprehensive diagnostic and treatment approach, incorporating the latest clinical practices and ongoing research into neural mechanisms.{{ArtBy|
 
The reevaluation of bruxism through the lens of basic knowledge and neurology underscores the need for a more nuanced understanding of this condition. It challenges the traditional boundaries between physiological and pathological states, suggesting that bruxism might not merely be a dental issue but a complex neurophysiological phenomenon that requires a comprehensive approach to diagnosis and treatment. This approach should incorporate not only the latest clinical practices but also ongoing research into the neural mechanisms underlying bruxism.<blockquote>
== Keywords ==
'''Bruxism''' - Refers to the medical condition involving involuntary teeth grinding and clenching, often occurring during sleep.
 
'''Trigeminal Nervous System''' - Pertains to the network of nerves responsible for sensation in the face and motor functions such as biting and chewing; critical in understanding the neurological aspects of bruxism.
 
'''Dental Wear''' - Describes the damage and wear to teeth that result from chronic grinding, a common symptom of bruxism.
 
'''Oral Parafunctional Activity''' - Involves non-functional activities of the mouth and jaws, including bruxism, that are not related to normal functions like eating or speaking.
 
'''Neurophysiological Aspects of Bruxism''' - Explores the brain and nerve functions influencing bruxism, providing insight into how neurological conditions contribute to this behavior.
 
'''Treatment of Bruxism''' - Discusses various management strategies and therapies to alleviate and control the symptoms of bruxism.
 
'''Trigeminal Motoneurons''' - Focuses on the specific neurons in the trigeminal nerve that impact jaw movement, essential for understanding the pathophysiology of bruxism.
 
'''Sleep Disorders''' - Covers the range of medical conditions affecting sleep patterns, including how bruxism is often associated with other sleep disturbances.
 
'''Neuromodulatory Treatment''' - Refers to therapies that modify nerve activity, used in managing neurological aspects of bruxism such as reducing muscle activity.
 
'''Thegosis Theory''' - A theory suggesting that teeth grinding serves a physiological function, increasing masticatory efficiency and muscle strength.
 
'''Neurological Basis of Bruxism''' - Investigates the brain-based causes of bruxism, emphasizing the role of central nervous system in this condition.
 
'''PIC (Persistent Inward Currents)''' - Discusses the continuous electrical currents within neurons that are thought to contribute to sustained contractions in bruxism.
 
'''Bruxism and Neurotransmitters''' - Explores the relationship between chemical messengers in the brain and their impact on bruxism, focusing on how imbalances can trigger grinding behaviors.
 
'''Clinical Management of Bruxism''' - Details approaches used by healthcare professionals to diagnose, treat, and manage bruxism effectively.
 
'''Neurobiological Research on Bruxism''' - Highlights studies and findings in the field of neurobiology that shed light on the underlying causes and potential treatments for bruxism.</blockquote>{{ArtBy|
| autore = Gianni Frisardi
| autore = Gianni Frisardi
| autore2 =  
| autore2 =  
| autore3 = Flavio Frisardi
| autore3 = Flavio Frisardi
}}
}}
== Introduction ==
== Introduction to the Bruxism ==


Let's start by asking ourselves some specific questions:
Let's start by asking ourselves some specific questions:
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Substantially, from this overview of the database research it is clear that if on the one hand bruxism is a complex phenomenon on the other the efforts have concentrated almost exclusively on occlusal and dental factors in general, leaving out one aspect, essential in our opinion, that of functionality of the trigeminal nervous system.
Substantially, from this overview of the database research it is clear that if on the one hand bruxism is a complex phenomenon on the other the efforts have concentrated almost exclusively on occlusal and dental factors in general, leaving out one aspect, essential in our opinion, that of functionality of the trigeminal nervous system.


==Evidences==
===Evidences===
A synthetic extraction of the contents of the article by Jessica M D'Amico et al.,<ref name=":12" />, shows evidence that the discharge of neurons in the raphe nuclei, in the locus coeruleus, in the subcoeruleus and in A5/A7 cells, releases serotonin and norepinephrine and facilitates PIC (persistent internal ionic currents referred to as 'PIC') to the trigeminal motor neuron pool. These episodes increase during micro-awakenings (Leung and Mason 1999,<ref>{{cita libro  
A synthetic extraction of the contents of the article by Jessica M D'Amico et al.,<ref name=":12" />, shows evidence that the discharge of neurons in the raphe nuclei, in the locus coeruleus, in the subcoeruleus and in A5/A7 cells, releases serotonin and norepinephrine and facilitates PIC (persistent internal ionic currents referred to as 'PIC') to the trigeminal motor neuron pool. These episodes increase during micro-awakenings (Leung and Mason 1999,<ref>{{cita libro  
  | autore = Leung CG
  | autore = Leung CG
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  | OCLC =  
  | OCLC =  
  }}</ref>). Individuals with bruxism experience an increase in the number of micro-awakenings during sleep (Kato et al. 2001,<ref>{{cita libro  
  }}</ref>). Individuals with bruxism experience an increase in the number of micro-awakenings during sleep (Kato et al. 2001,<ref>{{cita libro  
| autore = Kato T
<nowiki> </nowiki><nowiki>|</nowiki> autore = Kato T
| autore2 = Rompre PH
<nowiki> </nowiki><nowiki>|</nowiki> autore2 = Rompre PH
| autore3 = Montplaisir JY
<nowiki> </nowiki><nowiki>|</nowiki> autore3 = Montplaisir JY
| autore4 = Sessle BJ
<nowiki> </nowiki><nowiki>|</nowiki> autore4 = Sessle BJ
| autore5 = Lavigne GJ
<nowiki> </nowiki><nowiki>|</nowiki> autore5 = Lavigne GJ
| titolo = Sleep bruxism: an oromotor activity secondary to microarousal
<nowiki> </nowiki><nowiki>|</nowiki> titolo = Sleep bruxism: an oromotor activity secondary to microarousal
| url = https://pubmed.ncbi.nlm.nih.gov/11706956
<nowiki> </nowiki><nowiki>|</nowiki> url = https://pubmed.ncbi.nlm.nih.gov/11706956
  | volume =  
  | volume =  
  | opera = J Dent Res
  | opera = J Dent Res
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