Validity of Wear at the Upper Canine’s Cusp Tip in Predicting Sleep Bruxism
Piyawattanataworn W, DDS1, Siritapetawee M, DDS, MSc2,3, Chatrchaiwiwatana S, DDS, PhD2, Paphangkorakit J, DDS, PhD2,3
Affiliation : 1 Dental Department, Buriram Hospital, Buriram, Thailand 2 Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University, Thailand 3 Neuroscience Research and Development Group, Khon Kaen University, Khon Kaen, Thailand
Background : Sleep bruxism (SB) affects the dentition and could be the cause of temporomandibular disorders (TMD). Due to its
nocturnal nature, the diagnosis of SB is mainly based on history taken from patients and family members. A verified clinical
examination is still needed to help confirm the diagnosis.
Objective : To determine the validity of upper canine’s cusp-tip wear for the diagnosis of SB using Brux Checker® as the reference
diagnostic tool.
Materials and Methods : Eighty dental patients were screened for SB using ICSD-3 criteria. The wear at upper canine’s cusp tip as
well as any matched wear facets during eccentric movements were examined and scored according to Johansson et al (1993). They
were subsequently prescribed to wear Brux Checker® for 7 consecutive nights. The abraded and perforated areas on Brux Checker®
were used to identify ‘current’ bruxers. The sensitivity, specificity and AUC/ROC of upper canine’s wear were determined with
respect to ICSD-3 criteria and Brux Checker® perforation by day 1, day 2, and day 7 (P1, P2, P7).
Results : Prediction with good sensitivity (0.875) was found when Brux Checker® perforation was compared to ICSD-3 criteria
(AUC = 0.773). Mean wear scores could predict SB diagnosed by ICSD-3 criteria (AUC = 0.789; sensitivity = 0.789 to 0.875, specificity
= 0.641 to 0.703) but did not show any significant predictive values with respect to Brux Checker® perforation. However, the
tooth-level wear score >1, with the presence of matched wear facets, could predict P2, and P7 (AUC = 0.599 to 0.626; sensitivity =
0.776 to 0.842, specificity = 0.410 to 0.422).
Conclusion : Mean wear score at upper canine’s cusp tip seems to be a good indicator of SB based on ICSD-3 whereas individual
tooth wear combined with the presence of matched wear facets could be a fair indicator of ‘current’ SB as indicated by Brux
Checker® perforation.
Keywords : Sleep bruxism, Tooth wear, Brux Checker®
