IAAID International Congress on Bruxism 2015 – A Conference report
IAAID International Congress on Bruxism 2015 – A Conference report
Cid S1,2,, Greven M. 2,3,4,5
Brazil, Luxembourg, Chile, Columbia, Canada, United States, Japan, Korea, China, Russian Federation, The Baltic States, Greece, Portugal, Spain, France, The Netherlands, Belgium, Norway, Denmark, Sweden, Poland, Czech Republic, United Arab Emirates, Germany, among others, were the nations attending the 2015 IAAID International Conference on Bruxism in Munich, Germany, that took place on the January 30 and 31 of 2015 at the Westin Hotel Grand Hotel.
Emerging as an update congress after the remarkable event on this topic in Cologne five years ago (Bruxism Congress 2010), was attended by more than 370 participants.
Several were the disciplines working together during the conference to fulfill the scientific and practical needs of a vast and diverse audience, looking for the latest innovations, developments and experiences of the past years at the highest international professional level possible on Bruxism.
In order to have a short overview of the approached topics, a brief review will be done based on the given conferences citing the internationally recognized speakers.
Bruxism – Definition and Physiopathology
Prof. Slavicek (Fig 1), an internationally recognized master of function, has dedicated his two lectures by defining bruxism and clarifying its important role in medicine and dentistry. For him, the masticatory organ emerges as a tool for emotional management, whereby grinding and clenching activities mitigate stress-induced psychosomatic disorders. Occlusion is a key factor in this organ and therefore its quality is crucial to carry its role in managing stress. For this lecturer, bruxism lacks of evidence as being classified as a disease and is a somatization of a psychological backlog of emotion into the masticatory organ. For this reason, accepting bruxism as a physiological condition is of major importance in the medical and dental approach while dealing with these patients.
Fig.1: Prof. Rudolf Slavicek/Vienna, Austria was with the conference by video conference. His two-fold lecture (opening and closing speech) was on “The Definition of Bruxism”
Prof. Lavigne from the University of Montreal, was given the task of speaking about the genesis of sleep bruxism. Sleep bruxism (SB) is quantified by scoring recordings of rhythmic masticatory muscle activity (RMMA) and is preceded by a strong participation of the autonomic nervous system (mainly by the rise in heart rate and blood pressure, and a large number of respiratory breaths). According to Prof. Lavigne , stress as a putative factor related with SB remains to be confirmed. He defends that a single explanation for SB is outdated.
Dr. Kristian Basili (presented his experimental research work on day-time bruxism. The results suggest the ability of the masticatory organ to decrease stress-induced allostatic overload and occlusion as an important contribution to an individual ability for stress management. It was also highlighted that 30% of the sample showed an increased grinding activity during awake bruxism than sleep bruxism.
Bruxism and Psychological, Behavioral and Neurological Aspects
Prof. Dr. Daniele Manfredini’s topic was about the role of psychological factors in the etiology of bruxism – a topic vastly debated throughout the years. Professor Manfredini has shown that literature findings available have been biased due to the inclusion of different motor activities under the same term “bruxism”. The lecturer distinguishes tonic-clenching and phasic-grinding as being two different motor activities. The first one seems to be associated with awaken hours and as being a reaction to stress sensitivity. The second seems to have a more complex relation with psychological issues.
Referring the neurological aspects of bruxism, Prof Dr. Orlova considers bruxism as a disease, being a motor disorder in the facial area. The use of botolinum toxin type A is recommend for the management of this condition and should be followed by dental reconstruction with dental rehabilitation.
Prof. Dr. Jean-Daniel Orthlieb brought to discussion in his lecture the behavioral aspects of bruxism. In his opinion, in order for dentists to decrease the dental risks associated with bruxism, skills in psychotherapy should be acquired. He suggests the Cognitive Behavioral Therapy (CBT) that involves the management of dysfunctional emotions, behavior and cognition.
Bruxism and TMD
In a very evidence based approach, Prof. Dr. Frank Lobbezzo has shown that the relationship between bruxism and temporomandibular disorders is still unclear. Together with Manfredini in 2010, a systematic review was performed showing more research was necessary. In the past few years, the publications dedicated to this topic confirm the findings from 2010 and were presented in his lecture.
Bruxism and Occlusion
Prof. Dr. Sadao Sato defends that one of the bigger tasks of the masticatory organ is to manage physiological stress reduction through grinding or clenching activity. Once again, he brought to the audience some impressive research results, where with the preliminary report it seems that masticatory activity reduces DMBA-stress-induced carcinogenesis. Prof. Sato also introduced the term “autonomic imbalance”, meaning a hyperactivity of the sympathetic system with a consequent hypoactivity of the parasympathetic system. This term emerges associated with a presented research work where the results obtained show that the masticatory system seems to reduce sympathetic nerve response, preventing post-stress arrhythmias in rats.
Due to the importance of this stress-management role, occlusion plays a very important role and should be taken care individually by the dentist, aiming at a healthy functional occlusion in which the smooth grinding moment should be allowed. The importance of assessing the individual canine steepness is also important, as an improper increase of the steepness might lead to functional problems.
Bruxism in the dental office: Diagnostic Tools, Dental Materials and 3D
Prof. Dr. Daniel Edelhoff dedicated his lecture to modern treatment concepts based in a proper dental material selection applied to bruxism patients.
High-density polymers as an option for long-term provisional restorations, lithium-disilicate for single-tooth and high-strength zirconium-dioxide ceramics for frameworks are mentioned as part of the late significant material improvements. The importance of the selection of an adequate occlusal concept was also highlighted.
Tools to identify bruxing activity in an accurate way were also discussed during the conference. Dr. Kanji Onodera presented BruxChecker as being a very simple tool to identify and evaluate the grinding patterns during bruxism.
Prof. Dr. Michelle Ommerborn presented her study that aimed to evaluate a newly developed semiautomatic-computer based method for quantification of abrasion on the Bruxcore Bruxism-Monitoring Device (BBMD). With a sample of 48 sleep bruxism subjects and 21 controls, the author concludes that BBMD is a clinically convenient and applicable method that seems capable to differentiate between sleep bruxism and non sleep bruxisms.
Periodontal disease associated with the occlusal trauma as a consequence from bruxism was presented and discussed by Dr. Givi Ordhzonikize. In a very clinical approach, this lecturer gives an overview about the co-destruction theory (Glickman) mentioning the latest associated research.
Dr. Patrick Simonet contributed with his lecture debating parafunction associated with implant prosthodontics. He debated on the paradigms sustained with literature concerning the mechanical and biological implications in implantology related to bruxism. As a clinician, he also shared his clinical experience and discussed the factors that might influence the impact of overloading forces during bruxism on the implant, bone and final restoration.
Under the topic “Reconstructive Rehabilitation of bruxism patients”, Priv. Doz. Dr. Oliver Ahlers mentioned in a very illustrative step-by-step clinical approach, the indications, pre-requirements, types of restorations and materials, possible treatment concepts and longevity and prognosis applied to bruxism patients.
Finally, Prof. Dr Ian Stavness and Benedikt Sagl, brought us the latest developments towards 3D simulation of bruxism. Incorporating the biomechanical muscle-driven jaw simulation with the digital dental articular, they showed their preliminary results to simulate dynamic tooth contacts during bruxism.
Silvia Cid, Markus Greven
Underneath the link below we provided those presentations and scientific material that was authorized by the speakers:
1.Dental Practice Luxembourg
2.Vienna School of Interdisciplinary Dentistry (VieSID); Vienna; Austria
3.Medical University of Vienna; Bernhard-Gottlieb School of Dentistry; Department of Prosthodontics; Vienna; Austria
4.Kanagawa Dental University; Department of Craniofacial Growth and Development Dentistry; Yokosuka; Japan
5.Private Dental Clinic, Bonn, German