Determining the Relationship Between Posture, Muscle Stiffness, Pain, and Jaw Functionality in Individuals With Bruxism: A Comparative Cross-Sectional Study
Overview
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Istanbul Kent University
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Jaw Functional Limitation Total Score Assessed Using the 20-Item Jaw Functional Limitation Scale (JFLS-20)
Overview
Brief Summary
Bruxism is a repetitive jaw-muscle activity characterized by teeth clenching and/or grinding, often associated with temporomandibular joint dysfunction, pain, and impaired jaw function. This cross-sectional comparative study aims to investigate the relationship between jaw functionality, posture, muscle stiffness, pain, perceived stress, and sleep quality in young adults with bruxism. A total of 48 participants will be included: 24 individuals with clinically confirmed bruxism and 24 healthy controls.
Clinical and sociodemographic characteristics will be recorded using a Bruxism Assessment Form developed by dentists and physiotherapists. Posture will be assessed with the PostureScreen Mobile® application; pain intensity and thresholds will be measured using a digital algometer; masseter, temporalis, and trapezius muscle stiffness will be evaluated with a MyotonPro device. Perceived stress will be assessed using the Perceived Stress Scale-10, sleep quality with the Epworth Sleepiness Scale, and functional jaw limitation with the Jaw Functional Limitation Scale-20.
Statistical analysis will be performed using SPSS (Version 20.0). Between-group comparisons will be made using t-tests or Mann-Whitney U tests depending on distribution. Correlation analyses (Pearson or Spearman) will be used to evaluate associations among variables.
The primary outcome is to determine the relationship between jaw functionality, posture, muscle stiffness, and pain in individuals with bruxism. Secondary outcomes include the associations of sleep quality and perceived stress with these parameters. This study will provide novel insights into the multidimensional impact of bruxism and may guide future preventive and rehabilitative strategies.
Detailed Description
Bruxism is a repetitive jaw-muscle activity, characterized by teeth clenching or grinding, that may occur during sleep or wakefulness. It is associated with temporomandibular disorders, increased muscle activity, pain, impaired jaw function, and reduced quality of life. Although bruxism has been linked to psychological factors such as stress and sleep disturbances, the relationship between jaw functionality, posture, muscle stiffness, and pain remains unclear.
This cross-sectional comparative study will include 48 young adults, consisting of 24 individuals with clinically confirmed bruxism and 24 age-matched healthy controls. Participants will undergo a comprehensive evaluation process. Bruxism will be confirmed by a dental specialist through clinical examination combined with a standardized Bruxism Assessment Questionnaire. Clinical and sociodemographic data will be collected with a patient assessment form.
Outcome measures will include:
Posture assessment: PostureScreen Mobile® application, using standardized digital imaging.
Pain assessment: Pain intensity and thresholds measured with a digital algometer on masseter, temporalis, trapezius muscles, and temporomandibular joint regions.
Muscle stiffness: Quantified with the MyotonPro device on jaw and neck muscles.
Perceived stress: Evaluated using the Perceived Stress Scale-10.
Sleep quality: Assessed with the Epworth Sleepiness Scale.
Jaw functionality: Evaluated with the Jaw Functional Limitation Scale-20.
Data will be analyzed with SPSS (Version 20.0). Normality will be tested with Shapiro-Wilk. Depending on distribution, parametric or non-parametric tests (Independent Samples t-test, Mann-Whitney U test) will be applied for between-group comparisons. Correlation analyses (Pearson or Spearman) will explore associations among variables. A significance level of p<0.05 will be adopted.
The primary objective is to determine the relationship between jaw functionality, posture, muscle stiffness, and pain in individuals with bruxism. The secondary objective is to examine the impact of perceived stress and sleep quality on these parameters and to compare findings with a healthy control group.
This study is expected to fill a gap in the literature by providing evidence on the multifactorial associations between bruxism, postural control, muscle characteristics, and psychosocial factors. Findings may contribute to the development of multidisciplinary preventive and therapeutic strategies in dentistry, physiotherapy, and rehabilitation.
Study Design
- Study Type
- Observational
- Observational Model
- Case Control
- Time Perspective
- Cross Sectional
Eligibility Criteria
- Ages
- 18 Years to 30 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Individuals diagnosed with bruxism following a physical examination and assessment questionnaire administered by a specialist dentist were included in the study.
- •Being between the ages of 18 and 30
- •Having jaw pain that has persisted for at least 3 months
- •Patients who described pain in the face, temporal region, or ear, and who had pain detected in the masticatory muscles upon palpation.
- •Volunteering to participate in the study
- •Cooperative individuals with whom mutual communication is possible
Exclusion Criteria
- •History of surgery or trauma to the maxillofacial region
- •Active infection in the maxillofacial region
- •Presence of cysts, tumors, or malignant pathologies affecting the TMJ region and muscles
- •Presence of systemic rheumatic disease or musculoskeletal diseases affecting the bones
- •Presence of any neurological problem that would preclude evaluations
- •Diagnosis of any psychiatric disorder
- •Receiving physiotherapy or other treatment methods for the TMJ or cervical spinal region within the last 6 months
Arms & Interventions
Bruxism
24 patients diagnosed with bruxism will be included.
Intervention: Bruxism Assessment Form (Other)
Bruxism
24 patients diagnosed with bruxism will be included.
Intervention: Clinical Examination (Other)
Bruxism
24 patients diagnosed with bruxism will be included.
Intervention: Patient Evaluation Form (Other)
Bruxism
24 patients diagnosed with bruxism will be included.
Intervention: Perceived Stress Scale-10 (Other)
Bruxism
24 patients diagnosed with bruxism will be included.
Intervention: Posture Assessment (Other)
Bruxism
24 patients diagnosed with bruxism will be included.
Intervention: Muscle Stiffness Assessment (Other)
Bruxism
24 patients diagnosed with bruxism will be included.
Intervention: The Epworth Sleepiness Scale (ESS) (Other)
Bruxism
24 patients diagnosed with bruxism will be included.
Intervention: Jaw Function Limitation Scale-20 (MFFS-20) (Other)
Bruxism
24 patients diagnosed with bruxism will be included.
Intervention: Pain threshold assessment (Other)
Healthy
24 healthy individuals will be included
Intervention: Bruxism Assessment Form (Other)
Healthy
24 healthy individuals will be included
Intervention: Clinical Examination (Other)
Healthy
24 healthy individuals will be included
Intervention: Patient Evaluation Form (Other)
Healthy
24 healthy individuals will be included
Intervention: Perceived Stress Scale-10 (Other)
Healthy
24 healthy individuals will be included
Intervention: Posture Assessment (Other)
Healthy
24 healthy individuals will be included
Intervention: Muscle Stiffness Assessment (Other)
Healthy
24 healthy individuals will be included
Intervention: The Epworth Sleepiness Scale (ESS) (Other)
Healthy
24 healthy individuals will be included
Intervention: Jaw Function Limitation Scale-20 (MFFS-20) (Other)
Healthy
24 healthy individuals will be included
Intervention: Pain threshold assessment (Other)
Outcomes
Primary Outcomes
Jaw Functional Limitation Total Score Assessed Using the 20-Item Jaw Functional Limitation Scale (JFLS-20)
Time Frame: At baseline (study enrollment)
Jaw functional limitation will be assessed using the 20-Item Jaw Functional Limitation Scale (JFLS-20). The outcome measure will be the total JFLS-20 score, ranging from 0 to 10 (mean global score; 0 = no limitation, 10 = severe limitation). Higher scores indicate greater jaw functional limitation (worse outcome).
Pain Intensity and Pain Threshold
Time Frame: At baseline
Pain intensity will be assessed using the Visual Analog Scale (VAS), recorded as a score on a 0-10 cm (veya 0-100 mm, hangisini kullanıyorsanız) scale, with higher scores indicating greater pain intensity.Pressure pain threshold will be assessed using a digital algometer and recorded as pressure values (kg/cm², N/cm², ya da kullandığınız birim ne ise onu yazın), with higher values indicating higher pain threshold.
Postural Alignment Parameters Assessed Using the PostureScreen Mobile® Application
Time Frame: At baseline
Postural alignment parameters, including head position, shoulder alignment, spinal posture, and pelvic alignment (uygun olanları siz düzenleyin), will be quantitatively assessed using the PostureScreen Mobile® application.
Muscle Stiffness (N/m) of the Masseter, Temporalis, and Trapezius Muscles Assessed Using the MyotonPRO Device
Time Frame: At baseline
Muscle stiffness will be quantitatively assessed in the masseter, temporalis, and trapezius muscles using the MyotonPRO handheld myotonometer. Stiffness will be recorded in Newtons per meter (N/m) as the primary biomechanical parameter used for evaluation.
Secondary Outcomes
- Sleep Quality(At baseline)
- Perceived Stress(At baseline)
Investigators
Emine Nur Demircan
Assistant Professor
Istanbul Kent University