Research project regarding Hypnosis and Bruxism

Bruxism is an oral-motor parafunctional habit with a high prevalence in the general population. It has been and remains a point at which focuses great attention in dentistry because of its clinical implications. A number of hypotheses have been proposed to explain the etiology and pathophysiology of BS. Currently accepting a multifactorial model that includes factors: genetic, neurophysiological. (Neurotransmitters central structure of sleep, autonomic nervous system), Psycho-emotional and Pharmacologic. 1

Only a small percentage develop bruxism as a pathologic consequence of bruxism habit. Apparently, this occurs in cases where sleep bruxism (SB) exceeds the adaptive capacity of the body, in which case SB can cause craniomandibular dysfunction.1 Myofascial pain disorder (MPD) is defined as a pain in the regional organization, deaf, accompanied by the presence of trigger points located in the muscles of the temporomandibular joint, which produces a characteristic pattern of regional pain that is activated at the slightest provocation.

Hypnosis and hipnorelajación have been suggested as an effective treatment in diseases involving chronic pain 2 and are a logical choice for the treatment of MPD and bruxism. 3 Its use as a treatment modality for MPD or bruxism has been described in several case reports 3-4 and clinical studies demonstrating the efficacy of hypnosis in the treatment of nocturnal bruxism and temporomandibular disorders (TMD) . 3-5 We take into account the fluctuating nature of the disturbance, as suggested in the literature. 6

A wide range of methods of treatment or intervention have been proposed in recent decades to modify or decrease the level of bruxism. These methods include physical therapy, muscle relaxation exercises, acupuncture, biofeedback (biofeedback), hypnosis, occlusal adjustments, occlusal splints and pharmacology. 7 Today the most common treatment for bruxism is addressing dental protection by occlusal splints. 8 Although occlusal splints may be beneficial to protect the teeth from wear, the effectiveness of these devices intraoral-reducing activity of the jaw muscles at night and just as the existence of craniofacial pain upon awakening, continues still an outstanding issue. When it has considered the effectiveness of occlusal splints in the treatment of bruxism during sleep, at the individual level, studies have shown some reduction, no effect or even an increase in muscle activity. After the placement of occlusal splints have observed a significant activity of the jaw muscles. 9 The purpose of this study is to evaluate the effectiveness of hipnorelaxation in the treatment of MPD compared with another treatment modality. Replicating, in part, a previous study by Winokur et al. 2002. 10

Participants:

Prof Dr. Angel F. Espias Gómez, Dr. Luis Alberto Sánchez Soler & Dr. Santiago Masip Santurio. Departamento Odontoestomatología. Materiales Odontológicos. Universitat de Barcelona.

Prof. Guillem Feixas. Departamento de Personalidad, Evaluación y Tratamiento Psicológico de la Universitat de Barcelona.

Dr. Agustí Camino, PS. Institut Milton H. Erickson de Barcelona.

Dr. Juan M. Badosa, Mariano E. Robles y Albert Roig. VIAbcn. Barcelona.

With the support of

Dr. Ephraim Winocur. Coordinator of the Orofacial Pain & TMD Clinic. The Goldschleger School of Dental Medicine Ramat Aviv, Tel Aviv. Israel.

Dr, Peter Hawkins. Expert teaching in hypnosis. Elected Council Member, British Society of Clinical & Academic Hypnosis. Chartered Counselling Psychologist and Health Psychologist of the British Psychological Society.

References

1 de la Hoz-Aizpurua JL, Díaz-Alonso E, LaTouche-Arbizu R, Mesa-Jiménez J. Sleep bruxism. Conceptual review and update. Med Oral Patol Oral Cir Bucal. 2011 Mar 1;16 (2):e231-8.

2 Dworkin SF. Behavioral and educational modalities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:128-33.

3 Clarke JH, Reynolds PJ. Suggestive hypnotherapy for nocturnal bruxism: a pilot study. Am J Clin Hypn 1991;33:248-53.

4 Somer E. Hypnobehavioral and hypnodynamic intervention in temporomandibular disorders. In: Mehrstedt M, Wikstrom PO, editors. Hypnosis in dentistry. Hypnosis international monographs, no. 3. Munich: MEG Stiftung; 1997. p. 87-98.

5 Simon EP, Lewis DM. Medical hypnosis for temporomandibular disorders: treatment efficacy and medical utilization outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:54-63.

6 Storey AT. Unresolved issues and controversies. In: Zarb GA, Carlsson GE, Sessle BJ, Mohl ND, editors. Temporomandibular joint and masticatory muscle disorders. 2nd ed. Copenhagen: Munksgaard; 1995. p. 584-615.

7 Lobbezoo F, van der Zaag J, van Selms MK, Hamburger HL, Naeije M. Principles for the management of bruxism. J Oral Rehabil 2008; 35:509-23.

8 Dao TT, Lavigne GJ. Oral splints: the cruthches for temporomandibular disorders and bruxism. Crit Rev Oral Biol Med 1998; 9:345-361.

9 Harada T, Ichiki R, Tsukiyama Y, Koyano K. The effect of oral splint devices on sleep bruxism: a 6-week observation with an ambulatory electromyographic recording device. J Oral Rehabil, 2006; 33:482-488.

10 Winocur, E.; Gavish, A.; Emodi-Perlman, A.; Halachmi, M. and Eli, I. Hypnorelaxation as treatment for myofascial pain disorder: A comparative study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:429-34

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