顎関節症患者における歯ぎしりの自覚を用いた睡眠時ブラキシズム判定の妥当性

目的：顎関節症患者において，歯ぎしりの自覚が睡眠時ブラキシズムの臨床的判定に有効であるかどうかの妥当性を既知グループ技法により検証した。 方法：被験者として当科を受診した顎関節症患者148名を選択した。初診時に患者質問票およびSymptom Checklist-90-Revised（SCL-90-R）日本語版に回答させ，自覚的な頭頸部の疼痛の程度はVisual Analogue Scaleを用いて記録した。筋触診を含む臨床検査は，あらかじめ信頼性を確認した2名の検者が行った。問診による過去6か月間のブラキシズムの自覚の有無により，歯ぎしり自覚群74名と非自覚群74名の2群に分類した。 結果：年...

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Published in日本顎関節学会雑誌 Vol. 21; no. 3; pp. 209 - 215
Main Authors 矢谷, 博文, 中江, 佳代, 内田, 昌範, 稲野, 眞治, 石垣, 尚一, 角谷, 誠和
Format Journal Article
LanguageJapanese
Published 一般社団法人 日本顎関節学会 2009
Subjects
妥当性
既知グループ技法
歯ぎしりの自覚
睡眠時ブラキシズム
Online AccessGet full text
ISSN0915-3004
1884-4308
DOI10.11246/gakukansetsu.21.209

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Abstract 目的：顎関節症患者において，歯ぎしりの自覚が睡眠時ブラキシズムの臨床的判定に有効であるかどうかの妥当性を既知グループ技法により検証した。 方法：被験者として当科を受診した顎関節症患者148名を選択した。初診時に患者質問票およびSymptom Checklist-90-Revised（SCL-90-R）日本語版に回答させ，自覚的な頭頸部の疼痛の程度はVisual Analogue Scaleを用いて記録した。筋触診を含む臨床検査は，あらかじめ信頼性を確認した2名の検者が行った。問診による過去6か月間のブラキシズムの自覚の有無により，歯ぎしり自覚群74名と非自覚群74名の2群に分類した。 結果：年齢，性別および顎関節症の症型分布については2群間に有意差を認めなかった。自覚的な疼痛の程度（自発痛，運動時痛，頭痛），筋触診スコアおよび口腔内所見（咬耗および舌・頬粘膜の圧痕の頻度）には2群間に有意差を認めなかった。SCL-90-Rの5つの下位尺度に性別，年齢を加えてロジスティック回帰分析を行った結果，女性（オッズ比：3.15，P=.028）と不安（オッズ比：1.06，P=.003）が有意な変数であることが示された。 結論：女性の，また不安傾向の強い顎関節症患者と睡眠時ブラキシズムの自覚には関連があることが示され，歯ぎしりの自覚の有無をもって睡眠時ブラキシズムの臨床的診断基準とすることの妥当性は低いと考えられた。
AbstractList 目的：顎関節症患者において，歯ぎしりの自覚が睡眠時ブラキシズムの臨床的判定に有効であるかどうかの妥当性を既知グループ技法により検証した。 方法：被験者として当科を受診した顎関節症患者148名を選択した。初診時に患者質問票およびSymptom Checklist-90-Revised（SCL-90-R）日本語版に回答させ，自覚的な頭頸部の疼痛の程度はVisual Analogue Scaleを用いて記録した。筋触診を含む臨床検査は，あらかじめ信頼性を確認した2名の検者が行った。問診による過去6か月間のブラキシズムの自覚の有無により，歯ぎしり自覚群74名と非自覚群74名の2群に分類した。 結果：年齢，性別および顎関節症の症型分布については2群間に有意差を認めなかった。自覚的な疼痛の程度（自発痛，運動時痛，頭痛），筋触診スコアおよび口腔内所見（咬耗および舌・頬粘膜の圧痕の頻度）には2群間に有意差を認めなかった。SCL-90-Rの5つの下位尺度に性別，年齢を加えてロジスティック回帰分析を行った結果，女性（オッズ比：3.15，P=.028）と不安（オッズ比：1.06，P=.003）が有意な変数であることが示された。 結論：女性の，また不安傾向の強い顎関節症患者と睡眠時ブラキシズムの自覚には関連があることが示され，歯ぎしりの自覚の有無をもって睡眠時ブラキシズムの臨床的診断基準とすることの妥当性は低いと考えられた。
Author 中江, 佳代
角谷, 誠和
石垣, 尚一
内田, 昌範
稲野, 眞治
矢谷, 博文
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  fullname: 角谷, 誠和
  organization: 大阪大学大学院歯学研究科 統合機能口腔科学専攻 顎口腔機能再建学講座 歯科補綴学第一教室
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References 12) Wruble MK, Lumley MA, McGlynn FD. Sleep-related bruxism and sleep variables: a critical review. J Craniomandib Disord 1989; 3: 152-8.
19) Leslie GP, Mary PW. Foundations of Clinical Research: Applications to Practice. 2nd ed. Upper Saddle River: Prentice Hall; 2000. p. 89.
39) Lobbezoo F, Lavigne GJ, Tanguay R, Montplaisir JY. The effect of catecholamine precursor L-dopa on sleep bruxism: a controlled clinical trial. Mov Disord 1997; 12: 73-8.
35) Magnusson T, Egermark I, Carlsson GE. A longitudinal epidemiologic study of signs and symptoms of temporomandibular disorders from 15 to 35 years of age. J Orofac Pain 2000; 14: 310-9.
1) Kato T, Thie NM, Montplaisir JY, Lavigne GJ. Bruxism and orofacial movements during sleep. Dent Clin North Am 2001; 45: 657-84.
15) De Laat A, Macaluso GM. Sleep bruxism as a motor disorder. Mov Disord 2002; 17 Suppl 2: S67-9.
43) Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology of bruxism. J Orofac Pain 2009; 23: 153-66.
24) Huang GJ, LeResche L, Critchlow CW, Martin MD, Drangsholt MT. Risk factors for diagnostic subgroups of painful temporomandibular disorders (TMD). J Dent Res 2002; 81: 284-8.
23) McGregor NR, Butt HL, Zerbes M, Klineberg IJ, Dunstan RH, Roberts TK. Assessment of pain (distribution and onset), Symptoms, SCL-90-R Inventory responses, and the association with infectious events in patients with chronic orofacial pain. J Orofac Pain 1996; 10: 339-50.
29) Ahlberg J, Rantala M, Savolainen A, Suvinen T, Nissinen M, Sarna S, et al. Reported bruxism and stress experience. Community Dent Oral Epidemiol 2002; 30: 405-8.
9) Nadler SC. The treatment of bruxism-a review and analysis. NY State Dent J 1979; 45: 343-9.
32) Ahlberg K, Ahlberg J, Könönen M, Alakuijala A, Partinen M, Savolainen A. Perceived orofacial pain and its associations with reported bruxism and insomnia symptoms in media personnel with or without irregular shift work. Acta Odontol Scand 2005; 63: 213-7.
38) Lobbezoo F, Soucy JP, Montplaisir JY, Lavigne GJ. Striatal D2 receptor binding in sleep bruxism: a controlled study with iodine-123-iodobenzamide and single-photon-emission computed tomography. J Dent Res 1996; 75: 1804-10.
8) Glaros AG, Rao SM. Effect of bruxism: a review of the literature. J Prosthet Dent 1977; 38: 149-57.
20) 日本顎関節学会編. 顎関節症における各症型の診断基準. 日顎誌 1999; 11: 120-5.
7) Scharer P. Bruxism. Front Oral Physiol 1974; 1: 293-322.
4) Thompson BA, Blount BW, Krumholz TS. Treatment approaches to bruxism. Am Fam Physician 1994; 49: 1617-22.
27) AASM. International Classification of Sleep Disorders. 2nd ed. Westchester: American Academy of Sleep Medicine; 2005.
16) Huynh NT, Rompre PH, Montplaisir JY, Manzini C, Okura K, Lavigne GJ. Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size. Int J Prosthodont 2006; 19: 435-41.
41) Marbach JJ, Raphael KG, Janal MN, Hirschkorn-Roth R. Reliability of clinician judgments of bruxism. J Oral Rehabil 2003; 30: 113-8.
25) McKinney MW, Londeen TF, Turner SP, Levitt SR. Chronic TM disorder and non-TM disorder pain: a comparison of behavioral and psychological characteristics. Cranio 1990; 8: 40-6.
6) Yip KH, Chow TW, Chu FC. Rehabilitating a patient with bruxism-associated tooth tissue loss: A literature review and case report. Gen Dent 2003; 51: 70-4.
14) Lobbezoo F, Naeije M. Bruxism is mainly regulated centrally, not peripherally. J Oral Rehabil 2001; 28: 1085-91.
21) Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992; 6: 301-55.
37) Glaros AG, Williams K, Lausten L. The role of parafunctions, emotions and stress in predicting facial pain. J Am Dent Assoc 2005; 136: 451-8.
40) Baba K, Haketa T, Clark GT, Ohyama T. Does tooth wear status predict ongoing sleep bruxism in 30-year-old Japanese subjects? Int J Prosthodont 2004; 17: 39-44.
10) Schulte JK. Bruxism: a review and clinical approach to treatment. Northwest Dent 1982; 61: 13-8.
31) Nagamatu-Sakaguchi C, Minakuchi H, Clark GT, Kuboki T. Relationship between the frequency of sleep bruxism and the prevalence of signs and symptoms of temporomandibular disorders in an adolescent population. Int J Prosthodont 2008; 21: 292-8.
22) 中尾和久, 高石 穣. 日本語版SCL-90-Rの信頼性と妥当性. 大阪大学医学部精神医学教室研究助成報告集 1993; 6: 167-9.
17) Lavigne GJ, Huynh N, Kato T, Okura K, Adachi K, Yao D, et al. Genesis of sleep bruxism: motor and autonomic-cardiac interactions. Arch Oral Biol 2007; 52: 381-4.
5) Attanasio R. An overview of bruxism and its management. Dent Clin North Am 1997; 41: 229-41.
18) Glaros AG. Incidence of diurnal and nocturnal bruxism. J Prosthet Dent 1981; 45: 545-9.
13) Attanasio R. Nocturnal bruxism and its clinical management. Dent Clin North Am 1991; 35: 245-52.
33) Macfarlane TV, Blinkhorn AS, Davies RM, Worthington HV. Association between local mechanical factors and orofacial pain: survey in the community. J Dent 2003; 31: 535-42.
34) Macfarlane TV, Gray RJM, Kincey J, Worthington HV. Factors associated with the temporomandibular disorder, pain dysfunction syndrome (PDS): Manchester case-control study. Oral Dis 2001; 7: 321-30.
36) Chung SC, Kim YK, Kim HS. Prevalence and patterns of nocturnal bruxofacets on stabilization splints in temporomandibular disorder patients. Cranio 2000; 18: 92-7.
3) Biondi M, Picardi A. Temporomandibular joint pain-dysfunction syndrome and bruxism: ethiopathogenesis and treatment from a psychosomatic integrative viewpoint. Psychother Psychosom 1993; 59: 84-98.
28) Lavigne GJ, Manzini C, Kato T. Sleep bruxism. In: Kryger MH, Roth T, Dement WC, editors. Principles & Practice of Sleep Medicine. 4th ed. Philadelphia: Elsevier Saunders; 2005. p. 946-59.
42) Pergamalian A, Rudy TE, Zaki HS, Greco CM. The association between wear facets, bruxism, and severity of facial pain in patients with temporomandibular disorders. J Prosthet Dent 2003; 90: 194-200.
2) Cash RC. Bruxism in children: review of the literature. J Pedod 1988; 12: 107-27.
11) Rugh JD, Harlan J. Nocturnal bruxism and temporomandibular disorders. Adv Neurol 1988; 49: 329-41.
26) Nifosì F, Violato E, Pavan C, Sifari L, Novello G, Guarda Nardini L, et al. Psychopathology and clinical features in an Italian sample of patients with myofascial and temporomandibular joint pain: preliminary data. Int J Psychiatry Med 2007; 37: 283-300.
30) Rossetti LM, Pereira de Araujo Cdos R, Rossetti PH, Conti PC. Association between rhythmic masticatory muscle activity during sleep and masticatory myofascial pain: a polysomnographic study. J Orofac Pain 2008; 22: 190-200.
References_xml – reference: 32) Ahlberg K, Ahlberg J, Könönen M, Alakuijala A, Partinen M, Savolainen A. Perceived orofacial pain and its associations with reported bruxism and insomnia symptoms in media personnel with or without irregular shift work. Acta Odontol Scand 2005; 63: 213-7.
– reference: 1) Kato T, Thie NM, Montplaisir JY, Lavigne GJ. Bruxism and orofacial movements during sleep. Dent Clin North Am 2001; 45: 657-84.
– reference: 6) Yip KH, Chow TW, Chu FC. Rehabilitating a patient with bruxism-associated tooth tissue loss: A literature review and case report. Gen Dent 2003; 51: 70-4.
– reference: 18) Glaros AG. Incidence of diurnal and nocturnal bruxism. J Prosthet Dent 1981; 45: 545-9.
– reference: 36) Chung SC, Kim YK, Kim HS. Prevalence and patterns of nocturnal bruxofacets on stabilization splints in temporomandibular disorder patients. Cranio 2000; 18: 92-7.
– reference: 5) Attanasio R. An overview of bruxism and its management. Dent Clin North Am 1997; 41: 229-41.
– reference: 23) McGregor NR, Butt HL, Zerbes M, Klineberg IJ, Dunstan RH, Roberts TK. Assessment of pain (distribution and onset), Symptoms, SCL-90-R Inventory responses, and the association with infectious events in patients with chronic orofacial pain. J Orofac Pain 1996; 10: 339-50.
– reference: 29) Ahlberg J, Rantala M, Savolainen A, Suvinen T, Nissinen M, Sarna S, et al. Reported bruxism and stress experience. Community Dent Oral Epidemiol 2002; 30: 405-8.
– reference: 22) 中尾和久, 高石 穣. 日本語版SCL-90-Rの信頼性と妥当性. 大阪大学医学部精神医学教室研究助成報告集 1993; 6: 167-9.
– reference: 13) Attanasio R. Nocturnal bruxism and its clinical management. Dent Clin North Am 1991; 35: 245-52.
– reference: 16) Huynh NT, Rompre PH, Montplaisir JY, Manzini C, Okura K, Lavigne GJ. Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size. Int J Prosthodont 2006; 19: 435-41.
– reference: 27) AASM. International Classification of Sleep Disorders. 2nd ed. Westchester: American Academy of Sleep Medicine; 2005.
– reference: 39) Lobbezoo F, Lavigne GJ, Tanguay R, Montplaisir JY. The effect of catecholamine precursor L-dopa on sleep bruxism: a controlled clinical trial. Mov Disord 1997; 12: 73-8.
– reference: 37) Glaros AG, Williams K, Lausten L. The role of parafunctions, emotions and stress in predicting facial pain. J Am Dent Assoc 2005; 136: 451-8.
– reference: 4) Thompson BA, Blount BW, Krumholz TS. Treatment approaches to bruxism. Am Fam Physician 1994; 49: 1617-22.
– reference: 11) Rugh JD, Harlan J. Nocturnal bruxism and temporomandibular disorders. Adv Neurol 1988; 49: 329-41.
– reference: 38) Lobbezoo F, Soucy JP, Montplaisir JY, Lavigne GJ. Striatal D2 receptor binding in sleep bruxism: a controlled study with iodine-123-iodobenzamide and single-photon-emission computed tomography. J Dent Res 1996; 75: 1804-10.
– reference: 7) Scharer P. Bruxism. Front Oral Physiol 1974; 1: 293-322.
– reference: 35) Magnusson T, Egermark I, Carlsson GE. A longitudinal epidemiologic study of signs and symptoms of temporomandibular disorders from 15 to 35 years of age. J Orofac Pain 2000; 14: 310-9.
– reference: 42) Pergamalian A, Rudy TE, Zaki HS, Greco CM. The association between wear facets, bruxism, and severity of facial pain in patients with temporomandibular disorders. J Prosthet Dent 2003; 90: 194-200.
– reference: 41) Marbach JJ, Raphael KG, Janal MN, Hirschkorn-Roth R. Reliability of clinician judgments of bruxism. J Oral Rehabil 2003; 30: 113-8.
– reference: 25) McKinney MW, Londeen TF, Turner SP, Levitt SR. Chronic TM disorder and non-TM disorder pain: a comparison of behavioral and psychological characteristics. Cranio 1990; 8: 40-6.
– reference: 30) Rossetti LM, Pereira de Araujo Cdos R, Rossetti PH, Conti PC. Association between rhythmic masticatory muscle activity during sleep and masticatory myofascial pain: a polysomnographic study. J Orofac Pain 2008; 22: 190-200.
– reference: 33) Macfarlane TV, Blinkhorn AS, Davies RM, Worthington HV. Association between local mechanical factors and orofacial pain: survey in the community. J Dent 2003; 31: 535-42.
– reference: 43) Manfredini D, Lobbezoo F. Role of psychosocial factors in the etiology of bruxism. J Orofac Pain 2009; 23: 153-66.
– reference: 2) Cash RC. Bruxism in children: review of the literature. J Pedod 1988; 12: 107-27.
– reference: 3) Biondi M, Picardi A. Temporomandibular joint pain-dysfunction syndrome and bruxism: ethiopathogenesis and treatment from a psychosomatic integrative viewpoint. Psychother Psychosom 1993; 59: 84-98.
– reference: 28) Lavigne GJ, Manzini C, Kato T. Sleep bruxism. In: Kryger MH, Roth T, Dement WC, editors. Principles & Practice of Sleep Medicine. 4th ed. Philadelphia: Elsevier Saunders; 2005. p. 946-59.
– reference: 40) Baba K, Haketa T, Clark GT, Ohyama T. Does tooth wear status predict ongoing sleep bruxism in 30-year-old Japanese subjects? Int J Prosthodont 2004; 17: 39-44.
– reference: 9) Nadler SC. The treatment of bruxism-a review and analysis. NY State Dent J 1979; 45: 343-9.
– reference: 8) Glaros AG, Rao SM. Effect of bruxism: a review of the literature. J Prosthet Dent 1977; 38: 149-57.
– reference: 17) Lavigne GJ, Huynh N, Kato T, Okura K, Adachi K, Yao D, et al. Genesis of sleep bruxism: motor and autonomic-cardiac interactions. Arch Oral Biol 2007; 52: 381-4.
– reference: 21) Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992; 6: 301-55.
– reference: 31) Nagamatu-Sakaguchi C, Minakuchi H, Clark GT, Kuboki T. Relationship between the frequency of sleep bruxism and the prevalence of signs and symptoms of temporomandibular disorders in an adolescent population. Int J Prosthodont 2008; 21: 292-8.
– reference: 26) Nifosì F, Violato E, Pavan C, Sifari L, Novello G, Guarda Nardini L, et al. Psychopathology and clinical features in an Italian sample of patients with myofascial and temporomandibular joint pain: preliminary data. Int J Psychiatry Med 2007; 37: 283-300.
– reference: 15) De Laat A, Macaluso GM. Sleep bruxism as a motor disorder. Mov Disord 2002; 17 Suppl 2: S67-9.
– reference: 14) Lobbezoo F, Naeije M. Bruxism is mainly regulated centrally, not peripherally. J Oral Rehabil 2001; 28: 1085-91.
– reference: 20) 日本顎関節学会編. 顎関節症における各症型の診断基準. 日顎誌 1999; 11: 120-5.
– reference: 12) Wruble MK, Lumley MA, McGlynn FD. Sleep-related bruxism and sleep variables: a critical review. J Craniomandib Disord 1989; 3: 152-8.
– reference: 34) Macfarlane TV, Gray RJM, Kincey J, Worthington HV. Factors associated with the temporomandibular disorder, pain dysfunction syndrome (PDS): Manchester case-control study. Oral Dis 2001; 7: 321-30.
– reference: 10) Schulte JK. Bruxism: a review and clinical approach to treatment. Northwest Dent 1982; 61: 13-8.
– reference: 19) Leslie GP, Mary PW. Foundations of Clinical Research: Applications to Practice. 2nd ed. Upper Saddle River: Prentice Hall; 2000. p. 89.
– reference: 24) Huang GJ, LeResche L, Critchlow CW, Martin MD, Drangsholt MT. Risk factors for diagnostic subgroups of painful temporomandibular disorders (TMD). J Dent Res 2002; 81: 284-8.
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Snippet 目的：顎関節症患者において，歯ぎしりの自覚が睡眠時ブラキシズムの臨床的判定に有効であるかどうかの妥当性を既知グループ技法により検証した。 方法：被験者として当...
SourceID jstage
SourceType Publisher
StartPage 209
SubjectTerms 妥当性
既知グループ技法
歯ぎしりの自覚
睡眠時ブラキシズム
Title 顎関節症患者における歯ぎしりの自覚を用いた睡眠時ブラキシズム判定の妥当性
URI https://www.jstage.jst.go.jp/article/gakukansetsu/21/3/21_3_209/_article/-char/ja
Volume 21
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ispartofPNX 日本顎関節学会雑誌, 2009, Vol.21(3), pp.209-215
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