To describe the protocol of a prospective cohort study designed to answer the question: ‘Is sleep bruxism a risk factor for (peri-)implant complications? Our study is a single-centre, double-blind, prospective cohort study with a follow-up time of 2 years.Ninety-eight participants fulfilling inclusion criteria (planned treatment with implant-supported fixed suprastructure(s) and age 18 years or older) will be included.
To describe the protocol of a prospective cohort study designed to answer the question: ‘Is sleep bruxism a risk factor for (peri-)implant complications? Our study is a single-centre, double-blind, prospective cohort study with a follow-up time of 2 years.Tags: Depression EssaysJohn Edgar Wideman Our Time EssayRestaurant Business Plan FormatArgument Essay Against IngLinux Shell Script Variable AssignmentComputer And Society Essay4 Functions Of Management EssaysPharmacy Essay
Studies that have included bruxism as one of the factors contributing to complications show a large variation in terms of both the technical and the biological outcomes of implant treatments, so that their comparability is compromised.
On the basis of the assumption that SB can lead to complications, clinicians are so far instructed to be cautious, and are guided by expert opinions regarding practical aspects of implant treatments in patients with (suspected) bruxing behaviour.
The investigation will have two main outcomes, namely, technical complications and biological complications.
As to avoid variation in the outcomes caused by failing retention of removable suprastructures, we will confine our study population to patients treated with fixed suprastructures.
This lack of sound evidence is the consequence of mainly two factors.
First, up to the present time, there is no study with the specific design to assess the effect of bruxism on dental implants.The lack of high-level evidence also affects researchers, as suspected bruxism is often—but not always—an exclusion criterion in studies concerning the outcomes of dental implant treatments.Consequently, the populations in such studies may significantly differ from each other, which undermines the ability to compare their outcomes in an unequivocal way.However, this technique is costly and often impractical to perform, leading to the use of less accurate methods for diagnosing SB.In clinical practice and research settings, this involves self-report instruments, clinical examinations and electromyographic (EMG) recordings of masticatory muscle activity during sleep.However, as yet, causative relationships between mechanical loading and peri-implant biological complications have not been established, due to a general lack of clinical studies with an appropriate design to assess the effect of excessive loading on dental implants, Animal experimental data suggest that high loading of clinically stable dental implants is associated with marginal bone loss in the case of inadequate plaque removal, while when plaque control is sufficient, this loading might lead to an increase of bone density around the implant.Investigating the time-dependent associations between mechanical forces (such as those attributed to SB), the composition of microbial communities and host response will enhance our insight into the pathogenesis of peri-implant disease.Prevalence data based on sound criteria are important.However, the clinician interested in the consequences of SB should be aware that, even individuals who, after one or several PSG recordings, would not officially be characterised as sleep bruxers, can present (mild) bruxism activity during sleep.These guidelines include advices on implant and suprastructure characteristics, such as the number, length and diameter of implants, the material of the suprastructure, and the occlusion and articulation patterns.Expert opinions represent the lowest grade of evidence and cannot, therefore, fulfil modern clinicians’ needs for evidence-based decision-making.