Available online 18 April 2025

Author links open overlay panel, , , , AbstractStatement of problem

Bruxism may have positive clinical consequences, but whether it contributes to masticatory function remains unclear.

Purpose

The purpose of this clinical study was to clarify the relationship between sleep bruxism and masticatory performance in young adults with healthy dentitions and to determine the roles of occlusal force, dental occlusion, temporomandibular disorders (TMDs), and jaw symptoms.

Material and methods

Ninety-seven dental students with healthy dentitions participated in this cross-sectional study (median age, 21.9 years; 84 women). Sleep bruxism was assessed at the dental level as the relative peeled area of a BruxChecker worn for 3 nights. Occlusal contact area and maximum occlusal force were measured using silicone transillumination and the Innobyte system. Frequencies of bruxism-related jaw symptoms and TMD were determined using the BruxScreen and diagnostic criteria for TMD protocols. Masticatory performance was assessed by masticating bagged silicone for 20 cycles and calculating the masticatory performance index as the percentage of silicone in weight that passed a 3.15-mm sieve. Bivariate and multiple linear regression analyses were performed, followed by moderated mediation modeling that considered the relative peeled area as a predictor, masticatory performance index as an outcome, and sex as a covariate (α=.05).

Results

Relative peeled area showed a bivariate positive correlation with the masticatory performance index (P<.05), but this was not significant in the stepwise multiple regression model (P>.05). Moderated mediation analysis revealed the relative peeled area exerted a positive indirect effect on masticatory performance via the occlusal force and occlusal contact area, which functioned as serial mediators. This indirect effect was not significant in participants with TMD pain and frequent jaw symptoms (P>.05).

Conclusions

Sleep bruxism may enhance masticatory performance in healthy dentate adults without TMD pain or bruxism-related jaw symptoms. This effect is primarily mediated by an increase in occlusal force and an enlargement of the occlusal contact area.

Section snippetsMATERIAL AND METHODS

A cross-sectional observational study was performed between November 2023 and March 2024 at the University of Barcelona dental school. One hundred and nine third year dental students were invited to participate if they were aged between 18 and 45 years, had a healthy dentition of at least 24 natural teeth without severe malocclusion, were not taking sedation medication, did not have chronic disease, and were not undergoing active orthodontic treatment. Participants who slept with minimum

RESULTS

Among the 109 dental students invited to participate, 3 declined the invitation, 7 did not meet the inclusion criteria, and 2 were excluded because they failed to comminute any pieces during the masticatory assay. Another 13 participants did not participate in the BruxChecker tests: 2 slept with interruptions, 5 declined the invitation, and 6 were unavailable; finally, 1 participant did not wear the BruxChecker for all 3 nights and was excluded from the BruxChecker analysis. In addition, 1

DISCUSSION

This study revealed that sleep bruxism assessed at the dental level may improve masticatory performance among healthy individuals with a natural dentition. This effect was found to be mainly mediated through the occlusal force and the OCA. Therefore, the null hypothesis that sleep bruxism was not related to masticatory performance was rejected. However, sleep bruxism did not seem to affect the masticatory performance in individuals with muscular TMD pain, articular TMD pain, or frequent

CONCLUSIONSBased on the findings of this clinical study, the following conclusions were drawn:1.

Sleep bruxism may improve masticatory performance in young adults with healthy dentitions through a process that is mainly mediated by an increase in occlusal force and an enlargement of the OCA.

2.

However, sleep bruxism does not appear to improve masticatory performance in individuals with TMD pain or frequent jaw symptoms related to bruxism.

3.

The enhancement of masticatory performance can be considered a positive

PATIENT CONSENT

Written informed consent was obtained from all individual participants included in the study.

Ethics approval statement

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Barcelona University Dental Hospital (Ref. 25/2023; November 3, 2023).

CRediT authorship contribution statement

Mireia Ustrell-Barral: Conceptualization, Methodology, Validation, Investigation, Writing- original draft, Visualization. Carla Zamora-Olave: Conceptualization, Methodology, Resources, Writing- reviewing and editing, Supervision. Laura Khoury-Ribas: Conceptualization, Methodology, Writing- reviewing and editing. Bernat Rovira-Lastra: Conceptualization, Methodology, Resources, Writing- reviewing and editing, Supervision. Jordi Martinez-Gomis: Conceptualization, Methodology, Validation,

Acknowledgments

The authors thank the third-year dental students for collaborating in this study, the technicians Luis Lora and Carmen Moreno for providing technical support, and Michael Maudsley and Dr Robert Sykes for editing the text. Special recognition is given to Professor Joan Salsench for his exceptional leadership, guidance, and dedication to this research group and the University of Barcelona. His contributions have been invaluable, and his legacy will continue to serve as a source of inspiration.

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