NTI-tss和稳定咬合板治疗磨牙症的多导睡眠监测研究

Investigation of nociceptive trigeminal inhibitory tension suppression system and occlusal stabilization splint on bruxism patients by using polysomnography

目的比较NTI-tss咬合板和稳定咬合板(OS)对于磨牙症的短期疗效。方法 10例磨牙症患者采用随机自身交叉对照试验,戴用NTI-tss和OS治疗各1周,于戴用咬合板前一晚、戴用当晚和戴用1周后进行多导睡眠监测,计算磨牙指数和睡眠微觉醒指数,数据采用SAS 9.1混合效应模型进行分析。结果两种咬合板在戴用前、戴用当晚、戴用1周后的睡眠微觉醒指数均无明显差异(P>0.05)。两种咬合板戴用后,磨牙指数均降低。NTI-tss戴用前、戴用当晚和1周后的磨牙指数分别为(7.50±1.11)、(3.45±1.22)、(3.51±1.03)次.h-1,戴用当晚与戴用前、戴用1周与戴用前的差异均有统计学意义(t=26.52,t=26.12,P<0.01)。OS戴用前、戴用当晚和1周后的磨牙指数分别为(7.44±1.23)、(2.97±0.91)、(6.43±1.02)次.h-1,戴用当晚与戴用前、戴用1周与戴用前的差异也有统计学意义(t=16.79,t=3.79,P<0.01),但与NTI-tss相比,降低程度较小。结论 NTI-tss和OS对于睡眠微觉醒的发生无影响,两者都可以降低磨牙指数,但前者对于夜磨牙症的短期疗效可能更稳定。

Objective To study the short-term effects of nociceptive trigeminal inhibitory tension suppression system（NTI-tss） and occlusal stabilization splint （OS） on sleep bruxism patients. Methods Ten patients received the two splint treatments in a randomized cross-over fashion： An NTI-tss and an OS for a 1-week period, respectively. Record the bruxism episodes per hour, micro-arousals per hour of the patients before wearing the splints （baseline）, the first night and 1 week after wearing the splints with polysomnography. Statistical analysis was performed with SAS 9.1 by means of mixed effect model analysis. Results There were no differences among the micro-arousal index of the base-line, the first night and 1 week later with both types of the splints （P〉0.05）. The NTI-tss was associated with a signi- ficant reduction in bruxism index compared with baseline. The bruxism index of baseline, the first night and 1 week later were 7.50±1.11, 3.45±1.22, and 3.51±1.03 per hour（the first night vs baseline, t=26.52, P〈0.01; 1 week vs baseline, t=26.12, P〈0.01）. There were also significant differences in the bruxism index after wearing the OS. The bruxism index of baseline, the first night and I week later were 7.44±1.23, 2.97±0.91 and 6.43±1.02 per hour（the first night vs base-line, t=16.79, P〈0.01; 1 week vs baseline, t=3.79, P〈0.01）. Compared with the NTI-tss group, the reduction was much less, especially 1 week later. Conclusion Both the NTI-tss and the OS splints can reduce the bruxism index, and have no affect the incidence of micro-arousaL In this short term study, the NTI-tss was more effective than the OS for the treatment of sleep bruxism.