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Previous issue date: 2012-01-23 === The aim of this before-and-after study was to test the efficacy of the anterior mandibular positioning appliance in the treatment of sleep bruxism, through the comparison among the polysomnography and the BiteStrip? results, and the answers of the Sleep Assessment Questionnaire (SAQ) before and after the use of this appliance. Eighteen patients with bruxism, at the average age of 39,9 years old (SD 12,98) were assessed before and after the application of the anterior mandibular positioning appliance. Therefore, bruxism diagnosis was made through the clinical evaluation, the polysomnography and the use of BiteStrip?, and the sleep diagnosis was made through the answers of SAQ. After three month, the subjects made again polysomnography, used the Bitestrip? and answered the SAQ to evaluate if there was any improvement of the bruxism and, consequently, of the sleep. To be considered for bruxism in the polysomnography, the examination should present 4.5 bruxism episodes per hour of sleep or 25 bruxism bursts per hour of sleep, plus an episode of gnashing of teeth / hour of sleep in the polysomnography. The others methods already have their own evaluation scales. Besides, the effects that the stomatognathic system can suffer by the use of this kind of appliance were analyzed. There was a significative improvement in the sleep bruxism and in the sleep, beyond a direct relation among polysomnography, BiteStrip? and the SAQ. In the stomatognathic system, there were less joint sounds and no significative side effects. So, the anterior mandibular positioning appliance has a positive effect in sleep bruxism and doesn't cause significative side effects in the stomatognathic system in a three month period. Was made an initial validation of the method to diagnose bruxism BiteStrip ? by comparing the results of the same with polysomnography. The Kappa index showed that there was high agreement between the two diagnostic methods. Through the test of sensitivity and specificity, one may suggest that the BiteStrip ? has high sensitivity (84.21%) and high specificity (100%) in the range of 95% compared with polysomnography. === Foi realizado um trabalho do tipo experimental antes-e-depois com o objetivo de avaliar a efic?cia do aparelho de avan?o mandibular no tratamento contra o bruxismo noturno, atrav?s da compara??o dos resultados nos exames polissonogr?ficos, do uso do BiteStrip? e das respostas do Question?rio de Avalia??o do Sono (QAS) antes e depois da utiliza??o do aparelho. O BiteStrip? foi usado associado a polissonografia. Foram avaliados 19 indiv?duos brux?manos com idade m?dia de 39,9 anos (DP 12,98) antes e depois do uso da placa de avan?o mandibular. Foi, ent?o, realizado diagn?stico de bruxismo atrav?s do exame cl?nico, da polissonografia e do uso do dispositivo BiteStrip? e diagn?stico do sono atrav?s do QAS antes do uso da placa. Ap?s tr?s meses, os indiv?duos novamente, fizeram polissonografia utilizaram o BiteStrip? e responderam o QAS para avaliar se houve melhora no bruxismo e, conseq?entemente, no sono. Para ser considerado bruxismo, o exame devia apresentar 4,5 epis?diosde bruxismo por hora de sono ou 25 explos?es de bruxismo por hora de sono. Ambos os outros dois m?todos j? t?m sua escala de avalia??o. Al?m disso, foram analisados os efeitos que esse tipo de placa pode causar no sistema estomatogn?tico. Houve uma melhora significativa no bruxismo noturno e no sono, al?m de uma rela??o direta entre a polissonografia, o BiteStrip? e o QAS. No sistema estomatogn?tico, houve uma diminui??o significativa nos ru?dos articulares e n?o houve nenhum efeito colateral significativo. Portanto, a placa de avan?o mandibular teve um efeito positivo no bruxismo noturno e n?o provocou efeitos colaterais significantes no sistema estomatogn?tico num per?odo de tr?s meses. Al?m disso, foi realizado foi realizado valida??o inicial do BiteStrip?, comparando esse com a polissonografia. Houve uma grande concord?ncia segundo ao ?ndice Kappa, com alta especificidade (100%) e alta sensibilidade (84,21%).
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