Prof. Daniele Manfredini will be our Guest Speaker for this crucial closing evening of the Dentistry 4.0 Webinar Series for 2024.
Special attention will be given to the IADR Key Points for best Temporomandibular clinical practice, outlined in this scientific publication:
https://www.tandfonline.com/doi/full/10.1080/08869634.2024.2405298
After the presentation, there will be ample time for a Q&A session, where you’ll have the opportunity to ask direct questions to one of the top 3 experts in the world on Bruxism and Temporomandibular Disorders.
Don’t miss this unique opportunity!

The new definition of bruxism, in addition to establishing a clear distinction between sleep bruxism and awake bruxism, has broadened the spectrum of masticatory muscle activities previously not considered, such as jaw clenching.

In light of this paradigm shift, the need has arisen to employ strategies beyond self-report to investigate the frequency of different types of masticatory muscle activities. These are mainly represented by Ecological Momentary Assessment (EMA) and surface Electromyography (EMG). The new strategies currently available have enabled both researchers and clinicians to further investigate and study the frequency of different bruxism activities and the existing association between bruxism and various psychogenic conditions.

Both EMA and EMG are tools that allow clinicians to receive feedback on the reduction of bruxism activity following the different therapies adopted for its management. The aim of this report is to delve deeper into their clinical applications.

The use of botulinum toxin in the medical field has been spreading since the 1980s, when its beneficial effect of reducing muscle spasms was first noticed. The first application was in the ocular area for the correction of strabismus. This was followed by indications in the physiatric and orthopedic fields, aimed at reducing muscle spasms and, indirectly, pain.

In the dental-maxillofacial field, in recent years, botulinum toxin has found applications in the treatment of bruxism, teeth clenching, spasms of the masticatory muscles, the correction of masseter hypertrophy, and, more recently, in the treatment of temporomandibular joint degeneration, in combination with hyaluronic acid injections.

In addition to the indications related to the spasms of the masticatory muscles and the resulting pain-relieving action, it has recently emerged that botulinum toxin also has a direct action on nerve fibers, acting by inhibiting the release of certain neurotransmitters involved in pain transmission. These new characteristics have allowed for the further extension of botulinum toxin application in the treatment of oro-facial pain.

In recent years, bruxism has garnered increasing interest both in clinical and research fields due to its multiple clinical implications and its prevalence in the population. At the same time, the demand for orthodontic treatments has significantly increased in recent decades, particularly among adults, who are increasingly seeking aesthetic treatments with aligners. Therefore, the purpose of this report will be to delve into the topic of bruxism and temporomandibular disorders from the orthodontist's perspective through the discussion of clinical cases treated with fixed or removable appliances. 

Sleep disorders affect one in five people, with over 90 recognized types, including nocturnal bruxism, obstructive sleep apnea syndrome (OSAS), and snoring. The dentist plays a crucial role in the diagnostic screening phase and therapeutic management of these disorders. Thanks to modern technologies, clinicians can use advanced tools to perform polysomnography and electromyography to accurately complete the diagnostic process. Patients with dental wear, orofacial pain, or symptoms of temporomandibular dysfunction (TMD) may suffer from OSAS, nocturnal bruxism, or both conditions. In these complex cases, accurate instrumental and differential diagnosis is essential to develop an integrated and personalized therapeutic approach.

The report generated by the dia-BRUXO system also includes the entire EMG graph recorded during the exam, which is easy to read once its features are understood. This session highlights the basics for reading and interpreting the graph correctly.

In legal medicine, there are various aspects that dentistry must comply with regarding all bruxism patients. This meeting focuses on what can and should be done to demonstrate correct action according to law, underlining the importance of the dia-BRUXO system in such cases.

The dia-BRUXO system provides a range of information on spontaneous muscular behaviour over 24 hours (time index, work index, number of gnashing and clenching episodes, etc.), summarized in a PDF report that is easy to interpret for both professionals and patients. This meeting focuses on its correct reading.

The dia-BRUXO system is currently the only instrumental exam capable of providing data on spontaneous muscular behaviour, distinguishing between sleep and wakefulness. It consists of an EMG device and dedicated software that will be illustrated in this session.

It is now well-known that bruxism in sleep and wakefulness are two very different phenomena with respect to origin, evolution, and treatment. In this session, the official definition for both will be presented, along with their separate analysis, distinguishing the underlying causes and treatment.

With electromyography, it is possible to understand patients' muscular activity. Polysomnograms, polygraphs, chairside scans, and dia-BRUXO all rely on this technology, which is useful in diagnostics and therapeutic clinical activities, as well as treatment verification.

This session presents an overall view of the usefulness of having a precise picture of spontaneous muscular activity over 24 hours (sleep and wakefulness). It starts with general notions on electromyography and its use in dentistry and presents the other specific topics addressed in the individual dedicated webinars, which will be available in the future.