Manual Therapy in Vagus Nerve Neuromodulation for the Treatment of Bruxism

Inclusion Criteria

• •1. Sleep bruxism diagnosed according to the ICSD-III (International Classification of Sleep Disorders, 3rd edition):
• •* Regular or frequent tooth grinding sounds occurring during sleep and the presence of one or more of the following clinical signs and symptoms:
• •1. Abnormal tooth wear consistent with reports of clenching/grinding the teeth during sleep
• •2. Transient morning pain or fatigue in the jaw muscles; and/or temporal headaches; and/or jaw locking upon awakening, consistent with reports of clenching/grinding the teeth during sleep
• •2. Sleep bruxism diagnosed according to the RDC/TMD:
• •* Interview: During the interview, subjects are asked about the following symptoms: reports of regular or frequent tooth grinding during sleep, muscle fatigue, temporal headache, transient morning muscle pain in the jaw, and jaw locking upon awakening.
• •* Physical examination: Presence or signs suggesting abnormal dental wear, such as teeth with flattened cusps and/or loss of contour with dentin exposure.
• •* Hypertrophy of the masticatory muscles
• •* Dental impressions on the tongue
• •* Linea alba on the cheeks along the bite line
• •* Damage to dental tissue
• •* Excessive dental wear
• •3. A minimum pain intensity score of 3 on the Visual Analogue Scale at the masseter and temporal algometry points.
• •4. EMGs with elevated mean power frequency for the masseter and temporalis muscles (to be defined in the first clinical phase-observational study).
• •5. Age between 18 and 40 years.