A clinical study of specific signs and symptoms of CMD in bruxers classified by the degree of severity.

Two hundred and seventy-six CMD patients referred consecutively for diagnos is and treatment over a period of four years were assessed. Two hundred and eleven were classified as bruxers according to the use of a questionnaire and clinical examination. One hundred (47.39%) presented clinical character istics of mild bruxers, 66 (31.27%) presented moderate bruxism and 45 (21.3 2%) demonstrated severe bruxism. Severe bruxers presented the lowest degree of jaw opening (39.21 mm) and highest prevalence of capsulitis (97.77%), r etrodiskal pain ( 84.44%) and disk-attachment pain (48.88%). As compared to the mild and moderate groups, severe bruxers also demonstrated significant ly higher prevalence of protective splinting and transient locking or recen t history of intermittent locking, masticatory pain, reciprocal clicking an d signs and symptoms of Myofascial Pain Dysfunction Syndrome (MPDS). Becaus e higher prevalence of specific muscle and joint disorders were observed in bruxers and such prevalence was progressive from the mild to the moderate and severe group, it may be concluded that bruxing behavior is a significan t factor in the etiology and progression of muscle and joint disorders. Bas ed on the review of the literature, the analysis of our data in comparison to other studies allowed us to conclude that severe bruxers are more impair ed by muscular and joint disorders as compared to mild and moderate bruxers .