Evaluation of biochemical changes and treatment efficacy in patients with bruxism following botox or splint therapy: A Randomized Clinical Trial

Abstract

Abstract Objectives: This clinical study aims to analyse the levels of cortisol, dehydroepiandrosterone (DHEA) and tumour necrosis factor alpha (TNF-alpha) in the gingival crevicular fluid (GCF) of persons with bruxism and to compare the efficacy of Botox and occlusal splint treatments through biomarkers. Materials and methods: A total of 40 patients with bruxism were selected according to the clinical examination and anamnesis of which 20 patients received occlusal splint treatment and 20 botulinum toxin treatment. Gingival crevicular fluid samples were taken from the patients before and after treatment. Cortisol, DHEA and TNF-alpha levels were measured by ELISA test. The change in measurements between time and groups and the time-group interaction were tested by repeated measures ANOVA. Results: In individuals with bruxism, a statistically significant decrease in cortisol levels was observed after both treatments (p < 0.05), while DHEA levels increased after treatment but were not statistically significant (p > 0.05). There was no statistically significant difference between tnf-alpha intra-group measurements (p > 0.05). Conclusions: Stress and inflammatory biomarkers were found to be associated with the bruxism. Cortisol levels decreased in people with bruxism after treatment with both occlusal splint and Botox. Clinical Relevance: It can be suggested that splint and botox treatment are effective for bruxism by reducing the stress levels. Botox treatment is also more effective in reducing stress levels.