- - 3 2 1 * :. 683 - :.. 29/3. 0/05 χ2. 14/6 :. 12/2 16/8.. 53 55 42. 37/5. :.. :. * ( ) am_shirani@dnt.mui.ac.ir :1 :3 2 87/1/15 87/3/2. 87/3/11 94 89 :(2)4 :1387 89 1387 2 4

. -. 683 95. : 3 ( ) -. 1386 1385.. :. :. open bite crossbite Temporomandibular - disorder (TMDs) TM. TM TM. -.[1]. 31/4 [2]Ciancaglini [3]Carlsson Gunnar 20 10 8 [4]Wanman Agerberg 11 [5]Inkapool [6]Glaros Glass 20 19 10 8 [7] Choi. 9/9 1387 2 4 90

30. 43 40. 1 53-31. 16 37/5-37. 17/5 32. 1...(2 ).clenching χ2 -. 0/05 364 683. ( 46/7) 319 ( 53/3) 42/3 14/6 15/8 22/7 4/5. 14/6 29/3 7/8. 10/8 12/2 16/8.. 29 19 50.1.χ2 Cheek biting Odds ratio= 11/88 *p value= 0/016 Odds ratio= 1/9 *p value=0/03 Odds ratio= 1/64 p value= 0/54 Odds ratio= 1/46 Odds ratio= 2/68 Odds-ratio= 2/89 p value= 0/377 *p value= 0/028 *p value =0/002 *p value <0/001 *p value= 0/002 Odds ratio= 1/32 Odds ratio= 2/66 Odds ratio= 1/50 Odds ratio= 0/28 Odds ratio= 2/48 Odds ratio= 1/70 * Significant at level p value <.05 91 1387 2 4

60 50 40 30 دندان قروچه فشار دادن دندانها 20 10 0 هيپرتروفی عضلات لقی دندان جويدن گونه کنگره دار شدن لبه زبان براق شدگی ترميم سايش دندانی..1 [6]Glaros Glass 19 10 31/4 [2]Ciancaglini 9/9 8 [7]Choi [9]Chen Demir 38/4 12/6 [10] 38 [11]Chifetz [12] 13. 34 ( 55). ( 53) ( 42). ( 37/5).....[8]. 14/6. 29/3 10 [3]Carlsson Gunnar 20 8 [4]Wanman [5]Inkapool Agerberg 11 20 1387 2 4 92

.......... - [1] [2]Ciancaglini. [13]Seligman Pullinger [8]Gavish. 64. - -.[14] References 1. Blasberg B, Greenberg MS. Temporomandibular disorders. In: Greenberg MS, Glick M, Ship JA. Burket s oral medicine. 11 th ed. Hamilton: BC Decker Inc; 2008. p. 223-55. 2. Ciancaglini R, Gherlone EF, Radaelli G. The relationship of bruxism with craniofacial pain and symptoms from the masticatory system in the adult population. J Oral Rehabil 2001; 28(9): 842-48. 3. Agerberg G, Carlsson GE. Functional disorders of the masticatory system. I. Distribution of symptoms according to age and sex as judged from investigation by questionnaire. Acta Odontol Scand 1972; 30(6): 597-613. 4. Wanman A. Craniomandibular disorders in adolescents. A longitudinal study in an urban Swedish population. Swed Dent J Suppl 1987; 44: 1-61. 5. Agerberg G, Inkapool L. Craniomandibular disorder in urban Swedish population. J craniomandibular Disorders, 1990: 4(3): 154-64. 6. Glass EG, McGlynn FD, Glaros AG, Melton K, Romans K. Prevalence of temporomandibular disorder symptoms in a major metropolitan area. Cranio 1993; 11(3): 217-20. 7. Choi YS, Choung PH, Moon HS, Kim SG. Temporomandibular disorders in 19-year-old Korean men. J Oral Maxillofac Surg 2002; 60(7): 797-803. 93 1387 2 4

8. Gavish A, Halachmi M, Winocur E, Gazit E. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescent girls. J Oral Rehabil 2000; 27(1): 22-32. 9. Chen YQ, Cheng HJ, Yu CH, Gao Y, Shen YQ. [Epidemic investigation on 3 to 6 years children's bruxism in Shanghai.]. shanghai kou Qiang Yi Xue 2004; 13(5): 382-4. 10. Demir A, Uysal T, Guray E, Basciftci FA. The relationship between bruxism and occlusal factors among seven- to 19-year-old Turkish children. Angle Orthod 2004; 74(5): 672-6. 11. Cheifetz AT, Osganian SK, Allred EN, Needleman HL. Prevalence of bruxism and associated correlates in children as reported by parents. J Dent Child (Chic ) 2005; 72(2): 67-73. 12. Shirani AM, Maleki L. Relation of Oral Parafunction Habits and Signs and Symptoms of Temporomandibular Disorders. Journal of Isfahan Dental School 2007; 4(2): 34-9. 13. Pullinger AG, Seligman DA. The degree to which attrition characterizes differentiated patient groups of temporomandibular disorders. J Orofac Pain 1993; 7(2): 196-208. 14. Barbosa TS, Miyakoda LS, Pocztaruk RL, Rocha CP, Gaviao MB. Temporomandibular disorders and bruxism in childhood and adolescence: review of the literature. Int J Pediatr Otorhinolaryngol 2008; 72(3): 299-314. 1387 2 4 94

Prevalence assessment of bruxism and clenching by considering oral- temporomandibular signs in patients of clinics of Isfahan city Amir Mansour Shirani *, Faezeh Khozeimeh, Mojgan Rafizadeh, Azar Ghasemi Abstract Introduction: As bruxism and clenching are important parafunctional habits that cause disorders in masticatory muscles and temporomandibular joint (TMJ), and many patients are unaware of these parafunctions, this study was done to evaluate prevalence of these parafunctional habits and oral related signs. Methods and Materials: In this descriptive, analytic and cross-sectional study, 683 patients came to dental clinics in Isfahan were randomly selected and examined. The examination contained evaluation of history of bruxism and clenching and clinical examination for it including physical examination of masticatory muscles and TMJ, oral exam for finding occlusal wear, shining of amalgam fillings, cheek biting, scalloped tongue borders, tooth mobility, and masticatory muscles' hypertrophy. The data was analyzed and χ 2 was used. Results: The overall prevalence of bruxism and clenching was 14.6% and 29.3% respectively. 16.8% of females and 12.2% of males had bruxism. The prevalence of clenching had no statistical difference in two genders. In bruxers,, dental wear (55%) and pain of masticatory muscles (53%) were the most prevalent signs. In persons with clenching, dental wear (42%) and temporomandibular joint sound (37.5%) were the most prevalent signs. Conclusion: The prevalence of clenching was more than bruxism. In bruxers, dental wear and pain of masticatory muscles, and in persons with clenching dental wear and temporomandibular joint sound were most prevalent signs. There was a relation between oral signs and bruxism or clenching. By this consideration, more exactly prevalence evaluation of these parafunctional habits were possible. Key words: Bruxism, Clenching, Oral manifestation, Temporomandibular disorders. Received: 3 Apr, 2008 Accepted: 31 May, 2008 Address: Oral Medicine Department, Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail: am_shirani@dnt.mui.ac.ir Journal of Isfahan Dental School 2008; 4(2).