Changes in Bruxism Activity After Periodontal Treatment in Patients With Periodontitis

Impact of Non-Surgical Periodontal Therapy on Awake and Sleep Bruxism in Patients With Stage III-IV Periodontitis

This controlled pre-post study evaluates the effect of non-surgical periodontal therapy on awake and sleep bruxism in patients with Stage III and IV periodontitis. Bruxism activity and periodontal status will be assessed at baseline and three months after treatment.

This is a non-randomized controlled pre-post clinical study designed to investigate the impact of periodontal treatment on awake and sleep bruxism in individuals with advanced periodontitis. Two groups will be included: a periodontitis group undergoing full non-surgical periodontal therapy (step 1 and 2), and a healthy control group receiving supragingival plaque removal and polishing. All participants will receive standardized oral hygiene instructions and motivation. Bruxism activity will be recorded using portable electromyography (EMG) devices at baseline and after three months, evaluating both sleep and awake bruxism through Bruxism Work Index (BWI) and Bruxism Time Index (BTI). Clinical periodontal parameters will also be collected at both time points to assess potential correlations with bruxism variation.

Inclusion Criteria:

• Age between 25 and 50 years
• Good general health (ASA I or II)
• Signed informed consent
• Willingness to attend all study visits and follow instructions
• For periodontitis group: diagnosis of Stage III or IV periodontitis according to the 2017 classification
• For healthy control group: no clinical signs of periodontitis

Exclusion Criteria:

• Systemic diseases or medications affecting the periodontium (e.g., diabetes, immunosuppressants)
• Antibiotic or anti-inflammatory therapy within the last 3 months
• Periodontal treatment in the last 6 months
• Smoking more than 10 cigarettes/day
• Use of occlusal splints or bruxism-targeted therapy in the past 6 months
• Pregnancy or lactation
• Any condition impairing the ability to cooperate or comply with the study protocol