Somatosensory Training Versus Exercise Therapy in Awake Bruxism
ConditionBruxism
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-45
SponsorAydin Adnan Menderes University
About this trial
Awake bruxism (daytime teeth clenching or jaw tension) is a common condition that can cause jaw pain, facial pain, muscle fatigue, and reduced quality of life. Although current treatments often focus on the jaw muscles and posture, recent research suggests that changes in the brain's sensory processing may also play an important role in bruxism-related pain.
This randomized controlled trial aims to compare two physiotherapy-based treatment approaches with a wait-list control group in adults with awake bruxism. Participants will be randomly assigned to one of three groups: (1) somatosensory awareness-based training, (2) jaw and posture exercise therapy, or (3) a wait-list control group.
The somatosensory training program focuses on improving body awareness and sensory perception of the face and jaw, while the exercise program includes jaw mobility, postural alignment, and cervical exercises. Both active interventions will be delivered over a 4-week period. Participants will be assessed at baseline, immediately after treatment, and during follow-up to evaluate changes over time.
The main outcome of this study is orofacial pain intensity. Secondary outcomes include jaw function, sensory processing, muscle structure, oral parafunctional behaviors, and oral health-related quality of life. The results of this study may help improve physiotherapy-based treatment strategies for people with awake bruxism by addressing both physical and sensory aspects of the condition.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Adults aged 18 to 45 years
Clinical diagnosis of awake bruxism confirmed using standardized diagnostic criteria (STAB and DC/TMD Axis I)
Presence of at least one measurable somatosensory alteration confirmed at baseline using digital and clinical assessments
Self-reported daytime jaw clenching or parafunctional activity
Disqualifiers
GCPS Grade IV (high disability level)
Presence of systemic inflammatory, neurological, or rheumatological disorders
Diagnosis of severe chronic pain conditions unrelated to bruxism
Use of occlusal splints or participation in jaw, neck, or facial therapy within the past 3 months
Trial design
Design model
Parallel
Treatments tested in this trial
Jaw exercise therapy
Other interventionParticipants assigned to this group receive a structured jaw and posture exercise therapy program delivered by a physiotherapist. The intervention consists of supervised face-to-face sessions twice per week over a 4-week period, combined with a home exercise program performed on non-supervised days. The program includes jaw mobility and relaxation exercises, postural correction and stabilization exercises, and cervical region exercises. In addition, manual therapy techniques are applied as clinically indicated, including ischemic trigger point therapy, cervical joint mobilization, and intraoral manual techniques. Each treatment session lasts approximately 40-45 minutes. Adherence to the home exercise program is monitored throughout the intervention period.
Somatosensory Awareness-Based Training
Other interventionParticipants in this group receive an individualized somatosensory awareness-based training program designed to target altered sensory perception and body schema related to the face and jaw. The intervention focuses on laterality recognition, body schema representation, and tactile discrimination, including two-point discrimination-based tasks. No conventional exercise therapy or manual therapy techniques are provided in this group. The training is delivered using a flexible, patient-specific approach, supported by structured guidance materials aimed at increasing daily awareness and self-monitoring of somatosensory experiences. Participant adherence and engagement are monitored through regular follow-up and self-report tracking.
Wait-List Control
Other interventionParticipants allocated to the wait-list control group do not receive any active treatment during the initial study period and continue their usual daily activities. All outcome assessments are conducted at the same time points as the intervention groups. After completion of the assessment phase, participants in this group are offered exercise therapy according to clinical need.
Treatment groups
20 Participants
are divided into 3 treatment groupsGroup A: Somatosensory Awareness Training GroupExperimental treatment 1 intervention
Group B: Jaw and Posture Exercise GroupActive comparator 1 intervention
Group C: Wait-List Control GroupOther 1 intervention
Trial outcomes
Primary outcomes
1
Orofacial Pain-Related Disability
Orofacial pain-related disability will be assessed using the Craniofacial Pain and Disability Inventory (CF-PDI). The CF-PDI is a self-reported questionnaire evaluating pain-related functional limitations, psychosocial impact, and disability. The Craniofacial Pain and Disability Inventory (CF-PDI) total score ranges from 0 to 100, with higher scores indicating greater pain-related disability.
Time frame
Baseline, Week 4 (post-intervention), Week 6, Week 122
Orofacial Pain Intensity
Orofacial pain intensity will be assessed using a 0-10 Visual Analog Scale (VAS), where 0 indicates "no pain" and 10 indicates "worst imaginable pain." Participants will rate their current orofacial pain intensity at the time of assessment.
Time frame
Baseline, Week 4 (post-intervention), Week 6, Week 12Secondary outcomes
1
Mandibular Range of Motion
Mandibular range of motion will be assessed using standardized clinical measurements, including maximum mouth opening, lateral excursion (right and left, averaged), and protrusion, recorded in millimeters. Higher values indicate greater mandibular mobility.
Time frame
Baseline, Week 4 (post-intervention), Week 6, Week 122
Masseter Muscle Thickness
Masseter muscle thickness will be assessed using ultrasound imaging and recorded in millimeters (mm). Changes in muscle thickness over time will be evaluated as an indicator of structural and neuromuscular adaptation. No a priori assumption will be made regarding the direction of change.
Time frame
Baseline, Week 123
Oral Parafunctional Behaviors
The Oral Behaviors Checklist (OBC) assesses the frequency of oral parafunctional behaviors. The total score ranges from 0 to 84, with higher scores indicating more frequent oral behaviors.
Time frame
Baseline, Week 4 (post-intervention), Week 124
Facial Emotion Recognition Accuracy
Facial emotion recognition will be assessed using a standardized computerized task. The primary metric will be accuracy (%), with higher values indicating better emotion recognition performance.
Time frame
Baseline, Week 4 (post-intervention), Week 6, Week 12Sponsors and contacts
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Source ClinicalTrials.gov