L’effet du port nocturne des prothèses complètes sur l’activité rythmique des muscles masticateurs chez les personnes âgées souffrant de troubles du sommeil

Review: The association between tooth loss and the rhythmic activity of the muscles of mastication is not clearly proven. Our literature review does not establish a significant association between the nocturnal wear of complete dentures and the rhythmic activity of the muscles of mastication in the elderly, suffering from obstructive sleep apnea. There is no consensus on this concern, and the literature approaching this issue is rather limited. Some studies stipulated an increased rhythmic activity during the overnight denture wear, others demonstrated its decrease. Objectives: The main objective of this study is to evaluate the effect of overnight complete dentures wear during sleep on the rhythmic activity of the muscles of mastication in edentulous sleep apnea elderly patients. Methodology: This study is a part of a previous randomized controlled trial about the impact of nocturnal complete dentures wears on sleep and oral health-related quality of life. Data was collected after examining 27 completely edentulous participants aged 65 and older and was subsequently assessed and analyzed. Measurement of masticatory muscles rhythmic activity was made possible through an analysis of masseter muscles electromyography (EMG) obtained from Home Ambulatory Polysomnography. The procedure was to sleep with or without dentures overnight. For this purpose, the study participants were randomly assigned to alternate between wearing and not wearing their dentures for periods of 30 days, before each polysomnographic recording. The nonparametric statistical data analysis (Brunner-Langer model) was used. A P-value of <0.05 was obtained and is considered statistically significant. Results: The nocturnal wearing of complete dentures significantly increased the number of mixed episodes which are by definition a cocktail of phasic and tonic episodes, separated by an interval of less than 2 seconds, with respective medians =10,0 (min 1,0 - max 60,0) versus 6,00 (min 1,0 - max 49,0) p = 0,007*  as well as the frequency of events per hour of the index of mixed episodes, which is by definition the frequency of episodes of phases and tonic episodes per hour of sleep among the study participants, during the nights when they had worn their dentures, compared to the nights when they had not worn their dentures with medians = 1.5 (min 0.1- max 9.0) versus 1.0 (min 0.2- max 9.0) p = 0.032 * respectively. However, there was no significant difference regarding the relation between other rhythmic activities of the muscles of mastication and nocturnal complete dentures wear. Conclusion: The present study does not demonstrate a significant correlation between nocturnal denture wear and the rhythmic activity of muscles of mastication in the edentulous elderly patients with obstructive sleep apnea, except for the number of mixed episodes and the number of apnea events per hour of sleep of the mixed episodes index, where there was a significant increase in the latter during the nights when patients had worn the complete dentures. However, to overcome the lack of studies and publications investigating the effect of nocturnal complete dentures wear on the activity of the muscles of mastication, we suggest carrying out future clinical trials with a representative sample of the general population.

Keyphrases: Edentation, Edentulism, Complete dentures, Sleep disorders, Obstructive sleep apnea, Rhythmic activity of masticatory muscles