Alkan, Bulut, Arici, Sato using a splint by the end of the third month and locations of pain nor the nocturnal masseteric that these values increased in patients using electromyographic activities were significantly tricyclic antidepressants. In fact, the increase in affected by the tricyclic antidepressant. In the occlusal contact area and bite force after a fact, intake of amitriptyline was unpredictably prosthodontic, orthodontic or surgical treatment associated with either an increase or a decrease in is a desired and expected outcome. However, masseteric electromyographic activity (microV.s/ the purpose of treatment in bruxism patients min of sleep). Based on their study, small doses is to reduce the high muscle activity by using of amitriptyline cannot be recommended for antidepressants and/or a splint, thereby relieving the control of sleep bruxism and associated the pain by reducing the occlusal contact area discomfort. Although in our study subjects with and bite force. In our study, the bite force and sleep bruxism were administered amitriptyline occlusal contact area in Group S at 1 month and (10 mg/night) for longer periods (3 months) than 3 months of treatment were lower than those in the abovementioned studies, this small dose the Group C. We have concluded that the splint level may give an explanation for the increase treatment is superior to tricyclic antidepressants of the bite force and occlusal contact area in in bruxism patients. We have also observed group A. One may consider using higher doses a difference between groups with regard to for longer periods to decrease the bite force in pain values indicated on a VAS. We detected a sleep-bruxism, but it should be kept in mind that decrease in pain in both groups. However, the higher dose applications of amitriptyline have VAS scores of Group S were higher than Group A. been reported to have adverse effects.27 The literature reports that occlusal balance and muscle function are significantly correlated.23 ocnLusIons TCAs have been specifically advocated for the Although one of the primary requirements in treatment of nocturnal bruxism. However, only a designing a full-scale clinical trial is an adequate few randomized clinical controlled studies have sample size, in this preliminary study the records tested the usefulness and the efficacy of TCAs in of only ten patients with bruxism were used managing the signs and symptoms of nocturnal and the short-term effects of the two different bruxism.6,24 Their low-abuse potential, known treatment methods on occlusal contact area side effects, analgesic characteristics that are and bite force were examined. The results of the separate from their antidepressant qualities, present study can provide new information on and relatively low cost have all contributed this issue. However, a prolonged follow up study to the decision to use them.25 Amitriptyline is on a larger patient population must be performed effective in the treatment of chronic oral-facial in the future. It seems to be helpful to follow pain and that its efficacy is independent of its occlusal changes after treatment of bruxism effects on depression. It appears that tricyclic using a Dental Prescale. This measurement antidepressants act in a different fashion from method could be used to evaluate the results of opiate drugs that alter the sensory discriminative the treatment of bruxism. component of pain.6 Raigrodski et al25,26 reported that results of their study do not support the RefRencs administration of small doses of amitriptyline 1. Bruxism, in: The Glossary of Prosthodontic Terms(ed7). J over a period of 4 weeks for the management of Prosthet Dent 1999; 81:5. pain resulting from sleep bruxism. However, the 2. Israel HA, Diamond B, Saed- Nejad F, Raatcliffe A. The results support the administration of small doses relationship between parafunctional masticatory activity of amitriptyline (25 mg/night) for the management and arthroscopically diagnosed temporomandibular joint of the perception of stress levels associated pathology. J Oral Maxillofac Surg 1999;57:1034-1039. with sleep bruxism. Mohamed et al24 reported 3. Silverman S, Eversole LR, Trulove EL. Essentials of Oral that ten adult subjects with sleep bruxism were Medicine. Hamilton-London: BC Decker Inc; 2001. administered amitriptyline (25 mg/night) and 4. Bowley JF, Marx DB. Masticatory muscle activity placebo (25 mg/night), each compound over a assessment and reliability of a portable electromyographic period of one week. Neither the intensities and instrument. J Prosthet Dent 2001;85:252-260. October 2008 - Vol.2 281 European Journal of Dentistry