Effects of pergolide on severe sleep bruxism in a patient experiencing oral implant failure

Effects of pergolide on severe sleep bruxism in a patient experiencing oral implant failure
Published article online:
10 Aug 2006
Issue online:
13 Apr 2007
Accepted for publication 19 March 2006
To cite this article: J. VAN DER ZAAG, F. LOBBEZOO, P.G.G.L. VAN DER AVOORT, D.J. WICKS, H.L. HAMBURGER, M. NAEIJE (2007)
Effects of pergolide on severe sleep bruxism in a patient experiencing oral implant failure
Journal of Oral Rehabilitation 34 (5), 317Ò322.
doi:10.1111/j.1365-2842.2006.01651.x
Journal of Oral Rehabilitation
Blackwell Synergy

J. VAN DER ZAAG**Section of Oral Kinesiology, Department of Oral Function, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, F. LOBBEZOO**Section of Oral Kinesiology, Department of Oral Function, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, P.G.G.L. VAN DER AVOORTSection of Prosthetic Dentistry & Oral Implantology, Department of Oral Function, ACTA, Amsterdam, D.J. WICKSDepartment of Clinical Neurophysiology and Center for Sleep-Wake Disorders, Slotervaart General Hospital, Amsterdam, The Netherlands, H.L. HAMBURGERDepartment of Clinical Neurophysiology and Center for Sleep-Wake Disorders, Slotervaart General Hospital, Amsterdam, The Netherlands & M. NAEIJE*
Prof. Dr Frank Lobbezoo, Academic Centre for Dentistry Amsterdam (ACTA), Department of Oral Function, Section of Oral Kinesiology, Louwesweg 1, 1066 EA Amsterdam, The Netherlands.
E-mail: f.lobbezoo@acta.nl

Abstract

summary In the patient described in this study, oral implants failed as a probable consequence of severe, polysomnographically confirmed sleep bruxism. As this patient had the wish to be re-implanted after this failure, we decided to try diminishing the frequency of bruxism and duration first. To that end, two management strategies were used. Their efficacy was evaluated polysomnographically, yielding a total of six overnight recordings. Of the selected management strategies, the administration of low doses of the dopamine D1/D2 receptor agonist pergolide finally resulted in a substantial and lasting reduction in the bruxism outcome measures under study. This result supports the previous suggestion that central neurochemicals like dopamine may be involved in the modulation of sleep bruxism. The case report also illustrates the importance of an extensive history taking (questionnaires as well as oral) and clinical examination of oral implant patients for the presence of severe bruxism before the implant procedure is started. In case of doubt, polysomnography may be considered to definitively confirm or rule out the presence of severe sleep bruxism.

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