The BruxChecker system for quantitatively assessing sleep bruxism at the dental level: reliability, reference values and methodological considerations

Background: There is a need for reliable instruments that can quantitatively assess sleep bruxism at the dental level. Objectives: This study aimed to determine the test–retest reliability of the occlusal peeled area using the BruxChecker, the methodological aspects that affect this reliability, and the reference values in a population of dental students. Methods: Eighty-four dental students participated in this test–retest study (median age, 21.7 years; 74 women). A BruxChecker was worn for 3 consecutive nights and scanned after each night in the plaster model and by transillumination. The relative and absolute peeled areas were measured using the FIJI software, and BruxChecker perforation was determined visually. Reliability was assessed by the intraclass correlation coefficient (ICC) and Cohen's kappa. Results: The absolute and relative peeled areas of the BruxChecker by transillumination after 2 or 3 nights provided the highest ICC values, which ranged from 0.918 to 0.929. BruxChecker perforation was present in 45% of the participants, with a kappa value of 0.777. The respective median peeled areas were 84.3 mm2 and 9.9% for the absolute and relative values after using the BruxChecker for three nights. Ranges for the 10th–90th percentiles were 4.7%–17.0% and 39.4%–143.4 mm2, respectively. Conclusions: The BruxChecker system demonstrates excellent reliability in measuring the occlusal peeled area in the studied population. This study proposes reference values for absolute and relative peeled areas after using the BruxChecker for three nights and scanning by transillumination.