Department of Oral and Maxillofacial Pathology and Medicine, New York University College of Dentistry, 380 Second Ave., Suite 301, New York, NY 10010, USA.
J Am Dent Assoc. 2012 Nov;143(11):1223-31. doi: 10.14219/jada.archive.2012.0068.
Many dentists believe that sleep bruxism (SB) is a pathogenic factor in myofascial temporomandibular disorder (TMD), but almost all supportive data rely on patients' self-reports rather than on direct observation.
The authors administered a structured self-report interview to determine whether a large and well-characterized sample of patients with myofascial TMD (124 women) experienced SB more often than did matched control participants (46 women). The authors then used data from a two-night laboratory-based polysomnographic (PSG) study to determine whether the case participants exhibited more SB than the control participants.
The results of independent sample t tests and χ(2) analyses showed that, although self-reported rates of SB were significantly higher in case participants (55.3 percent) than in control participants (15.2 percent), PSG-based measures showed much lower and statistically similar rates of SB in the two groups (9.7 percent and 10.9 percent, respectively). Grinding noises were common in both case participants (59.7 percent) and control participants (78.3 percent).
Most case participants did not exhibit SB, and the common belief that SB is a sufficient explanation for myofascial TMD should be abandoned.
Although other reasons to consider treating SB may exist, misplaced concern about SB's sustaining or exacerbating a chronic myofascial TMD condition should not be used to justify SB treatment.
许多牙医认为睡眠磨牙症（SB）是咀嚼肌颞下颌关节紊乱病（TMD）的致病因素，但几乎所有支持性数据都依赖于患者的自我报告，而不是直接观察。
作者对大量患有咀嚼肌 TMD（124 名女性）的患者和相匹配的对照组（46 名女性）进行了结构化的自我报告访谈，以确定他们是否更频繁地经历 SB。作者随后使用两晚基于实验室的多导睡眠图（PSG）研究的数据，以确定病例组参与者的 SB 发生率是否高于对照组参与者。
独立样本 t 检验和 χ(2)分析的结果表明，尽管病例组参与者（55.3%）自我报告的 SB 发生率明显高于对照组参与者（15.2%），但 PSG 测量结果显示两组的 SB 发生率较低且统计学上相似（分别为 9.7%和 10.9%）。两组参与者的磨牙噪音都很常见（病例组为 59.7%，对照组为 78.3%）。
大多数病例组参与者并未表现出 SB，因此应摒弃 SB 是咀嚼肌 TMD 的充分解释这一普遍观点。
尽管可能存在其他治疗 SB 的原因，但不应将对 SB 持续或加重慢性咀嚼肌 TMD 状况的担忧作为 SB 治疗的理由。
