Manfredini Daniele, Winocur Ephraim, Guarda-Nardini Luca, Paesani Daniel, Lobbezoo Frank
Department of Maxillofacial Surgery, University of Padoma, Italy.
J Orofac Pain. 2013 Spring;27(2):99-110. doi: 10.11607/jop.921.
To perform a systematic review of the literature dealing with the prevalence of bruxism in adult populations.
A systematic search of the medical literature was performed to identify all peer-reviewed English-language papers dealing with the prevalence assessment of either awake or sleep bruxism at the general population level by the adoption of questionnaires, clinical assessments, and polysomnographic (PSG) or electromyographic (EMG) recordings. Quality assessment of the reviewed papers was performed according to the Methodological evaluation of Observational REsearch (MORE) checklist, which enables the identification of flaws in the external and internal validity. Cut-off criteria for an acceptable external validity were established to select studies for the discussion of prevalence data. For each included study, the sample features, diagnostic strategy, and prevalence of bruxism in relation to age, sex, and circadian rhythm, if available, were recorded.
Thirty-five publications were included in the review. Several methodological problems limited the external validity of findings in most studies, and prevalence data extraction was performed only on seven papers. Of those, only one paper had a flaw less external validity, whilst internal validity was low in all the selected papers due to their self-reported bruxism diagnosis alone, mainly based on only one or two questionnaire items. No epidemiologic data were available from studies adopting other diagnostic strategies (eg, PSG, EMG). Generically identified "bruxism" was assessed in two studies reporting an 8% to 31.4% prevalence, awake bruxism was investigated in two studies describing a 22.1% to 31% prevalence, and prevalence of sleep bruxism was found to be more consistent across the three studies investigating the report of "frequent" bruxism (12.8% ± 3.1%). Bruxism activities were found to be unrelated to sex, and a decrease with age was described in elderly people.
The present systematic review described variable prevalence data for bruxism activities. Findings must be interpreted with caution due to the poor methodological quality of the reviewed literature and to potential diagnostic bias related with having to rely on an individual's self-report of bruxism.
对有关成人磨牙症患病率的文献进行系统综述。
对医学文献进行系统检索，以识别所有采用问卷、临床评估以及多导睡眠图（PSG）或肌电图（EMG）记录，在一般人群层面评估清醒或睡眠磨牙症患病率的同行评审英文论文。根据观察性研究方法学评估（MORE）清单对纳入论文进行质量评估，该清单有助于识别外部和内部有效性方面的缺陷。确立了可接受外部有效性的截断标准，以选择用于讨论患病率数据的研究。对于每项纳入研究，记录样本特征、诊断策略以及磨牙症与年龄、性别和昼夜节律（若有）相关的患病率。
本综述纳入了35篇出版物。若干方法学问题限制了大多数研究结果的外部有效性，仅对7篇论文进行了患病率数据提取。其中，只有一篇论文的外部有效性缺陷较少，而所有入选论文的内部有效性较低，因为它们仅基于自我报告的磨牙症诊断，主要仅依据一两个问卷项目。采用其他诊断策略（如PSG、EMG）的研究未提供流行病学数据。两项研究评估了一般认定的“磨牙症”，报告患病率为8%至31.4%；两项研究调查了清醒磨牙症，描述患病率为22.1%至31%；在三项调查“频繁”磨牙症报告的研究中，睡眠磨牙症的患病率更为一致（12.8%±3.1%）。发现磨牙症活动与性别无关，且老年人中随年龄增长而有所下降。
本系统综述描述了磨牙症活动的不同患病率数据。由于所综述文献的方法学质量较差以及因不得不依赖个体对磨牙症的自我报告而可能存在的诊断偏差，对研究结果的解读必须谨慎。
