Jiménez-Silva Antonio, Peña-Durán Consuelo, Tobar-Reyes Julio, Frugone-Zambra Raúl
a Facultad de Ciencias de la Salud , Universidad Autónoma de Chile , Temuco , Chile.
b Ortodoncia y Ortopedia dentomaxilofacial, Facultad de Odontología , Universidad Andrés Bello , Santiago , Chile.
Acta Odontol Scand. 2017 Jan;75(1):36-58. doi: 10.1080/00016357.2016.1247465. Epub 2016 Oct 31.
In order to establish a relationship between bruxism and temporomandibular disorders (TMDs), a systematic review was performed.
A systematic research was performed based on PubMed, Cochrane Library, Medline, Embase, BIREME, Lilacs and Scielo data bases, between 2003 and 2014 including all languages. Descriptive clinical cases were identified. Two independent authors selected the articles. PICO format was used to analyse the studies and the Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence.
Thirty-nine studies (n = 39) were analysed in this review. According to bruxism diagnosis, articles were grouped as follows: polysomnographic diagnosis (PSG) (n = 7), clinical diagnosis (n = 11) and survey/self-report (n = 21). Thirty-three articles (n = 33) established a positive relation between bruxism and TMD and six (n = 6) did not. Quality of evidence was low to moderate. In general, the most part of the studies showed shortcomings on their design with bias risk, and also had a low sensitivity on bruxism diagnosis.
The evidence based on PSG was not as conclusive as the studies that used surveys and clinical exam to diagnosis bruxism, when bruxism was related to TMD. Sleep bruxism could be associated with myofascial pain, arthralgia and joint pathology as disc displacement and joint noises. Although the evidence at present is inconclusive and does not provide information according to the type of bruxism (bruxism sleep and wakefulness), it is possible to suggest that bruxism would be associated with TMD.
为了建立磨牙症与颞下颌关节紊乱病（TMDs）之间的关系，进行了一项系统评价。
基于2003年至2014年间的PubMed、Cochrane图书馆、Medline、Embase、BIREME、Lilacs和Scielo数据库进行了一项系统研究，涵盖所有语言。识别描述性临床病例。两名独立作者选择文章。采用PICO格式分析研究，并使用纽卡斯尔-渥太华量表（NOS）验证证据质量。
本评价分析了39项研究（n = 39）。根据磨牙症诊断，文章分为以下几类：多导睡眠图诊断（PSG）（n = 7）、临床诊断（n = 11）和调查/自我报告（n = 21）。33篇文章（n = 33）建立了磨牙症与TMD之间的正相关关系，6篇（n = 6）未建立。证据质量为低到中等。总体而言，大部分研究在设计上存在偏倚风险缺陷，并且在磨牙症诊断方面敏感性较低。
当磨牙症与TMD相关时，基于PSG的证据不如使用调查和临床检查来诊断磨牙症的研究那样具有决定性。睡眠磨牙症可能与肌筋膜疼痛、关节痛以及诸如盘移位和关节弹响等关节病变有关。尽管目前的证据尚无定论，且未根据磨牙症类型（睡眠磨牙症和清醒磨牙症）提供信息，但有可能提示磨牙症与TMD相关。
