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磨牙症——肉毒杆菌毒素是一种有效的治疗方法吗?

Bruxism- is botulinum toxin an effective treatment?

作者信息

Kumar Arthi, Spivakovsky Silvia

机构信息

New York University College of Dentistry, New York, USA.

出版信息

Evid Based Dent. 2018 Jun;19(2):59. doi: 10.1038/sj.ebd.6401311.

DOI:10.1038/sj.ebd.6401311
PMID:29930364
Abstract

Data sourcesPubMed, Scopus, Web of Science, Embase, Cochrane, Scielo and Lilacs databases were searched from 1980 to March 2016. Literature reviews were explored in order to retrieve any other relevant papers.Study selectionRandomised controlled studies (RCTs), prospective and before and after studies that applied botulinum toxin (BoNT-A) to the masseter and/or temporalis muscles assessing objective and subjective parameters of bruxism published in English were included.Data extraction and synthesisThree reviewers independently assessed for eligibility. Disagreement was solved by discussion and when reaching consensus between at least two. Standard data items were extracted. Quality assessment was assessed using the Cochrane Collaboration's risk of bias tool and the Critical Appraisal Skills Program (CASP) tool. Before-After Study Checklist was used for the nonrandomised studies. Results were presented as a narrative review.ResultsFive studies were included in the review, of those three were RCTs and two before and after. A total of 188 subjects were included. Regimen was unique in each study and the follow-up ranged from two to 24 weeks. The risk of bias of the RCTs was assessed as low to unclear, while the before and after studies were assessed as of moderate risk of bias.ConclusionsThe authors concluded that botulinum toxin represents a possible option for the management of sleep bruxism (SB), minimising symptoms and reducing the intensity of contractions rather than for SB itself.

摘要

数据来源

检索了1980年至2016年3月期间的PubMed、Scopus、Web of Science、Embase、Cochrane、Scielo和Lilacs数据库。探索了文献综述以检索任何其他相关论文。

研究选择

纳入以英文发表的、将肉毒杆菌毒素(BoNT-A)应用于咬肌和/或颞肌、评估磨牙症客观和主观参数的随机对照试验(RCT)、前瞻性研究以及前后对照研究。

数据提取与综合

三名评审员独立评估是否符合纳入标准。分歧通过讨论解决,至少两名评审员达成共识时确定最终结果。提取标准数据项。使用Cochrane协作网的偏倚风险工具和批判性评估技能计划(CASP)工具进行质量评估。前后对照研究清单用于非随机研究。结果以叙述性综述的形式呈现。

结果

该综述纳入了五项研究,其中三项为随机对照试验,两项为前后对照研究。总共纳入了188名受试者。每项研究中的治疗方案各不相同,随访时间从两周到24周不等。随机对照试验的偏倚风险评估为低到不明确,而前后对照研究的偏倚风险评估为中度。

结论

作者得出结论,肉毒杆菌毒素是治疗睡眠磨牙症(SB)的一种可能选择,可减轻症状并降低收缩强度,但并非针对睡眠磨牙症本身。

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本文引用的文献

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Validity of self-reported sleep bruxism among myofascial temporomandibular disorder patients and controls.肌筋膜性颞下颌关节紊乱病患者及对照组中自我报告的睡眠磨牙症的有效性。
J Oral Rehabil. 2015 Oct;42(10):751-8. doi: 10.1111/joor.12310. Epub 2015 May 26.
2
Bruxism defined and graded: an international consensus.磨牙症定义和分级:国际共识。
J Oral Rehabil. 2013 Jan;40(1):2-4. doi: 10.1111/joor.12011. Epub 2012 Nov 4.
A型肉毒杆菌毒素治疗磨牙症患者咬肌厚度变化与紧咬牙习惯之间关系的评估
J Med Ultrasound. 2022 Aug 18;31(1):22-28. doi: 10.4103/jmu.jmu_51_22. eCollection 2023 Jan-Mar.
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Can Botulinum Toxin-A Contribute to Reconstructing the Physiological Homeostasis of the Masticatory Complex in Short-Faced Patients during Occlusal Therapy? A Prospective Pilot Study.肉毒毒素 A 是否有助于在咬合治疗过程中重建短面患者咀嚼复合体的生理平衡?一项前瞻性初步研究。
Toxins (Basel). 2022 May 28;14(6):374. doi: 10.3390/toxins14060374.
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Consecutive Controlled Case Series on Effectiveness of Opipramol in Severe Sleep Bruxism Management-Preliminary Study on New Therapeutic Path.奥匹哌醇治疗重度磨牙症有效性的连续对照病例系列——新治疗途径的初步研究
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In vitro and in vivo studies using non-traditional bisphosphonates.使用非传统双膦酸盐的体外和体内研究。
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