Kumar Arthi, Spivakovsky Silvia
New York University College of Dentistry, New York, USA.
Evid Based Dent. 2018 Jun;19(2):59. doi: 10.1038/sj.ebd.6401311.
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.
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。