Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil.
Department of Dentistry, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil.
J Oral Rehabil. 2019 Jul;46(7):666-690. doi: 10.1111/joor.12801. Epub 2019 May 7.
To synthesise available knowledge about both sleep (SB) and awake bruxism (AB) as depicted by previous published systematic reviews (SR).
SR investigating any bruxism-related outcome were selected in a two-phase process. Searches were performed on seven main electronic databases and a partial grey literature search on three databases. Risk of bias of included SR was assessed using the "University of Bristol's tool for assessing risk of bias in SR".
From 1038 studies, 41 SR were included. Findings from these SR suggested that (a) among adults, prevalence of AB was 22%-30%, SB (1%-15%), and SB among children and adolescents (3%-49%); (b) factors consistently associated with bruxism were use of alcohol, caffeine, tobacco, some psychotropic medications, oesophageal acidification and second-hand smoke; temporomandibular disorder signs and symptoms presented a plausible association; (c) portable diagnostic devices showed overall higher values of specificity (0.83-1.00) and sensitivity (0.40-1.00); (d) bruxism might result in biomechanical complications regarding dental implants; however, evidence was inconclusive regarding other dental restorations and periodontal impact; (e) occlusal appliances were considered effective for bruxism management, although current evidence was considered weak regarding other therapies.
Current knowledge from SR was mostly related to SB. Higher prevalence rates were found in children and adolescents than in adults. Associated factors and bruxism effects on stomatognathic structures were considerably heterogeneous and inconsistent. Overall good accuracy regarding portable diagnostic devices was found. Interventions' effectiveness was mostly inconclusive regarding the majority of available therapies, with the exception of occlusal appliances.
综合先前发表的系统评价（SR）中关于睡眠性磨牙症（SB）和觉醒性磨牙症（AB）的现有知识。
在两阶段过程中选择了调查任何磨牙症相关结果的 SR。在七个主要电子数据库上进行了搜索，并在三个数据库上进行了部分灰色文献搜索。使用“布里斯托大学评估 SR 偏倚风险的工具”评估纳入的 SR 的偏倚风险。
从 1038 项研究中，纳入了 41 项 SR。这些 SR 的结果表明：（a）在成年人中，AB 的患病率为 22%-30%，SB 为 1%-15%，儿童和青少年的 SB 为 3%-49%；（b）与磨牙症一致相关的因素包括饮酒、咖啡因、烟草、某些精神药物、食管酸化和二手烟；颞下颌关节紊乱症的体征和症状呈现出合理的关联；（c）便携式诊断设备总体上显示出较高的特异性（0.83-1.00）和敏感性（0.40-1.00）；（d）磨牙症可能导致与牙种植体有关的生物力学并发症；然而，关于其他牙修复体和牙周影响的证据尚无定论；（e）咬合矫正器被认为对磨牙症的管理有效，尽管目前针对其他治疗方法的证据较弱。
目前来自 SR 的知识主要与 SB 相关。在儿童和青少年中发现的患病率高于成年人。相关因素和磨牙症对口腔颌面部结构的影响相当异质和不一致。总体而言，便携式诊断设备的准确性较好。大多数现有治疗方法的干预效果大多不确定，除了咬合矫正器。
