Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Central Library of the Health Science Center, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
J Oral Rehabil. 2020 Oct;47(10):1304-1318. doi: 10.1111/joor.12971. Epub 2020 Apr 21.
Given that current literature largely dissociates dental malocclusion and bruxism, the objective of this study was to gather, through a systematic review, scientific evidence to support their relationship.
This study was performed according to the PECO strategy (where P = general population; E = dental malocclusion; C = no dental malocclusion; and O = bruxism). Literature searches were conducted without language or date restrictions in the following databases: PubMed, Scopus, the Web of Science, the Cochrane Library, LILACS/BBO via VHL and the grey literature. The search strategy included Medical Subject Headings/DECs, synonyms and free terms relevant to each database, with no age restrictions applied. Once the relevant data were extracted from the articles, the Fowkes and Fulton guidelines were followed to assess the quality and risk of bias. For quantitative analysis, dental malocclusions were divided into groups according to their type in order to perform odds ratio (OR) meta-analyses with 95% confidence intervals (CI) using the Review Manager software program (Cochrane, London, UK). The level of certainty of evidence was demonstrated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
After 1,502 studies found, 10 studies were included for qualitative analysis and nine for quantitative synthesis. Four studies presented high methodological quality. Five meta-analyses suggested a non-association between bruxism and Angle class I (OR: 1.05, 95% CI: 0.41-2.69; P = .92; I = 84%), Angle class II (OR: 1.49, 95% CI: 0.77-2.87; P = .23; I = 71%) or Angle class III (OR: 0.77, 95% CI: 0.31-1.93; P = .58; I = 0%). Bruxism was associated with children who did not present with a posterior crossbite (OR: 0.70, 95% CI: 0.51-0.96; P = .03; I = 27%) and present crowding (OR: 1.53, 95% CI: 1.03-2.26; P = .03; I = 0%). The GRADE analysis presented a very low quality of evidence.
Individuals who present with bruxism have a greater chance of crowding. However, bruxism is not associated with the presence of any of the other malocclusions evaluated.
鉴于当前文献在很大程度上将牙颌畸形和磨牙症分开，本研究的目的是通过系统综述收集支持两者关系的科学证据。
本研究按照 PECo 策略（其中 P=一般人群；E=牙颌畸形；C=无牙颌畸形；O=磨牙症）进行。文献检索在以下数据库中进行，无语言或日期限制：PubMed、Scopus、Web of Science、Cochrane 图书馆、LILACS/BBO 通过 VHL 和灰色文献。检索策略包括与每个数据库相关的医学主题词/DECs、同义词和自由术语，不限制年龄。从文章中提取相关数据后，遵循 Fowkes 和 Fulton 指南评估质量和偏倚风险。为了进行定量分析，根据其类型将牙颌畸形分为几组，以便使用 Review Manager 软件程序（Cochrane，London，UK）进行优势比（OR）荟萃分析，并计算 95%置信区间（CI）。通过推荐评估、制定和评估（GRADE）展示证据的确定性水平。
在发现 1,502 项研究后，纳入 10 项研究进行定性分析，9 项研究进行定量综合分析。四项研究具有较高的方法学质量。五项荟萃分析表明磨牙症与 Angle Ⅰ类（OR：1.05，95%CI：0.41-2.69；P=0.92；I²=84%）、Angle Ⅱ类（OR：1.49，95%CI：0.77-2.87；P=0.23；I²=71%）或 Angle Ⅲ类（OR：0.77，95%CI：0.31-1.93；P=0.58；I²=0%）之间无关联。磨牙症与不伴有后牙反颌（OR：0.70，95%CI：0.51-0.96；P=0.03；I²=27%）和拥挤（OR：1.53，95%CI：1.03-2.26；P=0.03；I²=0%）的儿童有关。GRADE 分析显示证据质量非常低。
患有磨牙症的个体更有可能出现拥挤。然而，磨牙症与评估的其他任何牙颌畸形无关。
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