Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.
Health Sciences Faculty, University of Brasília (UnB), Brasília, Brazil.
J Oral Rehabil. 2021 May;48(5):621-631. doi: 10.1111/joor.13142. Epub 2021 Jan 28.
To synthesise and critically review the association between sleep bruxism (SB) and stress symptoms in adults. A systematic review was performed. The search was completed using seven primary electronic databases in addition to a grey literature search. Two reviewers blindly selected studies based on pre-defined eligibility criteria. Risk of bias of the included articles was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. RevMan 5.4 was used to perform the meta-analysis. The quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Ten studies were included for qualitative analysis, of which three were included for quantitative analysis. Three studies were evaluated to have low risk of bias, and seven were assessed with moderate risk of bias. Quality of evidence was classified as very low for all outcomes. Individuals with SB were found to have higher levels of some self-reported stress symptoms as assessed through questionnaires with a mean difference of 4.59 (95% CI 0.26-8.92). Biomarkers like epinephrine, norepinephrine, cortisol, adrenaline, dopamine, noradrenaline and prolidase enzyme levels also showed a positive association with SB. Although some associations were identified between probable SB and self-reported stress symptoms and biomarkers of stress in adults, given that the quality of evidence was found to be very low, caution should be exercised in interpreting these results. These findings suggest that additional and better designed studies are warranted in order to clarify the link between SB and stress.
综合评价成人磨牙症（SB）与应激症状之间的相关性。方法：进行了系统评价。除了灰色文献搜索外，还使用了七个主要的电子数据库进行搜索。两位评审员根据预先设定的纳入标准盲目选择研究。使用 Joanna Briggs Institute 分析性横断面研究批判性评价清单评估纳入文章的偏倚风险。RevMan 5.4 用于进行荟萃分析。根据推荐评估、制定和评估（GRADE）的标准来评估证据质量。纳入了 10 项研究进行定性分析，其中 3 项研究进行了定量分析。有 3 项研究被评估为低偏倚风险，7 项研究被评估为中度偏倚风险。所有结局的证据质量均归类为极低。通过问卷调查评估发现，磨牙症患者的一些自我报告的应激症状水平更高，平均差异为 4.59（95%CI 0.26-8.92）。肾上腺素、去甲肾上腺素、皮质醇、肾上腺素、多巴胺、去甲肾上腺素和脯氨酸酶水平等生物标志物也与 SB 呈正相关。尽管在成人中，可能的 SB 与自我报告的应激症状和应激生物标志物之间存在一些关联，但由于证据质量被发现非常低，因此在解释这些结果时应谨慎。这些发现表明，需要进行更多和更好设计的研究，以阐明 SB 与应激之间的联系。
