Chemelo Victória Dos Santos, Né Yago Gecy de Sousa, Frazão Deborah Ribeiro, de Souza-Rodrigues Renata Duarte, Fagundes Nathalia Carolina Fernandes, Magno Marcela Baraúna, da Silva Cláudia Maria Tavares, Maia Lucianne Cople, Lima Rafael Rodrigues
Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém-Pará, Brazil.
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Front Neurol. 2020 Dec 7;11:590779. doi: 10.3389/fneur.2020.590779. eCollection 2020.
This systematic review and meta-analysis aimed to investigate a possible association between stress and bruxism in humans. This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines under the code CRD42020188862, and the searches were performed on the following databases: PubMed, Scopus, Web of Science, Cochrane, LILACS, OpenGrey, and Google Scholar. This systematic review evaluated observational studies in adult humans with and without stress to verify the association between bruxism and the presence of stress. The risk of bias was evaluated through the Joanna Briggs Institute Critical Appraisal Tools for Analytical Cross-Sectional Studies. In quantitative analysis, the Odds Ratio (OR) and their 95% confidence interval (CI) were calculated through a fixed-effect model. Furthermore, a summary of the overall strength of evidence was presented using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). A total of 1,458 studies were identified, and six were included in this systematic review. Two studies included were classified with a low risk of bias, and the others were classified with a moderate risk of bias. In three articles, a meta-analysis was performed and showed an association between these two factors (OR 2.07 [1.51, 2.83], < 0.00001, = 45%). Besides that, a low certainty of the evidence was detected among this association. Stressed individuals show a higher chance of presenting bruxism when compared to healthy individuals. Despite the low heterogeneity found in the quantitative analysis among the articles reporting an association between stress and bruxism, further studies with similar methods are necessary to understand this relationship better.
本系统评价和荟萃分析旨在研究人类压力与磨牙症之间可能存在的关联。本研究按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行，项目编号为CRD42020188862，并在以下数据库进行检索：PubMed、Scopus、科学网、考克兰图书馆、拉丁美洲和加勒比卫生科学数据库、OpenGrey以及谷歌学术。本系统评价评估了有压力和无压力的成年人类的观察性研究，以验证磨牙症与压力存在之间的关联。通过乔安娜·布里格斯研究所分析性横断面研究的批判性评价工具评估偏倚风险。在定量分析中，通过固定效应模型计算比值比（OR）及其95%置信区间（CI）。此外，使用推荐分级、评估、制定和评价（GRADE）方法给出了证据总体强度的总结。共识别出1458项研究，本系统评价纳入了其中6项。纳入的两项研究被归类为低偏倚风险，其他研究被归类为中度偏倚风险。在三篇文章中进行了荟萃分析，结果显示这两个因素之间存在关联（OR 2.07 [1.51, 2.83]，P < 0.00001，I² = 45%）。除此之外，在这种关联中发现证据的确定性较低。与健康个体相比，有压力的个体出现磨牙症的可能性更高。尽管在报告压力与磨牙症之间存在关联的文章的定量分析中发现异质性较低，但仍需要采用类似方法进行进一步研究，以更好地理解这种关系。
