Professor, School of Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Professor, Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.
J Prosthet Dent. 2022 Nov;128(5):905-912. doi: 10.1016/j.prosdent.2021.01.026. Epub 2021 Mar 5.
The definition of bruxism has evolved, and the dental profession needs to align with the terminologies adopted in the current literature of sleep and orofacial pain medicine.
The purpose of this review was to discuss the recent evolution of bruxism concepts and the implications for changing the definition that is currently used by the prosthodontic community.
A historical perspective on the evolution of the definition of bruxism, as well as a systematic literature review on the validity of polysomnography (PSG)-based criteria for sleep bruxism diagnosis to detect the presence of clinical consequences, is presented. Selected articles were read in a structured Population, Intervention, Comparison, Outcome (PICO) format to answer the question "If a target population with conditions such as tooth wear, dental implant complications, and temporomandibular disorders (P) is diagnosed with sleep bruxism by means of PSG (I) and compared with a population of nonbruxers (C), is the occurrence of the condition under investigation (that is, the possible pathologic consequences of sleep bruxism) be different between the 2 groups (O)?"
Eight studies were eligible for the review, 6 of which assessed the relationship between PSG-diagnosed sleep bruxism and temporomandibular disorder pain, while the other 2 articles evaluated the predictive value of tooth wear for ongoing PSG-diagnosed sleep bruxism and the potential role of sleep bruxism in a population of patients with failed dental implants. Findings were contradictory and not supportive of a clear-cut relationship between sleep bruxism assessed based on available PSG criteria and any clinical consequence. The literature providing definitions of bruxism as a motor behavior and not pathology has been discussed.
The bruxism construct has shifted from pathology to motor activity with possibly even physiological or protective relevance. An expert panel including professionals from different medical fields published 2 consecutive articles focusing on the definition of bruxism, as well as an overview article presenting the ongoing work to prepare a Standardized Tool for the Assessment of Bruxism (STAB) to reflect the current bruxism paradigm shift from pathology to behavior (that is, muscle activity). As such, dental practitioners working in the field of restorative dentistry and prosthodontics are encouraged to appraise this evolution.
磨牙症的定义已经演变，口腔医学专业需要与当前睡眠和口面疼痛医学文献中采用的术语保持一致。
本综述的目的是讨论磨牙症概念的最新演变及其对改变义齿修复领域当前使用的定义的影响。
本文从历史角度探讨了磨牙症定义的演变，并对多导睡眠图（PSG）为基础的睡眠磨牙症诊断标准的有效性进行了系统的文献回顾，以检测其临床后果。选择的文章以结构化的人群、干预、比较、结果（PICO）格式阅读，以回答以下问题：“如果目标人群存在牙齿磨损、种植牙并发症和颞下颌关节紊乱等情况（P），通过 PSG（I）诊断为睡眠磨牙症，并与非磨牙症人群（C）进行比较，在这 2 组人群中（O），调查情况（即睡眠磨牙症的可能病理性后果）是否存在差异？”
共有 8 项研究符合综述标准，其中 6 项研究评估了 PSG 诊断的睡眠磨牙症与颞下颌关节紊乱疼痛之间的关系，另外 2 项文章评估了磨牙症与牙齿磨损的关系以及磨牙症在种植牙失败患者中的潜在作用。研究结果相互矛盾，不支持基于现有 PSG 标准评估的睡眠磨牙症与任何临床后果之间存在明确关系。本文还讨论了将磨牙症定义为运动行为而不是病理的文献。
磨牙症的概念已经从病理转变为运动活动，甚至可能具有生理或保护意义。一个由来自不同医学领域的专业人员组成的专家小组发表了 2 篇连续的文章，重点关注磨牙症的定义，并介绍了一篇概述文章，提出了一项正在进行的工作，以准备一个用于评估磨牙症的标准化工具（STAB），以反映从病理到行为（即肌肉活动）的当前磨牙症范式转变。因此，从事修复牙科和义齿修复学领域的口腔医生应评估这一演变。
