Minakuchi Hajime, Fujisawa Masanori, Abe Yuka, Iida Takashi, Oki Kyosuke, Okura Kazuo, Tanabe Norimasa, Nishiyama Akira
Department of Oral Rehabilitation and Regenerative Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Japan.
Jpn Dent Sci Rev. 2022 Nov;58:124-136. doi: 10.1016/j.jdsr.2022.02.004. Epub 2022 Mar 25.
This systematic review aimed to update the management of sleep bruxism (SB) in adults, as diagnosed using polysomnography (PSG) and/or electromyography (EMG). Management methods covered were oral appliance therapy (OAT) with stabilization splints, cognitive-behavioral therapy (CBT), biofeedback therapy (BFT), and pharmacological therapy. A comprehensive search was conducted on MEDLINE, Cochrane Library, and Web of Science up to October 1st, 2021. Reference list searches and hand searches were also performed by an external organization. Two reviewers for each therapy independently performed article selection, data extraction, and risk of bias assessment. The reviewers resolved any disagreements concerning the assortment of the articles by discussion. Finally, 11, 3, 14, and 22 articles were selected for each therapy. The results suggested that OAT tended to reduce the number of SB events, although there was no significant difference compared to other types of splints, that the potential benefits of CBT were not well supported, and that BFT, rabeprazole, clonazepam, clonidine, and botulinum toxin type A injection showed significant reductions in specific SB parameters, although several side effects were reported. It can be concluded that more methodologically rigorous randomized large-sample long-term follow-up clinical trials are needed to clarify the efficacy and safety of management for SB.
本系统评价旨在更新成人睡眠磨牙症（SB）的管理方法，其诊断采用多导睡眠图（PSG）和/或肌电图（EMG）。涵盖的管理方法包括使用稳定牙合夹板的口腔矫治器疗法（OAT）、认知行为疗法（CBT）、生物反馈疗法（BFT）和药物疗法。截至2021年10月1日，对MEDLINE、Cochrane图书馆和科学网进行了全面检索。外部组织也进行了参考文献检索和手工检索。每种疗法由两名评审员独立进行文章筛选、数据提取和偏倚风险评估。评审员通过讨论解决了有关文章分类的任何分歧。最后，每种疗法分别筛选出11篇、3篇、14篇和22篇文章。结果表明，OAT倾向于减少SB事件的数量，尽管与其他类型的牙合夹板相比没有显著差异，CBT的潜在益处没有得到充分支持，BFT、雷贝拉唑、氯硝西泮、可乐定和A型肉毒杆菌毒素注射在特定的SB参数上有显著降低，尽管报告了一些副作用。可以得出结论，需要更多方法学严谨的随机大样本长期随访临床试验来阐明SB管理的有效性和安全性。
