磨牙症是否为肌肉骨骼疾病的新风险因素？

Bruxism as a new risk factor of musculo-skeletal disorders?

机构信息

Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium; Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (CHU), Liège, Belgium.

出版信息

J Dent. 2023 Aug;135:104555. doi: 10.1016/j.jdent.2023.104555. Epub 2023 May 30.

DOI:10.1016/j.jdent.2023.104555

PMID:37263410

Abstract

OBJECTIVES

Musculoskeletal disorders (MSDs), particularly neck and low back pain, constitute a major public health issue worldwide with a heavy morbidity and economic impact. However, the relationships between the stomatognathic system and MSDs are subjected to debate, data sorely lacking. The study objective was to investigate the association between bruxism (BR) and MSDs. Secondary objective includes the study of the association between tooth wear (TW) and MSDs.

METHODS

This is a cross-sectional study on 425 participants frequenting a university dental clinic. The presence of MSDs was evaluated with the standardized Nordic questionnaire. The sleep and awake BR assessments were based on clinical examination and self-report. TW was measured with the BEWE index. Socio-demographic factors, medical history, life habits and stress were analyzed as potential confounding variables.

RESULTS

91% of patients reported at least one MSD during the preceding 12 months and 75.5% were diagnosed as bruxers. In multivariate analyses, BR was associated with a 5-fold increased risk of prevalent MSD (OR=5.88 (2.7-12.5), p<0.0001). Regarding TW, for a one-point increase in anterior BEWE score, the risk to present an MSD was increased by 53% (OR=1.53 (1.12-2.08), p = 0.0076). Moreover, BR was independently associated with neck, shoulder, upper back, low back, hip & thigh and knee MSDs. Anterior TW was independently associated with neck, low back and hip & thigh MSDs, and global TW with knee MSDs.

CONCLUSIONS

BR and TW were shown to be associated with MSDs. The cause-and-effect relationships between those factors needs to be analyzed to optimize prevention and therapeutic care.

CLINICAL SIGNIFICANCE

Results suggest that the body is a whole, a balanced muscular system, where every part constitutes a link of the chain. MSDs management and prevention may require a multidisciplinary team approach and future perspectives include defining the dentist's role in this context, particularly with respect to BR diagnostic and treatment.

摘要

目的

肌肉骨骼疾病（MSD），特别是颈部和下背部疼痛，是一个全球性的主要公共卫生问题，发病率和经济影响都很大。然而，口腔颌面部系统与 MSD 之间的关系存在争议，数据严重缺乏。本研究的目的是探讨磨牙症（BR）与 MSD 之间的关系。次要目的包括研究牙齿磨损（TW）与 MSD 之间的关系。

方法

这是一项在大学牙科诊所就诊的 425 名参与者的横断面研究。通过标准化的北欧问卷评估 MSD 的存在。睡眠和清醒时 BR 的评估基于临床检查和自我报告。TW 通过 BEWE 指数进行测量。社会人口统计学因素、病史、生活习惯和压力被分析为潜在的混杂因素。

结果

91%的患者在过去 12 个月内至少报告有一种 MSD，75.5%的患者被诊断为磨牙症患者。在多变量分析中，BR 与普遍存在的 MSD 风险增加 5 倍相关（OR=5.88（2.7-12.5），p<0.0001）。关于 TW，前 BEWE 评分每增加 1 分，出现 MSD 的风险增加 53%（OR=1.53（1.12-2.08），p=0.0076）。此外，BR 与颈部、肩部、上背部、下背部、臀部和大腿部以及膝盖 MSD 独立相关。前 TW 与颈部、下背部和臀部和大腿部 MSD 独立相关，全 TW 与膝盖 MSD 独立相关。