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儿童磨牙症:我们了解多少?当前证据的叙述性综述。

Bruxism in children: What do we know? Narrative Review of the current evidence.

机构信息

DDS,Department of Surgical Science, College of Dentistry, School of Orthodontics, University of Cagliari, Cagliari, Italy.

DDS,Department of Surgical Science, College of Dentistry, University of Cagliari, Cagliari, Italy.

出版信息

Eur J Paediatr Dent. 2023 Sep 1;24(3):207-210. doi: 10.23804/ejpd.2023.24.03.02.

Abstract

BACKGROUND

Bruxism is a repetitive masticatory muscles activity whose definition is being thoroughly reviewed in recent years. As in adults, two different forms of bruxism exist in children, namely awake and sleep bruxism. Scarcity of data, however,still persists about paediatric bruxism and no clear consensus has been developed. Therefore, the current review overviews the literature on bruxism in children tries to outline the state of art about this condition METHODS: Bruxism affects from 5% to 50% of the worldwide paediatric population. Sleep disturbances, parafunctional habits and psycho-social factors emerged to be the most likely associated factors with paediatric bruxism. Bruxism is characterised by several signs and symptoms variously combined, such as tooth wear and fractures, teeth impressions on soft tissues, temporomandibular disorders, headaches, behavioural and sleep disorders. About diagnosis, the most reliable tool in children remains the report of teeth grinding by parents or caregivers which must be accompanied by oral interview and accurate clinical examination. Electromyography and sleep polysomnography, albeit suitable in the diagnostic process, are not easy-to-use in children and are not strongly recommended. Currently, no evidence exists to support any kind of therapeutic options for bruxism in children. Management should be based on the identification of the underlying condition and conservative approaches are recommendable.

CONCLUSION

Notwithstanding the high prevalence, several aspects need to be further assessed in paediatric bruxism. Parental reports are still the most suitable diagnostic tool and conservative approaches are recommended in the management. Bruxism should be considered through a biopsychosocial model, and sleep, personality traits, stress and headaches are the factors towards whom research questions must be addressed to improve diagnosis and management.

摘要

背景

磨牙症是一种咀嚼肌重复性活动,其定义近年来一直在深入研究。与成人一样,儿童也存在两种不同形式的磨牙症,即清醒时磨牙症和睡眠时磨牙症。然而,关于儿童磨牙症的数据仍然很少,尚未达成明确共识。因此,本综述概述了儿童磨牙症的文献,试图概述该病症的现状。

方法

磨牙症影响全球 5%至 50%的儿童人群。睡眠障碍、功能紊乱习惯和心理社会因素似乎是与儿童磨牙症最相关的因素。磨牙症的特征是多种症状和体征的不同组合,如牙齿磨损和断裂、软组织上的牙齿印痕、颞下颌关节紊乱、头痛、行为和睡眠障碍。关于诊断,父母或照顾者报告的磨牙是儿童最可靠的工具,但必须辅以口腔访谈和准确的临床检查。肌电图和多导睡眠图虽然适用于诊断过程,但在儿童中不易使用,不强烈推荐。目前,没有证据支持儿童磨牙症的任何治疗选择。治疗应基于确定潜在疾病,建议采用保守方法。

结论

尽管患病率较高,但仍需要进一步评估儿童磨牙症的几个方面。父母报告仍然是最适合的诊断工具,建议在治疗中采用保守方法。磨牙症应通过生物心理社会模型进行考虑,睡眠、人格特质、压力和头痛是需要解决的问题,以改善诊断和管理。

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