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Systematic Reviews

, 6:4

First Online: 13 January 2017Received: 12 October 2016Accepted: 07 December 2016DOI: 10.1186-s13643-016-0397-z

Cite this article as: Mesko, M.E., Hutton, B., Skupien, J.A. et al. Syst Rev 2017 6: 4. doi:10.1186-s13643-016-0397-z


BackgroundBruxism is a sleep disorder characterized by grinding and clenching of the teeth that may be related to irreversible tooth injuries. It is a prevalent condition occurring in up to 31% of adults. However, there is no definitive answer as to which of the many currently available treatments including drug therapy, intramuscular injections, physiotherapy, biofeedback, kinesiotherapy, use of intraoral devices, or psychological therapy is the best for the clinical management of the different manifestations of bruxism. The aim of this systematic review and network meta-analysis is to answer the following question: what is the best treatment for adult bruxists?

Methods-designComprehensive searches of the Cochrane Library, MEDLINE via PubMed, Scopus, and LILACS will be completed using the following keywords: bruxism and therapies and related entry terms. Studies will be included, according to the eligibility criteria Controlled Clinical Trials and Randomized Clinical Trials, considering specific outcome measures for bruxism. The reference lists of included studies will be hand searched. Relevant data will be extracted from included studies using a specially designed data extraction sheet. Risk of bias of the included studies will be assessed, and the overall strength of the evidence will be summarized i.e., GRADE. A random effects model will be used for all pairwise meta-analyses with a 95% confidence interval. A Bayesian network meta-analysis will explore the relative benefits between the various treatments. The review will be reported using the Preferred Reporting Items for Systematic Reviews incorporating Network Meta-Analyses PRISMA-NMA statement.

DiscussionThis systematic review aims at identifying and evaluating therapies to treat bruxism. This systematic review may lead to several recommendations, for both patients and researchers, as which is the best therapy for a specific patient case and how future studies need to be designed, considering what is available now and what is the reality of the patient.

Systematic review registrationPROSPERO CRD42015023308

KeywordsBruxism therapy Sleep bruxism Evidence-based dentistry AbbreviationsCCTControlled clinical trials

CESContingent electrical stimulation

CIConfidence intervals

CrIsCredibility intervals

DICDeviance information criterion


MAAMandibular advancement appliances

NMANetwork meta-analysis

NTINociceptive trigeminal inhibitory

OROdds Ratios

PRISMA-NMAPreferred Reporting Items for Systematic Reviews incorporating Network Meta-Analyses

PRISMA-PPreferred Reporting Items for Systematic Review and Meta-Analysis Protocols

RCTRandomized controlled trials

SBSleep bruxism

SUCRASurface under the cumulative ranking curve

Electronic supplementary materialThe online version of this article doi:10.1186-s13643-016-0397-z contains supplementary material, which is available to authorized users.

Autor: Mauro Elias Mesko - Brian Hutton - Jovito Adiel Skupien - Rafael Sarkis-Onofre - David Moher - Tatiana Pereira-Cenci


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