Cochrane · intervention · CD005514

Occlusal splints for treating sleep bruxism (tooth grinding)

Macedo, CR, Silva, AB, Machado, MAC, et al. · Cochrane Database of Systematic Reviews · 2007 · Cochrane Library

Oral Health Temporomandibular disorders and sleep2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 3 · 13.6%Ungraded 19 · 86.4%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	All participants with sleep bruxism (tooth grinding or clenching); children (greater than 1 year old) and adults; diagnostic criteria clinical, polysomnographic, or both. Clinical: complaint of tooth grinding or clenching during sleep plus one or more of abnormal tooth wear, tooth grinding sounds during sleep, jaw muscle discomfort. Polysomnographic cut-offs: more than 4 bruxism episodes per hour; more than 6 bruxism bursts per episode or 25 bursts per hour of sleep; at least 2 episodes with grinding sounds. Exclusion: comorbidity such as movement disorders, neurological and psychiatric diseases	People with sleep bruxism (5 RCTs); 1 study in children aged 3 to 5 years and 4 studies in adults (majority women)
Intervention	Occlusal splint	Occlusal splint (n=5)
Comparison	Placebo; No treatment; Other types of appliances (palatal splint); Pharmacological interventions (benzodiazepine, anticonvulsants, beta blockers, dopamine agents, antidepressants, botulin toxin A and B, analgesics); Behaviour therapy (sleep hygiene, relaxation to control stress, psychotherapy, hypnosis, biofeedback)	Palatal splint (n=2); Transcutaneous electric nerve stimulation (n=1); No treatment (n=1); Mandibular advancement device (n=1)
Outcomes	Primary: indexes of bruxism motor activity (masseter EMG with polysomnographic audio-video recordings): frequency of sleep bruxism episodes per hour of sleep and number of episodes with grinding noise. Secondary: tooth wear; tooth restoration failure; quality of life; adherence; adverse events; temporomandibular joint pain (VAS); clicking (joint sound); jaw movement limitation; myofascial pain (VAS); headaches; stress level; mood factors; anxiety; depression; sleep variables (REM sleep latency, efficiency, arousals index, stages, sleep latency, wake after sleep onset, total sleep time); masseteric EMG activity; apnoea-hypopnoea index	Number of bruxism episodes per hour of sleep (n=2); Arousal index (n=2); Total sleep time (n=1); Episodes with grinding noise (n=1); Awakenings per hour (n=1); Sleep efficiency (n=1); Headaches (n=1); Pain in TMJ (n=1); Clicks TMJ oral opening and closing (n=1); Clicks TMJ oral opening or closing (n=1); Increase in the size of wear facets, canine teeth (n=1); Preference (n=2); Comfort (n=2); Pain during the night (n=1); Oral dryness (n=1)
Study designs	Randomised controlled trials (RCTs) in which occlusal splint was compared concurrently to no treatment, pharmacological interventions, any other occlusal appliances, placebo, or behaviour therapy; quasi-randomised trials (alternation, date of birth, record number) included and subject to a sensitivity analysis	RCT (n=4); quasi-RCT (n=1); 3 cross-over and 2 parallel-group designs
Timing	Not reported	Studies performed over 2 weeks to 2 months; 1 study with 6 months of follow up

Search date: 2007-05. Databases: Cochrane Oral Health Group's Trials Register; The Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; LILACS; Dissertation, Theses and Abstracts; Biblioteca Brasileira de Odontologia