Associated factors and treatment options for sleep bruxism in children: an umbrella review

Abstract Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.

摘要：目前关于乳牙列睡眠磨牙症（sleep bruxism）临床管理方案的相关研究证据尚无定论。本伞状综述旨在整合现有系统评价（systematic reviews, SRs）中关于儿童睡眠磨牙症的相关因素及临床治疗手段的证据。检索范围涵盖MEDLINE/PubMed、Web of Science、Embase及OpenGrey数据库，检索时限截至2022年3月。纳入文献需满足以下条件：已发表的针对儿童睡眠磨牙症的系统评价，且包含相关因素或治疗结局数据。采用AMSTAR-2评价工具对纳入系统评价的方法学质量进行评估。本次检索共获取444篇文献，最终纳入6篇。研究共识别出四类常见相关因素：睡眠状况、呼吸改变、人格特质及社会心理因素。治疗手段涵盖心理治疗、药物治疗、咬合装置、物理治疗及外科治疗。所有纳入的系统评价均存在较高偏倚风险，且纳入研究间的重叠度极高。目前针对儿童睡眠磨牙症管理的现有最佳证据均基于相关因素，其中睡眠时长与睡眠状况、呼吸改变、人格特质及社会心理因素为各研究普遍报道的最重要相关因素。然而，当前尚无足够证据支持针对特定治疗方案的临床推荐。