Slee bruxism: an overview for clinicians
Slee bruxism: an overview for clinicians
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DOI：
10.1038/sj.bdj.2018.757
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发表时间：
2018-09-28
影响因子：
2.6
通讯作者：
Davies, S.
中科院分区：
文献类型：
--
作者：
Beddis, H.;Pemberton, M.;Davies, S.
磨牙症的特点是由于咬肌、颞肌和其他颚肌的收缩而使牙齿紧咬或磨牙。磨牙可导致咀嚼肌肥大、牙面脱落、修复体或牙齿断裂、牙齿过敏或疼痛以及牙周支持丧失。睡眠磨牙症以前被认为是一种功能失调的运动或病理状态，而现在被认为是一种具有各种系统性风险因素的中央控制状态。据推测，睡眠磨牙症可能在睡眠中具有保护作用，例如与气道维护或刺激唾液流动有关。睡眠磨牙症的诊断可以通过患者报告和临床访谈、临床检查、口腔内器具或肌肉活动记录来进行。磨牙本身不需要治疗：只有在磨牙引起问题的地方才需要管理。口腔用具的主要目的是保护牙列免受紧咬/磨牙造成的伤害，尽管它们可能会减少肌肉活动。不可逆的咬合调整在磨牙症的治疗中没有证据依据。行为策略包括生物反馈、放松和改善睡眠卫生。在咀嚼肌肉中注射肉毒杆菌毒素（Botox）似乎可以减少磨牙症的发生频率，但人们对可能产生的不良反应表示担忧。牙医应该了解睡眠磨牙症的潜在病因、病理生理学和管理策略。
Bruxism is characterised by clenching or grinding of the teeth due to contraction of the masseter, temporalis and other jaw muscles. Bruxism may lead to masticatory muscle hypertrophy, tooth surface loss, fracture of restorations or teeth, hypersensitive or painful teeth and loss of periodontal support. Sleep bruxism has previously been viewed as a dysfunctional movement or pathological condition, whereas it is now accepted as a centrally controlled condition with various systemic risk factors. It has been postulated that sleep bruxism may have a protective role during sleep, for example in relation to airway maintenance or in stimulating saliva flow. A diagnosis of sleep bruxism may be made via patient report and clinical interview, clinical examination, intraoral appliances or recording of muscle activity. Bruxism in itself does not require treatment: management is only indicated where problems arise as a result of bruxism. Oral appliances primarily aim to protect the dentition from damage caused by clenching/grinding, although they may reduce muscle activity. Irreversible occlusal adjustments have no basis in evidence in the management of bruxism. Behavioural strategies include biofeedback, relaxation and improvement of sleep hygiene. Administration of botulinum toxin (Botox) to the masticatory muscles appears to reduce the frequency of bruxism, but concerns have been raised regarding possible adverse effects. Dentists should be aware of the potential aetiology, pathophysiology and management strategies of sleep bruxism.