Weighing the potential effectiveness of various treatments for sleep bruxism.
Weighing the potential effectiveness of various treatments for sleep bruxism.
复制标题
权衡各种治疗睡眠磨牙症的潜在疗效。
DOI：
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发表时间：
2007
期刊：
影响因子：
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通讯作者：
G. Lavigne
中科院分区：
文献类型：
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作者：
N. Huynh;C. Manzini;P. Rompré;G. Lavigne
睡眠磨牙症可能导致各种问题，但其病理生理尚未完全阐明。因此，没有明确的治疗方法，但某些预防措施和/或药物可用于急性病例，特别是涉及疼痛的病例。本文旨在指导临床科学家最适合未来临床研究的治疗方法。为了确定目前最好的治疗方法，采用2种方法比较了10项关于睡眠磨牙症的临床研究的结果，其中3项涉及口服器械，7项涉及药物治疗。第一个指标，需要治疗的人数（NNT），允许比较几个随机临床研究，并得出一般结论。第二项措施，效应量，允许使用类似设计的不同研究评估治疗相对于安慰剂的影响。考虑到NNT，每个研究的效应量和功效，可以得出结论，以下治疗方法可以减少睡眠磨牙症：下颌前移装置，可乐定和咬合板。然而，其中前两个与不良影响有关。因此，咬合板是治疗的首选，因为它减少了研磨噪音，并保护牙齿免受过早磨损，没有报告的不良影响。无法计算替代药物治疗（短期氯硝西泮治疗）的NNT，后者具有较大的效应量，并降低了平均磨牙症指数。然而，依赖性的风险限制了其长期使用。评估最有希望的治疗方法的有效性和安全性需要更长时间内更大样本量的研究。
Sleep bruxism may lead to a variety of problems, but its pathophysiology has not been completely elucidated. As such, there is no definitive treatment, but certain preventive measures and/or drugs may be used in acute cases, particularly those involving pain. This article is intended to guide clinician scientists to the treatment most appropriate for future clinical studies. To determine the best current treatment, 2 measures were used to compare the results of 10 clinical studies on sleep bruxism, 3 involving oral devices and 7 involving pharmacologic therapy. The first measure, the number needed to treat (NNT), allows several randomized clinical studies to be compared and a general conclusion to be drawn. The second measure, effect size, allows evaluation of the impact of treatment relative to a placebo using different studies of similar design. Taking into account the NNT, the effect size and the power of each study, it can be concluded that the following treatments reduce sleep bruxism: mandibular advancement device, clonidine and occlusal splint. However, the first 2 of these have been linked to adverse effects. The occlusal splint is therefore the treatment of choice, as it reduces grinding noise and protects the teeth from premature wear with no reported adverse effects. The NNT could not be calculated for an alternative pharmacologic treatment, short-term clonazepam therapy, which had a large effect size and reduced the average bruxism index. However, the risk of dependency limits its use over long periods. Assessment of efficacy and safety of the most promising treatments will require studies with larger sample sizes over longer periods.