PDF(Pubmed)
Abstract：
Sleep bruxism, characterized by involuntary grinding or clenching of teeth during sleep, poses significant challenges in management due to its potential to induce temporomandibular joint disorders (TMDs) and other related symptoms. The use of Botulinum toxin Type A (BoNT-A), also known as Botox®, has been proposed as a therapeutic intervention. This systematic review aims to evaluate the efficacy and safety of BoNT-A in the management of sleep bruxism, focusing on pain reduction, improvement in jaw function, reduction in bruxism episodes, and the incidence of adverse effects. An exhaustive search was conducted across PubMed, Scopus, and Embase databases up to January 2024, adhering to the PRISMA guidelines. Nine randomized clinical trials (RCTs) involving 137 participants were analyzed for efficacy and safety outcomes. The studies demonstrated a significant reduction in mean pain scores (from 7.1 to 0.2 at 6 months and 1 year post-treatment in one study) and a notable decrease in the number of bruxism events (from 4.97/h to 1.70/h in the BoNT-A group in another study). Additionally, improvements were observed in jaw stiffness and total sleep time. Adverse effects varied but were generally mild and transient, including injection site pain in 20% of participants in one study and cosmetic changes in smile in 15.4% of patients in another. These findings suggest that BoNT-A injections may provide some benefits for treating nocturnal bruxism, potentially reducing TMD symptoms like pain and improving jaw function. However, these findings are preliminary due to variability in study designs and the absence of detailed statistical analysis.
摘要：
睡眠磨牙症,其特点是在睡眠过程中不自主地磨牙或咬牙，由于其可能诱发颞下颌关节紊乱病（TMDs）和其他相关症状，因此在管理方面提出了重大挑战。A型肉毒杆菌毒素（BoNT-A）的使用，也被称为Botox®，已被提议作为治疗干预。本系统评价旨在评估BoNT-A在睡眠磨牙症治疗中的有效性和安全性。专注于减轻疼痛，改善下颌功能，减少磨牙症发作，以及不良反应的发生率。在PubMed进行了详尽的搜索，Scopus,和Embase数据库截至2024年1月，遵守PRISMA指南。9项随机临床试验（RCTs）包括137名参与者进行了疗效和安全性结果分析。研究表明，平均疼痛评分显着降低（在一项研究中，治疗后6个月和1年从7.1降至0.2），磨牙症事件的数量显着降低（在另一项研究中，BoNT-A组从4.97/h降至1.70/h）。此外,改善了颌骨僵硬和总睡眠时间。副作用各不相同，但通常是轻微和短暂的，包括一项研究中20%的参与者注射部位疼痛和另一项研究中15.4%的患者微笑的美容变化。这些结果表明，BoNT-A注射可能为治疗夜间磨牙症提供一些益处。可能减少TMD症状，如疼痛和改善颌骨功能。然而,由于研究设计的差异性和缺乏详细的统计分析,这些发现是初步的.
