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Is bruxism associated with temporomandibular joint disorders? A systematic review and meta-analysis

Evidence-Based Dentistry volume 24, page 144 (2023)Cite this article

Subjects

Abstract

Objectives

The aim of this review is to examine and quantify the association between bruxism and temporomandibular joint disorders in a systematic review and meta-analysis.

Methods

Electronic searches were performed in PubMed/Medline, Embase, Cochrane, Wiley, ProQuest, Web of Science, and Scopus databases for articles published up to March 2022. Two independent reviewers assessed the quality of the studies using the Newcastle-Ottawa Scale. A random-effects model was used to estimate the pooled odds ratio (OR) and its corresponding 95% confidence interval (CI) for each study.

Results

The search retrieved 1651 studies, and 20 studies were eligible for meta-analysis. The results of the study showed that there is a significant relationship between bruxism and TMD, with the presence of bruxism increasing the odds of TMD by 2.25 times (OR = 2.25, 95% CI (1.94–2.56)). Based on the type of bruxism, awake bruxism was found to increase the odds of TMD by 2.51 times (OR = 2.51, 95% CI: (2.02–2.99)), while sleep bruxism increased the odds of TMD by 2.06 times (OR = 2.06, 95% CI: (1.82–2.30)). Analysis of the results from studies that reported both types of bruxism showed that bruxism increases the odds of TMD by 2.17 times (OR = 2.17, 95% CI: (2.30–3.05)).

Conclusion

The available data demonstrate a positive relationship between bruxism and TMD, with the presence of bruxism increasing the likelihood of developing TMD in the future.

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Fig. 1
Fig. 2: The Foest Plot of the association between bruxism and TMD by type of model and other subgroups.
Fig. 3: A funnel plot illustrating publication bias in the included studies.

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Data availability

Data available on request from the authors. The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Dreweck FDS, Soares S, Duarte J, Conti PCR, De Luca Canto G, Luis Porporatti A. Association between painful temporomandibular disorders and sleep quality: a systematic review. J Oral Rehabil. 2020;47:1041–51.

    Article  PubMed  Google Scholar 

  2. Crincoli V, Cannavale M, Cazzolla AP, Dioguardi M, Piancino MG, Di Comite M. Temporomandibular disorders and oral features in Idiopathic Inflammatory Myopathies (IIMs) Patients: an observational study. Int J Med Sci. 2021;18:3158.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Calixtre LB, Grüninger BL, Chaves TC, Oliveira AB. Is there an association between anxiety/depression and temporomandibular disorders in college students? J Appl Oral Sci. 2014;22:15–21.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ahlberg K, Ahlberg J, Könönen M, Alakuijala A, Partinen M, Savolainen A. Perceived orofacial pain and its associations with reported bruxism and insomnia symptoms in media personnel with or without irregular shift work. Acta Odontol Scand. 2005;63:213–7.

    Article  PubMed  Google Scholar 

  5. Fillingim RB, Ohrbach R, Greenspan JD, Knott C, Diatchenko L, Dubner R, et al. Psychological factors associated with development of TMD: the OPPERA prospective cohort study. J Pain. 2013;14:T75–T90.

    Article  PubMed  Google Scholar 

  6. Liu F, Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent Clin. 2013;57:465–79.

    Google Scholar 

  7. Ryalat S, Baqain ZH, Amin WM, Sawair F, Samara O, Badran DH. Prevalence of temporomandibular joint disorders among students of the University of Jordan.J Clin Med Res. 2009;1:158.

    PubMed  PubMed Central  Google Scholar 

  8. Khawaja S, McCall W Jr, Dunford R, Nickel J, Iwasaki L, Crow H, et al. Infield masticatory muscle activity in subjects with pain‐related temporomandibular disorders diagnoses. Orthod Craniofac Res. 2015;18:137–45.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Khawaja SN, Crow H, Gonzalez Y. Goldenhar syndrome and pain-related temporomandibular disorders. NY State Dental J. 2016:82:21–4.

    Google Scholar 

  10. Peixoto KO, Abrantes PS, De Carvalho IHG, De Almeida EO, Barbosa GAS. Temporomandibular disorders and the use of traditional and laser acupuncture: a systematic review. CRANIO®. 2021:1–7. Online ahead of print.

  11. Oluwajana F, Clarke P, Foster-Thomas E, James M, Crawford C. Temporomandibular disorders. Part 1: anatomy, aetiology, diagnosis and classification. Dent Update. 2022;49:320–8.

    Article  Google Scholar 

  12. Schiffman E, Ohrbach R. Executive summary of the Diagnostic Criteria for Temporomandibular Disorders for clinical and research applications. J Am Dent Assoc. 2016;147:438–45.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Manfredini D, Chiappe G, Bosco M. Research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis I diagnoses in an Italian patient population. J Oral Rehabil. 2006;33:551–8.

    Article  PubMed  Google Scholar 

  14. Schiffman E, Truelove E, Ohrbach R, Anderson G, John M, List T, et al. The Research Diagnostic Criteria for Temporomandibular Disorders. I: overview and methodology for assessment of validity. J Orofac Pain. 2010;24:7–24.

    PubMed  PubMed Central  Google Scholar 

  15. Schiffman E, Ohrbach R, Truelove E, Truelove E, Look J, Anderson G, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications. J Oral Facial Pain Headache. 2014;28:6–27.

  16. Fernandes G, Franco A, Siqueira J, Gonçalves DAG, Camparis CM. Sleep bruxism increases the risk for painful temporomandibular disorder, depression and non‐specific physical symptoms. J Oral Rehabil. 2012;39:538–44.

    Article  PubMed  Google Scholar 

  17. De Leeuw R, Klasser GD. Orofacial pain: guidelines for assessment, diagnosis, and management. Hanover Park, IL, USA: Quintessence Publishing Company, Incorporated; 2018.

  18. Persaud R, Garas G, Silva S, Stamatoglou C, Chatrath P, Patel K. An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions. JRSM Short Rep. 2013;4:1–9.

    Article  Google Scholar 

  19. Demjaha G, Kapusevska B, Pejkovska-Shahpaska B. Bruxism unconscious oral habit in everyday life. Open Access Maced J Med Sci. 2019;7:876–81.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ, et al. Bruxism defined and graded: an international consensus. J Oral Rehabil. 2013;40:2–4.

    Article  PubMed  Google Scholar 

  21. Manfredini D, Ahlberg J, Lobbezoo F. Bruxism definition: past, present, and future—what should a prosthodontist know? J Prosthet Dent. 2022;128:905–12.

    Article  PubMed  Google Scholar 

  22. Murali R, Rangarajan P, Mounissamy A. Bruxism: conceptual discussion and review. J Pharm Bioallied Sci. 2015;7:S265.

    Article  PubMed  PubMed Central  Google Scholar 

  23. American Academy of Sleep Medicine. International classification of sleep disorders. Diagnostic and coding manual. American Academy of Sleep Medicine; 2005:148–52.

  24. Wieckiewicz M, Smardz J, Martynowicz H, Wojakowska A, Mazur G, Winocur E. Distribution of temporomandibular disorders among sleep bruxers and non‐bruxers—a polysomnographic study. J Oral Rehabil. 2020;47:820–6.

    Article  PubMed  Google Scholar 

  25. Jiménez-Silva A, Peña-Durán C, Tobar-Reyes J, Frugone-Zambra R. Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: a systematic review from 2003 to 2014. Acta Odontol Scand. 2017;75:36–58.

    Article  PubMed  Google Scholar 

  26. Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ott: Ott Hosp Res Inst. 2011;2:1–12.

    Google Scholar 

  27. Herzog R, Álvarez-Pasquin M, Díaz C, Del Barrio JL, Estrada JM, Gil Á. Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? a systematic review. BMC Public Health. 2013;13:1–17.

    Article  Google Scholar 

  28. de Santis TO, Motta LJ, Biasotto-Gonzalez DA, Mesquita-Ferrari RA, Fernandes KPS, de Godoy CHL, et al. Accuracy study of the main screening tools for temporomandibular disorder in children and adolescents. J Bodyw Mov Ther. 2014;18:87–91.

    Article  PubMed  Google Scholar 

  29. Manfredini D, Lobbezoo F. Sleep bruxism and temporomandibular disorders: a scoping review of the literature. J Dent. 2021;111:103711.

    Article  PubMed  Google Scholar 

  30. Beddis H, Pemberton M, Davies S. Sleep bruxism: an overview for clinicians. Br Dent J. 2018;225:497–501.

    Article  PubMed  Google Scholar 

  31. de Souza Barbosa T, Miyakoda LS, de Liz Pocztaruk R, Rocha CP, Gavião MBD. Temporomandibular disorders and bruxism in childhood and adolescence: review of the literature. Int J Pediatric Otorhinolaryngol. 2008;72:299–314.

    Article  Google Scholar 

  32. LeResche L, Mancl LA, Drangsholt MT, Saunders K, Von Korff M. Relationship of pain and symptoms to pubertal development in adolescents. Pain. 2005;118:201–9.

    Article  PubMed  Google Scholar 

  33. Nilsson I-M, List T, Drangsholt M. Prevalence of temporomandibular pain and subsequent dental treatment in swedish adolescents. J Orofacial Pain. 2005;19:144–50.

    PubMed  Google Scholar 

  34. Rogol AD, Roemmich JN, Clark PA. Growth at puberty. J Adolesc Health. 2002;31:192–200.

    Article  PubMed  Google Scholar 

  35. Reissmann DR, John MT, Aigner A, Schön G, Sierwald I, Schiffman EL. Interaction between awake and sleep bruxism is associated with increased presence of painful temporomandibular disorder. J Oral Facial Pain Headache. 2017;31:299–305.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Marpaung C, Lobbezoo F, van Selms MK. Temporomandibular disorders among dutch adolescents: prevalence and biological, psychological, and social risk indicators. Pain Res Manag. 2018;2018:5053709.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Leketas M, Šaferis V, Kubilius R, Cervino G, Bramanti E, Cicciù M. Oral behaviors and parafunctions: comparison of temporomandibular dysfunction patients and controls. J Craniofac Surg. 2017;28:1933–8.

    Article  PubMed  Google Scholar 

  38. Sierwald I, John MT, Schierz O, Hirsch C, Sagheri D, Jost-Brinkmann P-G, et al. Association of temporomandibular disorder pain with awake and sleep bruxism in adults zusammenhang von schmerzhaften kraniomandibulären dysfunktionen mit wach-und schlafbruxismus bei erwachsenen. J Orofac Orthop. 2015;76:305–17.

    Article  PubMed  Google Scholar 

  39. Manfredini D, Winocur E, Guarda-Nardini L, Lobbezoo F. Self-reported bruxism and temporomandibular disorders: findings from two specialised centres. J Oral Rehabil. 2012;39:319–25.

    Article  PubMed  Google Scholar 

  40. Manfredini D, Lobbezoo F. Relationship between bruxism and temporomandibular disorders: a systematic review of literature from 1998 to 2008. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, and Endod. 2010;109:e26–e50.

    Article  Google Scholar 

  41. Muzalev K, Visscher CM, Koutris M, Lobbezoo F. Effect of experimental temporomandibular disorder pain on sleep bruxism: a pilot study in males. Clin Oral Investig. 2020;24:103–11.

    Article  PubMed  Google Scholar 

  42. Camparis CM, Formigoni G, Teixeira MJ, Bittencourt LR, Tufik S, de Siqueira JT. Sleep bruxism and temporomandibular disorder: clinical and polysomnographic evaluation. Arch Oral Biol. 2006;51:721–8.

    Article  PubMed  Google Scholar 

  43. Sinclair A, Wieckiewicz M, Ettlin D, Junior R, Guimarães AS, Gomes M, et al. Temporomandibular disorders in patients with polysomnographic diagnosis of sleep bruxism: a case-control study. Sleep Breath. 2022;26:941–8.

    Article  PubMed  Google Scholar 

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Author information

Author notes

  1. These authors contributed equally: Masoud Mohammadi, Abdolhalim Rajabi.

Authors and Affiliations

  1. Department of Oral and Maxillofacial Medicine, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran

    Nazanin Mortazavi

  2. Dental Research Center, Golestan University of Medical Sciences, Gorgan, Iran

    Nazanin Mortazavi & Amene Hasanzade Tabatabaei

  3. Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran

    Masoud Mohammadi

  4. Environmental Health Research Center, Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran

    Abdolhalim Rajabi

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Contributions

The authors confirm contribution to the paper as follows: Study conception and design: AR, NM; Bibliographic search and data extraction: MM, AHT.; Analysis and interpretation of results: AR, NM; Draft manuscript preparation: AR, NM, MM; All authors have revised and approved the final version of the manuscript.

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Correspondence to Masoud Mohammadi or Abdolhalim Rajabi.

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Ethics

This systematic review was approved by ethics in research of Golestan University of Medical Sciences (IR.GOUMS.REC.1400.416).

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Mortazavi, N., Tabatabaei, A.H., Mohammadi, M. et al. Is bruxism associated with temporomandibular joint disorders? A systematic review and meta-analysis. Evid Based Dent 24, 144 (2023). https://doi.org/10.1038/s41432-023-00911-6

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