Bruxismo de vigília - diagnóstico e manejo: Uma revisão de escopo

Abstract

Bruxism is considered a behavior that involves a variety of jaw’s activities, with multifactorial etiology and great clinical importance. Defined as repetitive masticatory muscle activity, characterized by clenching or grinding the teeth and/or by bracing or thrusting the jaw, being evaluated as sleep bruxism (SB) and awake bruxism (AB). The causes, mechanisms and effects of bruxism are still unclear, and excessive levels of masticatory muscle activity may increase the risk of negative consequences for oral health. The aim of this scoping review was to investigate and outline the existing content of literature on the diagnosis and management of AB`s patients. Studies of systematic reviews, randomized and non-randomized clinical trials, cohort, case-control, cross-sectional and case series studies, without language restriction and year of publication, were included. The research was conducted in the following databases: Medline / PubMed, LILACS / VHL and Cochrane Library. Research of gray literature was performed on Google Scholar, BDTD, and one research of reference lists in included studies was performed. Two blindly reviewers analyzed the articles considering the pre-selected eligibility criteria. Initially, 968 studies were selected by title and abstract, of which 69 were included for completed text reading. In the end, eleven studies emcompassed this review and a mapping of data was performed. From a descriptive analysis of the results, it can note that self-report and Ecological Momentary Assessment (EMA) were the most used methods for diagnosis, and the combination of these two forms of approach provided promising for closer detection of definitive AB. Psychosocial factors and nocturnal chronotype were related to AB, indicating the importance of their investigation during AB evaluation. Regarding management, the Ecological Momentary Assessment / Ecological Momentary Intervention, exhibited good results in reducing the behaviors associated with AB, through cognitive-behavioral therapy. Therefore, this scoping review can highlight what the scientific literature presents on the diagnosis and management of AB until now, but emphasizing more powerful evidence on these aspects should be developed and enhanced, through the standardization of the evaluation methods, of studies involving diverse populations and that correlate the diurnal electromyographic activity of the masticatory muscles with the frequency of the AB behaviors.