Baren, T. van (2009) Farmacotherapeutische be1nvloeding van bruxisme; een effectieve methode? thesis, Dentistry.
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Abstract
Introduction Bruxism is a mandibular movement disorder that is characterized by grinding or clenching of the teeth. Bruxism may occur during sleep as well as during wakefulness, and has an estimated prevalence of 3-14%. Several dental problems have been ascribed to bruxism, such as attrition, abfraction and pain. There are occlusal, behavioural and pharmacological management approaches for bruxism. In this thesis, an overview is given of the use of pharmacological approaches for bruxism. Further, the definition and appearances, aetiology and other treatment approaches for bruxism has been described. Methods In March and April 2009 published research was collected using the medical databases Pubmed and Cochrane Library with the following query: "bruxism", "sleep bruxism", "nocturnal bruxism", "pharmacotherapy" and "bruxism management". Crosschecking of references has taken place. Inclusion criteria: Publication in last twenty years, publication in English, French or Dutch and research on human subjects. 24 articles and three books are included in this study. Six RCT's and five reviews are included. Results In several studies the definition of bruxism is described as an oral or mandibular movement disorder characterized by grinding or clenching of the teeth. Others describe bruxism as a parafunction, or parafunctional mandibular activity. Few researchers distinguish nocturnal bruxism from bruxism during wakefulness. Six articles described a multifactorial aetiology for bruxism, such as occlusal, psychosocial and pathophysiological factors. One author concluded that bruxism is mainly regulated centrally, not peripherally. Various management approaches for bruxism were discribed in three reviews. Splinttherapy was discussed in two reviews. The effect of various medicines on bruxism was researched in four RCT' s. Considering the title of this thesis 'pharmacological approach for bruxism; an effective approach?' it can be concluded that no clear answer can be given. Conclusion and recommendations The definition of bruxism is described differently in various studies. The difference between nocturnal bruxism and bruxism during wakefulness is not always made. Authors should use just one definition and description of bruxism in future research. It can be concluded that bruxism has a multifactorial aetiology. The use of oral splints in the management of bruxism is limited to the prevention of dental damage. The effect of behaviour therapy is questionable, because there is lack of evidence. Pharmacotherapy can be used to reduce pain. Clonazepam and clonidine significant reduced bruxism, but the long-term tolerability and risks need further research. It can be concluded that some pharmacological approaches for bruxism seem promising, they all need further efficacy and safety assessments before clinical recommendations can be made. Further longitudinal, large-sample size RCT are needed before evidence-based recommendations can be given.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Kalk, Prof dr. W. and Sectie Orale functieleer, Prothetische Tandheelkunde en Biom and Centrum voor Tandheelkunde en Mondzorgkunde and Universitair Medisch Centrum Groningen and Rijksuniversiteit Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:56 |
| Last Modified: | 25 Jun 2020 10:56 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1623 |
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