Background Bruxism in children and its relation to the development of temporomandibular disorders (TMD) has not been clearly determined yet. Aim The objective of this systematic review was to evaluate the possible association between bruxism and TMD in children. Design Seven databases were searched, and 497 articles were assessed. Methodological quality was assessed through Newcastle‐Ottawa Scale. The meta‐analysis was performed with the articles in which extraction of data was possible and the summary effect measure through odds ratio (OR) and respective 95% confidence intervals (CIs). Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to assess the certainty of evidence. Results Ten cross‐sectional studies were included in the systematic review. Of these, 8 showed a statistically significant association between bruxism and TMD. Seven studies however presented a high risk of bias. The meta‐analysis was performed with 3 articles and obtained an OR of 2.97 (95% CI ranging from 1.72‐5.15), indicating that children with bruxism are 2.97 times more likely to present TMD, with very low level of certainty defined by GRADE. Conclusions Although the studies showed high risk of bias, the qualitative analysis of individual studies showed that the children with bruxism have greater chance of developing TMD.

Objective To determine the prevalence of the elongated styloid process (ESP) and its characteristics, such as sex and age of the patient, unilateral and bilateral incidence, besides variations between different populations and panoramic and CBCT examinations. Materials and methods A search was performed in six databases (PubMed, Web of Science, Scopus, Cochrane, Lilacs, and Embase) to identify observational studies that used imaging exams and assessed ESP prevalence among panoramic radiograph CBCT examinations, whose transversal prevalence studies were included. Furthermore, studies with a specific group of patients or symptomatic patients were excluded. Additionally, Joanna Briggs Institute checklist was used to evaluate the quality of the studies. A meta-analysis was conducted, then subgroup analyses were performed by grouping studies according to the secondary outcomes, with a significance level set at 5%. The Grading of Recommendations Assessment, Development, and Evaluation system was used to rate the certainty in the evidence. ResultsThe initial search resulted in 1635 studies, from which 39 articles met the inclusion criteria, encompassing 50,655 participants. The sample size varied between 82 and 5,000 participants. The prevalence of the ESP ranged from 1.3 to 94.8%, with an overall prevalence of 30.2%. The bilateral occurrence was higher than the unilateral one, but no significant predilection was observed according to sex, age, or population. The type of imaging examination also showed no difference in its detection. ConclusionThe overall prevalence of ESP was 30.2%, with a propensity for bilaterality, but not for any sex, age, or population geographic location. The imaging examination modality did not influence the diagnosis of ESP. However, the quality level of the studies evaluated was very low, demonstrating the need for more homogeneous primary studies on the prevalence of the ESP with a more standardized methodology. Clinical relevance There is no consensus in the literature regarding the prevalence of the ESP and the characteristics of the affected patients that can cause chronic and debilitating discomfort in the head and neck region. Therefore, knowledge about the prevalence and characteristics of this condition would help dental clinicians reach the correct diagnosis.

No abstract

Background: There is no established acquisition protocol based on scientific evidence for the acquisition of cone-beam computed tomography (CBCT) exams to evaluate the temporomandibular joint (TMJ). Objectives:To evaluate the influence of acquisition protocols and jaw positioning on the diagnostic accuracy of TMJ condylar morphological alterations (CMA), dimension, position and excursion.Methods: Thirty-six TMJs on 18 dry skulls were imaged using a CBCT unit (OP300 Maxio, Instrumentarium, Tuusula, Finland) at two exposure settings (4.5 and 6.3 mA), three voxel resolutions (0.085, 0.125 and 0.280 mm), three jaw positions (concentric, anteriorised and posteriorised) and three jaw excursions (normoexcursion, hyperexcursion and hypoexcursion). The macroscopic anatomy examination and highresolution CBCT images were used as ground truth for CMA. Twenty-five TMJs had at least one CMA with 11 healthy TMJs serving as controls. Three experienced oral and maxillofacial radiologists evaluated the parasagittal images for the presence of CMA, position and excursion and measured dimensions. The area under the ROC curve, sensitivity and specificity were calculated. Weighted Kappa (α = 0.05) was used to determine intra-and interexaminer reliability and comparisons between dependent variables analysed by Analysis of Variance at an a prior level of significance of 0.05. Results:The agreement of the evaluation of the position and excursion with the reference standard was high, independent of the protocol (range, 0.75-0.91). Various combinations of acquisition protocols and jaw position did not influence the CMA evaluation. Erosion was overdiagnosed in protocols with larger voxel sizes and the detection of osteophytes greater in images with smaller voxel sizes. The anteroposterior dimension was greater in the open jaw position (p < .05). Conclusion:CBCT protocols using reduced radiation exposure from the CBCT machine evaluated in this study can be used to assess condylar morphology, dimension, position and excursion, without compromising diagnostic performances for these parameters.