Is there association between dental malocclusion and bruxism? A systematic review and meta‐analysis

Abstract

Objectives Given that current literature largely dissociates dental malocclusion and bruxism, the objective of this study was to gather, through a systematic review, scientific evidence to support their relationship. Methodology This study was performed according to the PECO strategy (where P = general population; E = dental malocclusion; C = no dental malocclusion; and O = bruxism). Literature searches were conducted without language or date restrictions in the following databases: PubMed, Scopus, the Web of Science, the Cochrane Library, LILACS/BBO via VHL and the grey literature. The search strategy included Medical Subject Headings/DECs, synonyms and free terms relevant to each database, with no age restrictions applied. Once the relevant data were extracted from the articles, the Fowkes and Fulton guidelines were followed to assess the quality and risk of bias. For quantitative analysis, dental malocclusions were divided into groups according to their type in order to perform odds ratio (OR) meta‐analyses with 95% confidence intervals (CI) using the Review Manager software program (Cochrane, London, UK). The level of certainty of evidence was demonstrated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results After 1,502 studies found, 10 studies were included for qualitative analysis and nine for quantitative synthesis. Four studies presented high methodological quality. Five meta‐analyses suggested a non‐association between bruxism and Angle class I (OR: 1.05, 95% CI: 0.41‐2.69; P = .92; I2 = 84%), Angle class II (OR: 1.49, 95% CI: 0.77‐2.87; P = .23; I2 = 71%) or Angle class III (OR: 0.77, 95% CI: 0.31‐1.93; P = .58; I2 = 0%). Bruxism was associated with children who did not present with a posterior crossbite (OR: 0.70, 95% CI: 0.51‐0.96; P = .03; I2 = 27%) and present crowding (OR: 1.53, 95% CI: 1.03‐2.26; P = .03; I2 = 0%). The GRADE analysis presented a very low quality of evidence. Conclusion Individuals who present with bruxism have a greater chance of crowding. However, bruxism is not associated with the presence of any of the other malocclusions evaluated.

Investigating the effect of bruxism on maxillary arch length and width in children using three-dimensional digital model analysis

“…The relationship between bruxism and occlusion has not been well understood although it has been investigated in dentistry [ 23 ]. Although some dentists have suggested that malocclusion may be the etiologic factor of bruxism, a recent review concluded that there is no evidence to support that belief [ 14 ]. However, bruxism may be a risk factor of malocclusion [ 7 , 9 , 13 , 14 ] because the wearing of dental tissues increases since bruxism generates higher forces due to the increased activity of the masticatory muscles, and the contacts between antagonist teeth get larger and flatter than they do in a normal occlusal relationship.…”

“…Although some dentists have suggested that malocclusion may be the etiologic factor of bruxism, a recent review concluded that there is no evidence to support that belief [ 14 ]. However, bruxism may be a risk factor of malocclusion [ 7 , 9 , 13 , 14 ] because the wearing of dental tissues increases since bruxism generates higher forces due to the increased activity of the masticatory muscles, and the contacts between antagonist teeth get larger and flatter than they do in a normal occlusal relationship. This situation allows the horizontal movement of the mandible against the maxilla, which increases stimulation of the alveolar bone [ 13 , 26 ].…”

“…Malocclusions have been evaluated in the etiology of bruxism, but few studies have evaluated bruxism’s connection to the etiology of malocclusions [ 7 , 9 , 14 ].…”

“…In addition, although the effect of bruxism on oral tissues has been investigated in various studies, no studies in the literature have investigated the effects of maxillary width and length on the basis of digital measurements [ 14 ]. For this reason, the present study aimed to investigate the effects of bruxism on maxillary arch length and width in children using three-dimensional (3D) imaging and digital measuring.…”

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

“…Another systematic review and meta-analysis set out to gather scientific evidence to support the relationship between dental malocclusion and bruxism. 411 The study was guided by the PECO strategy (P=general population; E=dental malocclusion; C=no dental malocclusion; O=bruxism). Literature searches were performed without language or date restrictions in the following databases: PubMed, Scopus, the Web of Science, the Cochrane Library, LILACS/BBO through VHL, and the gray literature.…”