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Association of sleep bruxism with ceramic restoration failure: A systematic review and meta-analysis
Authors:Gilberto de Souza Melo  Elis Ângela Batistella  Eduardo Bertazzo-Silveira  Thais Marques Simek Vega Gonçalves  Beatriz Dulcineia Mendes de Souza  André Luís Porporatti  Carlos Flores-Mir  Graziela De Luca Canto
Affiliation:1. Postgraduate student, Oral Diagnostic at the Department of Dentistry Federal University of Santa Catarina, Florianópolis, SC, Brazil;2. Postgraduate student, Oral Diagnostic at the Department of Dentistry Federal University of Santa Catarina, Florianópolis, SC, Brazil;3. Postgraduate student, Oral Diagnostic at the Department of Dentistry Federal University of Santa Catarina, Florianópolis, SC, Brazil;4. Adjunct Professor, Department of Dentistry Federal University of Santa Catarina, Florianopolis, SC, Brazil;5. Adjunct Professor, Department of Dentistry Federal University of Santa Catarina, Florianopolis, SC, Brazil;6. Adjunct Professor, Brazilian Centre for Evidence-Based Research, Department of Dentistry Federal University of Santa Catarina, Florianopolis, SC, Brazil;g. Professor and Division Head, Orthodontics at the School of Dentistry Faculty of Medicine and Dentistry University of Alberta, Edmonton, AB, Canada;h. Associate Professor, Brazilian Centre for Evidence-Based Research, Department of Dentistry Federal University of Santa Catarina, Florianopolis, SC, Brazil, and Adjunct Assistant Professor, School of Dentistry Faculty of Medicine and Dentistry University of Alberta, Edmonton, AB, Canada
Abstract:

Statement of problem

Ceramic restorations are popular because of their excellent optical properties. However, failures are still a major concern, and dentists are confronted with the following question: is sleep bruxism (SB) associated with an increased frequency of ceramic restoration failures?

Purpose

The purpose of this systematic review and meta-analysis was to assess whether the presence of SB is associated with increased ceramic restoration failure.

Material and methods

Observational studies and clinical trials that evaluated the short- and long-term survival rate of ceramic restorations in SB participants were selected. Sleep bruxism diagnostic criteria must have included at least 1 of the following: questionnaire, clinical evaluation, or polysomnography. Seven databases, in addition to 3 nonpeer-reviewed literature databases, were searched. The risk of bias was assessed by using the meta-analysis of statistics assessment and review instrument (MAStARI) checklist.

Results

Eight studies were included for qualitative synthesis, but only 5 for the meta-analysis. Three studies were categorized as moderate risk and 5 as high risk of bias. Clinical and methodological heterogeneity across studies were considered high. Increased hazard ratio (HR=7.74; 95% confidence interval [CI]=2.50 to 23.95) and odds ratio (OR=2.52; 95% CI=1.24 to 5.12) were observed considering only anterior ceramic veneers. Nevertheless, limited data from the meta-analysis and from the restricted number of included studies suggested that differences in the overall odds of failure concerning SB and other types of ceramic restorations did not favor or disfavor any association (OR=1.10; 95% CI=0.43 to 2.8). The overall quality of evidence was considered very low according to the GRADE criteria.

Conclusions

Within the limitations of this systematic review, the overall result from the meta-analysis did not favor any association between SB and increased odds of failure for ceramic restorations.
Keywords:Corresponding author: Dr Gilberto de Souza Melo   Federal University of Santa Catarina   Health Sciences Center   Department of Dentistry   University Campus   Mailbox 476 - Trindade   Florianópolis   SC 88040900   BRAZIL
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