Association of sleep bruxism with ceramic restoration failure: A systematic review and meta-analysis

Publication date: Available online 28 September 2017
Source:The Journal of Prosthetic Dentistry
Author(s): 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
Statement of problemCeramic 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?PurposeThe 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 methodsObservational 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.ResultsEight 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.ConclusionsWithin 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.



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