Efficacy of biofeedback therapy on sleep bruxism: a systematic review and meta-analysis

Abstract

INTRODUCTION Sleep bruxism (SB) is a recurrent rhythmic activation of masticatory muscles, characterised by clenching and/or grinding of the teeth and/or by bracing or thrusting of the mandible during sleep. General treatment approaches include behavioural strategies, pharmacotherapy, and intraoral devices, however, the control of SB itself is exceedingly difficult and, unfortunately, none of the techniques can permanently ‘cure’ or ‘stop’ it. Biofeedback, i.e. one of the behavioural techniques, is the process of using one’s own biological signals to achieve a change in physiological functioning. A 2014 review performed on the topic by Wang et al. concluded that there is not enough evidence to support the use of biofeedback on SB treatment. Since that time, knowledge has likely been improved. AIM The aim of the present study was to update the review published by Wang et al. in 2014 by assessing the most recent literature and providing a comprehensive summary of the efficacy of any biofeedback treatment approach for the reduction or control of SB. METHODS An electronic search was conducted in five databases (MEDLINE (searched via PubMed), EMBASE (searched via ScienceDirect), System for Information on Grey Literature in Europe, The Cochrane Library (Cochrane Central Register of Controlled Trials) and LILACS) searching for papers published later than the date of Wang et al.’s search, viz., Oct 2012. The inclusion was restricted to clinical investigations on humans, assessing the efficacy of any biofeedback treatment approach for the reduction or control of SB in children and adults, as diagnosed with polysomnography with or without audio-video recordings, sleep-time electromyography recorded by portable devices, or with clinical/anamnestic criteria (The International Classification of Sleep Disorders – Third Edition (ICSD- 3). The keyword term ‘bruxism’ was used to start [...].