Botulinum Toxin for Bruxism: An Overview

Area of Science:

• Neurology
• Dentistry
• Pharmacology

Background:

• Bruxism, characterized by involuntary teeth grinding and clenching, significantly impacts patient quality of life.
• Botulinum toxin type A (BoNT-A) is explored as a therapeutic option for managing bruxism symptoms.

Purpose of the Study:

• To assess the effectiveness of botulinum toxin type A (BoNT-A) for bruxism management.
• To compare BoNT-A against placebo, no treatment, or other interventions using systematic reviews.

Main Methods:

• A comprehensive literature search was performed across seven databases and grey literature.
• Fourteen systematic reviews (SRs), with or without meta-analysis, were included after a two-phase selection process.
• Methodological quality of SRs was assessed using AMSTAR-2, and overlap was evaluated using corrected covered area.

Main Results:

• BoNT-A demonstrated effectiveness in reducing pain (10 SRs), bruxism event frequency (7 SRs), and maximum bite force (5 SRs).
• No SRs adequately evaluated BoNT-A's impact on functional movements.
• All included SRs exhibited critically low or low confidence scores via AMSTAR-2, with high overlap (10.11% corrected covered area).

Conclusions:

• Current systematic reviews on BoNT-A for bruxism suffer from significant methodological limitations, impacting the reliability of findings.
• While preliminary evidence suggests potential benefits in pain and event reduction, definitive conclusions are precluded by study quality.
• High-quality research employing standardized methodologies is imperative to establish BoNT-A efficacy for bruxism and guide clinical practice.