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Association between signs and symptoms of bruxism and presence of tori: a systematic review

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Abstract

Objective

This systematic review aims to answer the question: “Is there an association between any specific signs and symptoms of bruxism and the presence of tori?”

Material and methods

Observational studies, which evaluated the association between signs and symptoms of bruxism and tori, were selected. Signs and symptoms of bruxism (such as teeth grinding, jaw clenching, abnormal tooth wear, facial muscle hypertrophy, pain, or fatigue) had to be determined by questionnaire or anamnesis and tori within clinical assessment. Search-strategies were developed for five databases, in addition to three gray literature’s databases. The risk of bias was evaluated using the “Meta-Analysis of Statistics Assessment and Review Instrument”. A summary of overall strength of evidence was estimated using GRADE’s Summary of findings table.

Results

Among 575 studies, five were included. Two studies were categorized as moderate risk of bias and three as high risk of bias. Self-report of teeth grinding and/or clenching presented contradictory results. Presence of abnormal tooth wear increased the odds of having tori, mainly for torus mandibularis. The overall quality of evidence ranged from low to very low.

Conclusion

Based on available evidence, the presence of abnormal tooth wear might be associated with tori, mainly torus mandibularis. There is no sufficient evidence to credit or discredit the association of tori and other signs and/or symptoms of bruxism.

Clinical relevance

Bruxism diagnosis is a challenge. The association between signs and symptoms of bruxism and tori could help clinicians on the recognition of patients susceptible to bruxism. This knowledge might also aid to the understanding of tori’s development and stimulate new relevant research.

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References

  1. Hrdlicka A (1940) Mandibular and maxillary hyperostoses. Am J Phys Anthropol 27:1–50. doi:10.1002/ajpa.1330270127

    Article  Google Scholar 

  2. Kolas S, Halperin V, Jefferis K, Huddleston S, Robinson HB (1953) The occurrence of torus palatinus and torus mandibularis in 2,478 dental patients. Oral surgery, oral medicine, and oral pathology 6:1134–1141

    Article  PubMed  Google Scholar 

  3. Garcia-Garcia AS, Martinez-Gonzalez JM, Gomez-Font R, Soto-Rivadeneira A, Oviedo-Roldan L (2010) Current status of the torus palatinus and torus mandibularis. Medicina oral, patologia oral y cirugia bucal 15(2):e353–e360

    Article  PubMed  Google Scholar 

  4. Eggen S, Natvig B (1991) Variation in torus mandibularis prevalence in Norway. A statistical analysis using logistic regression. Community Dent Oral Epidemiol 19(1):32–35

    Article  PubMed  Google Scholar 

  5. Bernaba JM (1977) Morphology and incidence of torus palantinus and mandibularis in Brazilian Indians. J Dent Res 56:499–501

    Article  PubMed  Google Scholar 

  6. Kerdpon D, Sirirungrojying S (1999) A clinical study of oral tori in southern Thailand: prevalence and the relation to parafunctional activity. Eur J Oral Sci 107(1):9–13

    Article  PubMed  Google Scholar 

  7. Dosumu O, Arotiba J, Oguniyinka A (1998) The prevalence of palatine and mandibular tori in Nigerian population. Tropical Dental Journal 7:6–8

    Google Scholar 

  8. Jainkittivong A, Apinhasmit W, Swasdison S (2007) Prevalence and clinical characteristics of oral tori in 1,520 Chulalongkorn University dental school patients. Surg Radiol Anat 29:125–131. doi:10.1007/s00276-007-0184-6

    Article  PubMed  Google Scholar 

  9. Igarashi Y, Ohzeki S, Uesu K, Nakabayashi T, Kanazawa E (2008) Frequency of mandibular tori in the present-day Japanese. Anthropol Sci 116(1):17–32

    Article  Google Scholar 

  10. Bukhari SGA, Qazi SS, Awan TM Prevalence of torus palatinus among 300 Indonesian patients. Pakistan Oral y Dental Journal 27:89–92

  11. Furtado ACN, Leite AKDM, Albuquerque RAD, Sobral APV (2008) Correlação entre a presença de exostoses e disfunção temporomandibular. Revista Brasileira em Promoção da Saúde 21:174–179. doi:10.5020/18061230.2008.p174

    Article  Google Scholar 

  12. De Luca Canto G, Torres de Freitas S, Schuldt Filho G, de Sousa Vieira R (2012) Association between mandibular torus and parafunctional activity. International Journal of Stomatology & Occlusion Medicine 6:43–49. doi:10.1007/s12548-012-0064-5

    Article  Google Scholar 

  13. Auskalnis A, Rutkunas V, Bernhardt O, Sidlauskas M, Salomskiene L, Baseviciene N (2015) Multifactorial etiology of torus mandibularis: study of twins. Stomatologija/issued by public institution "Odontologijos studija" [et al.] 17(2):35–40

    Google Scholar 

  14. Khaled Y, Flores C, Forst D (2016) Mandibular Tori and Sleep bruxism: is there a relationship? A Systematic Review EC Dental Science:733–741

  15. Pechenkina EA, Benfer RA Jr (2002) The role of occlusal stress and gingival infection in the formation of exostoses on mandible and maxilla from Neolithic China. Homo 53(2):112–130

    Article  PubMed  Google Scholar 

  16. Frost HM (1994) Wolff's law and bone's structural adaptations to mechanical usage: an overview for clinicians. The Angle orthodontist 64(3):175–188. doi:10.1043/0003-3219(1994)064<0175:wlabsa>2.0.co;2

    PubMed  Google Scholar 

  17. Singh GD (2010) On the etiology and significance of palatal and mandibular tori. Cranio 28(4):213–215. doi:10.1179/crn.2010.030

    Article  PubMed  Google Scholar 

  18. Kato T, Yamaguchi T, Okura K, Abe S, Lavigne GJ (2013) Sleep less and bite more: sleep disorders associated with occlusal loads during sleep. Journal of Prosthodontic Research 57:69–81. doi:10.1016/j.jpor.2013.03.001

    Article  PubMed  Google Scholar 

  19. Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ, de Leeuw R, Manfredini D, Svensson P, Winocur E (2013) Bruxism defined and graded: an international consensus. J Oral Rehabil 40:2–4. doi:10.1111/joor.12011

    Article  PubMed  Google Scholar 

  20. Lavigne GJ, Khoury S, Abe S, Yamaguchi T, Raphael K (2008) Bruxism physiology and pathology: an overview for clinicians. J Oral Rehabil 35(7):476–494. doi:10.1111/j.1365-2842.2008.01881.x

    Article  PubMed  Google Scholar 

  21. Hulterstrom AK, Bergman M (1993) Polishing systems for dental ceramics. Acta Odontol Scand 51:229–234

    Article  PubMed  Google Scholar 

  22. Choi AH, Matinlinna J, Ben-Nissan B (2013) Effects of micromovement on the changes in stress distribution of partially stabilized zirconia (PS-ZrO2) dental implants and bridge during clenching: a three-dimensional finite element analysis. Acta Odontol Scand 71:72–81. doi:10.3109/00016357.2011.654242

    Article  PubMed  Google Scholar 

  23. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–34. doi:10.1016/j.jclinepi.2009.06.006

    Article  PubMed  Google Scholar 

  24. Booth A, Clarke M, Ghersi D, Moher D, Petticrew M, Stewart L (2011) An international registry of systematic-review protocols. Lancet 377:108–109. doi:10.1016/S0140-6736(10)60903-8

    Article  PubMed  Google Scholar 

  25. Bertazzo-Silveira E, Stuginski-Barbosa J, Porporatti A, Dick B, Flores-Mir C, Manfredini D, De Luca Canto G (2016) Signs and symptoms of bruxism and presence of torus: a systematic review. PROSPERO 2016:CRD42016042073 Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016042073

  26. Institute TJB (2014) Joanna Briggs Institute Reviewers’ Manual: 2014 edition. The Joanna Briggs Institute 197

  27. The Nordic Cochrane Centre TCC (Denmark: 2014) RevMan, [Computer program]. Version 5.3[DB/CD]. Copenhagen

  28. Effective Practice and Organisation of Care (EPOC) (2013) Available at: http://epoc.cochrane.org/epoc-specific-resources-review-authors Synthesising results when it does not make sense to do a meta-analysis. EPOC resources for review authors. Norwegian Knowledge Centre for the Health Services, Oslo

    Google Scholar 

  29. Manheimer E (2012) Summary of findings tables: presenting the main findings of Cochrane complementary and alternative medicine-related reviews in a transparent and simple tabular format. Global advances in health and medicine: improving healthcare outcomes worldwide 1(1):90–91. doi:10.7453/gahmj.2012.1.1.015

    Article  Google Scholar 

  30. Yoshinaka M, Ikebe K, Furuya-Yoshinaka M, Hazeyama T, Maeda Y (2010) Prevalence of torus palatinus among a group of Japanese elderly. J Oral Rehabil 37(11):848–853. doi:10.1111/j.1365-2842.2010.02100.x

    Article  PubMed  Google Scholar 

  31. Sawair FA, Shayyab MH, Al-Rababah MA, Saku T (2009) Prevalence and clinical characteristics of tori and jaw exostoses in a teaching hospital in Jordan. Saudi Med J 30(12):1557–1562

    PubMed  Google Scholar 

  32. Morrison MD, Tamimi F (2013) Oral tori are associated with local mechanical and systemic factors: a case-control study. J Oral Maxillofac Surg 71(1):14–22. doi:10.1016/j.joms.2012.08.005

    Article  PubMed  Google Scholar 

  33. CANTO GDL Associação entre tórus mandibular e presença de bruxismo: estudo de caso-controle. 2010. 101 f. Tese (Doutorado em Odontologia–Área de Concentração Odontopediatria) – Programa de Pós-Graduação em Odontologia, Universidade Federal de Santa Catarina, Florianópolis

  34. Morgenthaler TI, Deriy L, Heald JL, Thomas SM (2016) The evolution of the AASM clinical practice guidelines: another step forward. J Clin Sleep Med 12:129–135. doi:10.5664/jcsm.5412

    Article  PubMed  PubMed Central  Google Scholar 

  35. Raphael KG, Santiago V, Lobbezoo F (2016) Is bruxism a disorder or a behaviour? Rethinking the international consensus on defining and grading of bruxism J Oral Rehabil. doi:10.1111/joor.12413

    PubMed  Google Scholar 

  36. Manfredini D, De Laat A, Winocur E, Ahlberg J (2016) Why not stop looking at bruxism as a black/white condition? Aetiology could be unrelated to clinical consequences. J Oral Rehabil 10–12. doi:10.1111/joor.12426

  37. IGARASHI Y, OHZEKI S, UESU K, NAKABAYASHI T, KANAZAWA E (2008) Frequency of mandibular tori in the present-day Japanese. Anthropol Sci 116:17–32. doi:10.1537/ase.050613

    Article  Google Scholar 

  38. Jeong CW (2014) The relationship between oral tori and bite forces. Journal of Oral and Maxillofacial Surgery Conference: 96th Annual Meeting Scientific Sessions and Exhibition of the American Association of Oral and Maxillofacial Surgeons, AAOMS 72 (9 SUPPL. 1). doi:10.1016/j.joms.2014.06.360

  39. Berna L, Dds Ç, Güngör M, Dds H, Dds ÖK (2005) Is there an association between torus mandibularis and bite force? Hacettepe Faculty of Dentistry Journal:Cilt: 29, Sayı: 24. Sayfa:15–17

  40. Mendes da Silva J, Pérola dos Anjos Braga Pires C, Angélica Mendes Rodrigues L, Palinkas M, de Luca Canto G, Batista de Vasconcelos P, Valéria Rancan S, Semprini M, Siéssere S, Regalo SCH (2016) Influence of mandibular tori on stomatognathic system function. Cranio® 1–8. doi:10.1080/08869634.2015.1122417

  41. Eggen S (1988) Torus mandibularis and muscular hyperactivity. [Norwegian]. Den Norske tannlaegeforenings tidende 98(6):220–226

    PubMed  Google Scholar 

  42. Lobbezoo F, Naeije M (2001) A reliability study of clinical tooth wear measurements. J Prosthet Dent 86(6):597–602. doi:10.1067/mpr.2001.118892

    Article  PubMed  Google Scholar 

  43. Carlsson GE, Egermark I, Magnusson T (2003) Predictors of bruxism, other oral parafunctions, and tooth wear over a 20-year follow-up period. J Orofac Pain 17(1):50–57

    PubMed  Google Scholar 

  44. Koyano K, Tsukiyama Y, Ichiki R, Kuwata T (2008) Assessment of bruxism in the clinic. J Oral Rehabil 35:495–508. doi:10.1111/j.1365-2842.2008.01880.x

    Article  PubMed  Google Scholar 

  45. Stuginski-Barbosa J, Porporatti AL, Costa YM, Svensson P, Conti PC (2016) Agreement of the international classification of sleep disorders criteria with polysomnography for sleep bruxism diagnosis: a preliminary study. J Prosthet Dent. doi:10.1016/j.prosdent.2016.01.035

    PubMed  Google Scholar 

  46. Palinkas M, Bataglion C, de Luca Canto G, Machado Camolezi N, Theodoro GT, Siéssere S, Semprini M, Regalo SCH (2016) Impact of sleep bruxism on masseter and temporalis muscles and bite force. Cranio® 1–7. doi:10.1080/08869634.2015.1106811

  47. Karakis D, Dogan A (2015) The craniofacial morphology and maximum bite force in sleep bruxism patients with signs and symptoms of temporomandibular disorders. Cranio 33(1):32–37. doi:10.1179/2151090314y.0000000009

    Article  PubMed  Google Scholar 

  48. Abe S, Yamaguchi T, Rompre PH, De Grandmont P, Chen YJ, Lavigne GJ (2009) Tooth wear in young subjects: a discriminator between sleep bruxers and controls? Int J Prosthodont 22(4):342–350

    PubMed  Google Scholar 

  49. Carra MC, Huynh N, Lavigne G (2012) Sleep bruxism: a comprehensive overview for the dental clinician interested in sleep medicine. Dent Clin N Am 56:387–413. doi:10.1016/j.cden.2012.01.003

    Article  PubMed  Google Scholar 

  50. Wetselaar P, Lobbezoo F (2016) The tooth wear evaluation system: a modular clinical guideline for the diagnosis and management planning of worn dentitions. J Oral Rehabil 43(1):69–80. doi:10.1111/joor.12340

    Article  PubMed  Google Scholar 

  51. Cortes AR, Jin Z, Morrison MD, Arita ES, Song J, Tamimi F (2014) Mandibular tori are associated with mechanical stress and mandibular shape. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 72(11):2115–2125. doi:10.1016/j.joms.2014.05.024

    Article  Google Scholar 

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Acknowledgements

The review authors would like to thank Wesam Ashour, who has contributed, throughout the article, with an attentive revision of the language syntax and grammar. Also, the first review author would like to thank CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), which provided him a scholarship to conduct this study.

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Authors and Affiliations

  1. Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil

    Eduardo Bertazzo-Silveira

  2. Bauru Orofacial Pain Group, Bauru, SP, Brazil

    Juliana Stuginski-Barbosa

  3. Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Campus Universitário-Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil

    André Luís Porporatti & Graziela De Luca Canto

  4. Departments of Anesthesiology and Pain Medicine, Psychiatry, and Pediatrics, Faculties of Medicine and Dentistry & Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada

    Bruce Dick

  5. School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

    Carlos Flores-Mir & Graziela De Luca Canto

  6. School of Dentistry, University of Padova, Padua, Italy

    Daniele Manfredini

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  1. Eduardo Bertazzo-Silveira
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  2. Juliana Stuginski-Barbosa
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  3. André Luís Porporatti
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  4. Bruce Dick
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  5. Carlos Flores-Mir
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  6. Daniele Manfredini
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  7. Graziela De Luca Canto
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Correspondence to André Luís Porporatti.

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Bertazzo-Silveira, E., Stuginski-Barbosa, J., Porporatti, A.L. et al. Association between signs and symptoms of bruxism and presence of tori: a systematic review. Clin Oral Invest 21, 2789–2799 (2017). https://doi.org/10.1007/s00784-017-2081-7

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  • DOI: https://doi.org/10.1007/s00784-017-2081-7

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