Etiología, diagnóstico y manejo de bruxismo de sueño

Sleep bruxism is a behaviour to which a variety of explanations, symptoms and therapies are linked. The aim of this review is to provide an updated view of the pathophysiology, diagnosis and treatment of sleep bruxism that will contribute to the general clinical approach. Sleep bruxism aetiology, among other things, has been connected to complex multisystemic physiological processes and associated with hypotheses of central dysregulation of motor and neuro-masticatory systems. These motor characteristics are shared with other pathologies and conditions, and in this way, it is related to activities that could favour mandibular muscle activity. Clinical history and examination contribute to the diagnosis, whereas a sleep lab test, with mandibular muscle electromyography and audiovisual recording, provides the definitive diagnosis. Given the different possibilities for assessing sleep bruxism, the level of diagnosis reached is classified under a suggested score, taking care to adjust each case according to general health needs. Despite the amount of literature on the subject, it is difficult to interpret the available scientific evidence and subsequent therapeutic selection due to the lack of clarity in sleep bruxism evaluation. Hence, clinicians must choose amongst the various suggested therapies with discretion and are encouraged to acquire the necessary knowledge to evaluate and identify other coexistences related to sleep bruxism. Future research in diagnosis and treatment that complies with due methodological soundness is undoubtedly needed.