title: Therapies for bruxism: a systematic review and network meta-analysis (protocol).
abstract: Bruxism is a sleep disorder characterized by grinding and clenching of the teeth that may be related to irreversible tooth injuries. It is a prevalent condition occurring in up to 31% of adults. However, there is no definitive answer as to which of the many currently available treatments (including drug therapy, intramuscular injections, physiotherapy, biofeedback, kinesiotherapy, use of intraoral devices, or psychological therapy) is the best for the clinical management of the different manifestations of bruxism. The aim of this systematic review and network meta-analysis is to answer the following question: what is the best treatment for adult bruxists?
  
  
  
  Comprehensive searches of the Cochrane Library, MEDLINE (via PubMed), Scopus, and LILACS will be completed using the following keywords: bruxism and therapies and related entry terms. Studies will be included, according to the eligibility criteria (Controlled Clinical Trials and Randomized Clinical Trials, considering specific outcome measures for bruxism). The reference lists of included studies will be hand searched. Relevant data will be extracted from included studies using a specially designed data extraction sheet. Risk of bias of the included studies will be assessed, and the overall strength of the evidence will be summarized (i.e., GRADE). A random effects model will be used for all pairwise meta-analyses (with a 95% confidence interval). A Bayesian network meta-analysis will explore the relative benefits between the various treatments. The review will be reported using the Preferred Reporting Items for Systematic Reviews incorporating Network Meta-Analyses (PRISMA-NMA) statement.
  
  
  
  This systematic review aims at identifying and evaluating therapies to treat bruxism. This systematic review may lead to several recommendations, for both patients and researchers, as which is the best therapy for a specific patient case and how future studies need to be designed, considering what is available now and what is the reality of the patient.
  
  
  
  PROSPERO CRD42015023308.
authors.affiliation: Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, Brazil.
authors.forename: Mauro Elias
authors.initials: ME
authors.lastname: Mesko
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa, ON, K1H8L6, Canada.|School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Hutton
authors.affiliation: School of Dentistry, Franciscan University Center, Rua Silva Jardim, 1175, 6th floor, Santa Maria, RS, 97010-491, Brazil.
authors.forename: Jovito Adiel
authors.initials: JA
authors.lastname: Skupien
authors.affiliation: Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Sarkis-Onofre
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Rd, Ottawa, ON, K1H8L6, Canada.|School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Moher
authors.affiliation: Graduate Program in Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, 5th floor, Pelotas, RS, Brazil. tatiana.cenci@ufpel.tche.br.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Pereira-Cenci
mesh_terms: D001676:Biofeedback, Psychology / Q000379:methods; D015928:Cognitive Behavioral Therapy; D004558:Electric Stimulation / Q000379:methods; D006801:Humans; D019186:Mandibular Advancement / Q000379:methods; D026741:Physical Therapy Modalities; D012064:Relaxation Therapy / Q000379:methods; D020186:Sleep Bruxism / Q000188:drug therapy / Q000628:therapy*; D000078202:Systematic Reviews as Topic; D000071076:Network Meta-Analysis as Topic
keywords: Bruxism therapy; Evidence-based dentistry; Sleep bruxism