title: Association between signs and symptoms of bruxism and presence of tori: a systematic review.
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?"
  
  
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bertazzo-Silveira
authors.affiliation: Bauru Orofacial Pain Group, Bauru, SP, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Stuginski-Barbosa
authors.affiliation: Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Campus Universitário-Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil. andreporporatti@yahoo.com.br.
authors.forename: André Luís
authors.initials: AL
authors.lastname: Porporatti
authors.affiliation: Departments of Anesthesiology and Pain Medicine, Psychiatry, and Pediatrics, Faculties of Medicine and Dentistry & Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
authors.forename: Bruce
authors.initials: B
authors.lastname: Dick
authors.affiliation: School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
authors.forename: Carlos
authors.initials: C
authors.lastname: Flores-Mir
authors.affiliation: School of Dentistry, University of Padova, Padua, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Manfredini
authors.affiliation: Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Campus Universitário-Trindade, Florianópolis, Santa Catarina, 88040-900, Brazil.|School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
authors.forename: Graziela
authors.initials: G
authors.lastname: De Luca Canto
mesh_terms: D002012:Bruxism / Q000150:complications*; D005096:Exostoses / Q000209:etiology*; D006801:Humans; D008336:Mandibular Diseases / Q000209:etiology*; D012307:Risk Factors
keywords: Bruxism; Systematic review; Teeth grinding; Tooth wear; Tori; Torus