Clear Aligners and Bruxism: A Systematic Review - PubMed

5 hours ago

Bruxism is a masticatory muscle activity occurring during sleep (SB) or wakefulness (AB), not classified as a movement or sleep disorder.
Clear aligner therapy modifies occlusal contacts and mandibular dynamics, potentially influencing bruxism behaviors.
Systematic review aimed to assess if clear aligners are neutral, protective, or a risk factor for bruxism.
Eleven studies involving 818 patients (72.8% female) were analyzed, with most suggesting a neutral effect of clear aligners on bruxism.
For SB, aligners reduced tonic contractions but had inconsistent effects on phasic activity and no change in overall SB index.
AB was generally unaffected, though one study noted reduced self-reported parafunctions with altered muscle recruitment.
Mixed/self-reported bruxism outcomes were conflicting, with some studies showing symptom improvement and others reporting increased prevalence during aligner therapy.
Methodological heterogeneity and risk of bias were notable, preventing meta-analysis.
GRADE certainty was moderate for randomized studies and very low for non-randomized studies.
Current evidence is limited and heterogeneous, with aligners not yet classified as protective or harmful for bruxism.

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