Comparison of various treatments for sleep bruxism using determinants of number needed to treat and effect size Huynh N T, Rompre P H, Montplaisir J Y, Manzini C, Okura K, Lavigne G J CRD summary This review concluded that although the mandibular advancement device and clonidine had shown the best results in sleep bruxism, both treatments were associated with side-effects. The authors considered the occlusal splint and clonazepam to be acceptable short-term alternatives, although they recommended further research. The reliability of the review is uncertain, owing to several methodological problems, but the authors’ recommendations for further research appear reasonable. Authors' objectives To compare the effectiveness of different treatments for sleep bruxism (SB) in order to determine best options for further research. Searching MEDLINE was searched and a recent review was also consulted, in addition to studies carried out at the Centre de Recherche du Sommeil, Hopital du Sacre Coeur, Montreal. Study selection Study designs of evaluations included in the review To be eligible, studies needed to be double-blind randomised controlled trials (RCTs). However, one single-blind RCT was included in the review. Case reports and open studies were excluded. Both parallel-group and crossover trials were included in the review. Specific interventions included in the review Eligible studies investigated drug treatments or oral devices compared with a placebo. The treatments used in the included studies comprised drugs (bromocriptine, L-dopa, propranolol, clonidine, clonazepam, tryptophan and amitriptyline) and oral devices (mandibular advancement device (MAD), occlusal splints and palatal splints). Treatment duration ranged from a single dose to 4 weeks. Participants included in the review No explicit inclusion criteria were stated. It appeared that studies of participants with SB were eligible for inclusion in the review. Outcomes assessed in the review To be eligible, studies needed to use electromyographic recordings. Some studies recorded the electromyographic signal together with polygraphic sleep recordings, whilst others used ambulatory devices. How were decisions on the relevance of primary studies made? The authors did not state how the studies were selected for the review, or how many reviewers performed the selection. Assessment of study quality The authors did not state how validity was assessed, or how many reviewers performed the assessment. Data extraction The authors did not state how many reviewers performed the data extraction. <<HOW WERE THE DATA EXTRACTED FROM PRIMARY STUDIES?>> Where possible, the number-needed-to-treat (NNT) or number-needed-to-harm was calculated for the included studies. The SB indices (SB episode/hour) were extracted. Effect sizes were calculated for all included studies, in terms of the ratio of the mean difference between treatment and placebo of the SB index relative to the standard deviation of that Database of Abstracts of Reviews of Effects (DARE) Produced by the Centre for Reviews and Dissemination Copyright © 2020 University of York Page: 1 / 3