Global trends and future perspectives in Bruxism Research - A Scientometric evaluation

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It has its complexity and multifactorial aetiology. However, knowledge and currents research trends in the field of bruxism have expanded extensively. Objective The aim of this scientometric evaluation was to evaluate the present status in bruxism research and identify potential future research directions and policy decisions. Methods Scopus database was searched with help of keywords. The search records were filtered based on relevance to bruxism and exported. The bibliometric analysis was performed using bibliometrix package in RStudio and VOSviewer™. Results Search yielded 1044 documents relevant to bruxism spanning from 1961 to 2025. Bruxism related research was first started in 1961. However, it expanded exponentially after 2003. Over these 64 years, Brazil, United States, Italy and Sweden were leading countries researching on bruxism scope. Frank Lobbezoo was a significant contributor, with the highest strength on almost all cluster analysis. The leading countries were USA (n = 2430) and Brazil (n = 1950). The Journal of Oral and Facial Pain and Headache (n = 32), The Journal Prosthetic Dentistry (n = 31), and Acta Odontologica Scandinavica (n = 30) are main sources of bruxism literature. Remarkably, there is a noticeable research trends in direction of epidemiology, tools of diagnosis, treatment and consequences of bruxism. Conclusion Our scientometric evaluation clearly highlighted the rise of interest in bruxism research mostly due to its impact on health. Our findings clearly supports multidisciplinary approach to treat as well provides an insight on preventive measures and policy decisions for bruxism among clinician and researchers. Dentistry Bruxism Bibliometric analyses Cluster Analysis Sleep Bruxism Behavior Scientometric evaluation Figures Figure 1 Figure 2 INTRODUCTION The concept of bruxism has evolved over the years since its introduction in stomatology. Currently, the world is experiencing a shift in the understanding of bruxism and its components. It is no longer considered as a parafunctional activity [ 1 ] but rather, involves non-physiological mandibular movements, such as dental contact, teeth grinding, or other oral behaviours [ 2 ]. Sleep bruxism (SB) refers to masticatory muscle activity during sleep, which can be classified as either rhythmic (phasic) or non-rhythmic (tonic), based on the circadian cycle [ 3 ]. On the other hand, awake bruxism (AB) involves masticatory muscle activity while awake, characterized by repetitive or sustained contact between the teeth and/or tension in the masticatory muscles, either in a fixed position or during mandibular movements without dental contact [ 4 ]. The prevalence of both types of bruxism, SB and AB, varies across different age groups. For example, SB in children and adolescents ranges from 3.5% to 49.6%, whereas in adults it ranges from 1.1% to 15.5%. AB occurs in nearly 25% of the world's population, though statistics may vary across different demographic areas [ 5 ]. Over the years, there have been significant advancements in understanding the aetiology, prevalence, and clinical implications of bruxism. However, the complexity and variability in its presentation, along with the diverse assessment methods used to diagnose and manage the condition, have contributed to ongoing debates in the field [ 6 ]. The last few decades have seen major shifts in the conceptualization of bruxism, especially following the 2013 and 2018 consensus meetings, which provided new insights into its classification and diagnostic criteria. Despite this progress, significant gaps remain in the understanding of its underlying mechanisms, risk factors, and effective management strategies. The wide range of detection techniques, behavioural factors, and comorbid conditions associated with bruxism further complicates the comprehensive understanding of the disorder. Overall, the global body of research on bruxism remains fragmented, with varying methodological approaches and inconsistent reporting of findings [ 7 ]. Bibliometric analysis has emerged as an invaluable tool in navigating this complexity, offering a quantitative approach to assessing publication trends, citation patterns, author collaboration networks, geographic distribution of research contributions, funding sources and research focuses in bruxism. By systematically reviewing the literature, bibliometric analyses can provide critical insights into the evolution of bruxism research, identify key areas of interest, and highlight research gaps that require further exploration. Hence this bibliometric analysis aims to examine the trends and patterns in the scientific literature on bruxism. By doing so, the analysis highlights key papers, authors, institutions, and regions contributing to the field of bruxism research. METHODS Data Source and Search strategy The report of this bibliometric review followed the guidelines for reporting bibliometric reviews of the Biomedical Literature (BIBLIO) [ 3 ]. The checklist is presented in Supplemental File 1 . An electronic search was conducted from 1961 until January 16th 2025 in Scopus database. For the selection of studies, a search strategy was developed using a combination of keywords and Boolean operators. The search formula was: TITLE-ABS-KEY (bruxism OR "sleep bruxism") AND TITLE-ABS-KEY (teeth OR tooth OR jaw OR head OR face OR mandible OR maxilla OR masseter OR "facial muscle") AND TITLE-ABS-KEY (pain OR tenderness OR spasm) AND (LIMIT-TO (SRCTYPE, "j")) AND (LIMIT-TO (DOCTYPE, "ar")) AND (EXCLUDE (SUBJAREA, "ECON") OR EXCLUDE (SUBJAREA, "DECI") OR EXCLUDE (SUBJAREA, "BUSI") OR EXCLUDE (SUBJAREA, "ENER") OR EXCLUDE (SUBJAREA, "EART") OR EXCLUDE (SUBJAREA, "CHEM") OR EXCLUDE (SUBJAREA, "Undefined") OR EXCLUDE (SUBJAREA, "MATH") OR EXCLUDE (SUBJAREA, "NURS") OR EXCLUDE (SUBJAREA, "ARTS") OR EXCLUDE (SUBJAREA, "PHYS") OR EXCLUDE (SUBJAREA, "ENVI") OR EXCLUDE (SUBJAREA, "VETE") OR EXCLUDE (SUBJAREA, "SOCI") OR EXCLUDE (SUBJAREA, "COMP") OR EXCLUDE (SUBJAREA, "AGRI") OR EXCLUDE (SUBJAREA, "CENG") OR EXCLUDE (SUBJAREA, "IMMU") OR EXCLUDE (SUBJAREA, "MULT") OR EXCLUDE (SUBJAREA, "MATE") OR EXCLUDE (SUBJAREA, "HEAL")). Since all papers categorized as "article" were included in the bibliometric analysis, no additional screening for document type was necessary. The inclusion criteria were literature categorized as “articles” in Scopus database, and language English. The exclusion criteria were the review papers, including systematic reviews and meta-analysis, conference papers, meeting abstracts, letters, opinion papers, editorial materials and non-English articles. Bibliometric analysis and visualization A comma-separated file (CSV) file containing citation and bibliographic information, abstracts, and keywords was generated. Bibliometrix™ is an open-source package in R™ software, specifically tailored for conducting a wide range of quantitative analyses, particularly emphasizing the visual representation of data [ 8 – 10 ]. This was used to facilitate the creation of various types of maps and graphs, enabling a clearer understanding of relationships and trends within the data. The VOSviewer™ software (version 1.6.18) [ 11 ] was utilized to create a graphical representation of bibliometric networks, highlighting connections between authors, countries, citations, publication year and keywords. The collaboration network and main author groups (with four or more occurrences) were visualized, where the author names associated with the largest circles correspond to the highest number of publications. Authors represented by circles of the same colour belong to the same group, while lines connecting the circles signify collaboration between authors or groups. Thicker lines indicate stronger collaboration. A similar collaboration network was visualized for countries with a minimum of 5 documents. Other networks include the most author keywords, and a keyword network map was generated to highlight the most frequent author keywords (with five or more occurrences) and their collaborative relationships. The bibliographic coupling of documents with a minimum of one citation was also visualized based on the year of publication, where larger circles indicate more citations. RESULTS Search Results The Scopus database search retrieved 1493 documents. Review (n = 222), Letter (n = 40), Conference paper (n = 26), Note(n = 14), Short survey (n = 11), Editorial (n = 10), Retracted (n = 1), Erratum(n = 1), Book/Book chapter (n = 19) and Undefined (n = 1) were excluded using filter option in databases. After filtering the results, 1044 documents were selected for bibliometric analysis (Fig. 1 ). The overall characteristics of the included studies is presented in Table 1. Publication trend and output Bruxism publications have steadily increased from 1961 to 2025, with a notable rise beginning in the late 2000s. The highest output occurred in 2024, with 65 articles published. The overall trend demonstrates sustained growth and increased interest in bruxism research over the decades (Fig. 2 ). Countries citation The USA and Brazil stand out significantly as leaders in citations. The United States also had the highest number of citations (n = 2430), significantly surpassing Brazil (n = 1950) and Italy (n = 1505). Sweden was almost equivalent to Italy (n = 1501), the remaining countries (Canada, Japan, Netherlands, Denmark, Turkey and Germany) show a much lower number of citations (n = 4040) (Fig. 3 ). Countries Scientific Production The country scientific production, as shown on the Fig. 4 , is bounded by the darker blue, which represents higher scientific production, the lighter blue indicates moderate and colour grey, countries with little to no reported scientific production. The leadership is centred in the Americas, with Brazil being the most significant output, followed by the USA and Canada. Some others countries on Europe, Africa and Asia showed moderate to simple or none collaboration in the field. Country Collaboration In the cluster results of VOSviewer™, the node (circle) represents a country and size of node indicates the volume of scientific production, i.e., the larger the node, the more significant the country's contribution to research. The colours categorize countries based on regions or specific research networks. The green represents countries with a strong connection or collaboration, the red indicates high output and strong influence, the blue and other colours are lower level of collaboration. The lines connecting the nodes (countries) depict collaboration or citation relationships, thicker lines suggest a stronger partnership or more frequent interactions between the countries. The USA marked as one of the largest nodes, reflecting its prominence in global scientific output. Its connections span numerous other countries, showcasing a wide range of collaboration. Italy and Brazil are also large, indicating significant contributions to scientific production in bruxism. They have a vast number of connections with other countries, highlighting their importance in global research networks. Following, Denmark and Japan, with sizeable nodes, also, Netherlands, Germany, and Turkey have their nodes lie within close proximity to each other, indicating strong collaborative networks among these nations (Fig. 5 ). Institutions A clear hierarchy in scientific production among the listed academic affiliations is presented on the Fig. 6 , with a sharp drop in output from the top institutions to those at the bottom. The data reflects at the top a more robust research programs on bruxism. Those institutions with higher article counts are leaded by the University of Amsterdam and Vrije Universiteit Amsterdam, with 79 articles, marking it as the most productive affiliation in the dataset. The second place is occupied by Tel Aviv University (n = 58), the University of São Paulo shows a strong contribution (n = 52), ranking the third. Followed by the Wroclaw Medical University (n = 46), the Aarhus University (n = 37), the Université de Montréal (n = 33), the Showa University (n = 29), the Saveetha University (n = 26), the Malmo University (n = 23) and finally, by the Universidade Federal de Minas Gerais with 20 articles. Sources As demonstrated on Fig. 7 , between 1961 and 2025, the Journal of Oral Rehabilitation (JOR) (n = 115), Journal of Oral and Facial Pain and Headache (JOFPH) (n = 32), The Journal Prosthetic Dentistry (JPD)(n = 31), and Acta Odontologica Scandinavica (AOS) (n = 30) collectively published over 208 manuscripts on bruxism, being the most relevant sources on this field. The impact factor of the sources with maximum publications on bruxism is presented in Table 2. Furthermore, was found that from 1993 to 1997, the number of publications on bruxism in AOS ceased to be the pioneer in publications due to JOR increased significantly their publications to the point to be more than 72% lower number of documents nowadays. Researchers Within the researchers, Fran Lobbezoo was identified as the pivotal connector, exhibits relatively high centrality, signifying active collaboration with other researchers in this domain as seen on the cluster bibliometric analysis with a large blue node. Followed by Peter Svensson, another significant figure in the bruxism network, possibly collaborating closely with various authors, indicated by numerous connections. Daniele Manfredini appears as a central figure in on bruxism research, with connections to multiple authors across different colours, suggesting diversity on his collaborations. Gunnar E. Carlsson is part of the network, but appear relatively smaller in comparison others main authors, indicating potentially fewer collaborations (Fig. 8 ). The most productive researchers in bruxism studies are Frank Lobbezoo, Peter Svensson (n = 48) followed by Svensson P (n = 34). However, Gunnar E. Carlsson took a significant large period for 25 publications indicating this consistent focus on bruxism related research areas. He started his research work on bruxism in the 70’s and continued till 2022. Other key researchers include Daniele Manfredini (n = 21), Gilles J. Lavigne (n = 14), Tomas Magnusson (n = 14), Ephraim Winocur (n = 13), Christensen Lars Vestergaard (n = 12), Corine M. Visscher (n = 12), Anders Wänman (n = 12) (Fig. 9 ). Citation Analysis The h-index (HI) is a metric used to evaluate a researcher's academic work by considering both the quantity of publications and the number of citations each publication receives, it helps to balance the impact of highly cited papers with the general steadiness of a researcher's publication record, providing a comprehensible scenario of the contribution of the work. With 571, Lavigne’s article [ 12 ] was the most cited document where they documented that all bruxers reported tooth grinding during sleep, with significant wear and discomfort while controls showed none of these symptoms through polysomnographic analysis. It was revealed that asymptomatic subjects had an average of 1.7 bruxism episodes per hour, whereas bruxers exhibited a significantly higher frequency of 5.4 episodes. In concerning the total amount of citation per year, Manfredini’s [ 13 ] paper is on the first place (20.18/year) in term of average citations per year, where were summarized the literature data about the role of psychosocial factors in the aetiology of bruxism, while AB, mainly clenching, seems to be associated with psychosocial factors and a number of psychopathological symptoms, was found that there is no evidence to relate SB and psychosocial disorders (Table 3). Keyword analysis There were 4294 index terms derived by keywords from the published papers where authors have used 1462 terms to categorize their published papers. The ten words with most occurrences were #bruxism (n = 1329), #female (n = 1173), #human (n = 1125), #male (n = 1125), #adult (n = 1096), #article (n = 750), #humans (n = 619), #adolescent (n = 421), #temporomandibular joint disorder (n = 411), #middle aged (n = 383). The software VOSviewer™ were used for the author’s keyword analysis, centering on generates significant results. The VOSviewer™ clustered the main author’s keywords and categorized into eight different color group, each node represents an article keyword in this area, and their sizes show the frequency of the keywords mentioned. The research topics in this area can be categorized into, at least, 20 most common author’s keywords, the top of them are #bruxism (244) which is undoubtedly the landmark node in keyword clustering, #temporomandibular disorders (135), #sleep bruxism (86). Furthermore, it was observed that researchers in this field focused on bruxism in general, being AB and SB, and the involvement of temporomandibular joint and its disorders, and the diagnostic methods (Fig. 10 ). References analysis Regarding the reference analysis, between the most global cited documents, the work of Gilles J. Lavigne (1996) was top notch and published at the Journal Dental Research, with 571 citations. Nevertheless, Manfredini (2009) appears to be the center of publications now a days (Fig. 11 ). Agerberg (1972) was shown as one of the oldest contributor being foundational relevance to the more recent publications. The colour’s range from yellow to blue, representing publication years. Yellow reflects more recent publications (closer to 2020), while blue indicates older works (near 2000), helping to identify trends over time. Countries Publication In terms of country of publications, the majority of bruxism articles were predominantly authored by individuals, from Brazil, USA, and Turkey being the primary contributors. Conversely, regarding multiple publications, Brazil, USA, and Italy hold similar positions within the top ten countries with the highest number of publications (Table 4). The average number of corresponding authors per document is 5.75, and multinational cooperation stands at 49.52%. DISCUSSION Bruxism manifest as an unconscious daily habit which significantly affect patients' quality of life, mainly due to pain [ 14 ] and discomfort [ 15 ]. The early diagnosis of bruxism is fundamental to prevent the temporomandibular joint (TMJ) dysfunction, dental commitment and masticatory muscles pain [ 14 ]. The bruxism can be diagnosed by self-reported validated questionnaire or clinical examination of the patient [ 4 ]. The presence of typical signs and symptoms of bruxism may include tooth mobility, tooth damage, masseteric hypertrophy, tongue indentation, hypersensitive teeth and pain in the masticatory muscles [ 4 , 16 , 17 ]. Our current bibliometric analysis curated the Scopus database from 1961 to 2025, containing 4,563 articles based on our search terms. The oldest article published on bruxism belongs to year 1961. In all these years, researchers focused primarily on exploring SB and its consequences as temporomandibular joint disorders. On another hand, through the years, the Awake bruxism (AB) was included in the bruxism classification and different kinds of oral behaviors were considered as part of the bruxism. In 2018 [ 4 , 16 , 17 ], the International Consensus on the assessment of bruxism was defined. Recently, a new diagnosis system named Standardized Tools for the Assessment of Bruxism (STAB) has been proposed. STAB has paved the pathway for faster diagnosis and have better outcome to patient [ 16 , 18 , 19 ]. With the technological advances, a group of researchers created a screening mobile app, which has been used for large population or community screening for early diagnosis of Bruxism [ 20 ]. The United States emerged as the foremost contributor with 2430 citations, underscoring its dominant position in global academic research and reflecting a robust research infrastructure and ample funding opportunities. Brazil follows with 1950 citations, indicating its increasing prominence and investment in research and development. Italy and Sweden, with 510 and 501 citations respectively, play important roles in research, though they remain significantly behind the leading nations. Their citation levels suggest a stable research community that may be constrained by limited funding or institutional capacities compared to the USA and Brazil. Canada, Japan, and the Netherlands exhibited citation counts around 392, 298, and 291, respectively, indicating a solid but less pronounced impact on the global academic landscape. This may reflect a focus on niche research areas or fewer highly cited studies. Denmark, Turkey, and Germany represent the countries with the lowest citation counts of 189, 145, and 134, respectively. Germany's unexpectedly low figures, given its strong industrial and academic reputation, imply potential areas for improvement in research visibility and collaboration. The United States stands as a central node in green, indicating its dominant role in the research network. Its prominence suggests extensive collaborations or citations with other countries. Brazil and Italy are significant nodes in red, reflecting strong engagement in the scholarly discourse, likely due to a high volume of relevant publications or collaborative efforts. With the clustering analysis, the connections between countries indicate collaborative links. Countries that cluster closely, such as Italy, the Netherlands, and Germany, may have shared research interests or frequent interactions in academic publishing. The presence of multiple countries in a similar colour indicates grouping by citation patterns or collaboration frequency. The distribution of countries across different regions as North America, Europe and Asia showcases a global approach to the topic. Those from Europe cluster closely, highlighting strong intra-regional collaboration. The varying thickness of the lines connecting countries shows the strength of collaborations or citation relationships, thicker lines imply stronger connections, suggesting countries with high citation interactions or partnerships in research Although, some countries indicated lesser engagement in the academic landscape of this specific topic as South Africa, New Zealand, and Saudi Arabia, as they appear more isolated. It may reflect limited research output or fewer collaborations compared to more connected nations There is a noticeable growth in the number of articles published by the top 10 Universities, starting around 2005–2006, with a steeper increase post-2010, especially in the later years. Aarhus University and Tel Aviv University have shown notable increases in their publication output in recent years, reflecting potentially expanding research programs or initiatives. While the University of Amsterdam and Vrije Universiteit Amsterdam shows a strong increase starting from 2007, with significant growth continuing through the most recent years, suggesting a robust research agenda, the University of São Paulo displayed moderate growth. Among the most relevant sources In respect to the Impact Factor, JDR holds the highest (5.7), indicating its significant influence in academic field. The JPD follows with impact factor (4.3), JOR and CLOI both have a respectable impact factor of 3.1 and a high number of articles published (115). With a consistent number of publications, Frank Lobbezoo and Peter Svensson stand out. Gunnar E. Carlsson shows significant citation activity alongside a steady publication trend, suggesting impactful research. The top cited document concerning bruxism is the Lavigne et al. [ 12 ] published in 1996, having highest citation count (571) indicating its significant influence in bruxism. Also, Solberg et al. [ 21 ] and Manfredini & Lobbezoo [ 13 ], showed strong citation numbers with 477 and 343 respectively. The citation pattern suggests that these research works have contributed substantial knowledge and have been frequently referenced by other researchers. Most of these documents are published in JDR and JOR, signifying the importance of these platforms for disseminating impactful research in the field. Earlier works like Agerberg & Carlsson [ 22 ] showed the historical context in which newer works developed.. In bruxism research, USA is the leader of citations, indicating both prolific output and significant impact on academic discourse. Despite Turkey has a fewer total publications comparing to USA but has a higher level of citation rate (33.4), suggesting that it’s published work is highly regarded. Italy and turkey leads the citation ranking. followed by USA and Sweden. Brazil has a high volume of publications (72) but a lower average citation rate (21.8), suggesting a larger volume of research that might not be as impactful as that from other countries. To our knowledge, this research represents the first comprehensive bibliometric study focusing specifically on bruxism. In an era of intensive access to data, bibliometric analysis offers researchers a new method to comprise the most important and influential studies . CONCLUSION Our research showed the competitive nature of academic contributions across nations, emphasizing the importance of collaboration, funding, and strategic focus on impactful research to bolster bruxism knowledge. Future directions could include examining the factors that contribute to high citation rates and how emerging countries can enhance their academic presence on the global stage. The cluster visualization reveals the dynamics of international collaboration in research, emphasizing the role of the USA, Brazil, and Italy as key players. The strong connections among European countries suggest a collaborative academic environment, which can lead to robust research relationships and enhance quality. The central position of the Journal of Oral Rehabilitation indicates its importance as a key resource for researchers and practitioners in bruxism, even though, the clustering analysis reflected the collaborative efforts and shared interests among journals, facilitating knowledge transfer and innovation in bruxism.The prominence of Frank Lobbezoo indicates that his work significantly influences the bruxism research, making his publications essential for those in this field. Declarations Acknowledgments The authors would like to thank Pontifícia Universidade Católica do Paraná for the valuable support and assistance during this study. Conflict of Interest The authors declare that there are no conflicts of interest related to the conduct or publication of this research. The study was conducted independently and adheres to the ethical guidelines set forth by the ICMJE and COPE. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors conducted the study independently and report no financial support influencing the study design, data collection, analysis, or publication. Ethical Statement This study is a scientometric analysis and does not involve human participants, animals, or identifiable personal data. Therefore, ethical approval and informed consent were not required. All data used in this research were obtained from publicly available databases and scientific publications. The authors affirm that the study was conducted in accordance with ethical standards for research integrity and transparency. Data Availability Statement All data used in this scientometric analysis are derived from publicly accessible databases and scientific publications. The datasets supporting the conclusions of this article are available upon reasonable request from the corresponding author. No proprietary or confidential data were used. The study adheres to data transparency principles recommended by the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE). Informed consent statement This study did not involve human participants, personal data, or clinical interventions. Therefore, informed consent was not required. The analysis was conducted exclusively using data from publicly available scientific literature. The authors confirm that the study complies with the ethical standards outlined by the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE). References Ohrbach R, Markiewicz MR, McCall WD Jr (2008) Waking-state oral parafunctional behaviors: specificity and validity as assessed by electromyography. 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Supplementary Files TABLE1.Maininformationaboutdata.xlsx Main information about data TABLE2.Top10Sourcesandtheirimpactfactor..xlsx Top 10 sources and their Impact factor TABLE3.Themostcitedarticles..xlsx The Most Cited articles TABLE4.Numberofpublicationsbycountryandnumberofcorrespondingauthorships..xlsx No. of publications by country Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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Andreis","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0003-4345-3803","institution":"Pontifícia Universidade Católica do Paraná, Curitiba, Brazil School of Medicine and Life Sciences","correspondingAuthor":true,"prefix":"","firstName":"Patricia","middleName":"Kern Di Scala","lastName":"Andreis","suffix":""},{"id":602237381,"identity":"19932855-b59b-4822-9e51-74dcd08b37b8","order_by":1,"name":"Monal Yuwanati","email":"","orcid":"https://orcid.org/0000-0001-9233-8292","institution":"Saveetha Dental College and Hospitals Department of Oral Pathology Saveetha Institute of Medical and Technical Sciences, Saveetha University,Chennai-600077,Tamil Nadu, India","correspondingAuthor":false,"prefix":"","firstName":"Monal","middleName":"","lastName":"Yuwanati","suffix":""},{"id":602238232,"identity":"6985386f-9ceb-4165-bb0f-5376b98ad8d5","order_by":2,"name":"Gowri Sivaramkrishnan","email":"","orcid":"","institution":"Bahrain Royal Medical Services Primary Health Care Centres, Bahrain","correspondingAuthor":false,"prefix":"","firstName":"Gowri","middleName":"","lastName":"Sivaramkrishnan","suffix":""},{"id":602238233,"identity":"8919844d-90f1-43a4-b07f-f1cf7cc97447","order_by":3,"name":"Elisa Souza Camargo","email":"","orcid":"https://orcid.org/0000-0002-7382-1526","institution":"Pontifícia Universidade Católica do Paraná, Curitiba, Brazil School of Medicine and Life 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Abstract\u003c/p\u003e","description":"","filename":"ddfb77c21.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9056300/v1/4c5d967ac11c6aac053a2ab0.jpg"},{"id":104333889,"identity":"dacdfe2d-0602-4388-8615-eeb4336c7d64","added_by":"auto","created_at":"2026-03-10 15:28:22","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":122202,"visible":true,"origin":"","legend":"\u003cp\u003ePrisma flow-diagram\u003c/p\u003e","description":"","filename":"fc31c43e1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9056300/v1/8579be4770d14f5da4f9ab6a.jpg"},{"id":104779986,"identity":"262c1198-d340-4a32-b0d2-93d5c92e0e45","added_by":"auto","created_at":"2026-03-17 07:48:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":848913,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9056300/v1/2ad1a38a-d5bd-448f-8efc-d2914027a45c.pdf"},{"id":104333891,"identity":"5de047a4-4d87-4e6c-a095-fb8c1b164a18","added_by":"auto","created_at":"2026-03-10 15:28:22","extension":"xlsx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":10225,"visible":true,"origin":"","legend":"\u003cp\u003eMain information about data\u003c/p\u003e","description":"","filename":"TABLE1.Maininformationaboutdata.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-9056300/v1/9362416170b13d0ceba9757d.xlsx"},{"id":104333887,"identity":"663c5f25-620f-4acd-916e-624e1f4152eb","added_by":"auto","created_at":"2026-03-10 15:28:22","extension":"xlsx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":10120,"visible":true,"origin":"","legend":"\u003cp\u003eTop 10 sources and their Impact factor\u003c/p\u003e","description":"","filename":"TABLE2.Top10Sourcesandtheirimpactfactor..xlsx","url":"https://assets-eu.researchsquare.com/files/rs-9056300/v1/691f4c2d1ac5def0b3e6272e.xlsx"},{"id":104405124,"identity":"c27e061b-b932-4f19-ad27-091f82a0d032","added_by":"auto","created_at":"2026-03-11 12:21:51","extension":"xlsx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":11018,"visible":true,"origin":"","legend":"\u003cp\u003eThe Most Cited articles\u003c/p\u003e","description":"","filename":"TABLE3.Themostcitedarticles..xlsx","url":"https://assets-eu.researchsquare.com/files/rs-9056300/v1/63351d92058715b003132414.xlsx"},{"id":104333892,"identity":"ea9a5d2a-6de7-4023-8184-f33875844439","added_by":"auto","created_at":"2026-03-10 15:28:22","extension":"xlsx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":10263,"visible":true,"origin":"","legend":"\u003cp\u003eNo. of publications by country\u003c/p\u003e","description":"","filename":"TABLE4.Numberofpublicationsbycountryandnumberofcorrespondingauthorships..xlsx","url":"https://assets-eu.researchsquare.com/files/rs-9056300/v1/93052218658a896521676bd2.xlsx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eGlobal trends and future perspectives in Bruxism Research - A Scientometric evaluation\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eThe concept of bruxism has evolved over the years since its introduction in stomatology. Currently, the world is experiencing a shift in the understanding of bruxism and its components. It is no longer considered as a parafunctional activity [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] but rather, involves non-physiological mandibular movements, such as dental contact, teeth grinding, or other oral behaviours [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSleep bruxism (SB) refers to masticatory muscle activity during sleep, which can be classified as either rhythmic (phasic) or non-rhythmic (tonic), based on the circadian cycle [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. On the other hand, awake bruxism (AB) involves masticatory muscle activity while awake, characterized by repetitive or sustained contact between the teeth and/or tension in the masticatory muscles, either in a fixed position or during mandibular movements without dental contact [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe prevalence of both types of bruxism, SB and AB, varies across different age groups. For example, SB in children and adolescents ranges from 3.5% to 49.6%, whereas in adults it ranges from 1.1% to 15.5%. AB occurs in nearly 25% of the world's population, though statistics may vary across different demographic areas [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Over the years, there have been significant advancements in understanding the aetiology, prevalence, and clinical implications of bruxism. However, the complexity and variability in its presentation, along with the diverse assessment methods used to diagnose and manage the condition, have contributed to ongoing debates in the field [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe last few decades have seen major shifts in the conceptualization of bruxism, especially following the 2013 and 2018 consensus meetings, which provided new insights into its classification and diagnostic criteria. Despite this progress, significant gaps remain in the understanding of its underlying mechanisms, risk factors, and effective management strategies. The wide range of detection techniques, behavioural factors, and comorbid conditions associated with bruxism further complicates the comprehensive understanding of the disorder. Overall, the global body of research on bruxism remains fragmented, with varying methodological approaches and inconsistent reporting of findings [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBibliometric analysis has emerged as an invaluable tool in navigating this complexity, offering a quantitative approach to assessing publication trends, citation patterns, author collaboration networks, geographic distribution of research contributions, funding sources and research focuses in bruxism. By systematically reviewing the literature, bibliometric analyses can provide critical insights into the evolution of bruxism research, identify key areas of interest, and highlight research gaps that require further exploration. Hence this bibliometric analysis aims to examine the trends and patterns in the scientific literature on bruxism. By doing so, the analysis highlights key papers, authors, institutions, and regions contributing to the field of bruxism research.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData Source and Search strategy\u003c/h2\u003e \u003cp\u003eThe report of this bibliometric review followed the guidelines for reporting bibliometric reviews of the Biomedical Literature (BIBLIO) [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The checklist is presented in \u003cb\u003eSupplemental File 1\u003c/b\u003e. An electronic search was conducted from 1961 until January 16th 2025 in Scopus database. For the selection of studies, a search strategy was developed using a combination of keywords and Boolean operators.\u003c/p\u003e \u003cp\u003eThe search formula was: TITLE-ABS-KEY (bruxism OR \"sleep bruxism\") AND TITLE-ABS-KEY (teeth OR tooth OR jaw OR head OR face OR mandible OR maxilla OR masseter OR \"facial muscle\") AND TITLE-ABS-KEY (pain OR tenderness OR spasm) AND (LIMIT-TO (SRCTYPE, \"j\")) AND (LIMIT-TO (DOCTYPE, \"ar\")) AND (EXCLUDE (SUBJAREA, \"ECON\") OR EXCLUDE (SUBJAREA, \"DECI\") OR EXCLUDE (SUBJAREA, \"BUSI\") OR EXCLUDE (SUBJAREA, \"ENER\") OR EXCLUDE (SUBJAREA, \"EART\") OR EXCLUDE (SUBJAREA, \"CHEM\") OR EXCLUDE (SUBJAREA, \"Undefined\") OR EXCLUDE (SUBJAREA, \"MATH\") OR EXCLUDE (SUBJAREA, \"NURS\") OR EXCLUDE (SUBJAREA, \"ARTS\") OR EXCLUDE (SUBJAREA, \"PHYS\") OR EXCLUDE (SUBJAREA, \"ENVI\") OR EXCLUDE (SUBJAREA, \"VETE\") OR EXCLUDE (SUBJAREA, \"SOCI\") OR EXCLUDE (SUBJAREA, \"COMP\") OR EXCLUDE (SUBJAREA, \"AGRI\") OR EXCLUDE (SUBJAREA, \"CENG\") OR EXCLUDE (SUBJAREA, \"IMMU\") OR EXCLUDE (SUBJAREA, \"MULT\") OR EXCLUDE (SUBJAREA, \"MATE\") OR EXCLUDE (SUBJAREA, \"HEAL\")). Since all papers categorized as \"article\" were included in the bibliometric analysis, no additional screening for document type was necessary. The inclusion criteria were literature categorized as \u0026ldquo;articles\u0026rdquo; in Scopus database, and language English. The exclusion criteria were the review papers, including systematic reviews and meta-analysis, conference papers, meeting abstracts, letters, opinion papers, editorial materials and non-English articles.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eBibliometric analysis and visualization\u003c/h3\u003e\n\u003cp\u003eA comma-separated file (CSV) file containing citation and bibliographic information, abstracts, and keywords was generated. Bibliometrix\u0026trade; is an open-source package in R\u0026trade; software, specifically tailored for conducting a wide range of quantitative analyses, particularly emphasizing the visual representation of data [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. This was used to facilitate the creation of various types of maps and graphs, enabling a clearer understanding of relationships and trends within the data. The VOSviewer\u0026trade; software (version 1.6.18) [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] was utilized to create a graphical representation of bibliometric networks, highlighting connections between authors, countries, citations, publication year and keywords.\u003c/p\u003e \u003cp\u003eThe collaboration network and main author groups (with four or more occurrences) were visualized, where the author names associated with the largest circles correspond to the highest number of publications. Authors represented by circles of the same colour belong to the same group, while lines connecting the circles signify collaboration between authors or groups. Thicker lines indicate stronger collaboration.\u003c/p\u003e \u003cp\u003eA similar collaboration network was visualized for countries with a minimum of 5 documents. Other networks include the most author keywords, and a keyword network map was generated to highlight the most frequent author keywords (with five or more occurrences) and their collaborative relationships. The bibliographic coupling of documents with a minimum of one citation was also visualized based on the year of publication, where larger circles indicate more citations.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSearch Results\u003c/h2\u003e \u003cp\u003eThe Scopus database search retrieved 1493 documents. Review (n\u0026thinsp;=\u0026thinsp;222), Letter (n\u0026thinsp;=\u0026thinsp;40), Conference paper (n\u0026thinsp;=\u0026thinsp;26), Note(n\u0026thinsp;=\u0026thinsp;14), Short survey (n\u0026thinsp;=\u0026thinsp;11), Editorial (n\u0026thinsp;=\u0026thinsp;10), Retracted (n\u0026thinsp;=\u0026thinsp;1), Erratum(n\u0026thinsp;=\u0026thinsp;1), Book/Book chapter (n\u0026thinsp;=\u0026thinsp;19) and Undefined (n\u0026thinsp;=\u0026thinsp;1) were excluded using filter option in databases. After filtering the results, 1044 documents were selected for bibliometric analysis (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The overall characteristics of the included studies is presented in Table\u0026nbsp;1.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePublication trend and output\u003c/h3\u003e\n\u003cp\u003eBruxism publications have steadily increased from 1961 to 2025, with a notable rise beginning in the late 2000s. The highest output occurred in 2024, with 65 articles published. The overall trend demonstrates sustained growth and increased interest in bruxism research over the decades (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eCountries citation\u003c/h2\u003e \u003cp\u003eThe USA and Brazil stand out significantly as leaders in citations. The United States also had the highest number of citations (n\u0026thinsp;=\u0026thinsp;2430), significantly surpassing Brazil (n\u0026thinsp;=\u0026thinsp;1950) and Italy (n\u0026thinsp;=\u0026thinsp;1505). Sweden was almost equivalent to Italy (n\u0026thinsp;=\u0026thinsp;1501), the remaining countries (Canada, Japan, Netherlands, Denmark, Turkey and Germany) show a much lower number of citations (n\u0026thinsp;=\u0026thinsp;4040) (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eCountries Scientific Production\u003c/h3\u003e\n\u003cp\u003eThe country scientific production, as shown on the Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, is bounded by the darker blue, which represents higher scientific production, the lighter blue indicates moderate and colour grey, countries with little to no reported scientific production. The leadership is centred in the Americas, with Brazil being the most significant output, followed by the USA and Canada. Some others countries on Europe, Africa and Asia showed moderate to simple or none collaboration in the field.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eCountry Collaboration\u003c/h3\u003e\n\u003cp\u003eIn the cluster results of VOSviewer\u0026trade;, the node (circle) represents a country and size of node indicates the volume of scientific production, i.e., the larger the node, the more significant the country's contribution to research. The colours categorize countries based on regions or specific research networks. The green represents countries with a strong connection or collaboration, the red indicates high output and strong influence, the blue and other colours are lower level of collaboration. The lines connecting the nodes (countries) depict collaboration or citation relationships, thicker lines suggest a stronger partnership or more frequent interactions between the countries.\u003c/p\u003e \u003cp\u003eThe USA marked as one of the largest nodes, reflecting its prominence in global scientific output. Its connections span numerous other countries, showcasing a wide range of collaboration. Italy and Brazil are also large, indicating significant contributions to scientific production in bruxism. They have a vast number of connections with other countries, highlighting their importance in global research networks. Following, Denmark and Japan, with sizeable nodes, also, Netherlands, Germany, and Turkey have their nodes lie within close proximity to each other, indicating strong collaborative networks among these nations (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eInstitutions\u003c/h2\u003e \u003cp\u003eA clear hierarchy in scientific production among the listed academic affiliations is presented on the Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e, with a sharp drop in output from the top institutions to those at the bottom. The data reflects at the top a more robust research programs on bruxism. Those institutions with higher article counts are leaded by the University of Amsterdam and Vrije Universiteit Amsterdam, with 79 articles, marking it as the most productive affiliation in the dataset. The second place is occupied by Tel Aviv University (n\u0026thinsp;=\u0026thinsp;58), the University of S\u0026atilde;o Paulo shows a strong contribution (n\u0026thinsp;=\u0026thinsp;52), ranking the third. Followed by the Wroclaw Medical University (n\u0026thinsp;=\u0026thinsp;46), the Aarhus University (n\u0026thinsp;=\u0026thinsp;37), the Universit\u0026eacute; de Montr\u0026eacute;al (n\u0026thinsp;=\u0026thinsp;33), the Showa University (n\u0026thinsp;=\u0026thinsp;29), the Saveetha University (n\u0026thinsp;=\u0026thinsp;26), the Malmo University (n\u0026thinsp;=\u0026thinsp;23) and finally, by the Universidade Federal de Minas Gerais with 20 articles.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSources\u003c/h2\u003e \u003cp\u003eAs demonstrated on Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e, between 1961 and 2025, the Journal of Oral Rehabilitation (JOR) (n\u0026thinsp;=\u0026thinsp;115), Journal of Oral and Facial Pain and Headache (JOFPH) (n\u0026thinsp;=\u0026thinsp;32), The Journal Prosthetic Dentistry (JPD)(n\u0026thinsp;=\u0026thinsp;31), and Acta Odontologica Scandinavica (AOS) (n\u0026thinsp;=\u0026thinsp;30) collectively published over 208 manuscripts on bruxism, being the most relevant sources on this field. The impact factor of the sources with maximum publications on bruxism is presented in Table\u0026nbsp;2. Furthermore, was found that from 1993 to 1997, the number of publications on bruxism in AOS ceased to be the pioneer in publications due to JOR increased significantly their publications to the point to be more than 72% lower number of documents nowadays.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eResearchers\u003c/h2\u003e \u003cp\u003eWithin the researchers, Fran Lobbezoo was identified as the pivotal connector, exhibits relatively high centrality, signifying active collaboration with other researchers in this domain as seen on the cluster bibliometric analysis with a large blue node. Followed by Peter Svensson, another significant figure in the bruxism network, possibly collaborating closely with various authors, indicated by numerous connections. Daniele Manfredini appears as a central figure in on bruxism research, with connections to multiple authors across different colours, suggesting diversity on his collaborations. Gunnar E. Carlsson is part of the network, but appear relatively smaller in comparison others main authors, indicating potentially fewer collaborations (Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe most productive researchers in bruxism studies are Frank Lobbezoo, Peter Svensson (n\u0026thinsp;=\u0026thinsp;48) followed by Svensson P (n\u0026thinsp;=\u0026thinsp;34). However, Gunnar E. Carlsson took a significant large period for 25 publications indicating this consistent focus on bruxism related research areas. He started his research work on bruxism in the 70\u0026rsquo;s and continued till 2022. Other key researchers include Daniele Manfredini (n\u0026thinsp;=\u0026thinsp;21), Gilles J. Lavigne (n\u0026thinsp;=\u0026thinsp;14), Tomas Magnusson (n\u0026thinsp;=\u0026thinsp;14), Ephraim Winocur (n\u0026thinsp;=\u0026thinsp;13), Christensen Lars Vestergaard (n\u0026thinsp;=\u0026thinsp;12), Corine M. Visscher (n\u0026thinsp;=\u0026thinsp;12), Anders W\u0026auml;nman (n\u0026thinsp;=\u0026thinsp;12) (Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eCitation Analysis\u003c/h2\u003e \u003cp\u003eThe h-index (HI) is a metric used to evaluate a researcher's academic work by considering both the quantity of publications and the number of citations each publication receives, it helps to balance the impact of highly cited papers with the general steadiness of a researcher's publication record, providing a comprehensible scenario of the contribution of the work. With 571, Lavigne\u0026rsquo;s article [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] was the most cited document where they documented that all bruxers reported tooth grinding during sleep, with significant wear and discomfort while controls showed none of these symptoms through polysomnographic analysis. It was revealed that asymptomatic subjects had an average of 1.7 bruxism episodes per hour, whereas bruxers exhibited a significantly higher frequency of 5.4 episodes.\u003c/p\u003e \u003cp\u003eIn concerning the total amount of citation per year, Manfredini\u0026rsquo;s [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] paper is on the first place (20.18/year) in term of average citations per year, where were summarized the literature data about the role of psychosocial factors in the aetiology of bruxism, while AB, mainly clenching, seems to be associated with psychosocial factors and a number of psychopathological symptoms, was found that there is no evidence to relate SB and psychosocial disorders (Table\u0026nbsp;3).\u003c/p\u003e \u003cp\u003e \u003cb\u003eKeyword analysis\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThere were 4294 index terms derived by keywords from the published papers where authors have used 1462 terms to categorize their published papers. The ten words with most occurrences were #bruxism (n\u0026thinsp;=\u0026thinsp;1329), #female (n\u0026thinsp;=\u0026thinsp;1173), #human (n\u0026thinsp;=\u0026thinsp;1125), #male (n\u0026thinsp;=\u0026thinsp;1125), #adult (n\u0026thinsp;=\u0026thinsp;1096), #article (n\u0026thinsp;=\u0026thinsp;750), #humans (n\u0026thinsp;=\u0026thinsp;619), #adolescent (n\u0026thinsp;=\u0026thinsp;421), #temporomandibular joint disorder (n\u0026thinsp;=\u0026thinsp;411), #middle aged (n\u0026thinsp;=\u0026thinsp;383).\u003c/p\u003e \u003cp\u003eThe software VOSviewer\u0026trade; were used for the author\u0026rsquo;s keyword analysis, centering on generates significant results. The VOSviewer\u0026trade; clustered the main author\u0026rsquo;s keywords and categorized into eight different color group, each node represents an article keyword in this area, and their sizes show the frequency of the keywords mentioned. The research topics in this area can be categorized into, at least, 20 most common author\u0026rsquo;s keywords, the top of them are #bruxism (244) which is undoubtedly the landmark node in keyword clustering, #temporomandibular disorders (135), #sleep bruxism (86). Furthermore, it was observed that researchers in this field focused on bruxism in general, being AB and SB, and the involvement of temporomandibular joint and its disorders, and the diagnostic methods (Fig.\u0026nbsp;\u003cspan refid=\"Fig10\" class=\"InternalRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eReferences analysis\u003c/b\u003e \u003c/p\u003e \u003cp\u003eRegarding the reference analysis, between the most global cited documents, the work of Gilles J. Lavigne (1996) was top notch and published at the Journal Dental Research, with 571 citations. Nevertheless, Manfredini (2009) appears to be the center of publications now a days (Fig.\u0026nbsp;\u003cspan refid=\"Fig11\" class=\"InternalRef\"\u003e11\u003c/span\u003e). Agerberg (1972) was shown as one of the oldest contributor being foundational relevance to the more recent publications. The colour\u0026rsquo;s range from yellow to blue, representing publication years. Yellow reflects more recent publications (closer to 2020), while blue indicates older works (near 2000), helping to identify trends over time.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eCountries Publication\u003c/h2\u003e \u003cp\u003eIn terms of country of publications, the majority of bruxism articles were predominantly authored by individuals, from Brazil, USA, and Turkey being the primary contributors. Conversely, regarding multiple publications, Brazil, USA, and Italy hold similar positions within the top ten countries with the highest number of publications (Table\u0026nbsp;4). The average number of corresponding authors per document is 5.75, and multinational cooperation stands at 49.52%.\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eBruxism manifest as an unconscious daily habit which significantly affect patients' quality of life, mainly due to pain [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] and discomfort [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The early diagnosis of bruxism is fundamental to prevent the temporomandibular joint (TMJ) dysfunction, dental commitment\u003c/p\u003e \u003cp\u003eand masticatory muscles pain [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The bruxism can be diagnosed by self-reported validated questionnaire or clinical examination of the patient [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The presence of typical signs and symptoms of bruxism may include tooth mobility, tooth damage, masseteric hypertrophy, tongue indentation, hypersensitive teeth and pain in the masticatory muscles [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur current bibliometric analysis curated the Scopus database from 1961 to 2025, containing 4,563 articles based on our search terms. The oldest article published on bruxism belongs to year 1961. In all these years, researchers focused primarily on exploring SB and its consequences as temporomandibular joint disorders. On another hand, through the years, the Awake bruxism (AB) was included in the bruxism classification and different kinds of oral behaviors were considered as part of the bruxism. In 2018 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], the International Consensus on the assessment of bruxism was defined. Recently, a new diagnosis system named Standardized Tools for the Assessment of Bruxism (STAB) has been proposed. STAB has paved the pathway for faster diagnosis and have better outcome to patient [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. With the technological advances, a group of researchers created a screening mobile app, which has been used for large population or community screening for early diagnosis of Bruxism [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe United States emerged as the foremost contributor with 2430 citations, underscoring its dominant position in global academic research and reflecting a robust research infrastructure and ample funding opportunities. Brazil follows with 1950 citations, indicating its increasing prominence and investment in research and development. Italy and Sweden, with 510 and 501 citations respectively, play important roles in research, though they remain significantly behind the leading nations. Their citation levels suggest a stable research community that may be constrained by limited funding or institutional capacities compared to the USA and Brazil. Canada, Japan, and the Netherlands exhibited citation counts around 392, 298, and 291, respectively, indicating a solid but less pronounced impact on the global academic landscape. This may reflect a focus on niche research areas or fewer highly cited studies. Denmark, Turkey, and Germany represent the countries with the lowest citation counts of 189, 145, and 134, respectively. Germany's unexpectedly low figures, given its strong industrial and academic reputation, imply potential areas for improvement in research visibility and collaboration.\u003c/p\u003e \u003cp\u003eThe United States stands as a central node in green, indicating its dominant role in the research network. Its prominence suggests extensive collaborations or citations with other countries. Brazil and Italy are significant nodes in red, reflecting strong engagement in the scholarly discourse, likely due to a high volume of relevant publications or collaborative efforts. With the clustering analysis, the connections between countries indicate collaborative links. Countries that cluster closely, such as Italy, the Netherlands, and Germany, may have shared research interests or frequent interactions in academic publishing. The presence of multiple countries in a similar colour indicates grouping by citation patterns or collaboration frequency.\u003c/p\u003e \u003cp\u003eThe distribution of countries across different regions as North America, Europe and Asia showcases a global approach to the topic. Those from Europe cluster closely, highlighting strong intra-regional collaboration. The varying thickness of the lines connecting countries shows the strength of collaborations or citation relationships, thicker lines imply stronger connections, suggesting countries with high citation interactions or partnerships in research Although, some countries indicated lesser engagement in the academic landscape of this specific topic as South Africa, New Zealand, and Saudi Arabia, as they appear more isolated. It may reflect limited research output or fewer collaborations compared to more connected nations\u003c/p\u003e \u003cp\u003eThere is a noticeable growth in the number of articles published by the top 10 Universities, starting around 2005\u0026ndash;2006, with a steeper increase post-2010, especially in the later years. Aarhus University and Tel Aviv University have shown notable increases in their publication output in recent years, reflecting potentially expanding research programs or initiatives. While the University of Amsterdam and Vrije Universiteit Amsterdam shows a strong increase starting from 2007, with significant growth continuing through the most recent years, suggesting a robust research agenda, the University of S\u0026atilde;o Paulo displayed moderate growth. Among the most relevant sources\u003c/p\u003e \u003cp\u003eIn respect to the Impact Factor, JDR holds the highest (5.7), indicating its significant influence in academic field. The JPD follows with impact factor (4.3), JOR and CLOI both have a respectable impact factor of 3.1 and a high number of articles published (115). With a consistent number of publications, Frank Lobbezoo and Peter Svensson stand out. Gunnar E. Carlsson shows significant citation activity alongside a steady publication trend, suggesting impactful research.\u003c/p\u003e \u003cp\u003eThe top cited document concerning bruxism is the Lavigne et al. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] published in 1996, having highest citation count (571) indicating its significant influence in bruxism. Also, Solberg et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] and Manfredini \u0026amp; Lobbezoo [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], showed strong citation numbers with 477 and 343 respectively. The citation pattern suggests that these research works have contributed substantial knowledge and have been frequently referenced by other researchers. Most of these documents are published in JDR and JOR, signifying the importance of these platforms for disseminating impactful research in the field. Earlier works like Agerberg \u0026amp; Carlsson [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] showed the historical context in which newer works developed..\u003c/p\u003e \u003cp\u003eIn bruxism research, USA is the leader of citations, indicating both prolific output and significant impact on academic discourse. Despite Turkey has a fewer total publications comparing to USA but has a higher level of citation rate (33.4), suggesting that it\u0026rsquo;s published work is highly regarded. Italy and turkey leads the citation ranking. followed by USA and Sweden. Brazil has a high volume of publications (72) but a lower average citation rate (21.8), suggesting a larger volume of research that might not be as impactful as that from other countries.\u003c/p\u003e \u003cp\u003eTo our knowledge, this research represents the first comprehensive bibliometric study focusing specifically on bruxism. In an era of intensive access to data, bibliometric analysis offers researchers a new method to comprise the most important and influential studies .\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eOur research showed the competitive nature of academic contributions across nations, emphasizing the importance of collaboration, funding, and strategic focus on impactful research to bolster bruxism knowledge. Future directions could include examining the factors that contribute to high citation rates and how emerging countries can enhance their academic presence on the global stage.\u003c/p\u003e \u003cp\u003eThe cluster visualization reveals the dynamics of international collaboration in research, emphasizing the role of the USA, Brazil, and Italy as key players. The strong connections among European countries suggest a collaborative academic environment, which can lead to robust research relationships and enhance quality.\u003c/p\u003e \u003cp\u003eThe central position of the Journal of Oral Rehabilitation indicates its importance as a key resource for researchers and practitioners in bruxism, even though, the clustering analysis reflected the collaborative efforts and shared interests among journals, facilitating knowledge transfer and innovation in bruxism.The prominence of Frank Lobbezoo indicates that his work significantly influences the bruxism research, making his publications essential for those in this field.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank Pontifícia Universidade Católica do Paraná for the valuable support and assistance during this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there are no conflicts of interest related to the conduct or publication of this research. The study was conducted independently and adheres to the ethical guidelines set forth by the ICMJE and COPE.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The authors conducted the study independently and report no financial support influencing the study design, data collection, analysis, or publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is a scientometric analysis and does not involve human participants, animals, or identifiable personal data. Therefore, ethical approval and informed consent were not required. All data used in this research were obtained from publicly available databases and scientific publications. The authors affirm that the study was conducted in accordance with ethical standards for research integrity and transparency.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data used in this scientometric analysis are derived from publicly accessible databases and scientific publications. The datasets supporting the conclusions of this article are available upon reasonable request from the corresponding author. No proprietary or confidential data were used. The study adheres to data transparency principles recommended by the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not involve human participants, personal data, or clinical interventions. Therefore, informed consent was not required. The analysis was conducted exclusively using data from publicly available scientific literature. The authors confirm that the study complies with the ethical standards outlined by the International Committee of Medical Journal Editors (ICMJE) and the Committee on Publication Ethics (COPE).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOhrbach R, Markiewicz MR, McCall WD Jr (2008) Waking-state oral parafunctional behaviors: specificity and validity as assessed by electromyography. 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J Indian Prosthodont Soc Sep 10(3):141\u0026ndash;148. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s13191-011-0041-5\u003c/span\u003e\u003cspan address=\"10.1007/s13191-011-0041-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eManfredini D, Ahlberg J, Aarab G et al (2024) The development of the Standardised Tool for the Assessment of Bruxism (STAB): An international road map. J Oral Rehabil Jan 51(1):15\u0026ndash;28. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/joor.13380\u003c/span\u003e\u003cspan address=\"10.1111/joor.13380\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eManfredini D, Ahlberg J, Aarab G et al (2024) Standardised Tool for the Assessment of Bruxism. J Oral Rehabil Jan 51(1):29\u0026ndash;58. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/joor.13411\u003c/span\u003e\u003cspan address=\"10.1111/joor.13411\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eManfredini D, Ahlberg J, Aarab G et al (2020) Towards a Standardized Tool for the Assessment of Bruxism (STAB)-Overview and general remarks of a multidimensional bruxism evaluation system. J Oral Rehabil May 47(5):549\u0026ndash;556. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/joor.12938\u003c/span\u003e\u003cspan address=\"10.1111/joor.12938\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLobbezoo F, Ahlberg J, Manfredini D (2024) The advancement of a discipline: The past, present and future of bruxism research. 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Acta Odontol Scand Dec 30(6):597\u0026ndash;613. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3109/00016357209019791\u003c/span\u003e\u003cspan address=\"10.3109/00016357209019791\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Pontifícia Universidade Católica do Paraná, Curitiba, Brazil School of Medicine and Life Sciences","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Bruxism, Bibliometric analyses, Cluster Analysis, Sleep Bruxism, Behavior, Scientometric evaluation","lastPublishedDoi":"10.21203/rs.3.rs-9056300/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9056300/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eBruxism is a behavior involving the clinching or grindings of teeth. It has its complexity and multifactorial aetiology. However, knowledge and currents research trends in the field of bruxism have expanded extensively.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThe aim of this scientometric evaluation was to evaluate the present status in bruxism research and identify potential future research directions and policy decisions.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eScopus database was searched with help of keywords. The search records were filtered based on relevance to bruxism and exported. The bibliometric analysis was performed using bibliometrix package in RStudio and VOSviewer\u0026trade;.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eSearch yielded 1044 documents relevant to bruxism spanning from 1961 to 2025. Bruxism related research was first started in 1961. However, it expanded exponentially after 2003. Over these 64 years, Brazil, United States, Italy and Sweden were leading countries researching on bruxism scope. Frank Lobbezoo was a significant contributor, with the highest strength on almost all cluster analysis. The leading countries were USA (n\u0026thinsp;=\u0026thinsp;2430) and Brazil (n\u0026thinsp;=\u0026thinsp;1950). The Journal of Oral and Facial Pain and Headache (n\u0026thinsp;=\u0026thinsp;32), The Journal Prosthetic Dentistry (n\u0026thinsp;=\u0026thinsp;31), and Acta Odontologica Scandinavica (n\u0026thinsp;=\u0026thinsp;30) are main sources of bruxism literature. Remarkably, there is a noticeable research trends in direction of epidemiology, tools of diagnosis, treatment and consequences of bruxism.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eOur scientometric evaluation clearly highlighted the rise of interest in bruxism research mostly due to its impact on health. Our findings clearly supports multidisciplinary approach to treat as well provides an insight on preventive measures and policy decisions for bruxism among clinician and researchers.\u003c/p\u003e","manuscriptTitle":"Global trends and future perspectives in Bruxism Research - A Scientometric evaluation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-10 15:28:17","doi":"10.21203/rs.3.rs-9056300/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f6c4ffeb-3941-44cf-a231-0dd6fd9c7133","owner":[],"postedDate":"March 10th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":64093376,"name":"Dentistry"}],"tags":[],"updatedAt":"2026-03-10T15:28:18+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-10 15:28:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9056300","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9056300","identity":"rs-9056300","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}