Leite Ronaldo Antônio, Rodrigues Joacir Ferreira, Sakima Maurício Tatsuei, Sakima Tatsuko
UNIFESP.
Dental Press J Orthod. 2013 Jan-Feb;18(1):150-7. doi: 10.1590/s2176-94512013000100027.
The objective of this study was to review the most recent studies from the last 15 years, in search of clinical studies that report the relationship between TMD and orthodontic treatment and/or malocclusion. Our intention was to determine whether orthodontic treatment would increase the incidence of signs and symptoms of TMD, and whether orthodontic treatment would be recommended for treating or preventing signs and symptoms of TMD.
Literature reviews, editorials, letters to the editor, experimental studies in animals and short communications were excluded from this review. Were included only prospective, longitudinal, case-control or retrospective studies with a large sample and significant statistical analysis. Studies that dealt with craniofacial deformities and syndromes or orthognathic surgery treatment were also excluded, as well as those that reported only the association between malocclusion and TMD.
There were 20 articles relating orthodontics to TMD according to the inclusion criteria. The studies that associated signs and symptoms of TMD to orthodontic treatment showed discrepant results. Some have found positive effects of orthodontic treatment on signs and symptoms of TMD, however, none showed a statistically significant difference.
All studies cited in this literature review reported that orthodontic treatment did not provide risk to the development of signs and symptoms of TMD, regardless of the technique used for treatment, the extraction or non-extraction of premolars and the type of malocclusion previously presented by the patient. Some studies with long-term follow-up concluded that orthodontic treatment would not be preventive or a treatment option for TMD.
本研究的目的是回顾过去15年的最新研究,寻找报告颞下颌关节紊乱病(TMD)与正畸治疗和/或错牙合关系的临床研究。我们的目的是确定正畸治疗是否会增加TMD体征和症状的发生率,以及正畸治疗是否推荐用于治疗或预防TMD的体征和症状。
本综述排除文献综述、社论、给编辑的信、动物实验研究和简短通讯。仅纳入具有大样本和显著统计分析的前瞻性、纵向、病例对照或回顾性研究。涉及颅面畸形和综合征或正颌外科治疗的研究也被排除,以及那些仅报告错牙合与TMD之间关联的研究。
根据纳入标准,有20篇文章将正畸与TMD相关联。将TMD体征和症状与正畸治疗相关联的研究结果存在差异。一些研究发现正畸治疗对TMD体征和症状有积极影响,然而,没有一项研究显示出统计学上的显著差异。
本综述引用的所有研究均报告,无论采用何种治疗技术、是否拔除前磨牙以及患者先前存在的错牙合类型如何,正畸治疗都不会增加TMD体征和症状发生的风险。一些长期随访研究得出结论,正畸治疗不是TMD的预防性或治疗选择。