不同全颞下颌关节置换假体的临床随访比较：一项系统评价与Meta分析
A Comparison of Clinical Follow-Up of Different Total Temporomandibular Joint Replacement Prostheses: A Systematic Review and Meta-Analysis.
作者信息
Zou Luxiang, He Dongmei, Ellis Edward
机构信息
Resident Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China.
Professor, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China.
出版信息
J Oral Maxillofac Surg. 2018 Feb;76(2):294-303. doi: 10.1016/j.joms.2017.08.022. Epub 2017 Aug 24.
PURPOSE
There are different total temporomandibular joint (TMJ) prostheses on the market but no comparison of their efficacy. The purpose of this meta-analysis was to evaluate the effectiveness of different TMJ replacement (TJR) systems.
MATERIALS AND METHODS
A systematic review and meta-analysis was performed using the PubMed, Embase, Medline, and Cochrane Library search engines in May 2017 to identify qualified studies. Outcome measurements were changes in maximal incisal opening (MIO), pain, dietary limitations, and functional deficiencies from before to after TJR. Analyses of heterogeneity, sensitivity, and publication bias were performed. A fixed-effects model was used for the meta-analysis of pooled weighted mean differences in pre- versus postoperative MIO, pain, diet, and function.
RESULTS
Twenty studies with 1,262 patients were included in the meta-analysis. Comparison of the TJR systems showed no real difference for pre- versus postoperative MIO, pain, diet, and function. MIO and functional efficiency decreased gradually over time, but effective pain relief and improvements in dietary limitations were stable with no relevant differences during follow-up. Comparison of the custom and stock devices showed similar results for pre- and postoperative MIO, pain, function, and diet.
CONCLUSION
This analysis showed no relevant difference in treatment outcomes among the TJR systems.
目的
市面上有不同的全颞下颌关节（TMJ）假体，但尚无对其疗效的比较。本荟萃分析的目的是评估不同颞下颌关节置换（TJR）系统的有效性。
材料与方法
2017年5月使用PubMed、Embase、Medline和Cochrane图书馆搜索引擎进行了系统评价和荟萃分析，以确定合格的研究。结局指标为TJR前后最大切牙开口度（MIO）、疼痛、饮食限制和功能缺陷的变化。进行了异质性、敏感性和发表偏倚分析。采用固定效应模型对术前与术后MIO、疼痛、饮食和功能的合并加权平均差异进行荟萃分析。
结果
荟萃分析纳入了20项研究，共1262例患者。TJR系统的比较显示，术前与术后的MIO、疼痛、饮食和功能无实际差异。MIO和功能效率随时间逐渐下降，但有效的疼痛缓解和饮食限制的改善是稳定的，随访期间无相关差异。定制装置和现货装置的比较显示，术前和术后的MIO、疼痛、功能和饮食结果相似。
结论
该分析表明TJR系统之间的治疗结果无相关差异。
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