Melo G, Casett E, Stuginski-Barbosa J, Guerra E N S, Fernandes D A, Porporatti A L, Flores-Mir C, De Luca Canto G
Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil.
Department of Dentistry, Bauru School of Dentistry, University of São Paulo (USP), São Paulo, São Paulo, Brazil.
J Oral Rehabil. 2018 May;45(5):414-422. doi: 10.1111/joor.12616. Epub 2018 Mar 2.
The purpose of this study was to systematically review the literature for studies that assessed the effects of glucosamine supplements (GS) on pain and maximum mouth opening (MMO) restriction compared to other therapies, placebo or no intervention on painful temporomandibular joint osteoarthritis (TMJ OA). Randomised controlled trials were selected in a two-phase process. Seven electronic databases, in addition to three grey literature databases, were searched. Risk of bias was assessed using the Cochrane Collaboration's tool for assessing risk of bias in randomised trials. Twelve potentially eligible studies were identified, from which three were finally included. Furthermore, two were categorised at low risk and one at high risk of bias. Intervention groups were treated with glucosamine-sulphate, while controls were treated with placebo or ibuprofen. In two studies, GS were equally effective regarding pain reduction and mouth opening improvement compared to ibuprofen taken two or three times a day over 12 weeks; however, one study did not find significant differences in follow-up evaluations concerning these clinical variables in both glucosamine and placebo groups administered over six weeks. There is very low evidence regarding GS therapeutic effects on TMJ OA. Considering a follow-up of 12 weeks, GS were as effective as ibuprofen taken two or three times a day. However, over six weeks of medication intake, GS were not superior to placebo. Still, included studies presented major drawbacks, and therefore, conclusions must be interpreted with caution.
本研究的目的是系统回顾文献，以评估与其他疗法、安慰剂或无干预措施相比，氨基葡萄糖补充剂（GS）对疼痛性颞下颌关节骨关节炎（TMJ OA）患者疼痛及最大开口度（MMO）受限的影响。随机对照试验通过两阶段过程进行筛选。除三个灰色文献数据库外，还检索了七个电子数据库。使用Cochrane协作网评估随机试验偏倚风险的工具评估偏倚风险。共识别出12项潜在符合条件的研究，最终纳入3项。此外，两项研究的偏倚风险被归类为低风险，一项为高风险。干预组接受硫酸氨基葡萄糖治疗，对照组接受安慰剂或布洛芬治疗。在两项研究中，与每天服用两到三次布洛芬、持续12周相比，GS在减轻疼痛和改善开口度方面效果相当；然而，一项研究发现，在为期六周的治疗中，氨基葡萄糖组和安慰剂组在这些临床变量的随访评估中未发现显著差异。关于GS对TMJ OA的治疗效果，证据非常有限。考虑到12周的随访，GS与每天服用两到三次布洛芬的效果相当。然而，在六周的药物摄入期间，GS并不优于安慰剂。尽管如此，纳入的研究存在重大缺陷，因此，对结论的解读必须谨慎。
