Ferreira M C, Porto de Toledo I, Dutra K L, Stefani F M, Porporatti A L, Flores-Mir C, De Luca Canto G
Department of Speech Language Pathology, Federal University of Santa Catarina, Florianópolis, Brazil.
Health Sciences Faculty, University of Brasilia, Brasilia, Brazil.
J Oral Rehabil. 2018 Oct;45(10):819-835. doi: 10.1111/joor.12681. Epub 2018 Jul 4.
Temporomandibular disorder (TMD) is an umbrella condition presenting several signs and symptoms including pain in the temporomandibular joint (TMJ) and masticatory muscles, articular noises, earache, headache, irregular or restricted jaw function, chewing difficulty, and limited mouth opening. Such TMD impairment may cause disorders during the chewing process. Therefore, the purpose of this systematic review was to assess chewing dysfunctions measured by sEMG, and their association with TMD. A combination and variation in the descriptors "temporomandibular joint disorders", "masticatory dysfunctions", and electromyography were used to perform the searches across databases. The databases chosen were: LILACS, PubMed, Science Direct, Scopus, and Web of Science. Additionally, grey literature was assessed using Google Scholar, ProQuest, and OpenGrey. Studies in adults that diagnosed TMD through the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Helkimo Protocol were selected. Furthermore, those studies should have evaluated chewing processes through surface electromyography (sEMG). Risk of bias of the included studies was assessed through the Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) tool. Eleven included studies shown significant results; however, they evaluated discrepant parameters, presented high inconsistency in the application, and had chosen different tasks to analyse the sEMG and hence, there was no consensus in the results of studies. In conclusion, strength of recommendations was very low due to a series of limitations on studies and it was not possible to made categorical statement about association between TMD and chewing dysfunctions in adults when parameters of sEMG were analysed.
颞下颌关节紊乱病（TMD）是一种综合病症，表现出多种体征和症状，包括颞下颌关节（TMJ）和咀嚼肌疼痛、关节弹响、耳痛、头痛、下颌功能不规则或受限、咀嚼困难以及张口受限。这种TMD损伤可能会在咀嚼过程中引发紊乱。因此，本系统评价的目的是评估通过表面肌电图（sEMG）测量的咀嚼功能障碍及其与TMD的关联。使用了“颞下颌关节紊乱病”“咀嚼功能障碍”和肌电图等描述词的组合与变体在多个数据库中进行检索。所选择的数据库有：拉丁美洲和加勒比地区卫生科学数据库（LILACS）、美国国立医学图书馆生物医学数据库（PubMed）、爱思唯尔科学Direct数据库、Scopus数据库和科学引文索引（Web of Science）。此外，还使用谷歌学术、ProQuest和OpenGrey对灰色文献进行了评估。选择了通过颞下颌关节紊乱病研究诊断标准（RDC/TMD）、颞下颌关节紊乱病诊断标准（DC/TMD）或赫尔基莫检查法诊断TMD的成人研究。此外，这些研究应通过表面肌电图（sEMG）评估咀嚼过程。通过统计评估与综述工具的Meta分析（MAStARI）工具评估纳入研究的偏倚风险。纳入的11项研究显示出显著结果；然而，它们评估的参数不一致，在应用中存在高度不一致性，并且选择了不同的任务来分析sEMG，因此，研究结果没有达成共识。总之，由于研究存在一系列局限性，推荐强度非常低，在分析sEMG参数时，无法就成人TMD与咀嚼功能障碍之间的关联做出明确的陈述。
