Christidis Nikolaos, Lindström Ndanshau Elisande, Sandberg Amanda, Tsilingaridis Georgios
Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
Scandinavian Center for Orofacial Neurosciences (SCON), Huddinge, Sweden.
J Oral Rehabil. 2019 Mar;46(3):291-301. doi: 10.1111/joor.12759. Epub 2019 Jan 8.
Temporomandibular disorders (TMD) in children/adolescents are very common. Yet, there is a lack of consensus regarding which clinical interventions are appropriate. The aim of this systematic review was to gather and assess the quality of the available literature on the prevalence and evidence-based treatment strategies in children and adolescents suffering from TMD.
A systematic literature review was conducted including articles from 1992 to 2016. A total of 2293 articles were found. Eight were included, six regarding prevalence and two regarding treatment. Simple or multiple conjunctions of different search words: "temporomandibular disorder", "temporomandibular joint disorder", "prevalence", "children" "adolescents", "occlusal appliance", "jaw exercise" and "relaxation" were used on the databases PubMed and Web of Science. Inclusion criteria were (a) scientific articles or randomised controlled clinical trials evaluating prevalence, choice of therapy and treatment outcome for children and/or adolescents with TMD published in Swedish or English and (b) a TMD diagnosis according to the Research Diagnostic Criteria for TMD or Diagnostic Criteria for TMD.
Prevalence (ages 10-19 years) varied between 7.3 and 30.4%, and the most common diagnoses were myofascial pain and anterior disc displacement with reduction. Only two articles were found regarding treatment in adolescents (ages 12-18 years). The stabilising occlusal appliance had superior treatment outcome compared to relaxation therapy or brief information.
The general absence of standardised studies concerning children/adolescents with TMD pain states the evident need for further systematic prevalence and treatment evaluations. Considering this, it is not possible to achieve any evidence-based treatment strategies or guidelines for children and adolescents with TMD.
儿童/青少年颞下颌关节紊乱病（TMD）非常常见。然而，对于哪些临床干预措施是合适的，目前尚无共识。本系统评价的目的是收集并评估有关TMD患儿及青少年患病率和循证治疗策略的现有文献质量。
进行系统的文献回顾，纳入1992年至2016年的文章。共检索到2293篇文章。纳入8篇，其中6篇关于患病率，2篇关于治疗。在PubMed和科学网数据库中使用不同检索词的简单或多重组合：“颞下颌关节紊乱病”、“颞下颌关节紊乱”、“患病率”、“儿童”、“青少年”、“咬合器”、“颌部运动”和“放松”。纳入标准为：（a）以瑞典语或英语发表的评估TMD患儿及青少年患病率、治疗选择和治疗结果的科学文章或随机对照临床试验；（b）根据TMD研究诊断标准或TMD诊断标准作出的TMD诊断。
患病率（10 - 19岁）在7.3%至30.4%之间，最常见的诊断为肌筋膜疼痛和可复性盘前移位。仅发现两篇关于青少年（12 - 18岁）治疗的文章。与放松疗法或简短信息相比，稳定咬合器的治疗效果更佳。
关于TMD疼痛状态的儿童/青少年，普遍缺乏标准化研究，这表明明显需要进一步进行系统的患病率和治疗评估。考虑到这一点，无法为患有TMD的儿童和青少年制定任何循证治疗策略或指南。
