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在短期和长期随访的系统评价及荟萃分析研究中,没有证据表明口腔矫治器对颞下颌关节紊乱疼痛的治疗有效。

No evidence on the effectiveness of oral splints for the management of temporomandibular joint dysfunction pain in both short and long-term follow-up systematic reviews and meta-analysis studies.

作者信息

Fouda Atef Abdel Hameed

机构信息

Department of Maxillofacial Surgery, Kasr El Eyne Hospital, Cairo University, Cairo, Egypt.

出版信息

J Korean Assoc Oral Maxillofac Surg. 2020 Apr 30;46(2):87-98. doi: 10.5125/jkaoms.2020.46.2.87.

Abstract

The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, =0.002, I=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.

摘要

本研究的目的是确定口腔矫治器在短期和长期治疗过程中减轻颞下颌关节紊乱症患者疼痛强度的疗效。检索了电子数据库、Cochrane图书馆、通过PubMed检索的MEDLINE、Web of Science、埃及知识库和EMBASE,以查找比较不同类型矫治器与非咬合矫治器、行为疗法、药物疗法、咨询和不治疗的随机对照试验。采用Cochrane偏倚风险推荐评估偏倚风险。使用固定效应和随机效应汇总结果。效应估计值以标准化均数差(SMD)或风险比表示,并伴有95%置信区间(CI)。根据治疗持续时间进行亚组分析。22项研究符合纳入标准。对长达三个月的短期研究进行的荟萃分析显示,各研究组之间无显著差异。然而,长期研究表明,对照组在减轻疼痛方面存在显著差异。总体分析显示,对照组导致疼痛显著减轻(SMD 0.14,95%CI 0.05-0.23,P=0.002,I²=0%)。口腔矫治器在减轻颞下颌关节紊乱症患者的疼痛强度或改善功能方面无效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82b7/7222619/72368138f7ca/JKAOMS-46-087-f1.jpg

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