Neff Andreas, McLeod Niall, Spijkervet Frederik, Riechmann Merle, Vieth Ulla, Kolk Andreas, Sidebottom Andrew J, Bonte Bernard, Speculand Bernard, Saridin Carrol, Wilms Christian T, Politis Constantinus, Ângelo David Faustino, Hirjak Dušan, Aagaard Esben, Spallaccia Fabrizio, Monje Florencio, Undt Gerhard, Gerbino Giovanni, Lehman Hadas, Sanromán Jacinto F, Mercuri Louis G, Cascarini Luke, Ulmner Mattias, Mommaerts Maurice, Saeed Nadeem R, Güven Orhan, Sembronio Salvatore, Machoň Vladimir, Skroch Linda
Department of Oral and Craniomaxillofacial Surgery, Philipps University Marburg, 35043 Marburg, Germany.
The European Society of Temporomandibular Joint Surgeons (ESTMJS), c/o Secretariat: 16 Hemlegh Vale, Helsby, Cheshire WA6 0DB, UK.
J Clin Med. 2021 Oct 29;10(21):5068. doi: 10.3390/jcm10215068.
Although condylar dislocation is not uncommon, terminology, diagnostics, and treatment concepts vary considerably worldwide. This study aims to present a consensus recommendation based on systematically reviewed literature and approved by the European Society of TMJ Surgeons (ESTMJS). Based on the template of the evidence-based German guideline (register # 007-063) the ESTMJS members voted on 30 draft recommendations regarding terminology, diagnostics, and treatment initially via a blinded modified Delphi procedure. After unblinding, a discussion and voting followed, using a structured consensus process in 2019. An independent moderator documented and evaluated voting results and alterations from the original draft. Although the results of the preliminary voting were very heterogenous and differed significantly from the German S3 guideline ( < 0.0005), a strong consensus was achieved in the final voting on terminology, diagnostics, and treatment. In this voting, multiple alterations, including adding and discarding recommendations, led to 24 final recommendations on assessment and management of TMJ dislocation. To our knowledge, the ESTMJS condylar dislocation recommendations are the first both evidence and consensus-based international recommendations in the field of TMJ surgery. We recommend they form the basis for clinical practice guidelines for the management of dislocations of the mandibular condyle.
虽然髁突脱位并不罕见,但在全球范围内,其术语、诊断方法和治疗理念差异很大。本研究旨在基于系统综述的文献,提出一份经欧洲颞下颌关节外科学会(ESTMJS)批准的共识性建议。基于循证德国指南(注册号#007 - 063)的模板,ESTMJS成员最初通过盲法改良德尔菲程序,对30条关于术语、诊断和治疗的建议草案进行投票。在解除盲态后,于2019年采用结构化共识流程进行了讨论和投票。一名独立主持人记录并评估了投票结果以及与原始草案的差异。尽管初步投票结果差异很大,且与德国S3指南有显著不同(<0.0005),但在关于术语、诊断和治疗的最终投票中达成了强烈共识。在这次投票中,包括增加和舍弃建议在内的多项修改,产生了24条关于颞下颌关节脱位评估和管理的最终建议。据我们所知,ESTMJS关于髁突脱位的建议是颞下颌关节外科领域首个基于证据和共识的国际建议。我们建议将它们作为下颌髁突脱位管理临床实践指南的基础。