Universidad Andres Bello, Faculty of Dentistry, Quillota # 980 Torre E, Viña del Mar, Chile.
Private Practice, Viña del Mar, Chile.
Oral Maxillofac Surg. 2024 Mar;28(1):29-38. doi: 10.1007/s10006-022-01134-2. Epub 2023 Jan 12.
To perform a scoping review to identify the available evidence regarding osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ).
An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: 'Temporomandibular Joint Disorders', 'Osteochondritis Dissecans', 'Joint Loose Bodies' and 'Temporomandibular Joint'. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria.
Ten articles were included in the analysis - six case reports, one case series, one retrospective study, one comparative study and one correlational study - with a total of 39 patients. The most frequently reported clinical presentation involved TMJ pain, locked jaw and articular noises (clicking and crepitus). The imaging methods used to identify OCD were radiographs, tomography, arthrography and magnetic resonance imaging. The reported imaging findings varied widely, but the most frequent were (single or multiple) calcified intra-articular loose bodies, signs of degenerative osseous changes, disc displacements, widening of the joint space and alterations in condylar morphology. Seven articles reported treatments (surgical or conservative), but the treatment outcome was not reported in all of the articles, which makes it difficult to make comparisons.
OCD of the TMJ may present various non-specific clinical characteristics, and given the heterogeneous imaging findings, multiplanar images are required for an accurate diagnosis. Finally, the results do not allow recommending a standard treatment for OCD of the TMJ.
进行范围综述,以确定有关颞下颌关节(TMJ)剥脱性骨软骨炎(OCD)的现有证据。
使用以下术语在 PubMed、Web of Science 和 Scopus 数据库中进行电子检索:“颞下颌关节紊乱”、“剥脱性骨软骨炎”、“关节游离体”和“颞下颌关节”。应用纳入/排除标准后,从记录中获取全文文章。
共纳入 10 篇文章进行分析 - 6 篇病例报告、1 篇病例系列、1 篇回顾性研究、1 篇比较研究和 1 篇相关性研究 - 共 39 例患者。最常报道的临床表现涉及 TMJ 疼痛、下颌锁定和关节噪音(咔哒声和嘎吱声)。用于识别 OCD 的影像学方法包括 X 线片、断层扫描、关节造影和磁共振成像。报告的影像学发现差异很大,但最常见的是(单个或多个)关节内钙化游离体、退行性骨改变迹象、盘移位、关节间隙增宽和髁突形态改变。7 篇文章报告了治疗方法(手术或保守治疗),但并非所有文章都报告了治疗结果,这使得难以进行比较。
TMJ 的 OCD 可能表现出各种非特异性临床特征,鉴于异质的影像学发现,需要多平面图像进行准确诊断。最后,结果不允许推荐 TMJ OCD 的标准治疗方法。