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颞下颌关节紊乱病管理中影响颌骨运动和生长的神经内分泌因素及相关因素:临床和影像学证据的系统评价

Neuroendocrine Influencers and Associated Factors That Shape Jaw Movement and Growth in Temporomandibular Joint Disorder Management: A Systematic Review of Clinical and Radiographic Evidence.

作者信息

Farook Taseef Hasan, Dudley James

机构信息

Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia.

出版信息

J Pers Med. 2023 May 16;13(5):840. doi: 10.3390/jpm13050840.

Abstract

OBJECTIVE

To investigate the influence of endogenous and exogenous neuroendocrine analogues on the range and motion of jaw movement, mandibular growth, and factors affecting condylar guidance in patients with temporomandibular joint disorders using clinical assessment and radiographic imaging.

MATERIAL AND METHODS

Eligible articles were extracted from eleven databases in early 2023 and screened following PRISMA protocols. Certainty of evidence and potential biases were assessed using the GRADE approach.

RESULTS

Nineteen articles were screened, with four deemed to be of high quality, eight of moderate quality, and the remaining seven of low to very low quality. Corticosteroids improve maximal incisal opening but not TMJ disorder symptoms. Higher doses worsen jaw movement and cause osseous deformity. Growth hormone affects occlusal development, and delayed treatment affects arch width. Sex hormone correlation with TMJ disorder is complex, with some studies showing a correlation between menstrual cycle phases and pain/limited mobility.

CONCLUSIONS

The evaluation of neuroendocrine influencers in relation to jaw movement in patients with temporomandibular joint disorders involves the complex interplay of potentially confounding factors that each require careful consideration to ensure accurate diagnoses and evaluations.

摘要

目的

采用临床评估和影像学检查,研究内源性和外源性神经内分泌类似物对颞下颌关节紊乱病患者下颌运动范围和运动、下颌生长以及影响髁突引导的因素的影响。

材料与方法

2023年初从11个数据库中提取符合条件的文章,并按照PRISMA方案进行筛选。采用GRADE方法评估证据的确定性和潜在偏倚。

结果

共筛选出19篇文章,其中4篇为高质量,8篇为中等质量,其余7篇为低质量至极低质量。皮质类固醇可改善最大切牙开口度,但不能改善颞下颌关节紊乱症状。高剂量会使下颌运动恶化并导致骨质畸形。生长激素影响咬合发育,延迟治疗会影响牙弓宽度。性激素与颞下颌关节紊乱的相关性很复杂,一些研究表明月经周期阶段与疼痛/活动受限之间存在相关性。

结论

在颞下颌关节紊乱病患者中,评估神经内分泌影响因素与下颌运动的关系涉及潜在混杂因素的复杂相互作用,每个因素都需要仔细考虑,以确保准确的诊断和评估。

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