Department of Conservative Dentistry and Endodontics AMC Dental College and Hospital, Ahmedabad, Gujarat, India.
Orthodontic Division, Preventive Dentistry Department, Orthodontic Division, College of Dentistry, Jouf University, Sakakah, Saudi Arabia.
J Oral Rehabil. 2023 Dec;50(12):1554-1563. doi: 10.1111/joor.13574. Epub 2023 Aug 30.
Patients undergoing mandibular advancement device (MAD) therapy for obstructive sleep apnea (OSA) may experience changes in jaw position and altered occlusion. This could potentially contribute to the development or exacerbation of TMD symptoms. The literature on the long-term impact of MAD treated for OSA on TMD is scarce. Hence, this review was undertaken to ascertain the occurrence of TMD in MAD users.
A comprehensive search protocol was implemented across several online databases using MeSH keywords and Boolean operators. A standardised data extraction form was developed specifically for this review. Two reviewers independently extracted the data. RoB-2 was used to evaluate the methodological quality of the included studies.
A total of 13 clinical studies were selected for this review. Some studies reported a significant reduction in the severity and frequency of TMD symptoms following MAD treatment. However, other studies did not observe significant changes in TMD symptoms or TMJ-related parameters from baseline to follow-up intervals. Temporary increases in TMJ-related pain or symptoms at the beginning of the follow-up period, which later subsided, were reported in some studies. Overall, MAD was not discontinued in any OSA patient due to TMDs.
The findings reveal that different outcomes associated with TMD are affected differently by MAD treatment for OSAS. According to a few studies, MAD therapy significantly reduced the severity and frequency of TMD symptoms. Other research, however, found no appreciable modifications in TMD symptoms or TMJ-related indicators. Although the overall results point to no significant effect of MAD treatment on TMD symptoms, the disparity in results between studies highlights the need for additional studies using standardised approaches.
接受下颌前伸装置（MAD）治疗阻塞性睡眠呼吸暂停（OSA）的患者可能会经历颌位变化和咬合改变。这可能会导致颞下颌关节紊乱（TMD）症状的发展或加重。关于 MAD 治疗 OSA 对 TMD 的长期影响的文献很少。因此，进行了这项综述以确定 MAD 使用者 TMD 的发生情况。
使用 MeSH 关键词和布尔运算符在几个在线数据库中实施了全面的搜索方案。专门为此综述制定了标准化的数据提取表。两位审查员独立提取数据。使用 RoB-2 评估纳入研究的方法学质量。
共选择了 13 项临床研究进行综述。一些研究报告称，MAD 治疗后 TMD 症状的严重程度和频率显著降低。然而，其他研究没有观察到 TMD 症状或 TMJ 相关参数从基线到随访间隔的显著变化。一些研究报告称，在随访期开始时 TMJ 相关疼痛或症状暂时增加，但后来缓解。总体而言，没有任何 OSA 患者因 TMD 而停止使用 MAD。
研究结果表明，TMD 相关的不同结果受到 MAD 治疗 OSAS 的不同影响。根据一些研究，MAD 治疗显著降低了 TMD 症状的严重程度和频率。然而，其他研究没有发现 TMD 症状或 TMJ 相关指标有明显变化。尽管总体结果表明 MAD 治疗对 TMD 症状没有显著影响，但研究结果之间的差异突出表明需要使用标准化方法进行更多研究。
Zotero 插件