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通过颞下颌关节紊乱病诊断标准(DC/TDM)轴II评估与轴I评估相比的颞下颌关节紊乱病诊断准确性:一项系统评价和荟萃分析。

Accuracy of temporomandibular disorders diagnosis evaluated through the diagnostic criteria for temporomandibular disorder (DC/TDM) Axis II compared to the Axis I evaluations: a systematic review and meta-analysis.

作者信息

Minervini Giuseppe, Marrapodi Maria Maddalena, Siurkel Yuliia, Cicciù Marco, Ronsivalle Vincenzo

机构信息

Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.

Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania, Luigi Vanvitelli, Caserta, 81100, Italy.

出版信息

BMC Oral Health. 2024 Mar 2;24(1):299. doi: 10.1186/s12903-024-03983-7.

Abstract

BACKGROUND

The temporomandibular joint (TMJ) is a complex joint that facilitates mandibular movements during speech, chewing, and swallowing activities. The Axis I evaluation of the DC/TMD focuses on assessing physical diagnoses related to TMDs. It includes an assessment of pain and functional limitations, such as jaw opening range, joint sounds, and joint tenderness. The Axis II evaluation of the DC/TMD provides information on the patient's psychological status and quality of life. This Systematic Review with Meta-Analysis aimed to evaluate the accuracy of Temporomandibular Disorders diagnosis considered through the Diagnostic Criteria for Temporomandibular Disorder (DC/TDM) axis II compared to the Axis I evaluations.

METHODS

A search was made in PubMed, Web of Science and Lilacs for articles published from the inception until 20 January 2023. We applied the Population, Exposure, Comparator, and Outcomes (PECO) model [1] to assess document eligibility. Only studies that evaluated patients by DC/TMD Axis I and Axis II were considered. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (Axis I and Axis II).

RESULTS

Fifty-one articles were selected because of the search. Four papers were excluded before the screening: 2 pieces were not in English, and two were reviewed. The remaining 47 articles were selected for the title and abstract screening to evaluate whether they met the PECO criteria. Among these, four papers were established; the overall effect showed that there was no difference in TMD diagnosis between Axis I and Axis II (RR 1.17; 95% CI: 0.80- 1.71; Z:0.82; P = .41), suggesting that there is no difference between Axis I and Axis II.

CONCLUSION

In conclusion, DC/TMD is an effective tool for the diagnosis of TMD. It improves the accuracy of TMD diagnosis, allows for the classification of subtypes, and assesses psychosocial factors that may impact the development or maintenance of TMD symptoms.

摘要

背景

颞下颌关节(TMJ)是一个复杂的关节,在言语、咀嚼和吞咽活动中促进下颌运动。颞下颌关节紊乱病(DC/TMD)的轴I评估侧重于评估与颞下颌关节紊乱病相关的身体诊断。它包括对疼痛和功能限制的评估,如下颌开口范围、关节弹响和关节压痛。DC/TMD的轴II评估提供有关患者心理状态和生活质量的信息。本系统评价与Meta分析旨在评估通过颞下颌关节紊乱病诊断标准(DC/TDM)轴II与轴I评估相比,颞下颌关节紊乱病诊断的准确性。

方法

在PubMed、科学网和Lilacs中检索从创刊到2023年1月20日发表的文章。我们应用人群、暴露、对照和结局(PECO)模型[1]来评估文献的 eligibility。仅考虑通过DC/TMD轴I和轴II评估患者的研究。使用Review Manager 5.2.8版(Cochrane协作网)进行汇总分析。我们测量了两组(轴I和轴II)之间的比值比(OR)。

结果

因检索共选择了51篇文章。在筛选前排除了4篇论文:2篇不是英文的,2篇经过了评审。其余47篇文章被选用于标题和摘要筛选,以评估它们是否符合PECO标准。其中,4篇论文被确定;总体效应表明轴I和轴II之间的颞下颌关节紊乱病诊断没有差异(RR 1.17;95%CI:0.80 - 1.71;Z:0.82;P = 0.41),表明轴I和轴II之间没有差异。

结论

总之,DC/TMD是诊断颞下颌关节紊乱病的有效工具。它提高了颞下颌关节紊乱病诊断的准确性,允许对亚型进行分类,并评估可能影响颞下颌关节紊乱病症状发展或维持的心理社会因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5cd/10909276/fdeb0d50701a/12903_2024_3983_Fig1_HTML.jpg

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