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埃勒斯-当洛斯综合征中的颞下颌关节紊乱:一篇叙述性综述。

Temporomandibular disorders among Ehlers-Danlos syndromes: a narrative review.

机构信息

Department of Prosthodontics, University Hospital Münster, Münster, Germany.

Department of Oral and Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations (RDOM), University Hospital Münster, Münster, Germany.

出版信息

J Int Med Res. 2024 Apr;52(4):3000605241242582. doi: 10.1177/03000605241242582.

Abstract

This narrative review aims to demonstrate and summarize the complex relationship between Ehlers-Danlos syndromes (EDS) and temporomandibular disorders (TMD) by reviewing the results of observational studies and case reports. EDS are a set of hereditary connective tissue disorders, where generalized joint hypermobility (GJH), especially in the hypermobile subtype (hEDS), is a key symptom. Mutations have been identified in genes that impact the production or assembly of collagen for all subtypes except hEDS. While the correlation between GJH and TMD has been analysed in various studies, fewer studies have examined TMD in patients with EDS, with most showing an increased prevalence of TMD. In case-control studies, an elevated prevalence of myalgia, arthralgia and disc-related disorders was found in individuals with EDS. Various therapeutic interventions have been reported within the literature in the form of case reports and observational studies, but there are no long-term clinical trials with results on the efficacy of different therapeutic approaches to date. This review demonstrates the high prevalence of different TMDs in different subtypes of EDS, but also shows that little is known about the success of treatment thus far. Further clinical research is necessary to provide adequate guidance on targeted treatment.

摘要

本综述旨在通过回顾观察性研究和病例报告的结果,展示和总结埃勒斯-当洛斯综合征(EDS)与颞下颌关节紊乱(TMD)之间的复杂关系。EDS 是一组遗传性结缔组织疾病,其中全身性关节过度活动(GJH),特别是在高活动亚型(hEDS)中,是一个关键症状。除了 hEDS 之外,所有亚型的基因都已经确定了影响胶原蛋白产生或组装的突变。虽然已经在各种研究中分析了 GJH 与 TMD 之间的相关性,但对 EDS 患者的 TMD 进行的研究较少,大多数研究显示 TMD 的患病率增加。在病例对照研究中,发现 EDS 患者的肌痛、关节炎和关节盘相关疾病的患病率升高。文献中已经报道了各种治疗干预措施,包括病例报告和观察性研究,但迄今为止,尚无关于不同治疗方法疗效的长期临床试验。本综述表明,不同 EDS 亚型中存在不同的 TMD 患病率较高,但也表明到目前为止,对治疗效果的了解甚少。需要进一步的临床研究为有针对性的治疗提供充分的指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cb4/11010766/914b33396917/10.1177_03000605241242582-fig1.jpg

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