Alowaimer Hesham A, Al Shutwi Sultan S, Alsaegh Mohammed K, Alruwaili Ohood M, Alrashed Abdullah R, AlQahtani Salwa H, Batais Mohammed S
Maxillofacial Surgery, Ministry of Health, Al-Qassim, SAU.
Dentistry, Qassim University, Al-Ras, SAU.
Cureus. 2024 Mar 22;16(3):e56713. doi: 10.7759/cureus.56713. eCollection 2024 Mar.
Temporomandibular disorder (TMD) is a multifaceted disorder impacting the temporomandibular joint (TMJ), causing substantial discomfort and functional limitations. This systematic review aims to comprehensively assess the effectiveness of non-invasive treatment modalities for TMJ dysfunction, prioritizing a definitive protocol to ensure patient safety and enhance quality of life. Employing the PRISMA guidelines, we meticulously analyzed 20 studies from a pool of 1,417 articles sourced from databases such as PubMed, Google Scholar, ScienceDirect, and Medline. These studies underscore the multifarious nature of TMD and the varied responses to treatments such as physical therapy, laser therapy, ultrasound and electrical stimulation, splint therapy, injections, and arthrocentesis. Notably, the review highlights the paramount importance of precise diagnosis, often through surface electromyography, followed by a tailored treatment approach integrating manual therapy, counseling, and splint therapy. The systematic analysis revealed that while certain treatments such as transcutaneous electrical nerve stimulation and low-level laser therapy showed limited efficacy, combination therapies, especially those involving manual therapy, counseling, and splint therapy, demonstrated substantial improvement in reducing pain, depression, and anxiety. The findings advocate for a non-invasive, patient-centric approach, emphasizing education and symptom management before considering more invasive procedures such as injections and arthrocentesis. The review identifies the need for more comprehensive, longitudinal studies to establish a standardized, evidence-based treatment protocol for TMJ dysfunction, aiming to improve patient outcomes holistically.
颞下颌关节紊乱病（TMD）是一种多方面的疾病，影响颞下颌关节（TMJ），会导致严重不适和功能受限。本系统评价旨在全面评估非侵入性治疗方式对颞下颌关节功能障碍的有效性，优先制定明确的方案以确保患者安全并提高生活质量。我们采用PRISMA指南，对从PubMed、谷歌学术、ScienceDirect和Medline等数据库中筛选出的1417篇文章中的20项研究进行了细致分析。这些研究强调了TMD的多面性以及对物理治疗、激光治疗、超声和电刺激、夹板治疗、注射和关节穿刺等治疗的不同反应。值得注意的是，该评价突出了精确诊断的至关重要性，通常通过表面肌电图进行，随后采用结合手法治疗、咨询和夹板治疗的个性化治疗方法。系统分析表明，虽然经皮电刺激神经疗法和低强度激光疗法等某些治疗显示出有限的疗效，但联合疗法，尤其是那些涉及手法治疗、咨询和夹板治疗的联合疗法，在减轻疼痛、抑郁和焦虑方面有显著改善。研究结果提倡采用非侵入性、以患者为中心的方法，强调在考虑注射和关节穿刺等更具侵入性的程序之前进行教育和症状管理。该评价指出需要进行更全面的纵向研究，以建立针对颞下颌关节功能障碍的标准化、循证治疗方案，旨在全面改善患者预后。
