Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile.
Private practice, Viña del Mar, Chile.
J Oral Rehabil. 2024 Oct;51(10):2209-2219. doi: 10.1111/joor.13801. Epub 2024 Jul 14.
To identify the available evidence on the ultrasonographic characteristics of masticatory muscles in subjects with myogenous TMD, as well as the potential use of ultrasonography as a diagnostic and treatment assessment outcomes tool.
An electronic search of the PubMed, Web of Science and Scopus databases was performed using the following terms: 'ultrasonography', 'ultrasound', 'masseter', 'temporal', 'masticatory muscles', 'temporomandibular disorders', 'temporomandibular joint disorders'. Full-text articles were obtained from the records after applying the inclusion/exclusion criteria.
Thirteen articles were included for analysis: one comparative cross-sectional study, five case-control studies, six clinical trials and one randomised clinical trial. Main ultrasonographic characteristic assessed were local cross-sectional dimension and intramuscular ultrasonographic appearance. Retrieved studies reported the use ultrasonography for diagnosis or treatment assessment purposes showing heterogeneous results. For diagnosis purposes, the results of local cross-sectional dimension are not consistent; therefore, its diagnostic value for myogenous TMD diagnosis is weak. However, more homogeneous results were observed for intramuscular ultrasonographic appearance showing a higher prevalence of type-II pattern in myogenous TMD subjects than non-TMD subjects. On the other hand, for treatment assessment purposes, muscles were observed thinner after treatment compared to pre-treatment. Also, results of intramuscular ultrasonographic appearance show disappearance or reduction of anechoic areas, higher prevalence of type-II pattern and significant distinction of echogenic bands were observed after treating TMD subjects.
Ultrasonography cannot be considered as a diagnostic instrument, but maybe as a complementary tool for treatment assessment of myogenous TMD subjects, even though future research is required to confirm its utility.
确定肌源性颞下颌关节紊乱病患者咀嚼肌超声特征的现有证据,以及超声作为诊断和治疗评估结果工具的潜在用途。
通过电子检索 PubMed、Web of Science 和 Scopus 数据库,使用以下术语:“超声检查”、“超声”、“咬肌”、“颞肌”、“咀嚼肌”、“颞下颌关节紊乱病”、“颞下颌关节紊乱”。对符合纳入/排除标准的记录进行全文获取。
纳入 13 篇文章进行分析:1 项比较性横断面研究、5 项病例对照研究、6 项临床试验和 1 项随机临床试验。主要评估的超声特征为局部横截面积和肌内超声表现。研究报告了使用超声进行诊断或治疗评估的结果,结果存在差异。对于诊断目的,局部横截面积的结果不一致;因此,其对肌源性颞下颌关节紊乱病的诊断价值较弱。然而,对于肌内超声表现,观察到更一致的结果,肌源性颞下颌关节紊乱病患者的 II 型模式发生率高于非颞下颌关节紊乱病患者。另一方面,对于治疗评估目的,治疗后肌肉比治疗前更薄。此外,治疗后肌内超声表现观察到无回声区消失或减少,II 型模式发生率更高,回声带明显区分,提示治疗后 TMD 患者的改善。
超声不能作为诊断工具,但可以作为肌源性颞下颌关节紊乱病患者治疗评估的辅助工具,尽管需要进一步的研究来证实其效用。