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肌源性颞下颌关节紊乱的超声影像学特征:综述性研究。

Ultrasonographic characteristics of myogenous temporomandibular disorders: A scoping review.

机构信息

Faculty of Dentistry, Universidad Andres Bello, Viña del Mar, Chile.

Private practice, Viña del Mar, Chile.

出版信息

J Oral Rehabil. 2024 Oct;51(10):2209-2219. doi: 10.1111/joor.13801. Epub 2024 Jul 14.

Abstract

OBJECTIVE

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.

METHOD

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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