Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Oral Biol. 2025 Jan;169:106108. doi: 10.1016/j.archoralbio.2024.106108. Epub 2024 Oct 15.
This systematic review evaluates the connection between vitamin D serum levels, deficiency, and temporomandibular disorders (TMD), offering a meta-analysis of the existing evidence in this domain.
The Scopus, ISI Web of Science, and Pubmed databases were searched for human studies concerning the connection between vitamin D and TMD comprising a control group. A random-effect model with forest plots was used for vitamin D serum levels mean difference (MD), vitamin D deficiency odds ratio (OR), and risk difference (RD) between subjects with and without TMD. Subgroup analysis was conducted based on ethnicity, overall risk of bias, TMD diagnosis method, and study designs. A p-value lower than 0.05 was considered significant. The certainty of the meta-evidence was evaluated according to the GRADE approach.
Of the 2621 identified unique records, 15 studies were included in the study, eight of which were considered for the meta-analysis. The meta-analysis revealed a significant vitamin D deficiency OR (3.85; 95 % CI: 2.35 - 5.43; Certainty: Low) and RD (22 %; 95 % CI: 11 % - 32 %; Certainty: Very low), and vitamin D serum levels MD (-5.03 ng/mL; 95 % CI: -9.92 - -0.13; Certainty: Very low) between subjects with and without TMD. Among subgroup analyses, only the difference in vitamin D MD between Middle Eastern and European patients was significant (P < 0.01).
Considering the low to very low certainty of the evidence, vitamin D serum levels are significantly lower, and vitamin D deficiency is significantly more prevalent in TMD patients.
本系统评价评估了血清维生素 D 水平、缺乏与颞下颌关节紊乱（TMD）之间的关系，对该领域现有证据进行了荟萃分析。
在 Scopus、ISI Web of Science 和 Pubmed 数据库中检索了关于维生素 D 与 TMD 之间存在对照的人类研究。采用随机效应模型和森林图分析维生素 D 血清水平均数差值（MD）、TMD 患者与非 TMD 患者之间维生素 D 缺乏比值比（OR）和风险差（RD）。根据种族、整体偏倚风险、TMD 诊断方法和研究设计进行了亚组分析。p 值低于 0.05 被认为具有统计学意义。根据 GRADE 方法评估荟萃证据的确定性。
在 2621 条独特记录中，有 15 项研究被纳入本研究，其中 8 项被纳入荟萃分析。荟萃分析显示，维生素 D 缺乏 OR（3.85；95%置信区间：2.35-5.43；确定性：低）和 RD（22%；95%置信区间：11%-32%；确定性：极低）有显著差异，且 TMD 患者与非 TMD 患者之间的维生素 D 血清水平 MD（-5.03ng/ml；95%置信区间：-9.92 至-0.13；确定性：极低）也有显著差异。在亚组分析中，只有中东和欧洲患者之间的维生素 D MD 差异具有统计学意义（P<0.01）。
考虑到证据的确定性为低到极低，TMD 患者的血清维生素 D 水平显著较低，维生素 D 缺乏更为常见。
