Helmer Loreine M L, Dalmeijer Sebastiaan W R, Koutris Michail, de Vries Ralph, Dubois Leander, de Lange Jan, Lobbezoo Frank
Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Oral and Maxillofacial Surgery, Academic Centre for Dentistry (ACTA), Academic Medical Centre of Amsterdam (AUMC), University of Amsterdam, Amsterdam, The Netherlands.
Clin Oral Investig. 2024 Dec 31;29(1):35. doi: 10.1007/s00784-024-06095-2.
Temporomandibular disorders (TMD) are musculoskeletal conditions with a multifactorial aetiology. The predictive role of direct orofacial macrotrauma in the development of TMD is considered controversial. This systematic review aims to elucidate the association between direct orofacial macrotrauma and TMD, and to identify potential factors involved in this relationship.
A comprehensive literature search of PubMed, Embase, and Web of Science databases up to November 1, 2023, was performed in collaboration with a medical information specialist, identifying 2,047 unique studies. Of these, 139 met the inclusion criteria of this investigation.
Our synthesis of the literature indicates a consistent association between TMD and direct orofacial macrotrauma in adults, while this relationship appears less defined in paediatric and adolescent populations. The association shows robustness across various TMD diagnoses and trauma locations, remaining not only immediately following the direct orofacial macrotrauma but also after long time, despite other interventions. These outcomes could be due to the physical effect of the trauma, but they might be associated with the psychosocial effect of the trauma as well.
The evidence supports a robust, but complex, association between direct orofacial macrotrauma and TMD.
This finding underscores the importance of considering both physical and psychosocial sequelae of trauma in the clinical management of direct orofacial macrotrauma and TMD.
颞下颌关节紊乱病（TMD）是一种病因多因素的肌肉骨骼疾病。直接口腔颌面部大创伤在TMD发病中的预测作用存在争议。本系统评价旨在阐明直接口腔颌面部大创伤与TMD之间的关联，并确定这种关系中涉及的潜在因素。
与医学信息专家合作，对截至2023年11月1日的PubMed、Embase和Web of Science数据库进行全面文献检索，共识别出2047项独特研究。其中，139项符合本研究的纳入标准。
我们对文献的综合分析表明，成人TMD与直接口腔颌面部大创伤之间存在一致的关联，而在儿童和青少年人群中，这种关系似乎不太明确。这种关联在各种TMD诊断和创伤部位都表现出稳健性，不仅在直接口腔颌面部大创伤后立即存在，而且在经过长时间以及其他干预后仍然存在。这些结果可能是由于创伤的物理效应，但也可能与创伤的心理社会效应有关。
证据支持直接口腔颌面部大创伤与TMD之间存在稳健但复杂的关联。
这一发现强调了在直接口腔颌面部大创伤和TMD的临床管理中考虑创伤的身体和心理社会后遗症的重要性。
