国际口腔医学杂志

国际口腔医学杂志 ›› 2017, Vol. 44 ›› Issue (4): 405-410.doi: 10.7518/gjkq.2017.04.008

• 论著 • 上一篇    下一篇

稳定咬合板治疗慢性颞下颌关节盘不可复性移位的临床随机对照试验的系统评价

黎静1, 刘星辰1, 李佳园2, 李小兵1   

  1. 1.口腔疾病研究国家重点实验室,国家口腔疾病临床研究中心,四川大学华西口腔医院儿童口腔科 成都 610041;
    2.四川大学华西公共卫生学院流行病学教研室 成都 610041
  • 收稿日期:2016-09-02 修回日期:2017-01-17 出版日期:2017-07-01 发布日期:2017-07-01
  • 通讯作者: 李小兵,教授,博士,Email：909984963@qq.com
  • 作者简介:黎静,硕士,Email：837019676@qq.com

Stabilization splint treatment for chronic temporomandibular joint disk displacement without reduction: a systematic review based on randomized controlled trials

Li Jing1, Liu Xingchen1, Li Jiayuan2, Li Xiaobing1   

  1. 1. State Key Labora-tory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Pediatrics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China;
    2. Dept. of Epidemiology, West China School of Public Health, Sichuan University, Chengdu 610041, China
  • Received:2016-09-02 Revised:2017-01-17 Online:2017-07-01 Published:2017-07-01

RichHTML

7

PDF (PC)

289

被引次数

8

摘要： 目的 运用系统评价方法总结稳定咬合板治疗慢性颞下颌关节盘不可复性移位的临床随机对照试验,评价稳定咬合板治疗慢性颞下颌关节盘不可复性移位的有效性。方法 检索电子数据库CENTRAL、Medline、EMBASE（Ovid）、CBM和CNKI,检索时间至2015年7月,手工检索19种中文口腔医学杂志。按照纳入、排除标准筛选相关研究,提取数据并进行风险偏倚评价。采用Rveman 5.3.5进行Meta分析。结果 最终纳入6项研究,其中4个为中等偏倚风险,2项为高偏倚风险。与其他保守治疗相比,在短期内稳定咬合板改善颞下颌关节盘不可复性移位患者的疼痛和最大张口度无明显优势（P>0.05）;在长期疗效上,稳定咬合板可提高治疗的成功率（P<0.01）。结论 稳定咬合板治疗颞下颌关节盘不可复性移位的长期疗效需要更多高质量随机对照试验进一步的证实。

关键词: 咬合板, 颞下颌关节, 系统评价, Meta分析

Abstract: Objective This study aims to assess the efficacy of stabilization splint(SS) treatment on patients with chronic temporomandibular joint disk displacement without reduction(DDwoR) through systematic review of relevant randomized controlled trials. Methods An electronic search strategy was performed on Cochrane Central, Medline, EMBASE(Ovid), Chinese Biomedical Database, and China National Knowledge Infrastructure until July 2015. A manual search covering 19 dental journals in Chinese was performed as well. Data extraction of included studies and risk of bias assessment with the recommended tool of Cochrane Collaboration was then performed. Meta-analysis was processed by Rveman 5.3.5. Results Four studies of unclear risk of bias and two studies of high-risk bias were included. Compared with other conservative therapies, SS did not show a significant advantage(P>0.05) on pain relief and maximal mouth opening of DDwoR patients in the short term. However, SS may have increased the success rate(P<0.01) in the long term. Conclusion High-quality randomized controlled trials are necessary for the evaluation of the long-term efficacy of SS treatment on chronic DDwoR.

Key words: splint, temporomandibular joint, systematic review, Meta analysis

中图分类号: 

  • R782.6
[1] Manfredini D, Guarda-Nardini L, Winocur E, et al. Research diagnostic criteria for temporomandibular disorders: a systematic review of axisⅠepidemiolo-gic findings[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2011, 112(4):453-462.
[2] Ahmad M, Hollender L, Anderson Q, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009,107(6):844-860.
[3] Seymour RA, Simpson JM, Charlton JE, et al. An evaluation of length and end-phrase of visual analo-gue scales in dental pain[J]. Pain, 1985, 21(2):177- 185.
[4] Higgins J, Green S. Cochrane handbook for systema-tic reviews of interventions[J]. Naunyn-Schmiede-bergs Arch Expe Pathol Pharmakol, 2011, 2011(14):S38.
[5] 汪谋岳. 2010 年新版CONSORT声明简介[J]. 中国科技期刊研究, 2011, 22(2):309-310.
Wang MY. Brief introduction to CONSORT State-ment 2010[J]. Chin J Sci Tech Perio, 2010, 22(2): 309-310.
[6] Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations[J]. BMJ, 2008, 336(7650):924-926.
[7] Lundh H, Westesson PL, Eriksson L, et al. Temporo-mandibular joint disk displacement without reduc-tion. Treatment with flat occlusal splint versus no treatment[J]. Oral Surg Oral Med Oral Pathol, 1992, 73(6):655-658.
[8] Linde C, Isacsson G, Jonsson BG. Outcome of 6- week treatment with transcutaneous electric nerve stimulation compared with splint on symptomatic temporomandibular joint disk displacement without reduction[J]. Acta Odontol Scand, 1995, 53(2):92- 98.
[9] Schmitter M, Zahran M, Duc JM, et al. Conservative therapy in patients with anterior disc displacement without reduction using 2 common splints: a ran-domized clinical trial[J]. J Oral Maxillofac Surg, 2005, 63(9):1295-1303.
[10] Stiesch-Scholz M, Kempert J, Wolter S, et al. Com-parative prospective study on splint therapy of ante-rior disc displacement without reduction[J]. J Oral Rehabil, 2005, 32(7):474-479.
[11] Conti PC, Dos Santos CN, Kogawa EM, et al. The treatment of painful temporomandibular joint cli-cking with oral splints: a randomized clinical trial [J]. J Am Dent Assoc, 2006, 137(8):1108-1114.
[12] Haketa T, Kino K, Sugisaki M, et al. Randomized clinical trial of treatment for TMJ disc displacement [J]. J Dent Res, 2010, 89(11):1259-1263.
[13] 李春洁, 贾源源, 张绮, 等. 盐酸氨基葡萄糖片联合玻璃酸钠治疗颞下颌关节骨关节炎的临床随机对照试验[J]. 华西口腔医学杂志, 2011, 29(6):632- 635.
Li CJ, Jia YY, Zhang Q, et al. Glucosamine hydro-chloride combined with hyaluronate for temporo-mandibular joint osteoarthritis: a primary report of randomized controlled trial[J]. West China J Sto-matol, 2011, 29(6):632-635.
[14] 李春洁, 张一帆, 贾源源, 等. 透明质酸钠治疗颞下颌关节结构紊乱临床随机对照试验的系统评价[J]. 华西口腔医学杂志, 2011, 29(5):488-493.
Li CJ, Zhang YF, Jia YY, et al. Hyaluronate sodium treatment for internal derangement of temporo-mandibular joint: a systematic review based on ran-domized controlled trials[J]. West China J Stomatol, 2011, 29(5):488-493.
[15] Al-Baghdadi M, Durham J, Araujo-Soares V, et al. TMJ disc displacement without reduction manage-ment: a systematic review[J]. J Dent Res, 2014, 93(7 Suppl):37S-51S.
[16] Fricton J, Look JO, Wright E, et al. Systematic re-view and meta-analysis of randomized controlled trials evaluating intraoral orthopedic appliances for temporomandibular disorders[J]. J Orofac Pain, 2010, 24(3):237-254.
[17] Türp JC, Komine F, Hugger A. Efficacy of stabi-lization splints for the management of patients with masticatory muscle pain: a qualitative systematic review[J]. Clin Oral Investig, 2004, 8(4):179-195.
[18] Greene CS. The etiology of temporomandibular disorders: implications for treatment[J]. J Orofac Pain, 2001, 15(2):93-116.
[19] Auerbach SM, Laskin DM, Frantsve LM, et al. Depression, pain, exposure to stressful life events, and long-term outcomes in temporomandibular disorder patients[J]. J Oral Maxillofac Surg, 2001, 59(6):628-634.
[1] 侯亚丽,马利. 亚洲人群干扰素调节因子6基因多态性与非综合征型唇腭裂相关性研究的Meta分析[J]. 国际口腔医学杂志, 2020, 47(4): 397-405.
[2] 林阳阳,侯敏. 双侧下颌支矢状骨劈开术对下颌近心骨段位移变化的影响[J]. 国际口腔医学杂志, 2019, 46(6): 718-723.
[3] 高洁,马锐,葛振林. 热激活镍钛弓丝矫治效率的系统评价[J]. 国际口腔医学杂志, 2019, 46(4): 393-399.
[4] 潘韦霖,曹钰彬,刘畅,刘济远,李春洁,潘剑,华成舸. 不同翻瓣设计对下颌第三磨牙拔除术后疼痛的影响：系统评价与Meta分析[J]. 国际口腔医学杂志, 2019, 46(2): 142-148.
[5] 黄婕,林云红. 种植体周围角化龈宽度与种植体周围骨高度的相关性[J]. 国际口腔医学杂志, 2019, 46(2): 149-155.
[6] 李天成,夏恺,邹淑娟,刘钧. 正畸治疗中拔牙对上气道影响的系统评价[J]. 国际口腔医学杂志, 2019, 46(2): 156-165.
[7] 郭骏,费伟,李庆华. 创伤性颞下颌关节强直转归机制的动物研究[J]. 国际口腔医学杂志, 2019, 46(1): 12-19.
[8] 刘洋, 赵翰驰. 前牙重度磨损伴关节弹响患者的咬合重建[J]. 国际口腔医学杂志, 2017, 44(1): 11-18.
[9] 胡欣欣，朱耀旻，郑苍尚. 特发性髁突吸收的研究进展[J]. 国际口腔医学杂志, 2016, 43(4): 412-416.
[10] 李唐 李春洁 门乙 杨文宾 韩波 李龙江. Meta分析评价全景片在口腔癌下颌骨侵犯中的诊断效能[J]. 国际口腔医学杂志, 2016, 43(1): 26-.
[11] 吕春晓 陈嵩. 颞下颌关节病的临床诊断与磁共振成像影像诊断的相关性研究[J]. 国际口腔医学杂志, 2016, 43(1): 47-.
[12] 杨文英1 张文丽1 罗应伟2. 颞下颌关节骨关节炎动物模型的研究进展[J]. 国际口腔医学杂志, 2015, 42(6): 677-680.
[13] 李放，王建国. 不同垂直骨面型安氏Ⅰ类成年患者颞下颌关节形态特征的锥形束CT研究[J]. 国际口腔医学杂志, 2015, 42(5): 538-541.
[14] 陈琦 吴芸. 肿痛安治疗癌症放射治疗后颞下颌关节疼痛的疗效评价[J]. 国际口腔医学杂志, 2015, 42(1): 24-27.
[15] 肖朋1 王兵1 黄旭1 刘海霞1 王虹2. 应激状态下大鼠咬肌活动性与颞下颌关节病变的相关性分析[J]. 国际口腔医学杂志, 2014, 41(4): 406-408.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 张京剧. 青年期至中年期颅面复合体变化的头影测量研究[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 刘玲. 镍铬合金中铍对可铸造性和陶瓷金属结合力的影响[J]. 国际口腔医学杂志, 1999, 26(06): .
[3] 王昆润. 在种植体上制作固定义齿以后下颌骨密度的动态变化[J]. 国际口腔医学杂志, 1999, 26(06): .
[4] 王昆润. 重型颌面部炎症死亡和康复病例的实验室检查指标比较[J]. 国际口腔医学杂志, 1999, 26(06): .
[5] 温秀杰. 氟化物对牙本质脱矿抑制作用的体外实验研究[J]. 国际口腔医学杂志, 1999, 26(05): .
[6] 杨春惠. 耳颞神经在颞颌关节周围的分布[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 王昆润. 牙周炎加重期应选用何种抗生素[J]. 国际口腔医学杂志, 1999, 26(04): .
[8] 杨儒壮 孙宏晨 欧阳喈. 纳米级高分子支架材料在组织工程中的研究进展[J]. 国际口腔医学杂志, 2004, 31(02): 126 -128 .
[9] 严超然,李龙江. 肿瘤靶向药物载体系统的研究进展[J]. 国际口腔医学杂志, 2008, 35(S1): .
[10] 沈末伦,华成舸. 上皮间质转化及其调控基因Twist在肿瘤侵袭转移中的作用[J]. 国际口腔医学杂志, 2008, 35(S1): .