PDF(Pubmed)
Abstract：
Objectives: This overview was conducted following the Preferred Reporting Items for Overviews of Reviews guidelines and aimed to collect and compare the results of systematic reviews on temporomandibular joint injection treatment. Methods: Systematic reviews of randomized clinical trials on temporomandibular disorders treated with lavage or intra-articular administrations were qualified for syntheses. The final searches were conducted on 27 February 2024, without time frame restrictions. Results: Of the 232 identified records, 42 systematic reviews were selected. The most evidence-based conclusions call into question the clinical differences between many therapeutic approaches, including the following: (1) injectable selection for the treatment of pain and hypomobility; (2) the method of performing arthrocentesis; (3) the use of imaging when rinsing the TMJ cavity; (4) the supplementation of the extracapsular administration of unprocessed blood with intracapsular deposition in the treatment of TMJ hypermobility. Conclusions: Systematic reviews based solely on randomized clinical trials proved the following differences: (1) in painful temporomandibular hypomobility, a better therapeutic effect is observed with arthrocentesis followed by I-PRF administration compared to lavage alone; (2) in painful temporomandibular hypomobility, inferior- or double-compartment injection leads to better results than superior-compartment injection; (3) in temporomandibular joint recurrent dislocation, hypertonic dextrose administration is superior to placebo, although (4) unprocessed blood has a better effect than hypertonic dextrose. PROSPERO registration number: CRD42024496142.
摘要：
目标：本概述是根据首选报告项目概述指南进行的，旨在收集和比较颞下颌关节注射治疗的系统评价结果。方法：对通过灌洗或关节内给药治疗的颞下颌关节紊乱病的随机临床试验进行系统综述，以进行综合。最终搜索于2024年2月27日进行，没有时间限制。结果：在232条确定的记录中，选择了42项系统评价。最基于证据的结论质疑许多治疗方法之间的临床差异，包括：（1）选择可注射的治疗疼痛和机能减退；（2）进行关节穿刺术的方法；（3）冲洗TMJ腔时使用成像；（4）在TMJ过度活动治疗中补充囊外给药未经处理的血液和囊内沉积。结论：仅基于随机临床试验的系统评价证明了以下差异：（1）在痛性颞下颌关节功能减退中，与单独灌洗相比，关节穿刺术后I-PRF给药观察到更好的治疗效果;（2）在疼痛的颞下颌关节功能减退中，下或双室注射导致更好的结果优于上室注射;（3）在颞下颌关节复发性脱位，高渗葡萄糖给药优于安慰剂，虽然(4)未经处理的血液比高渗葡萄糖有更好的效果。PROSPERO注册号：CRD42024496142。
