背景:通过设备探索下颌运动轨迹的数字化,并讨论生理因素和设备相关变量及其对下颌运动分析的后续影响。
方法:基于预定义的资格标准,搜索是按照PRISMA-P2015关于MEDLINE的指南进行的,EBSCO主机,Scopus,PubMed,和WebofScience数据库在2022年由2名审阅。然后,文章进行了Cochrane等级方法和JBI关键评估,以确定证据和偏见评估。
结果:在资格筛选后纳入了30篇文章。体外实验(20%)和体内(80%)的设备范围从电子轴描记术,肌电图,光电和超声波,口腔或口腔外跟踪,摄影测量,sirognathography,数字压力传感器,下颌电图,并记录了计算机化的医学图像追踪。53.53%的研究被评为低于“中等”证据的确定性。严格评估显示,80%的病例对照研究未能解决混杂变量,而90%的非随机实验研究未能建立对照参考。
结论:下颌和髁突生长,神经肌肉系统的运动功能障碍,缩短牙弓,以前的正畸治疗,习惯性头部姿势的变化,颞下颌关节病,摩擦音,并且在有限的程度上,功能异常习惯和不平衡的咬合接触被确定为混杂变量,这些混杂变量塑造了下颌运动轨迹,但并不高度依赖于年龄,性别,或饮食。在整个数字系统中,设备精度的实际变化在50到330µm之间,对于照片的运动跟踪,评分者间的可靠性非常低。法医和体外模拟设备无法准确地重现下颌运动和肌肉收缩的变化。
BACKGROUND: To explore the digitisation of jaw movement trajectories through devices and discuss the physiological factors and device-dependent variables with their subsequent effects on the jaw movement analyses.
METHODS: Based on predefined eligibility criteria, the search was conducted following PRISMA-P 2015 guidelines on MEDLINE, EBSCO Host, Scopus, PubMed, and Web of Science databases in 2022 by 2 reviewers. Articles then underwent Cochrane GRADE approach and JBI critical appraisal for certainty of evidence and bias evaluation.
RESULTS: Thirty articles were included following eligibility screening. Both in vitro experiments (20%) and in vivo (80%) devices ranging from electronic axiography, electromyography, optoelectronic and ultrasonic, oral or extra-oral tracking, photogrammetry, sirognathography, digital pressure sensors, electrognathography, and computerised medical-image tracing were documented. 53.53% of the studies were rated below \"moderate\" certainty of evidence. Critical appraisal showed 80% case-control investigations failed to address confounding variables while 90% of the included non-randomised experimental studies failed to establish control reference.
CONCLUSIONS: Mandibular and condylar growth, kinematic dysfunction of the neuromuscular system, shortened dental arches, previous orthodontic treatment, variations in habitual head posture, temporomandibular joint disorders, fricative phonetics, and to a limited extent parafunctional habits and unbalanced occlusal contact were identified confounding variables that shaped jaw movement trajectories but were not highly dependent on age, gender, or diet. Realistic variations in device accuracy were found between 50 and 330 µm across the digital systems with very low interrater reliability for motion tracing from photographs. Forensic and in vitro simulation devices could not accurately recreate variations in jaw motion and muscle contractions.