背景:咬咬是人类口颌系统的重要功能。尽管如此,它通常在颞下颌关节紊乱病(TMD)人群中受损。这篇综述的目的是评估保守干预措施对TMD患者的自我报告和物理咬伤功能的有效性。
方法:本综述按照PRISMA指南进行。对包括PubMed在内的数据库进行了电子搜索,CINAHL,Embase,和CochraneCentral.纳入标准是评估任何非药物保守干预对被诊断为TMD的参与者的咬合功能的影响的期刊文章。使用Cochrane偏差风险v2工具评估个体研究的偏差风险,和NIHNHLBIpre-post工具。数据是根据咬合功能的结果测量来合成的,使用建议分级评估来评估证据的质量,开发和评估方法。
结果:11项研究符合本综述的条件。干预措施包括夹板,光生物调节,针刺,锻炼,手动治疗,和病人教育,使用咀嚼相关疼痛进行评估,自我报告咀嚼困难,和咬力/耐力结果测量。调查结果建议手动治疗,针刺,口腔夹板,锻炼,PBM干预可能会改善TMD的咬合功能,尽管对累积证据的信心从中度到极低不等.没有证据表明患者教育可以改善咬合功能。
结论:保守干预措施可能有助于解决与TMD相关的咬伤损伤,尽管需要进一步的研究来提高证据质量和指导临床指南.
BACKGROUND: Bite is an important function of the human stomatognathic system. Despite this, it is commonly impaired in temporomandibular disorder (TMD) populations. The aim of this
review is to evaluate the effectiveness of conservative interventions on self-reported and physical measures of bite function in individuals with TMD.
METHODS: This
review was performed in compliance with PRISMA guidelines. An electronic search was performed on databases including PubMed, CINAHL, Embase, and Cochrane Central. Inclusion criteria were journal articles evaluating the effect of any non-pharmacological conservative interventions on bite function in participants diagnosed with TMD. Risk of bias for individual studies was assessed using the Cochrane risk-of-bias v2 tool, and the NIH NHLBI pre-post tool. Data was synthesised based on outcome measures of bite function, and the quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS: Eleven studies were eligible for this
review. Interventions included splinting, photobiomodulation, needling, exercise, manual therapy, and patient education, which were evaluated using mastication-related pain, self-reported chewing difficulty, and bite force/endurance outcome measures. Findings suggested manual therapy, needling, oral splinting, exercise, and PBM interventions may improve bite function in TMD, although confidence in cumulative evidence ranged from moderate to very low. There was no evidence that patient education improved bite function.
CONCLUSIONS: Conservative interventions may be helpful to address bite-related impairments associated with TMD, although further research is needed to improve the quality of evidence and direct clinical guidelines.