背景:幼年特发性关节炎(JIA)是儿童时期最常见的风湿性疾病,和颞下颌关节(TMJ)涉及39%-78%的患者。
目的:本系统评价的目的是评估保守治疗方法改善JIA患儿和青少年TMJ关节炎的有效性。
方法:PubMed,Scopus,从一开始到2024年2月25日,对WebofScience进行了系统搜索,以确定观察性研究,这些研究表明参与者被诊断为影响TMJ的JIA,颞下颌关节炎的康复方法作为干预措施,和TMJ关节炎的临床或放射学评估作为结果。
结果:在478篇适合标题/摘要筛选的论文中,共纳入13项研究。这些研究评估了关节内(IA)皮质类固醇(CS)注射的有效性,IA英夫利昔单抗注射液,关节穿刺术单独或与IACS注射相结合,咬合夹板,功能电器,和物理治疗。IACS注射的有效性在8项研究中显示。IA英夫利昔单抗注射似乎并未显着改善TMJ关节炎。
结论:这项系统评价的结果表明,保守治疗,尤其是IACS注射,可能有效改善JIA患者的TMJ关节炎。应进行更高水平的证据和更具代表性的样本的进一步研究。
BACKGROUND: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, and temporomandibular joints (TMJs) are involved in 39%-78% of patients.
OBJECTIVE: The aim of this systematic review was to assess the effectiveness of conservative approaches in improving TMJ arthritis in children and adolescents affected by JIA.
METHODS: PubMed, Scopus, and Web of Science were systematically searched from the inception until February 25, 2024, to identify observational studies presenting participants with a diagnosis of JIA affecting the TMJ, rehabilitative approaches for TMJ arthritis as interventions, and clinical or radiological assessment of TMJ arthritis as outcome.
RESULTS: Of 478 papers suitable for title/abstract screening, 13 studies were included. The studies evaluated the effectiveness of intra-articular (IA) corticosteroid (CS) injections, IA infliximab injections, arthrocentesis alone or in combination with IACS injections, occlusal splint, functional appliance, and physiotherapy. The effectiveness of IACS injections was shown in eight studies. IA infliximab injections did not appear to significantly improve TMJ arthritis.
CONCLUSIONS: Results of this systematic review suggested that conservative treatments, especially IACS injections, might be effective in improving TMJ arthritis in patients affected by JIA. Further studies with a higher level of evidence and more representative samples should be conducted.