Effects of total temporomandibular joint replacement with alloplastic prosthesis - a systematic review.

IF 1.4 4区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Pär Morin, Jani Talvilahti, Mattias Ulmner, Per Alstergren, Eva Nordendahl, Aron Naimi- Akbar
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Abstract

Objectives: This paper studies the treatment effect of total joint replacement (TJR) of the temporomandibular joint (TMJ) with alloplastic joint prosthesis regarding function, symptoms and health-related quality of life compared to other surgical and non-surgical treatments in patients with TMJ disorders.

Methods: Three databases (PubMed, Cochrane Library and Web of Science) were searched up to 11 March 2025. Studies in which TJR was compared with other surgical or non-surgical methods were searched and analyzed. Data extraction and quality assessments were performed by at least two investigators independently. Risk of bias was assessed with the ROBINS-I-tool. Certainty of evidence was assessed with GRADE.

Results: A total of 2,891 studies were identified in the search. One study met the criteria with comparison of TJR with a control group consisting of patients treated with another surgical method, namely, interpositional arthroplasty. The study investigated the outcome variables such as pain reduction and improvement in mouth opening and had a moderate risk of bias. No significant difference between the groups was found after regression analysis. Quality of life assessment was not the objective of this study. No meta-analysis could be performed from this literature search, for obvious reasons.

Conclusion: TMJ reconstruction with alloplastic prostheses is rapidly evolving, with new systems continually entering the market. This review highlights the urgent need for further scientific efforts, including well-designed trials capable of demonstrating the comparative effectiveness of alloplastic TJR against other treatment modalities, ideally randomized trials with controls.

同种异体假体全颞下颌关节置换术的疗效综述。
目的:研究同种异体假体颞下颌关节(TMJ)全关节置换术(TJR)与其他手术和非手术治疗相比在功能、症状和健康相关生活质量方面的治疗效果。方法:检索截至2025年3月11日的PubMed、Cochrane Library和Web of Science三个数据库。对TJR与其他手术或非手术方法比较的研究进行检索和分析。数据提取和质量评估由至少两名研究者独立完成。使用robins - i工具评估偏倚风险。用GRADE评价证据的确定性。结果:在检索中共确定了2891项研究。其中一项研究通过将TJR与另一种手术方法(即置换术)治疗的患者组成的对照组进行比较,符合标准。该研究调查了结果变量,如疼痛减轻和开口改善,并有中等偏倚风险。经回归分析,各组间无显著差异。生活质量评估不是本研究的目的。由于显而易见的原因,本文献检索无法进行meta分析。结论:同种异体假体重建颞下颌关节发展迅速,新系统不断进入市场。这篇综述强调,迫切需要进一步的科学努力,包括设计良好的试验,能够证明同种异体TJR与其他治疗方式的比较有效性,最好是随机对照试验。
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来源期刊
Acta Odontologica Scandinavica
Acta Odontologica Scandinavica 医学-牙科与口腔外科
CiteScore
4.00
自引率
5.00%
发文量
69
审稿时长
6-12 weeks
期刊介绍: Acta Odontologica Scandinavica publishes papers conveying new knowledge within all areas of oral health and disease sciences.
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