阻塞性睡眠呼吸暂停与颞下颌关节紊乱之间的关系：荟萃分析

IF 3.1 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2024-07-15 DOI:10.1111/joor.13794

Cláudia Aparecida de Oliveira Machado, Camila Maria Bastos Machado de Resende, Juliana Stuginski-Barbosa, André Luís Porporatti, Maria Clotilde Carra, Ambra Michelloti, Yves Boucher, Paulo Cezar Simamoto Junior

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引用次数: 0

摘要

背景：阻塞性睡眠呼吸暂停（OSA）是颞下颌关节紊乱症（TMD）患者的常见病。然而，几乎没有证据表明它们之间存在联系：本系统综述和荟萃分析旨在评估成年人群中 OSA 与 TMD 之间的关联：方法：在 EMBASE、LILACS、LIVIVO、PubMed/MEDLINE、Scopus、Web of Science、Google Scholar、Open Grey 和 Pro Quest 数据库中检索有关 TMD 与 OSA 关系的病例对照、横断面和队列研究。TMD应使用研究诊断标准（RDC/TMD）或诊断标准（DC/TMD）进行评估，OSA应使用多导睡眠图（PSG）和/或有效问卷进行评估。采用乔安娜-布里格斯研究所的关键评估清单对偏倚风险进行了评估，并进行了关联荟萃分析。效果测量包括二分变量的几率比（OR）和 95% 的置信区间（CI）。采用建议评估、发展和评价分级法（GRADE）对各组进行分析，以确定证据的确定性：在筛选出的 1024 篇文章中，7 篇符合定性综合的纳入标准，6 篇符合定量分析的纳入标准。所有文章的偏倚风险都很低。研究发现，TMD 患者与 OSA 呈正相关（OR = 2.61；95% CI = 2.31，2.95）。无论采用哪种 OSA 诊断方法，也都发现了明显的关联性（采用 PSG + 有效问卷的研究：OR = 2.74；95% CI = 2.31；2.95）：OR = 2.74; 95% CI = 2.11, 3.57; 仅使用有效问卷的研究：OR = 2.55; 95% CI = 2.22, 2.92）。GRADE为中度：无论采用哪种 OSA 诊断方法（PSG 和/或有效问卷），TMD 患者均与 OSA 密切相关。OSA筛查应成为TMD常规检查的一部分。此外，由于采用的 OSA 评估方法不同，且纳入的研究数量较少，因此有必要纳入更多使用 PSG 的研究，以更好地阐明这种关联。

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Association between obstructive sleep apnea and temporomandibular disorders: A meta-analysis

Background

Obstructive sleep apnea (OSA) is a very common condition in patients with temporomandibular disorders (TMD). However, there is little evidence of a connection between them.

Objective

The aim of this systematic review and meta-analysis is to assess the association between OSA and TMD in adult population.

Methods

Case–control, cross-sectional and cohort studies on the association between TMD and OSA were searched in the EMBASE, LILACS, LIVIVO, PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, Open Grey and Pro Quest databases. TMD should be assessed using Research Diagnostic Criteria (RDC/TMD) or Diagnostic Criteria (DC/TMD) and OSA using polysomnography (PSG) and/or a validated questionnaire. The risk of bias was evaluated using the Joanna Briggs Institute Critical Assessment Checklists; and an association meta-analysis was performed. The effect measure included the odds ratio (OR) in dichotomous variables and a 95% confidence interval (CI). Certainty of evidence was determined by analysing groups using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results

Out of the 1024 articles screened, 7 met the inclusion criteria for the qualitative synthesis, and 6 for quantitative analysis. All articles were classified at low risk of bias. A positive association with OSA was found in patients with TMD (OR = 2.61; 95% CI = 2.31, 2.95). A significant association was also found irrespective to the OSA diagnostic methods applied (for studies using PSG + validated questionnaires: OR = 2.74; 95% CI = 2.11, 3.57; for studies using validated questionnaires only: OR = 2.55; 95% CI = 2.22, 2.92). GRADE was moderate.

Conclusion

Patients with TMD presented a significant association with OSA regardless of the OSA diagnostic method (PSG and/or validated questionnaires). OSA screening should be part of the TMD examination routine. Furthermore, due to the different OSA assessment methods used and the small number of studies included, there is a need to include a larger number of studies using PSG to better elucidate this association.

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.