Kata Kelemen, János König, Szilárd Váncsa, Bence Szabó, Péter Hegyi, Gábor Gerber, Péter Schmidt, Péter Hermann
{"title":"不同关节内注射材料在关节源性颞下颌紊乱的关节置换术中的疗效：随机对照试验的系统回顾和网络荟萃分析。","authors":"Kata Kelemen, János König, Szilárd Váncsa, Bence Szabó, Péter Hegyi, Gábor Gerber, Péter Schmidt, Péter Hermann","doi":"10.2186/jpr.JPR_D_23_00272","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Arthrogenic temporomandibular disorders (TMDs) that do not respond to conservative treatment necessitate the use of semi-conservative methods, such as arthrocentesis. However, the ranking of intraarticular devices used in arthrocentesis remains controversial. Therefore, a network meta-analysis and systematic review were conducted to compare the different materials used for arthrocentesis.</p><p><strong>Study selection: </strong>Databases of Cochrane Library, EMBASE, PubMed, and Web of Science were searched systematically to retrieve randomized controlled trials (RCTs) published in English comparing the efficacy of different intraarticular materials used for arthrocentesis. The mean differences (MD) and 95% confidence interval (CI) were calculated for maximum mouth opening (MMO) and pain perception using Bayesian network meta-analysis.</p><p><strong>Results: </strong>Among the 7674 studies retrieved, 13 RCTs were included in the quantitative synthesis. Evaluation of the short-term follow-up (1-3 months) outcomes revealed that saline-platelet-rich plasma (saline-PRP) and saline-steroid yielded the greatest improvement in MMO, with MDs of 3.49 (CI: -4.23, 10.81) and 3.36 (CI: -4.70, 10.46), respectively. Saline-PRP exhibited improvement in terms of pain reduction (MD=-2.72 (CI: -5.80, 0.35). Evaluation of the long-term follow-up outcomes revealed that saline-PRP yielded promising results for both outcomes: MD of 1.58 (CI: -6.84, 9.92) and -2.79 (CI: -9.44, 3.60) for MMO and pain reduction, respectively.</p><p><strong>Conclusion: </strong>Saline-PRP injection led to a clinically noticeable shift in MMO and pain perception in the short term; in contrast, the results of saline-PRP, saline-hyaluronic acid (HA), and saline steroids were statistically insignificant. Saline-HA and saline-steroid effectively increased MMO in the long term, whereas saline-PRP yielded the most distinct reduction in pain.</p>","PeriodicalId":16887,"journal":{"name":"Journal of prosthodontic research","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of different intraarticular injection materials in the arthrocentesis of arthrogenic temporomandibular disorders: A systematic review and network meta-analysis of randomized controlled trials.\",\"authors\":\"Kata Kelemen, János König, Szilárd Váncsa, Bence Szabó, Péter Hegyi, Gábor Gerber, Péter Schmidt, Péter Hermann\",\"doi\":\"10.2186/jpr.JPR_D_23_00272\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Arthrogenic temporomandibular disorders (TMDs) that do not respond to conservative treatment necessitate the use of semi-conservative methods, such as arthrocentesis. However, the ranking of intraarticular devices used in arthrocentesis remains controversial. Therefore, a network meta-analysis and systematic review were conducted to compare the different materials used for arthrocentesis.</p><p><strong>Study selection: </strong>Databases of Cochrane Library, EMBASE, PubMed, and Web of Science were searched systematically to retrieve randomized controlled trials (RCTs) published in English comparing the efficacy of different intraarticular materials used for arthrocentesis. The mean differences (MD) and 95% confidence interval (CI) were calculated for maximum mouth opening (MMO) and pain perception using Bayesian network meta-analysis.</p><p><strong>Results: </strong>Among the 7674 studies retrieved, 13 RCTs were included in the quantitative synthesis. Evaluation of the short-term follow-up (1-3 months) outcomes revealed that saline-platelet-rich plasma (saline-PRP) and saline-steroid yielded the greatest improvement in MMO, with MDs of 3.49 (CI: -4.23, 10.81) and 3.36 (CI: -4.70, 10.46), respectively. Saline-PRP exhibited improvement in terms of pain reduction (MD=-2.72 (CI: -5.80, 0.35). Evaluation of the long-term follow-up outcomes revealed that saline-PRP yielded promising results for both outcomes: MD of 1.58 (CI: -6.84, 9.92) and -2.79 (CI: -9.44, 3.60) for MMO and pain reduction, respectively.</p><p><strong>Conclusion: </strong>Saline-PRP injection led to a clinically noticeable shift in MMO and pain perception in the short term; in contrast, the results of saline-PRP, saline-hyaluronic acid (HA), and saline steroids were statistically insignificant. Saline-HA and saline-steroid effectively increased MMO in the long term, whereas saline-PRP yielded the most distinct reduction in pain.</p>\",\"PeriodicalId\":16887,\"journal\":{\"name\":\"Journal of prosthodontic research\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-01-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of prosthodontic research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2186/jpr.JPR_D_23_00272\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of prosthodontic research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2186/jpr.JPR_D_23_00272","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Efficacy of different intraarticular injection materials in the arthrocentesis of arthrogenic temporomandibular disorders: A systematic review and network meta-analysis of randomized controlled trials.
Purpose: Arthrogenic temporomandibular disorders (TMDs) that do not respond to conservative treatment necessitate the use of semi-conservative methods, such as arthrocentesis. However, the ranking of intraarticular devices used in arthrocentesis remains controversial. Therefore, a network meta-analysis and systematic review were conducted to compare the different materials used for arthrocentesis.
Study selection: Databases of Cochrane Library, EMBASE, PubMed, and Web of Science were searched systematically to retrieve randomized controlled trials (RCTs) published in English comparing the efficacy of different intraarticular materials used for arthrocentesis. The mean differences (MD) and 95% confidence interval (CI) were calculated for maximum mouth opening (MMO) and pain perception using Bayesian network meta-analysis.
Results: Among the 7674 studies retrieved, 13 RCTs were included in the quantitative synthesis. Evaluation of the short-term follow-up (1-3 months) outcomes revealed that saline-platelet-rich plasma (saline-PRP) and saline-steroid yielded the greatest improvement in MMO, with MDs of 3.49 (CI: -4.23, 10.81) and 3.36 (CI: -4.70, 10.46), respectively. Saline-PRP exhibited improvement in terms of pain reduction (MD=-2.72 (CI: -5.80, 0.35). Evaluation of the long-term follow-up outcomes revealed that saline-PRP yielded promising results for both outcomes: MD of 1.58 (CI: -6.84, 9.92) and -2.79 (CI: -9.44, 3.60) for MMO and pain reduction, respectively.
Conclusion: Saline-PRP injection led to a clinically noticeable shift in MMO and pain perception in the short term; in contrast, the results of saline-PRP, saline-hyaluronic acid (HA), and saline steroids were statistically insignificant. Saline-HA and saline-steroid effectively increased MMO in the long term, whereas saline-PRP yielded the most distinct reduction in pain.
期刊介绍：
Journal of Prosthodontic Research is published 4 times annually, in January, April, July, and October, under supervision by the Editorial Board of Japan Prosthodontic Society, which selects all materials submitted for publication.
Journal of Prosthodontic Research originated as an official journal of Japan Prosthodontic Society. It has recently developed a long-range plan to become the most prestigious Asian journal of dental research regarding all aspects of oral and occlusal rehabilitation, fixed/removable prosthodontics, oral implantology and applied oral biology and physiology. The Journal will cover all diagnostic and clinical management aspects necessary to reestablish subjective and objective harmonious oral aesthetics and function.
The most-targeted topics:
1) Clinical Epidemiology and Prosthodontics
2) Fixed/Removable Prosthodontics
3) Oral Implantology
4) Prosthodontics-Related Biosciences (Regenerative Medicine, Bone Biology, Mechanobiology, Microbiology/Immunology)
5) Oral Physiology and Biomechanics (Masticating and Swallowing Function, Parafunction, e.g., bruxism)
6) Orofacial Pain and Temporomandibular Disorders (TMDs)
7) Adhesive Dentistry / Dental Materials / Aesthetic Dentistry
8) Maxillofacial Prosthodontics and Dysphagia Rehabilitation
9) Digital Dentistry
Prosthodontic treatment may become necessary as a result of developmental or acquired disturbances in the orofacial region, of orofacial trauma, or of a variety of dental and oral diseases and orofacial pain conditions.
Reviews, Original articles, technical procedure and case reports can be submitted. Letters to the Editor commenting on papers or any aspect of Journal of Prosthodontic Research are welcomed.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
