Prevalence of degenerative disease in temporomandibular disorder patients with disc displacement: A systematic review and meta-analysis.

To assess the available literature on the prevalence of degenerative joint disease (DJD) in patients with anterior disc displacement (ADD) of the temporomandibular joint (TMJ), using a systematic review with meta-analysis. Search strategies were performed in the following databases: PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, and LIVIVO. A search was also carried out in the gray literature. Two independent reviewers selected the included articles using a two-phase process based on the eligibility criteria. Three reviewers independently collected the required information from the included articles. The methodological quality of the selected studies was assessed individually. In accordance with the inclusion and exclusion criteria, 1349 studies were found and 18 articles were included. The total sample size was 3158 TMJs. The sex distribution was predominant for females (1161 females and 345 males). The average age was 46 (range 10-82) years. Among the 1762 TMJs quantitatively assessed, the prevalence of DJD involving disc displacement with reduction (DDWR) was 35%, while for disc displacement without reduction (DDWoR) the prevalence was 66%. The prevalences of different features of DJD were as follows: sclerosis 24.3%, erosion 23.5%, osteophyte 17.9%, and subcortical cyst 7.6%. The prevalence of DJD in temporomandibular disorder patients with disc displacement is around 50% and is higher in DDWoR (66%) than in DDWR (35%). Sclerosis and erosion would be the most expected radiological signs in a developing DJD. Clinicians should adequately address the frequent DJD features associated with disc displacement in terms of diagnostics and therapeutic management.

Deglutition disorders as a consequence of head and neck cancer therapies: a systematic review and meta-analysis.

PURPOSE: In this study, we aimed to estimate the frequency of deglutition disorders in patients pre- and post-treatment for head and neck cancer (HNC). METHODS: Search strategies were developed for the following databases: LILACS, PubMed, SpeechBITE, LIVIVO, Web of Science, and Scopus. Additionally, the gray literature was searched using Google Scholar, OpenGrey, and ProQuest. Only studies that conducted an evaluation of deglutition before and after cancer treatment and had sufficient quantitative data were included. We conducted a proportion of random effects meta-analysis using R statistical software. RESULTS: Seventeen studies were included. Aspiration showed a high frequency in the period less than 3 months post-treatment, with 28.6% (total sample = 229). Penetration of fluids above the vocal folds and reduced laryngeal elevation were more frequent in the period less than 6 months post-treatment. CONCLUSION: The frequency of deglutition disorders and its complications, such as aspiration, appears to be higher in the immediate to 6-month post-treatment period in patients with HNC. The parameter pharyngeal residue continued to increase through the period analyzed.

Prevalence of degenerative joint disease of the temporomandibular joint: a systematic review.

OBJECTIVES: The purpose of this systematic review was to evaluate evidence about the prevalence of degenerative joint disease (DJD) of the temporomandibular joints (TMJ). MATERIALS AND METHODS: We performed search on electronic databases and gray literature from their inception to January 2018. Studies reporting prevalence data of DJD on TMJ were included. DJD was assessed through clinical and imaging diagnosis. Studies risk of bias was evaluated using the Critical Appraisal Checklist for Studies Reporting Prevalence Data. RESULTS: From 1082 studies, 32 were identified, and the sample size included 3435 subjects. They were clustered into two groups: the first comprised studies that reported prevalence of DJD in TMJ secondary to rheumatic systemic diseases like juvenile idiopathic arthritis (JIA) and rheumatoid arthritis (RA) and the second group comprised studies that reported prevalence of DJD on temporomandibular disorder patients. The prevalence of DJD on JIA patients ranged from 40.42% (n = 47) to 93.33% (n = 15) and on RA patients from 45.00% (n = 20) to 92.85% (n = 56). Among TMD patients, the prevalence of DJD reported according to patients ranged from 18.01% (n = 1038) to 84.74% (n = 118) and reported according to joints ranged from 17.97% (n = 178) to 77.23% (n = 224). CONCLUSION: This review attempts to high prevalence of DJD in patients with systemic rheumatic disease and a less prevalent, but still high, occurrence in patients with TMD without systemic involvement. CLINICAL RELEVANCE: Specialist doctors and dentists should be alert to not underestimate and to correctly diagnose DJD of the TMJ early in patients with rheumatic disease and TMD.

Diagnostic validity of clinical protocols to assess temporomandibular disk displacement disorders: a meta-analysis.

OBJECTIVE: To evaluate the diagnostic validity of clinical examination protocols compared with magnetic resonance imaging (MRI) in adults with temporomandibular joint disk displacement disorders. STUDY DESIGN: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was undertaken using a selection process in 2 phases; 283 different references were identified, and 10 articles were included for qualitative analysis and 7 for meta-analysis. Temporomandibular joint disorders were assessed through clinical diagnosis protocols with the aid of Research Diagnostic Criteria for Temporomandibular Disorders, Diagnostic Criteria for Temporomandibular Disorders, or Clinical Diagnostic Criteria for Temporomandibular Disorders. The authors searched the following electronic databases: Cochrane, LILACS, PubMed, Science Direct, SCOPUS, and Web of Science. Additional search of gray literature was performed. Selected studies were evaluated by using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. Two subgroups were analyzed: Disk displacement with reduction (DDwR) and disk displacement without reduction (DDwoR). RESULTS: The validity of clinical protocols compared with MRI performed in studies evaluating only DDwR presented sensitivity of 44% (39%-49%) and specificity 51% (46%-57%). In studies evaluating only DDwoR, sensitivity was 22% (16%-30%) and specificity 93% (85%-98%). The area under the curve value for validity of clinical protocols in all studies was 0.63, 0.56 for studies evaluating DDwR and 0.64 for studies evaluating DDwoR. Area under the curve values were considered poor. CONCLUSIONS: Clinical examination protocols have poor validity to diagnose DDwR and DDwoR compared with MRI. MRI should be used to increase the diagnostic accuracy when the information provided can influence clinical decisions.