ABSTRACT
Temporomandibular disorder (TMD) is an umbrella condition presenting several signs and symptoms including pain in the temporomandibular joint (TMJ) and masticatory muscles, articular noises, earache, headache, irregular or restricted jaw function, chewing difficulty, and limited mouth opening. Such TMD impairment may cause disorders during the chewing process. Therefore, the purpose of this systematic review was to assess chewing dysfunctions measured by sEMG, and their association with TMD. A combination and variation in the descriptors "temporomandibular joint disorders", "masticatory dysfunctions", and electromyography were used to perform the searches across databases. The databases chosen were: LILACS, PubMed, Science Direct, Scopus, and Web of Science. Additionally, grey literature was assessed using Google Scholar, ProQuest, and OpenGrey. Studies in adults that diagnosed TMD through the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Helkimo Protocol were selected. Furthermore, those studies should have evaluated chewing processes through surface electromyography (sEMG). Risk of bias of the included studies was assessed through the Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) tool. Eleven included studies shown significant results; however, they evaluated discrepant parameters, presented high inconsistency in the application, and had chosen different tasks to analyse the sEMG and hence, there was no consensus in the results of studies. In conclusion, strength of recommendations was very low due to a series of limitations on studies and it was not possible to made categorical statement about association between TMD and chewing dysfunctions in adults when parameters of sEMG were analysed.
Subject(s)
Bruxism/physiopathology , Facial Pain/physiopathology , Headache/physiopathology , Mastication/physiology , Masticatory Muscles/physiopathology , Temporomandibular Joint Disorders/physiopathology , Electromyography , Facial Pain/etiology , Headache/etiology , Humans , Masticatory Muscles/diagnostic imaging , Range of Motion, Articular , Reproducibility of Results , Temporomandibular Joint Disorders/diagnostic imagingABSTRACT
The most common temporomandibular disorders (TMD) signs and symptoms are related to muscle sensitivity through palpation, restricted mouth opening, asymmetric mandibular movements, joint sounds, pain and otologic signs and symptoms. To date, counselling, occlusal splints, exercises, biofeedback and acupuncture are examples of conservative modalities proposed for TMD therapy. The aim of this systematic review was to investigate the effect of these conservative therapies for TMD on otologic signs and symptoms. The authors searched the following electronic databases published up to 1st May 2015: PubMed, LILACS, Scopus, Web of Science and Science Direct with no time or language limitations. Using a two-phase selection process, the authors identified 08 articles and used them to conduct a qualitative analysis. Methodological quality of each article was performed with the aid of 'Quality Assessment of a Cohort Study' and 'Quality Assessment of a Randomized Clinical Trial', developed by the Dutch Cochrane Centre, a centre of the Cochrane Collaboration. This systematic review showed in seven of the eight studies included that a total or partial resolution of otologic complains occurred after counselling, exercise therapies and occlusal splint therapy. Upon the limitations of the studies included in this systematic review, the present outcomes suggested that there is insufficient evidence in favour or against the conservative therapies for TMD on changes in otologic signs and symptoms. Thus, further studies with a higher level of evidence and more representative samples should be conducted to better understand the relationship of TMD therapy changes on otologic complains.