RESUMEN
Temporomandibular disorders (TMD) are a group of clinical problems affecting temporomandibular joint (TMJ), myofascial muscles and other related structures. Splint therapy is the most commonly used approach to treatment of TMD, but its effectiveness is remains unclear. We therefore conducted a meta-analysis to evaluate the effectiveness of splint therapy for TMD in adults. The electronic databases PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov were searched for reports published up to March 31, 2016. Thirteen eligible studies involving 538 patients were identified. The results indicated that splint therapy increased maximal mouth opening (MMO) for patients with a MMO <45mm and reduced pain intensity measured using the visual analogue scale (VAS) for patients with TMD without specific description (TMDSD). Splint therapy also reduced the frequency of painful episodes for patients with TMJ clicking. No publication bias was observed, as determined with Egger's test for all outcomes. On the basis of this evidence, we recommend the use of splints for the treatment and control of TMD in adults.
Asunto(s)
Músculos Faciales/fisiopatología , Dolor Facial/terapia , Férulas (Fijadores) , Trastornos de la Articulación Temporomandibular/terapia , Articulación Temporomandibular/fisiopatología , Adolescente , Adulto , Anciano , Fenómenos Biomecánicos , Dolor Facial/diagnóstico , Dolor Facial/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Umbral del Dolor , Recuperación de la Función , Férulas (Fijadores)/efectos adversos , Trastornos de la Articulación Temporomandibular/diagnóstico , Trastornos de la Articulación Temporomandibular/fisiopatología , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND The aim of this study was to investigate the association between cyclooxygenase-2 (COX-2) rs689466 (-1195 G>A) polymorphism and susceptibility to head and neck squamous cell carcinoma (HNSCC) by performing a meta-analysis. MATERIAL AND METHODS PubMed and Embase were searched for relevant cohort and case-control studies up to 13 March 2015. After data extraction and methodological quality assessment for eligible studies, the overall, subgroup, sensitivity, and cumulative meta-analyses were conducted using the Comprehensive Meta-Analysis software (version 2.2). RESULTS Finally, 5 case-control studies involving 1564 HNSCC patients and 2346 healthy controls were included. For overall population, the results of 3 genetic models showed significant association, while the other 2 presented negative association [A vs. G: OR=0.97-1.09, 95%CI=0.97-1.09; AA vs. GG: OR=1.26, 95%CI=1.01-1.57; AA vs. GA: OR=1.21, 95%CI=1.01-1.45); AA vs. (GG+GA): OR=1.20, 95%CI=1.01-1.43; (AA+GA) vs. GG: OR=0.98, 95%CI=0.84-1.15]. Publication bias was not assessed due to the limited number of included studies. CONCLUSIONS This meta-analysis indicated that COX-2 rs689466 polymorphism might be associated with increased susceptibility to HNSCC. We also suggest performing more relevant studies in order to enlarge the sample size and obtain more precise results.