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Are temporomandibular disorders associated with facial asymmetry? A systematic review and meta‐analysis
Author(s) -
Marques Fernanda Blaudt Carvalho,
Lima Lílian Siqueira,
Oliveira Pedro Lima Emmerich,
Magno Marcela Baraúna,
Ferreira Daniele Masterson Tavares P.,
Castro Amanda Cunha Regal,
Maciel Jose Vinicius Bolognesi,
Ruellas Antonio Carlos de Oliveira,
Maia Lucianne Copple
Publication year - 2021
Publication title -
orthodontics and craniofacial research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.664
H-Index - 55
eISSN - 1601-6343
pISSN - 1601-6335
DOI - 10.1111/ocr.12404
Subject(s) - medicine , cochrane library , meta analysis , medline , temporomandibular joint , checklist , tmj disorders , observational study , facial symmetry , systematic review , physical therapy , dentistry , orthodontics , psychology , political science , law , cognitive psychology
Abstract Objective To assess scientific evidence of the association between temporomandibular joint (TMJ) disorders and facial asymmetry (FA). Methods A systematic review was performed in accordance with the PRISMA checklist. A search strategy was developed in electronic databases including MEDLINE, Scopus, Web of Science, Virtual Health Library and Cochrane Library until January 2020. Eligibility criteria included observational studies that investigated the occurrence of FA among patients with and without signs and symptoms of TMJ disorders. Risk of bias of individual studies was analysed after study selection and data collection processes according to Fowkes and Fulton guidelines. Four meta‐analyses (MA) were performed to evaluate the association between TMJ disorders and linear/angular menton deviation, subgrouping the studies into unilateral and bilateral cases. The evidence was certainty‐tested using the GRADE approach. Results The search retrieved 2371 studies, 31 of which were eligible for full‐text reading. Seven cross‐sectional clinical studies met the eligibility criteria and were included in the qualitative synthesis, comprising a total of 621 subjects (345 with TMJ disease and 276 in control group), four of which were classified as being methodologically sound. Five studies were eligible for quantitative synthesis. Linear and angular menton deviation was greater in individuals with unilateral TMJ disorders than controls (MD = 2.41 [0.33, 4.50] P = .02; I 2 = 86% and MD = 2.68 [0.99, 4.38] P = .002; I 2 = 0%, respectively). Conclusions Despite the low certainty in evidence, the present study indicated that unilateral TMJ disorders are associated with FA. However, longitudinal studies with greater certainty of evidence should be conducted to achieve a stronger estimate of this association.