Relação entre disfunção temporomandibular e qualidade de vida : revisão sistemática com metanálise

Abstract

Objective: To evaluate the quality of life in TMD adult clinical observational studies. Methodology: A systematic review using PUBMED, EMBASE and LILACS database published after 1992 in English, Spanish and Portuguese was performed. Two independent reviewers performed the search. The data from a manual search and the gray literature were also included. The inclusion criteria were clinical studies that used the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I and used quality of life validated questionnaires in adult populations (>16 years). The data were analyzed quantitatively by combining the results in a meta-analysis and presenting them in Forest Plot graphics. The measure of effect was the Standardized Mean Difference (SMD) because of the high heterogeneity. An adapted Newcastle-Ottawa Scale (NOS) was used to evaluate the studies quality, and the publication bias was assessed by the funnel plot graphic. Results: The initial search included 806 articles without duplications. After the final full-text reading of 96 articles, 24 articles were included in the systematic review. Of these, 9 were included in the meta-analysis, where it was shown a statistically significant in the following Axis I groups: (a) global TMD (groups I, II and III combined, N=3,829, SMD=1.06, p=0.000); (b) group I (muscle disorders, N=3,056, SMD=0.82, p=0.000), (c) group II (disc displacements, N=3,184, SMD=0.59, p=0.000); and (d) group III (arthralgia/arthritis/arthrosis, N=2,781, SMD=0.98, p=0.001) when compared with controls without TMD. Conclusions: The TMD influence on the quality of life of the patients, mainly related to pain intensity and duration for TMD.