EFICÁCIA DE DIAGNÓSTICO DA TOMOGRAFIA COMPUTADORIZADA E RESSONÂNCIA MAGNÉTICA NO TRATAMENTO DAS DESORDENS DA ARTICULAÇÃO TEMPOROMANDIBULAR: UMA REVISÃO SISTEMÁTICA

• Autor(a) principal: MARQUES, Karlla Dias Siqueira
• Data de Publicação: 2009
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tde/1387
• topic: Eficácia; Desordem da articulação temporomandibular; tomografia computadorizada; ressonância magnética; revisão; 1.Articulação temporomandibular - doenças 2.Articulação temporomandibular - diagnóstico 3.Temporomandibular - tomografia computadorizada 4.Temporomandibular - ressonância magnética; Effectiveness; temporomandibular joint disorder; CT; MRI; Review; CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA::CLINICA ODONTOLOGICA

Diagnosis of disorders affecting the temporomandibular joint (TMJ) is a difficult task for many reasons. These include the structural and functional complexity of this joint, the multifactorial origin of these disorders and limited knowledge of their natural course, the presence of common symptoms among its various subclasses and other craniofacial conditions. If the premise for effective treatment is a correct diagnosis, it is clear that the treatment of these disorders is not any less complex than their diagnosis. The aim of this study was to do a systematic analysis of the literature in relation to proof of the therapeutic efficacy of computed tomography (CT) and magnetic resonance imaging (MRI) in the treatment planning of TMJDs (disc displacement, inflammatory disorders without systemic involvement or osteoarthosis). This systematic review was comprised of three steps: (1) Specifying the problem and the inclusion/exclusion criteria used in the publications; (2) Formulation and detailing of a plan to conduct the literature search; (3) Interpretation and integration of the evidence in the studies and formulation of recommendations based on the quality of the evidence. The bibliographical search was undertaken in PubMed and Cochrane Library databases from January 1966 to July 2009, using specific indexed terms, selected according to the objectives. The titles and abstracts found were analyzed by three examiners and the publications fulfilling the inclusion criteria were selected. The same three examiners read the full texts of these selected publications, and extracted data with the help of a previously drawn up protocol. A publication was considered relevant and included in the review when its results expressed any type of impact of the information obtained with CT and MRI on the treatment of disc displacement, local inflammatory disorders or osteoarthosis therapeutic efficacy. Publications considered relevant were interpreted with the aid of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool and publications that critically evaluate systematic reviews. Results: The literature search yielded 584 titles and abstracts, of which 257 were selected and read in full text. One study was judged relevant. This study evaluated evidence of the efficacy of magnetic resonance imaging (MRI) in the diagnosis of disc position and configuration, disc perforation, joint effusion, and osseous and bone marrow changes in the temporomandibular joint, but no publication reported diagnostic thinking efficacy or therapeutic efficacy. The absence of studies on the therapeutic efficacy of CT and MRI on TMJD reinforces the need for investment in decision-making studies; meanwhile, sectional imaging tests should be prescribed with caution, especially when health budgets are limited.