Gap arthroplasty versus interpositional arthroplasty for temporomandibular joint ankylosis: a Meta-analysis
10.3969/j.issn.2095-4344.2017.20.017
- VernacularTitle:裂隙关节成形与间置物关节成形修复颞下颌关节强直的系统分析
- Author:
Jun WU
- From:
Chinese Journal of Tissue Engineering Research
2017;21(20):3216-3223
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Efficacy of gap arthroplasty (GA) versus interpositional arthroplasty (IA) for temporomandibular joint ankylosis (TMJA) is rarely reported, and the treatment efficacy is still under discussion. OBJECTIVE: To systematically review the efficacy of GA versus IA in the TMJA treatment and patient's prognosis. METHODS: A computer-based online research of the databases of WanFang, CqVip, PubMed, Ovid, Embase, Clinical Evidence, Cochrance Library combined with the manual search of relevant controlled trials that compared the resurrence postoperative maximal incision opening and/or recurrence of the two methods for TMJA published before October, 2015 was performed. According to heterogeneity results, the maximal incision opening index was analyzed by random-effect model, and the two groups were subdivided into temporomandibular myofascial flap and other material groups, and then MD and 95%CI were calculated; recurrence was analyzed through fixed effect model, and OR and 95%CI were calculated.RESULTS AND CONCLUSION: According to the inclusion and exclusion criteria, a total of 18 eligible articles involving 999 patients were enrolled, and the GA and IA were conducted in 656 and 343 cases, respectively. Meta-analysis results of the maximal incision opening were as followings: MD= -1.85, 95%CI: (-3.15, -0.55), Z=2.80, P=0.005, I2=55.4%; the temporomandibular myofascial flap subgroup: MD= -0.94, 95%CI: (-1.84, -0.04), Z=2.05, P=0.040, I2=0.0%; the other material group: MD= -3.36, 95%CI: (-6.66, -0.66), Z=2.39, P=0.017, I2=67.0%. Meta-analysis of the recurrence showed that OR=1.38, 95%CI: (0.87, 2.17), Z=1.37, P=0.170, I2=14.9%. Egger test manifested that there were no publication biases in the literatures. Sensitivity test showed that only one study influenced the total combined Meta-analysis results, and the others were steady. These results indicate that the IA can markedly increases the maximal incision opening in the TMJA treatment compared with the GA, but the two methods have the similar recurrence rate. Due to the limited quantity and quality of the included studies, the above conclusion needs to be verified by more high quality researchs.
