Research of the major approaches to temporomandibular disorders and space maintainers: a concise systematic review

Abstract

Introduction: The temporomandibular joint (TMJ), being the only mobile joint in the skull, is one of the most complex structures to study, this joint allows rotation and translation movements, this is due to its double joint with the condyle and its condylar cavity. The term Temporomandibular Disorders (TMD) is used to describe TMJ diseases that may be related to the joint, musculature, ligaments, bone, tooth, and psychological aspects. Objective: It was to address the main considerations and clinical findings of temporomandibular disorders and the use of space maintainers through a concise systematic review. Methods: The present study followed a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The quality of the studies was based on the GRADE instrument, and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: The total of 136 articles were found. A total of 76 articles were fully evaluated and 34 were included in this study. A total of 34 studies were excluded with a high risk of bias (studies with a small sample size). Also, 42 studies were excluded because they did not meet the GRADE. The results showed that the stomatognathic system (SS) is extremely important in the physiological interconnection with its constituent elements and the central nervous system. An interference can lead the masticatory muscles to adapt their function to protect the SS, leading the mandible to a position with different dental contacts, which can cause damage to the TMJ. These damages can generate parafunction or TMD. Space maintenance is one of the most important activities in the prevention of malocclusion. A practical option to obtain this rehabilitation is through the installation of aesthetic or functional space maintainers.