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SLEEP DISORDERS AND THE RISK OF TEMPOROMANDIBULAR DISORDERS: SYSTEMATIC REVIEW AND META-ANALYSIS
According to the American Academy of Orofacial Pain, temporomandibular disorders (TMD) are defined as a "group of disorders involving the masticatory muscles, the temporomandibular joint (TMJ) and associated structures". Efforts have been made in order to identify related disorders concerning TMD's multifactorial etiology, with the purpose of providing the best healthcare for the patients in need. Among those conditions, sleep disorders stand out.
The study aims to evaluate the relation between sleep disorders and TMD based on the available literature, as well as to verify the distribution of sleep disorders in the different diagnostic groups presented by the DC/TMD questionnaire.
The research protocol was registered in PROSPERO (CRD42018109382). A systematic review was performed in the PubMed, Embase, Lilacs, Web of Science, Scielo, Cinahl and Cochrane Central databases. Manual search and gray literature search were also performed. Only observational studies that were published since 1992 were included. Two reviewers participated independently. Quality analysis on the included papers was conducted according to the Ottawa-Newcastle Scale. The extracted data were submitted to heterogeneity calculation, publication bias analysis and meta-analysis.
1071 articles were found after the online search. 3 papers were added manually. Duplicate exclusion was carried out. According to the eligibility criteria, 131 articles were selected for full-text reading. 30 were included in the final work. Meta-analysis indicates a positive relationship between sleep disorders and TMD in all DC/TMD diagnostic groups, except for axis 1 group II (disc displacements). The calculated Odds Ratio was 3.48.
Based on the obtained results, there is a positive relationship between sleep disorders and TMD (except for the diagnosis of disc displacements). There is a 3.48 times increased risk of TMD for individuals who suffer from sleep disorders compared to those without this diagnosis.
temporomandibular disorders; TMD; sleep disorders; systematic review; meta-analysis
Carlos Augusto Gomes da Silva, Camila Caspary Roithmann, Márcio Lima Grossi, M P Patussi