Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jun 22;9(7):269.
doi: 10.3390/bioengineering9070269.

Efficacy of Kinematic Parameters for Assessment of Temporomandibular Joint Function and Disfunction: A Systematic Review and Meta-Analysis

Alessandra Scolaro  1   2 , Shahnawaz Khijmatgar  1   2 , Pooja Mali Rai  1   2 , Francesca Falsarone  2 , Francesca Alicchio  2 , Arianna Mosca  2 , Christian Greco  3 , Massimo Del Fabbro  1   4 , Gianluca Martino Tartaglia  1   2
Affiliations
Review

Efficacy of Kinematic Parameters for Assessment of Temporomandibular Joint Function and Disfunction: A Systematic Review and Meta-Analysis

Alessandra Scolaro et al. Bioengineering (Basel). .

Abstract

The aim of this review was to answer the following PICO question: "Do TMJ kinematic parameters (intervention and comparison) show efficacy for assessment of mandibular function (Outcome) both in asymptomatic and TMD subjects? (Population)". PubMed, Scopus, Web of Science, Embase, Central databases were searched. The inclusion criteria were (1) performed on human, (2) English only, (3) on healthy, symptomatic or surgically altered TMJ, (4) measured dynamic kinematics of mandible or TMJ (5) with six degrees of freedom. To assess the Risk of Bias, the Joanna Briggs Institute tool for non-randomised clinical studies was employed. A pairwise meta-analysis was carried out using STATA v.17.0 (Stata). The heterogeneity was estimated using the Q value and the inconsistency index. Ninety-two articles were included in qualitative synthesis, nine studies in quantitative synthesis. The condylar inclination was significantly increased in female (effect size 0.03°, 95% CI: -0.06, 0.12, p = 0.00). Maximum mouth opening (MMO) was increased significantly in female population in comparison with males (effect size 0.65 millimetres (0.36, 1.66). Incisor displacement at MMO showed higher values for control groups compared with TMD subjects (overall effect size 0.16 millimetres (-0.37, 0.69). Evidence is still needed, considering the great variety of devices and parameters used for arthrokinematics. The present study suggests standardising outcomes, design, and population of the future studies in order to obtain more reliable and repeatable values.

Keywords: TMJ dysfunction; kinematics; motion analysis; temporomandibular joint; temporomandibular joint disorders.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart.
Figure 2
Figure 2
Forest plot for condylar inclination outcome.
Figure 3
Figure 3
Forest plot for different method employed to estimate the condylar inclination.
Figure 4
Figure 4
Condylar inclination subgroup analysis forest plot displays the study labels (id), the number of studies within each group (K), the plot of effect sizes and their CIs (plot), the values of effect sizes and their CIs (esci), and the p-values (p-value) of the corresponding significance tests. The between-group homogeneity test based on the Qb is reported for each subgroup analysis. For example, for subgroup analysis based on variable “Group”, there are two groups “test” and “control”. The test investigates whether the overall effect sizes corresponding to these two groups are the same. The results of this test are identical to those we would have obtained if we had specified subgroup (Group).
Figure 5
Figure 5
Forest plot for MMO outcome. The overall effect size was 0.65 (−0.36, 1.66). The highest weight was 27.01% with sample size N = 48 in males and N = 44 in females. The heterogeneity is I2 = 90.12% which indicates, the studies were found to be highly heterogeneous in characteristics. The pooled effect has passed the line of no effect, hence there exists statistically significant difference between the studies in MMO outcome favouring females.
Figure 6
Figure 6
Subgroup analysis for MMO outcomes. The overall effect size was 0.65 (−0.36, 1.66). There is statistical significance between the type of studies included and its impact of results in MMO outcome. In addition, the method employed to record MMO outcome was statistically significant. Children and adult did not have significant values although the effect size varied i.e., child 0.31 (−1.10, 0.72) and adult 0.80 (−0.64, 2.23).
Figure 7
Figure 7
Galbraith Plot for MMO Outcome illustrating heterogeneity of the studies and detecting potential outliers. Two studies identified as an outlier.
Figure 8
Figure 8
Publication bias for MMO outcome.
Figure 9
Figure 9
Forest plot for IP-MMO outcome.
Figure 10
Figure 10
Publication Bias for IP-MMO outcome.
Figure 11
Figure 11
Galbraith plot for IP-MMO outcome.
Figure 12
Figure 12
Forest plot for horizontal angle outcome.
Figure 13
Figure 13
Publication bias for horizontal angle outcome.
Figure 14
Figure 14
Galbraith plot for horizontal angle outcome.
Figure 15
Figure 15
Forrest plot for sagittal angle outcome.
Figure 16
Figure 16
Funnel plot for sagittal angle outcome.
Figure 17
Figure 17
Galbraith plot for Sagittal angle outcome.
See this image and copyright information in PMC

References

    1. Okeson J.P. Management of Temporomandibular Disorders and Occlusion. 7th ed. Elsevier; Mosby, MO, USA: Louis, MO, USA: 2012.
    1. Reisine S.T., Weber J. The effects of temporomandibular joint disorders on patients’ quality of life. Community Dent. Health. 1989;6:257–270. - PubMed
    1. Schiffman E., Ohrbach R., Truelove E., Look J., Anderson G., Goulet J.P., List T., Svensson P. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: Recommendations of the international RDC/TMD consortium network and orofacial pain special interest group. J. Oral Facial Pain Headache. 2014;28:6–27. doi: 10.11607/jop.1151. - DOI - PMC - PubMed
    1. Liu F., Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent. Clin. N. Am. 2013;57:465–479. doi: 10.1016/j.cden.2013.04.006. - DOI - PubMed
    1. Peck C.C., Goulet J.-P., Lobbezoo F., Schiffman E.L., Alstergren P., Anderson G.C., de Leeuw R., Jensen R., Michelotti A., Ohrbach R., et al. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J. Oral Rehabil. 2014;41:2e23. doi: 10.1111/joor.12132. - DOI - PMC - PubMed