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Meta-Analysis
. 2024 Oct;51(10):2220-2233.
doi: 10.1111/joor.13794. Epub 2024 Jul 15.

Association between obstructive sleep apnea and temporomandibular disorders: A meta-analysis

Cláudia Aparecida de Oliveira Machado  1 , Camila Maria Bastos Machado de Resende  2 , Juliana Stuginski-Barbosa  3 , André Luís Porporatti  4 , Maria Clotilde Carra  5 , Ambra Michelloti  6 , Yves Boucher  4 , Paulo Cezar Simamoto Junior  1
Affiliations
Meta-Analysis

Association between obstructive sleep apnea and temporomandibular disorders: A meta-analysis

Cláudia Aparecida de Oliveira Machado et al. J Oral Rehabil. 2024 Oct.

Abstract

Background: Obstructive sleep apnea (OSA) is a very common condition in patients with temporomandibular disorders (TMD). However, there is little evidence of a connection between them.

Objective: The aim of this systematic review and meta-analysis is to assess the association between OSA and TMD in adult population.

Methods: Case-control, cross-sectional and cohort studies on the association between TMD and OSA were searched in the EMBASE, LILACS, LIVIVO, PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, Open Grey and Pro Quest databases. TMD should be assessed using Research Diagnostic Criteria (RDC/TMD) or Diagnostic Criteria (DC/TMD) and OSA using polysomnography (PSG) and/or a validated questionnaire. The risk of bias was evaluated using the Joanna Briggs Institute Critical Assessment Checklists; and an association meta-analysis was performed. The effect measure included the odds ratio (OR) in dichotomous variables and a 95% confidence interval (CI). Certainty of evidence was determined by analysing groups using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results: Out of the 1024 articles screened, 7 met the inclusion criteria for the qualitative synthesis, and 6 for quantitative analysis. All articles were classified at low risk of bias. A positive association with OSA was found in patients with TMD (OR = 2.61; 95% CI = 2.31, 2.95). A significant association was also found irrespective to the OSA diagnostic methods applied (for studies using PSG + validated questionnaires: OR = 2.74; 95% CI = 2.11, 3.57; for studies using validated questionnaires only: OR = 2.55; 95% CI = 2.22, 2.92). GRADE was moderate.

Conclusion: Patients with TMD presented a significant association with OSA regardless of the OSA diagnostic method (PSG and/or validated questionnaires). OSA screening should be part of the TMD examination routine. Furthermore, due to the different OSA assessment methods used and the small number of studies included, there is a need to include a larger number of studies using PSG to better elucidate this association.

Keywords: meta‐analysis; obstructive sleep apnea; sleep disorders; systematic review; temporomandibular disorder.

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References

REFERENCES

    1. De Leeuw R, Klasser GD. Differential diagnosis and management of TMDs. In: De Leeuw R, Klasser GD, eds. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management/American Academy of Orofacial Pain. 6th ed. Quintessence Publishing Co, Inc; 2018:143‐207.
    1. Su N, Visscher CM, van Wijk AJ, Lobbezoo F, van der Heijden GJ. A prediction model for types of treatment indicated for patients with temporomandibular disorders. J Oral Facial Pain Headache. 2019;33:33‐38. doi:10.11607/ofph.2076
    1. Svensson P, Graven‐Nielsen T. Craniofacial muscle pain: review of mechanisms and clinical manifestations. J Orofac Pain. 2001;15:117‐145.
    1. National Institute of Dental and Craniofacial Research. Facial Pain. 2018. Available from: https://www.nidcr.nih.gov/research/data‐statistics/facial‐pain
    1. Dreweck FDS, Soares S, Duarte J, Conti PCR, De Luca Canto G, Luís Porporatti A. Association between painful temporomandibular disorders and sleep quality: a systematic review. J Oral Rehabil. 2020;47(8):1041‐1051. doi:10.1111/joor.12993

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