Abstract
Statement of problem
Diagnosing temporomandibular disorders without an adjunctive chairside diagnostic
tool has made the management of temporomandibular disorders challenging and subjective.
The use of magnetic resonance imaging, considered the standard imaging modality, is
hindered because of high cost, a long learning curve, availability, and a longer examination
time.
Purpose
The purpose of this systematic review and meta-analysis was to determine whether ultrasonography
could be a chairside tool to help clinicians diagnose disc displacement in temporomandibular
disorders.
Material and methods
An electronic search was conducted of the PubMed (including MEDLINE) and Cochrane
Central database and the Google Scholar search engine for articles published from
January 2000 to July 2020. Studies were chosen based on the inclusion criteria, which
included the diagnostic technique's sensitivity, specificity, positive predictive
value (PPV), and negative predictive value (NPV) with respect to imaging the displacement
of the articular disc. The quality assessment of diagnostic accuracy studies (QUADAS-
2) tool was applied to assess the risk of bias for the included studies. The Meta-Disc
1.4 and RevMan 5.3 software program were used to conduct the meta-analysis.
Results
Seventeen articles were included in this systematic review, and a meta-analysis of
14 articles was done after applying the inclusion and exclusion criteria. None of
the included articles were considered to have applicability concerns; however, 2 articles
had a high risk of bias. The sensitivities and specificities for the different selected
studies vary substantially from 21% to 95% with a good pooled sensitivity estimate
of 71% while the specificities varied from 15% to 96% with a good pooled specificity
estimate of 76%.
Conclusions
This systematic review and meta-analysis suggested that ultrasonography may have clinically
acceptable diagnostic accuracy in diagnosing disc displacement of the temporomandibular
joint, allowing the treatment of patients with temporomandibular disorders with greater
assurance and success. Additional training in the operation and interpretation of
ultrasonography is required to reduce the learning curve and make the use of ultrasonography
relevant, straightforward, and routine in dentistry to supplement clinical examination
and diagnosis in patients with suspected disc displacement of the temporomandibular
joint. The evidence acquired needs to be standardized, and further research is required
to provide stronger evidence.
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Article info
Publication history
Published online: April 17, 2023
Publication stage
In Press Corrected ProofIdentification
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© 2023 by the Editorial Council for The Journal of Prosthetic Dentistry.
