Temporomandibular joint dysfunction in Parkinson's Disease: an integrative literature review

ABSTRACT Temporomandibular joint dysfunction is a set of disorders involving the masticatory muscles, temporomandibular joint and associated structures. It is known that the progression of motor symptoms in Parkinson's disease is an indication that these people are more prone to the development of this dysfunction. Thus, this study aims to investigate the signs and symptoms of temporomandibular dysfunction in people with Parkinson's disease. The search was performed in the databases: MEDLINE/ PubMed, LILACs, CINAHL, SCOPUS, Web of Science and PEDro, without timing or language restriction. Specific descriptors were used for each database and keywords, evaluated by the instruments: Critical Appraisal Skill Program and Agency for Health care and Research and Quality. A total of 4,209 articles were found but only 5 were included. After critical analysis of the methodology of the articles, one did not reach the minimum score required by the evaluation instruments, thus, it was excluded. The selected articles addressed, as signs and symptoms of temporomandibular joint dysfunction, the following: myofascial pain, bruxism, limitation of mouth opening, dislocation of the articular disc and asymmetry in the distribution of occlusal contacts. Further studies are needed in order to determine the relationship between cause and effect of the analyzed variables, so as to contribute to more specific and effective therapeutic interventions.摘要 颞下颌关节功能紊乱（temporomandibular joint dysfunction）是一类累及咀嚼肌、颞下颌关节及其附属结构的疾病谱。已有研究表明，帕金森病（Parkinson's disease）患者的运动症状进展会使其更易发生该类功能紊乱。因此，本研究旨在探讨帕金森病患者的颞下颌关节功能紊乱体征与症状。本次检索覆盖MEDLINE/PubMed、LILACs、CINAHL、SCOPUS、Web of Science及PEDro数据库，未设置时间与语言限制。针对各数据库采用专用检索式与关键词，并通过关键评价技能计划（Critical Appraisal Skill Program）以及美国医疗保健研究与质量局（Agency for Health care and Research and Quality）制定的工具开展文献质量评估。初步检索共获得4209篇文献，最终纳入5篇。经对文献方法学进行批判性分析后，其中1篇未达到评估工具要求的最低评分标准，故予以排除。纳入文献所提及的颞下颌关节功能紊乱体征与症状包括肌筋膜疼痛、磨牙症、张口受限、关节盘脱位以及咬合接触分布不对称。本研究提示，仍需开展进一步研究以明确上述分析变量间的因果关系，从而为更具针对性与有效性的治疗干预提供科学依据。