Implication of general anaesthetic and sedation techniques in temporomandibular joint disorders - a systematic review.
The purpose of this study was to conduct a systematic review of the literature on temporomandibular joint damage directly related to general anaesthesia and sedation. We searched MEDLINE, SCOPUS and the COCHRANE Library for titles and abstracts containing terms related to the subject. The search delimiters were analytical and descriptive studies with abstracts in Spanish, German, English or French, with no time limit. The search was updated in January 2015. Of the 398 articles found, 89 were duplicates and only 28 were of interest. Of these, 23 (82.14%) were case and case series reports, 4 (14.28%) were longitudinal studies and 1 (3.57%) was a cross-sectional study. General anaesthesia and sedation are risk factors for temporomandibular joint damage because of the drop in muscle tone caused by the drugs employed and because of airway management manoeuvres involving the joint. Joint complications have been described with spontaneous ventilation as well as with ventilation assisted by a face or laryngeal mask and with intubation. They are more frequent in women and/or patients with previous temporomandibular problems. Proper assessment is required both before and after anaesthesia or sedation in order to foresee and avoid or minimize temporomandibular complications. The data should be treated with caution, as the evidence of case and case series reports is not of a high standard and the small number of analytical studies is not entirely comparable. General anaesthesia and sedation techniques can influence the onset of temporomandibular joint disorders. More studies are needed to provide better clinical evidence.
Department of Anaesthesiology and Reanimation, Ontinyent General Hospital, Avda. Francisco Cerdà, 3, 46870 Valencia, Spain. Electronic address: jutaser@alumni.uv.es.
J
J
Talaván-Serna
Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag No. 10, 46010 Valencia, Spain.
J M
JM
Montiel-Company
Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag No. 10, 46010 Valencia, Spain.
C
C
Bellot-Arcís
Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, C/Gascó Oliag No. 10, 46010 Valencia, Spain.
J M
JM
Almerich-Silla
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058109:Airway Management / Q000379:methods / Q000706:statistics & numerical data; D000766:Anesthesia, Dental / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D018681:Anesthetics, General / Q000145:classification / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000145:classification / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology / Q000601:surgery*; D055815:Young Adult
D018681:Anesthetics, General; D006993:Hypnotics and Sedatives
Anaesthesia; Disorders; Joint; Mandibular; Sedation