Qualidade da descrição de intervenções com substâncias injetáveis em disfunção temporomandibular articular dolorosa - Revisão sistemática

• Ano de defesa: 2023
• Autor(a) principal: Machado, Alinny Jéssica Gobetti
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Espírito Santo; BR; Mestrado em Ciências Odontológicas; Centro de Ciências da Saúde; UFES; Programa de Pós-Graduação em Ciências Odontológicas
• Palavras-chave em Português: Plasma rico em plaquetas; Corticoesteroide; Ácido hialurônico; Articulação temporomandibular; Syndrome da disfunção temporomandibular; Dor facial; subject.br-rjbn; Ciências da Saúde
• Link de acesso: http://repositorio.ufes.br/handle/10/17123

Introduction: Many clinical studies are developed annually in order to detect the best minimally invasive treatment for temporomandibular disorder (TMD) with injectable substances such as Hyaluronic Acid (HA), Platelet-rich Plasma (PRP) or fibrin (PRF) and corticosteroids. In order to be replicable in research or clinical practice, these studies need to describe interventions appropriately. Objective: To evaluate the quality of the description of interventions in randomized controlled trials (RCTs) on intra-articular injection of substances after arthrocentesis for the treatment of painful joint TMD. Methodology: This is a systematic review built under the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis protocols - PRISMA 2020 and registered in the Open Science Framework (osf.io/8fx3a protocol), carried out in the bibliographic search databases PubMed, Embase, Scopus, Web of Science and Cochrane, and in the gray literature Google Scholar. Inclusion criteria: RCTs with the following characteristics defined from the PICO: P (Population) = patients over 18 years of age, of both genders, with painful joint TMD; I (Intervention) = intraarticular injection of substances after arthrocentesis; C (Control) = placebo or other injectable techniques and O (outcome/outcome) = joint pain. The following were excluded: pilot studies, feasibility studies and in patients with systemic alterations. The risk of bias was assessed using the PEDro scale. The quality of the description of interventions was assessed using the Template for Intervention Description and Replication (TIDier) questionnaire. The direction and magnitude of the association between TIDieR and PEDro was analyzed using the Spearman test. Results: The electronic bibliographic search strategy identified 8878 articles (PubMed = 1653, Embase = 3195, Scopus = 2085, Web of Science = 1437, Cochrane = 308; Google Scholar = 200 latest publications), of which 4800 were duplicates. After screening titles, abstracts and reference lists, 98 potentially relevant full articles were retrieved. Of these, 16 articles were included for analysis in this systematic review. Characterization of the RCTs included: the number of patients in the studies ranged from 20 to 102, with a mean age of patients from 26.87 to 55 years; predominantly women (76.2%). Among the intra-articular substances for the treatment of DMT, the following were used: HA (n=11, 68.75%), PRP (n=6, 37.5%), PRF (n=1, 6.25%), Corticosteroid (n=5, 31.25%). The RCT risk of bias analysis had an average score of 8.5 (±1.11) for 10 items on the PEDro scale. Seven articles (43.75%) informed the previous registration/protocol of the study. The quality of the intervention description obtained an average of 7.31 (±1.04) of 12 items of the TIDiR, with 13 studies having a score ≥7. Only three items (Intervention name, Why it was used, Procedures performed) scored 12 in all RCTs; while 3 items (There was adaptation, There were modifications and Adherence assessment) obtained a score of 0 in all articles. Most publications had a good result in the topics Materials used (87.5%), How it was applied (93.75%), When and how much it was applied (93.75%), while the topics Who carried out the intervention (50 %), Where it was performed (37.5%) and Result of the adherence assessment (68.75%) were not satisfactorily described. There was no correlation between PEDro and TIDieR (r=0.158). Conclusion: The RCTs with a low risk of bias, despite not including all the TIDier items, mostly present satisfactory quality in the description of the interventions. The use of TIDieR as a guide for describing these interventions would contribute to more detailed reports and, therefore, more faithful reproduction of therapies in research and clinical practice.