FCS (MIMED) - Mestrado Integrado em Medicina Dentária
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- Ultrasonography, an alternative image method in temporomandibular articular disorder diagnosis and therapeutic follow-up: systematic review and meta-analysisPublication . Comby, Théophile; Barbosa, Cláudia Maria Rebelo; Manso, M. ConceiçãoThe temporomandibular joint (TMJ) is one of the body's most complex joints, making temporomandibular joint disorders (TMJDs) difficult to diagnose. If TMJDs are not diagnosed early, serious morphological changes can occur, affecting stomatognathic system function. The primary method for diagnosing TMJDs is clinical evaluation, although imaging exams are used for diagnosis, therapeutic decisions, and follow-up. MRI remains the gold standard. Ultrasonography (US) is an alternative imaging method, and this systematic review assessed whether it could be a valid substitute for MRI or CT in adult TMJD diagnosis and monitoring. Articles from PubMed, Cochrane Library, LILACS, Web of Science, and Embase were included, with no temporal limits and in English, French, Spanish, Italian, and Portuguese. The review protocol was registered in PROSPERO (ID: CRD42024562747) and followed the PICOS framework. Three independent authors screened titles, abstracts, and full texts, and 5 papers (4 studies) were included. The meta-analysis showed that US is effective in diagnosing TMJ internal derangements in adults, with a sensitivity of 80.33% and specificity of 92.71% compared to MRI. Despite the limitations, US can be an alternative method for assessing TMJ internal derangements in adults, with good cost-effectiveness. Future studies should compare AI-based evaluations of US images with gold-standard imaging techniques.