Publicado jun 25, 2015



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Luis Vicente González Rodríguez

Liz Beth Bello Cubillos

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Resumen

Antecedentes: Diferentes estudios actuales identifican la artroscopia temporomandibular como una técnica operatoria. Sin embargo, la gran utilidad diagnóstica de este método es muy poco abordada en la literatura. Asimismo, pocas investigaciones describen su precisión diagnóstica en el manejo de las alteraciones degenerativas intrarticulares. Propósito: Determinar la eficacia de la artroscopia temporomandibular en el diagnóstico de patologías articulares frente a la resonancia magnética nuclear, por medio de una revisión sistemática de la literatura. Métodos: Se realizó una búsqueda de artículos en diferentes bases de datos. Se aplicaron los siguientes criterios de inclusión: estudios clínicos abiertos en humanos, estudios con enfoque diagnóstico que mostraran especificidad y sensibilidad de la técnica de artroscopia diagnóstica y resonancia magnética nuclear, referentes a patologías de desplazamiento anterior del disco con reducción o sin esta, adherencias del espacio articular superior y perforaciones discales, e idioma inglés. La búsqueda inicial arrojó un total de 632 títulos, de los cuales se seleccionaron 3 artículos a los cuales se les realizó análisis de calidad. Resultados: Los estudios muestran una eficacia diagnóstica del 92,39 % de perforaciones discales y del 61 % para adherencias intrarticulares con resonancia magnética. El diagnóstico con artroscopia de adherencias y perforaciones discales tuvo una sensibilidad y especificidad del 97 %. Conclusiones: Los estudios analizados muestran una baja precisión diagnóstica con deficiente sensibilidad y especificidad de la resonancia magnética nuclear para el diagnóstico de adherencias. Por otra parte, la artroscopia presentó una especificidad y sensibilidad diagnóstica elevada. Sin embargo, no hubo diferencias significativas entre ambas técnicas.

Background: Several recent studies describe temporomandibular arthroscopy as an operatory technique. However, the diagnostic usefulness of this method has not been examined much in the literature. Likewise, a few studies describe its accuracy to diagnose intra-articular degenerative anomalies. Purpose: To determine the effectiveness of temporomandibular arthroscopy to diagnose articular pathologies, when compared to nuclear magnetic resonance, through a systematic review of literature. Methods: An article search was conducted using several databases. The inclusion criteria included: open clinical studies; in humans; diagnostic studies that show specificity and sensitivity of diagnostic arthroscopy and nuclear magnetic resonance regarding articular disc anterior displacement with or without reduction, upper joint space adherence and disc perforations; and English language. The initial search showed 632 titles, of which 3 were chosen to conduct the quality analysis. Results: Studies show 92.39% diagnostic effectiveness of magnetic resonance for disc perforations and 61% for intra-articular adherences. Diagnostics of adherences and perforations with arthroscopy had a sensitivity and specificity of 97%. Conclusions: Studies analyzed show low diagnostic accuracy with low sensitivity and specificity of nuclear magnetic resonance to diagnose adherences. On the other side, arthroscopy showed high specificity and sensitivity. However, there were not statistically significant differences between both techniques.

Keywords
References
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Cómo citar
González Rodríguez, L. V., & Bello Cubillos, L. B. (2015). Efectividad de la artroscopia temporomandibular para el diagnóstico de adherencias intrarticulares y perforaciones discales: revisión sistemática de la literatura / Effectiveness of Temporomandibular Arthroscopy for the Diagnosis of Intra-articular. Universitas Odontologica, 34(72), 47–56. https://doi.org/10.11144/Javeriana.uo34-72.eatd
Sección
Dossier Temático