Guía de práctica clínica (GPC) de manejo de alteraciones complejo cóndilo disco basado en la evidencia científica

Abstract

Introduction. Clinical Practice Guidelines (CPGs) are "statements consistently developed to assist decisions of health professionals and patients about appropriate care in specific clinical circumstances" (1,2). Like Temproromandibular Disorders (TMD) requiring disc displacement with and without reduction of Temporomandibular Joint (TMJ). Objective. To carry out an evidence-based clinical guideline (CPG) in order to facilitate the diagnosis and effective treatment of dislocation of the disc condyle complex. Materials and methods. The Clinical Practice Guide (GPC) was developed through a Systematic Review (RS) of the literature, using Scopus, Medline-Pub Med, Wos and Embase databases, using Mesh terms and search equation. included scientific studies containing randomized clinical trials that evaluated the effectiveness of treatment in disc displacements, along with inclusion and exclusion criteria, critical reading of documents, evidence analysis and recommendations (Grading of Recommendations Assessment, Development and Evaluation - GRADE). On the other hand, information from doctoral theses and academic books was used, which together with the information extracted from the RS allowed the documentation of this Guide of Clinical Practice of Management of Alterations of the Condyle-Disc Complex. Results. The elaboration of a Practical Clinical Guide for the Management of Alterations of the Cóndilo-Disco Complex was accomplished, which was carried out from a systematic review of the literature where 85 scientific articles were identified, which were evaluated by phases (title, summary and complete text), in the last phase, 18 randomized clinical trials were selected, which met the established criteria for constructing CPG. The results in this CPG, present information corresponding to diagnosis, treatment and care, that professionals in this area of health, should give to patients who have Temporomandibular Disorders, especially those related to alterations of the condyle-disc complex, such as it is the displacements of the disk with or without reduction. Conclusions. In the analyzed literature, several treatments for TMD are reported, which initially suggest, be focused mainly with the use of conservative therapies, reversible with emphasis in interdisciplinary management, including maxillary rest, soft diet, pharmacotherapy, splints and physiotherapy; surgical treatment is recommended as a last resort.