Abstract
Objectives: This study aimed to assess whether functional mandibular advancement will induce or aggravate temporomandibular joint disorders.Methods: All searched databases, including PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trails were searched. Gray literature and unpublished literature was also searched. Randomized controlled trails directly observe the condition of patients’ TMJ after finishing treatment will be considered to include in our study. Cochrane Collaboration risk of bias tool was used to assess the quality of included studies according to the established inclusion criteria.Result:Finally 13 researches were statistically pooled in meta-analysis. The number of samples under investigated among primary studies was 285 individuals ,there were 142 patients who developed temporomandibular symptoms during or after treatment. But all the subjective symptoms disappeared during follow-up time. The statistical outcomes proved that patients recieved FMA didn’t show more tendency to develop temporomandibular symptoms[I²=25%, OR=0.39, 95%CI (0.22 ,0.68), p=0.001].Conclusion: (1) TMJ symptoms may occur during the functional oral appliance wearing, but the symptoms will release or disappear during follow-up period. (2) Less convinced evidence indicate that slightly previous TMD will be improved after treatment. (3) There is TMJ disc anterior displacement observed during treatment, but most of them will return to the normal position later. (4) Moderate evidence support that FMA will not induce or aggravate TMD.