# Impact of zygomaticomaxillary complex fracture on masticatory muscle dysfunction and pain: systematic review and observational meta-analysis

## TL;DR

This study reviews how zygomaticomaxillary complex fractures affect chewing muscles and pain, finding that surgical and physical therapy interventions significantly improve outcomes.

## Contribution

A systematic review and meta-analysis quantifying the impact of ZMC fractures on masticatory function and pain, and evaluating intervention effectiveness.

## Key findings

- ZMC fractures reduce bite force and alter muscle activity patterns.
- Surgical repair and physical therapy significantly improve pain and muscle function.
- Pain levels decreased from an average of 7.5 pre-operatively to 2.3 post-operatively.

## Abstract

Background: Zygomaticomaxillary complex (ZMC) fractures significantly
affect facial aesthetics and masticatory function, necessitating effective
rehabilitation strategies. This systematic review and meta-analysis investigated
the effects of fractures on masticatory muscle function and pain management.
Methods: Adhering to PRISMA (Preferred Reporting Items for
Systematic Reviews and Meta-Analyses) guidelines, conducted a comprehensive
search across databases, including PubMed, MEDLINE, Embase, PsycINFO, Web of
Knowledge, Scopus, CINAHL, LILACS, SciELO, Cochrane and Google Scholar, and
selected studies that assessed masticatory function through metrics such as bite
force, electromyography activity, and post-intervention pain levels in patients
with ZMC fractures. Data were synthesized using a random-effects model.
Results: Fourteen studies were included, which highlighted diminished
bite force and altered muscle activity patterns in patients with ZMC fractures.
Significant improvements in muscle function and pain management were observed
postoperatively, with interventions including surgical repair and physical
therapy proving to be effective. The meta-analysis demonstrated a marked
reduction in pain, substantiated by changes in visual analog scale scores from an
average of 7.5 pre-operatively to 2.3 post-operatively. Conclusions: ZMC
fractures profoundly affect masticatory efficiency and cause notable pain, which
can be substantially alleviated by targeted surgical and therapeutic
interventions. The PROSPERO Registration: This systematic review and
meta-analysis followed the PRISMA guidelines and was registered in PROSPERO
(CRD42024595963).