Current Evidence Providing Clarity in Management of Temporomandibular Disorders: Summary of a Systematic Review of Randomized Clinical Trials for Intra-oral Appliances and Occlusal Therapies

Abstract

Pain and dysfunction from temporomandibular disorders (TMJD) is a significant clinical problem for which many diverse treatments have been used. Numerous articles evaluating success/failure of these TMJD treatments have been published with a wide range of success rates and methods to evaluate outcomes.1-6 Nearly all of these treatments have been evaluated for efficacy using the highest level of research evidence from randomized controlled trials (RCTs). With this available literature, clinicians are faced with the challenge of reviewing the methods and results of each study to make evidence-based clinical decisions. This process is further compounded by considerable variability with regard to their study designs, treatment techniques, and outcome measures. The Guidelines Committee for the American Academy of Orofacial Pain conducted an evidence-based literature review to systematically search and review the literature for all randomized clinical trials for TMJD treatment using methods derived from the Cochrane Collaboration (www.cochrane.org); the Oxford Centre for Evidence-based Medicine, (www.cebm.net); and the Centre for Reviews and Dissemination, University of York, United Kingdom (www.york.ac.uk/ inst/crd/index.htm). Trials in which placebo, no treatment, or other treatments were used in the control group were included as were trials in which postrandomization exclusions occurred since there was no evidence that these occurred preferentially in one or other arm of the trials. This presentation reviews the results of this review for intraoral splints and occlusal therapies for temporomandibular disorders. This paper only provides a summary of the methods and results. The full results can be found in the subsequent journal publication. METHODS OF THE REVIEW