Effectiveness of Analgesics in the Treatment of Temporomandibular Dysfunction: A Systematic Literature Review

Abstract

Introduction: Temporo-mandibular dysfunctions correspond to a defect adaptation of the manducatory apparatus. Different therapeutic methods are available for the treatment of these pathologies: Splints, physical therapies, occlusal therapies, surgery or pharmacological treatments. The objective of our work is to analyze the clinical effectiveness of analgesics in the treatment of disorders of the masticatory apparatus by applying the Evidence approach Based Dentistry. Methods: The collection of data from the literature scientific was carried out among the production that appeared during the period from 2011 to 2021. The documentary research was carried out using accessible databases via the Internet namely MEDLINE, ELSEVIER and Cochrane Database of Systematic through their PubMed, Science Direct and Cochrane library search engines, as well as the website Google Scholar. A bottom-up manual search covering the same study period was carried out in order to enrich our bibliography. The writing of this systematic review followed the guidelines of the PRISMA Statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Results: 9 relevant randomized clinical trials were selected after critical reading guided by the CASP type reading grids. The items have been listed in 4 categories according to the route of administration of the analgesics (topical route, oral, intramuscular route and intra-articular route) and classified in tables according to the PICO criteria (Participants/Interventions/Comparison/Results “Outcomes”). The results of our study show a significant reduction in the intensity of the pain and the rates of cytokines as well as a significant increase in maximum mouth opening. Conclusion: The use of analgesics increases the efficacy of treatment by decreasing pain intensity and cytokine levels, through both their analgesic and anti-inflammatory actions. This efficacy is similar for both levels II and III. However, additional long-term clinical studies with a larger sample size are needed to confirm the data collected and to further explore the effect of analgesics in the treatment of TMDs.