Systematic reviews related to this topic

loading
18 References (18 articles) loading Revert Studify

Systematic review

Unclassified

The Effect of Upper Cervical Mobilization/Manipulation on Temporomandibular Joint Pain, Maximal Mouth Opening, and Pressure Pain Thresholds: A Systematic Review and Meta-Analysis

blocked
Authors Lam AC , Liddle LJ , MacLellan CL
Journal Archives of rehabilitation research and clinical translation
Year 2023
Links Pubmed DOI PubMed Central

This article includes 8 Primary studies 8 Primary studies (8 references)

Loading references information
OBJECTIVE: To evaluate the efficacy of upper cervical joint mobilization and/or manipulation on reducing pain and improving maximal mouth opening (MMO) and pressure pain thresholds (PPTs) in adults with temporomandibular joint (TMJ) dysfunction compared with sham or other intervention. DATA SOURCES: MEDLINE, CINAHL, EMBASE, and Cochrane Library from inception to June 3, 2022, were searched. STUDY SELECTION: Eight randomized controlled trials with 437 participants evaluating manual therapy (MT) vs sham and MT vs other intervention were included. Two reviewers independently extracted data and assessed risk of bias. DATA EXTRACTION: Two independent reviewers extracted information about origin, number of study participants, eligibility criteria, type of intervention, and outcome measures. DATA SYNTHESIS: Manual therapy was statistically significant in reducing pain compared with sham (mean difference [MD]: -1.93 points, 95% confidence interval [CI]: -3.61 to -0.24, P=.03), and other intervention (MD: -1.03 points, 95% CI: -1.73 to -0.33, P=.004), improved MMO compared with sham (MD: 2.11 mm, 95% CI: 0.26 to 3.96, P=.03), and other intervention (MD: 2.25 mm, 95% CI: 1.01 to 3.48, P<.001), but not statistically significant in improving PPT of masseter compared with sham (MD: 0.45 kg/cm2, 95% CI: -0.21 to 1.11, P=.18), and other intervention (MD: 0.42 kg/cm2, 95% CI: -0.19 to 1.03, P=.18), or the PPT of temporalis compared with sham (MD: 0.37 kg/cm2, 95% CI: -0.03 to 0.77, P=.07), and other intervention (MD: 0.43 kg/cm2, 95% CI: -0.60 to 1.45, P=.42). CONCLUSION: There appears to be limited benefit of upper cervical spine MT on TMJ dysfunction, but definitive conclusions cannot be made because of heterogeneity and imprecision of treatment effects.

Systematic review

Unclassified

No Sufficient Evidence for an Immediate Hypoalgesic Effect of Spinal Manual Therapy on Pressure Pain Thresholds in Asymptomatic and Chronic Pain Populations: A Systematic Review and Meta-Analysis.

blocked
Journal Physical therapy
Year 2023
Links Pubmed DOI

This article includes 22 Primary studies 22 Primary studies (22 references)

Loading references information
OBJECTIVE: Spinal manual therapy (SMT) is often used to treat patients with spinal disorders; however, the underlying mechanisms of SMT are not fully understood. This systematic review and meta-analysis investigates the effect of SMT compared with sham treatment or no intervention on local or remote (segmental or non-segmental) pressure pain thresholds (PPTs) in patients with chronic musculoskeletal conditions and people who are pain free. METHODS: A systematic search was conducted in the PubMed, Cochrane Library, Web of Science, and CINAHL databases. Randomized controlled trials investigating the effect of SMT on PPTs in patients with chronic musculoskeletal conditions and in people who were pain free were included. Quality assessment and evidence synthesis were performed according to Cochrane Handbook recommendations. A meta-analysis was performed using standardized mean difference and 95% CIs. RESULTS: Twenty-two reports were included in the present review. There were no significant results for an immediate effect of SMT on local (low certainty of evidence), remote (segmental) (low certainty of evidence), and remote (non-segmental) (low certainty of evidence) PPTs in patients with chronic pain as well as on local (moderate certainty of evidence) and remote (segmental) (low certainty of evidence) PPTs in people who were pain free. A small but significant effect (standardized mean difference = 0.26; 95% CI = 0.01 to 0.51; low certainty of evidence) was observed on remote (non-segmental) PPTs in people who were pain free, which was not considered a meaningful effect size. CONCLUSION: No immediate, consistent, or meaningful hypoalgetic effect of SMT was shown on PPTs on various body areas. Involvement of spinal or supraspinal underlying mechanisms were, therefore, not confirmed via PPTs but should still be investigated using methods designed to assess central nervous pain processing. IMPACT: No consistent and meaningful hypoalgesic effects of spinal manual therapy were demonstrated on PPTs in participants who were pain free and in patients with chronic musculoskeletal disorders.

Systematic review

Unclassified

The Efficacy of Manual Therapy Approaches on Pain, Maximum Mouth Opening and Disability in Temporomandibular Disorders: A Systematic Review of Randomised Controlled Trials.

blocked
Journal Life (Basel, Switzerland)
Year 2023
Links Pubmed DOI PubMed Central

This article includes 20 Primary studies 20 Primary studies (20 references)

Loading references information
Temporomandibular disorder (TMD) is a common condition disabling people and bringing up costs. The aim of this study was to investigate the effects of manual therapy on pain intensity, maximum mouth opening (MMO) and disability. Searches were conducted in six databases for randomised controlled trials (RCTs). Selection of trials, data extraction and methodological quality assessment were conducted by two reviewers with discrepancies resolved by a third reviewer. Estimates were presented as mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). Quality of the evidence was assessed using the GRADE approach. Twenty trials met the eligibility criteria and were included. For pain intensity, high and moderate quality evidence demonstrated the additional effects of manual therapy at short- (95% CI -2.12 to -0.82 points) and long-term (95% CI -2.17 to -0.40 points) on the 0-10 points scale. For MMO, moderate to high quality evidence was found in favour of manual therapy alone (95% CI 0.01 to 7.30 mm) and its additional effects (95% CI 1.58 to 3.58 mm) at short- and long-term (95% CI 1.22 to 8.40 mm). Moderate quality evidence demonstrated an additional effect of manual therapy for disability (95% CI = -0.87 to -0.14). Evidence supports manual therapy as effective for TMD.

Systematic review

Unclassified

Botulinum Toxin for Treating Temporomandibular Disorders: What is the Evidence?

blocked
Journal Journal of oral & facial pain and headache
Year 2022
Links Pubmed DOI

This article includes 24 Primary studies 24 Primary studies (24 references)

Loading references information
AIMS: To systematically review the scientific literature for evidence concerning the clinical use of botulinum toxin (BTX) for the management of various temporomandibular disorders (TMDs). METHODS: A comprehensive literature search was conducted in the Medline, Web of Science, and Cochrane Library databases to find randomized clinical trials (RCT) published between 2000 and the end of April 2021 investigating the use of BTX to treat TMDs. The selected articles were reviewed and tabulated according to the PICO (patients/problem/population, intervention, comparison, outcome) format. RESULTS: A total of 24 RCTs were selected. Nine articles used BTX injections to treat myofascial pain, 4 to treat temporomandibular joint (TMJ) articular TMDs, 8 for the management of bruxism, and 3 to treat masseter hypertrophy. A total of 411 patients were treated by injection of BTX. Wide variability was found in the methods of injection and in the doses injected. Many trials concluded superiority of BTX injections over placebo for reducing TMD pain levels and improving maximum mouth opening; however, this was not universal. CONCLUSION: There is good scientific evidence to support the use of BTX injections for treatment of masseter hypertrophy and equivocal evidence for myogenous TMDs, but very little for TMJ articular disorders. Studies with improved methodologic design are needed to gain better insight into the utility and effectiveness of BTX injections for treating both myogenous and TMJ articular TMDs and to establish suitable protocols for treating different TMDs.

Systematic review

Unclassified

Manual Therapy in the Treatment of Myofascial Pain Related to Temporomandibular Disorders: A Systematic Review.

blocked
Journal Journal of oral & facial pain and headache
Year 2020
Links Pubmed DOI

This article includes 5 Primary studies 5 Primary studies (5 references)

Loading references information
AIMS: To evaluate the effectiveness of manual therapy in the treatment of myofascial pain related to temporomandibular disorders. METHODS: Randomized clinical trials were searched in the Cochrane Library, MEDLINE, Web of Science, Scopus, LILACS, and SciELO databases using the following keywords: temporomandibular joint disorders; craniomandibular disorders; myofascial pain syndromes; myofascial pain; exercise therapy; myofunctional therapy; physical therapy modalities; clinical trial; prospective studies; and longitudinal studies. Studies using the RDC/TMD and manual therapy for myofascial pain were included. All studies were evaluated using the Cochrane Risk of Bias tool. RESULTS: Five studies were included in the present review. Of 279 total patients, 156 were treated with manual therapy only or manual therapy with counseling. Manual therapy was efficient for pain relief in all studies evaluated; however, manual therapy was not better than counseling or botulinum toxin. CONCLUSION: Manual therapy was better than no treatment in one study and better than counseling in another study; however, manual therapy combined with counseling was not statistically better than counseling alone, and manual therapy alone was not better than botulinum toxin. Manual therapy combined with home therapy was better than home therapy alone in one study. Further studies are required due to the inconclusive data and poor homogeneity found in this review.

Systematic review

Unclassified

Botulinum toxin in the management of temporomandibular disorders: a systematic review

blocked
Journal Br. J. Oral Maxillofac. Surg.
Year 2020
Links Pubmed DOI

This article includes 7 Primary studies 7 Primary studies (7 references)

Loading references information
The aim of this review was to critically investigate and assess the evidence relating to the use and efficacy of botulinum toxin (BTX) in the management of temporomandibular joint disorders (TMD) and masticatory myofascial pain. A comprehensive search was conducted of PubMed, Scopus, Embase, and Cochrane CENTRAL, to find relevant studies from the last 30 years up to the end of July 2018. Seven were identified. Three showed a significant reduction in pain between the BTX and placebo groups and one showed a clinical, but not a significant, difference. In one that compared BTX with another novel treatment, myofascial pain reduced equally in both groups, and in the remaining two there was no significant difference in pain reduction between the BTX and control groups. Of the four studies that assessed mouth opening, two reported that BTX had resulted in a slight improvement; one reported no improvement, and the other a worsening of the condition. A meta-analysis was not possible because of the considerable variation in the studies' designs, the heterogeneity between the groups, and the different assessment tools used. Despite showing benefits, consensus on the therapeutic benefit of BTX in the management of myofascial TMD is lacking. Further randomised controlled trials with larger sample sizes, minimal bias, and longer follow-up periods are now needed.

Systematic review

Unclassified

No evidence on the effectiveness of oral splints for the management of temporomandibular joint dysfunction pain in both short and long-term follow-up systematic reviews and meta-analysis studies

blocked
Authors Fouda AAH
Journal Journal of the Korean Association of Oral and Maxillofacial Surgeons
Year 2020
Links Pubmed DOI PubMed Central

This article includes 22 Primary studies 22 Primary studies (22 references)

Loading references information
The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, P=0.002, I2=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.

Systematic review

Unclassified

A systematic review of botulinum toxin in the management of patients with temporomandibular disorders and bruxism.

blocked
Authors Patel J , Cardoso JA , Mehta S
Journal British dental journal
Year 2019
Links Pubmed DOI

This article includes 11 Primary studies 11 Primary studies (11 references)

Loading references information
Introduction The medical and cosmetic use of botulinum toxin (BTX) is now widespread. With an increased number of clinicians adopting the use of BTX in the management of temporomandibular disorders (TMD) and/or bruxism, as either a standalone treatment or as an adjunct, affirmation is required in regards to whether it has a clinically justifiable position among the current spectrum of available treatment modalities.Objectives To establish the usefulness of BTX when treating patients with TMD and/or bruxism, and thereby determine whether there may be an appropriate purpose for the prescription of BTX in the management of these patients.Data sources and data selection A systematic review of the relevant literature was conducted. The literature search was carried out by applying key terms to appropriate data sources (Medline, Embase, Pubmed, Cochrane Central Register of Controlled Trials, and OpenSIGLE). The resultant papers were subjected to inclusion and exclusion criteria, which were then assessed for bias using a framework outlined in the Cochrane Handbook.Results A total of 11 trials met the inclusion criteria. The primary outcome measure was changes in pain experience in groups that had been treated with BTX, relative to an appropriate control group. Secondary outcomes included changes in the frequency of bruxism events, changes in maximum mouth opening, changes in occlusal force and changes in electromyography (EMG) readings of muscles of mastication.Conclusion The evidence to support the use of BTX in the management of TMD and/or bruxism is not entirely unequivocal. A number of studies that have met the inclusion criteria have shown promising results and thereby justify further investigation. Given the current evidence, BTX should certainly be considered but due to financial implications and possible side effects, it seems appropriate that conservative options, such as self-management with explanation and physical therapies, should be exhausted first.

Systematic review

Unclassified

Placebo and nocebo response magnitude on temporomandibular disorders related-pain: a systematic review and meta-analysis.

blocked
Journal Journal of oral rehabilitation
Year 2019
Links Pubmed DOI

This article includes 42 Primary studies 42 Primary studies (42 references)

Loading references information
OBJECTIVES: The aim of this systematic review (SR) was to answer the following question: "In adult patients with temporomandibular disorders (TMD) related-pain, what is the placebo or nocebo effect of different therapies?" METHODS: A SR was performed with randomized clinical placebo-controlled trials on diagnosed painful TMD studies from five main databases and from three grey literature. Studies included must to have sample older than 18 years, with painful TMD, which diagnosis was done by Research Diagnostic Criteria (RDC/TMD) or Diagnostic Criteria (DC/TMD). RESULTS: Out of 770 articles obtained, 42 met the inclusion criteria for qualitative and 26 for quantitative analysis. Meta-analysis indicated mean variation on pain intensity for placebo therapy was higher on laser acupuncture with 45.5mm points reduction, followed by avocado soybean extract with 36mm, and amitriptyline 25mg with 25.2mm. Laser showed a 29% of placebo effect, as well medicine with 19% and other therapies with 26%. Possible nocebo effect of 8% pain increase was found for intra-articular injection of ultracain. CONCLUSIONS: Based on the available data, the placebo response could play a major effect on TMD pain management and may be responsible from 10 to 75% of pain relief. Laser acupuncture, avocado soybean and amitriptyline promoted the higher placebo effect. Possible nocebo effect was found only for Ultracain Injection with 8%. CLINICAL RELEVANCE: Clinicians could apply such evidence to optimize pain management and judgment about treatment efficacy and researches may find it useful when designing their investigations. This article is protected by copyright. All rights reserved.

Systematic review

Unclassified

Botulinum toxin type A applications for masticatory myofascial pain and trigeminal neuralgia: what is the evidence regarding adverse effects?

blocked
Journal Clinical oral investigations
Year 2019
Links Pubmed DOI www.epistemonikos.org

This article includes 16 Primary studies 16 Primary studies (16 references)

Loading references information
OBJECTIVES: The objective of the study was to conduct a systematic review of literature assessing botulinum toxin type A (BoNT-A) safety and adverse effects in the treatment of myofascial pain (MFP) and trigeminal neuralgia (TN). MATERIALS AND METHODS: The search for articles by two specific researchers involved the PubMed, EMBASE, Web of Science, and Scopus databases. Specific terms were used, and no publication time and language restrictions were applied. Clinical trials that investigated the effects of BoNT-A among participants with myofascial pain in masticatory muscles or trigeminal neuralgia were considered eligible for this systematic review. Data for each study were extracted and analyzed according to a PICO-like structured reading. RESULTS: The search strategy provided 436 citations. After analysis, 16 citations were included, seven for MFP and nine for TN. In all studies, BoNT-A was well tolerated and improved pain. The most common adverse effects were temporary regional weakness, tenderness over the injection sites, and minor discomfort during chewing. Most studies reported a spontaneous resolution of adverse effect. CONCLUSIONS: It can be concluded that BoNT-A treatment is well tolerated, since minor adverse effects were the most frequently reported; however, it is recommended that future studies aim to assess the safety and possible adverse effects of multiples applications or high doses of this treatment. CLINICAL RELEVANCE: BoNT-A has been increasingly diffused in dentistry, being used for the management of masticatory myofascial pain and trigeminal neuralgia. Nonetheless, there is no consensus about its efficacy and adverse effects that could occur when this treatment is applied.