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โœฆ   LIBER   โœฆ

Management of TMD: evidence from systematic reviews and meta-analyses

โœ Scribed by T. LIST; S. AXELSSON


Book ID
108881988
Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
227 KB
Volume
37
Category
Article
ISSN
0305-182X

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โœฆ Synopsis


This systematic review (SR) synthesises recent evidence and assesses the methodological quality of published SRs in the management of temporomandibular disorders (TMD). A systematic literature search was conducted in the PubMed, Cochrane Library, and Bandolier databases for 1987 to September 2009. Two investigators evaluated the methodological quality of each identified SR using two measurement tools: the assessment of multiple systematic reviews (AMSTAR) and level of research design scoring. Thirty-eight SRs met inclusion criteria and 30 were analysed: 23 qualitative SRs and seven meta-analyses. Ten SRs were related to occlusal appliances, occlusal adjustment or bruxism; eight to physical therapy; seven to pharmacologic treatment; four to TMJ and maxillofacial surgery; and six to behavioural therapy and multimodal treatment. The median AMSTAR score was 6 (range 2-11). Eighteen of the SRs were based on randomised clinical trials (RCTs), three were based on case-control studies, and nine were a mix of RCTs and case series. Most SRs had pain and clinical measures as primary outcome variables, while few SRs reported psychological status, daily activities, or quality of life. There is some evidence that the following can be effective in alleviating TMD pain: occlusal appliances, acupuncture, behavioural therapy, jaw exercises, postural training, and some pharmacological treatments. Evidence for the effect of electrophysical modalities and surgery is insufficient, and occlusal adjustment seems to have no effect. One limitation of most of the reviewed SRs was that the considerable variation in methodology between the primary studies made definitive conclusions impossible.


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## Objectives/Hypothesis To evaluate the existing level of evidence for tinnitus management strategies identified in the UK Department of Health's Good Practice Guideline. ## Study Design Systematic review of peer-reviewed literature and meta-analyses. ## Methods Searches were conducted in PubM