Conservative therapies to treat pain and anxiety associated with temporomandibular disorders: a randomized clinical trial

Melo, Rafaela Albuquerque; Resende, Camila Maria Bastos Machado de; Rêgo, Cássia Renata de Figueiredo; Bispo, Andressa de Sousa Leite; Barbosa, Gustavo Augusto Seabra; Almeida, Érika Oliveira de

doi:10.1111/idj.12546

Cited by 35 publications

(58 citation statements)

References 16 publications

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“…The finding of the present meta-analysis demonstrated that no significant difference was found for mandibular movement between the two treatment modalities. Our results are in line with previous studies on TMD patients that concluded that exercise therapy and occlusal splint therapy had similar positive effects on the improvement of mandibular ROM (4,12). Given the small number of studies included in the sub-analysis for pain relief and mobility improvement, and the small overall standardized mean difference observed, these results have to be interpreted with caution.…”

Section: Discussionsupporting

confidence: 90%

“…Because the accurate etiology of TMD is unknown, conservative modalities are the preferred first-line treatment, and include counseling, medication, manual therapy, therapeutic exercise, and occlusal splint therapy among others (1). Many studies have identified the effectiveness of exercise therapy and occlusal splint therapy to relieve pain and increase mandibular movement for painful TMD (1,(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of exercise therapy versus occlusal splint therapy for the treatment of painful temporomandibular disorders: a systematic review and meta-analysis

Zhang

et al. 2021

Ann Palliat Med

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Background: This systematic review of the literature was to compare the effects of exercise therapy and occlusal splint therapy on pain and mobility in individuals with painful temporomandibular disorders (TMD).Methods: PubMed, Embase and the Cochrane Central Register of Controlled Trials were searched for English publications from database root to March 1, 2020. Search terms were [("temporomandibular joint disorders" or "temporomandibular disorders" or "craniomandibular disorders" or "orofacial pain" or "myofascial pain" or "myofascial pain" or "facial pain") AND (exercise or "physical therapy modalities" or physiotherapy or "exercise therapy") AND ("splints" or "occlusal splints" or "stabilization splint" or "occlusal appliance" or "occlusal splint therapy")]. We included randomized controlled trials that evaluated the effects of therapeutic exercise therapy and occlusal splint therapy, and were published in English. Trial quality was assessed with the Physiotherapy Evidence Database scale.Results: Six studies were included (498 patients: 251 occlusal splint therapy, 247 therapeutic exercise).The results revealed that exercise therapy was not superior to occlusal splint therapy for pain reduction in patients with painful TMD (P=0.08; weighted standardized mean difference −0.29; 95% CI, −0.62 to 0.04). The effectiveness of occlusal splint therapy and exercise therapy was found to be equivalent in the maximum mouth-opening range (P=0.51; weighted standardized mean difference 0.12; 95% CI, −0.24 to 0.48), right laterotrusion (P=0.99; weighted standardized mean difference −0.00; 95% CI, −0.31 to 0.31), left laterotrusion (P=0.32; weighted standardized mean difference 0.16; 95% CI, −0.16 to 0.48), and protrusion (P=0.77; weighted standardized mean difference 0.06; 95% CI, −0.32 to 0.43) for painful TMD patients.Conclusions: Given the limitations of the study, the small number of studies included in the sub-analysis for pain relief and the maximum mouth-opening range, and the small overall standardized mean difference for pain relief and mandibular movement observed, no high-quality evidence was found to distinguish the clinical effectiveness between occlusal splint therapy and exercise therapy for painful TMD patients. It appears that more randomized controlled trials comparing the effects of exercise therapy and occlusal splint therapy need to be implemented.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Effectiveness of exercise therapy versus occlusal splint therapy for the treatment of painful temporomandibular disorders: a systematic review and meta-analysis

Zhang

et al. 2021

Ann Palliat Med

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“…So, conservative and individualized approaches, including relaxation and self-massage techniques, jaw movements education and sleep hygiene are indicated. Guidance for the use of a variety of online tools and devices (apps and/or telemedicine) is also useful during this pandemic period [3,28]. However, in cases of higher levels of pain intensity and/or severity, face-to-face appointments with a professional are essential and should be indicated.…”

Section: Discussionmentioning

confidence: 99%

“…This TMDs can be asymptomatic or manifest as an episodic or chronic pain with dysfunctional episodes to the stomatognathic system. However, it is also common to find patients with TMD seeking treatment to others associated or comorbid symptoms, such as headaches and otological manifestations [3].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and Painful Temporomandibular Disorders: what does the dentist need to know?

Miranda

Bonato

Tesch

2021

RGO, Rev. Gaúch. Odontol.

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COVID-19 outbreak may lead to major impacts in applied oral sciences. Remarkably, it could be expected that factors associated to pandemic may lead to a greater risk of developing, worsening and perpetuating TMD and its associated risk factors. This non systematic literature review aims to discuss how the COVID-19 pandemic can influence the emergence, maintenance or worsening of TMD worldwide. During epidemics: the number of people whose mental health is affected tends to be greater than the number affected by the infection, and fear increases anxiety and stress levels in healthy individuals; chronic pain patients probably not receipt important treatments; overuse of medications becomes frequent; there are manifestation of unconscious oral parafunctional habits and poor sleep quality. All these facts represent risk factors common to TMD. Dentists should be aware of these issues and adapt their practices to properly diagnose and treat these patients within a multifactorial approach, increasing the quality of life of these individuals.

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“…The STAI has not been used in rheumatology clinical trials. It has been used as a primary outcome in randomized clinical trials in a variety of other patients with physical conditions, including those with temporomandibular disorders (93) and breast cancer (94).…”

Section: State Trait Anxiety Inventorymentioning

confidence: 99%

Measures of Anxiety in Rheumatic Diseases

Kwan

Bingham

Touma

2020

Arthritis Care & Research

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Conservative therapies to treat pain and anxiety associated with temporomandibular disorders: a randomized clinical trial

Cited by 35 publications

References 16 publications

Effectiveness of exercise therapy versus occlusal splint therapy for the treatment of painful temporomandibular disorders: a systematic review and meta-analysis

Effectiveness of exercise therapy versus occlusal splint therapy for the treatment of painful temporomandibular disorders: a systematic review and meta-analysis

COVID-19 and Painful Temporomandibular Disorders: what does the dentist need to know?

Measures of Anxiety in Rheumatic Diseases

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