Efficacy of conservative approaches on pain relief in patients with temporomandibular joint disorders: a systematic review with network meta-analysis

Ferrillo, Martina; Nucci, Ludovica; Giudice, Amerigo; Calafiore, Dario; Marotta, Nicola; Minervini, Giuseppe; d’Apuzzo, Fabrizia; Ammendolia, Antonio; Perillo, Letizia; Sire, Alessandro de

doi:10.1080/08869634.2022.2126079

Cited by 46 publications

(31 citation statements)

References 53 publications

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“…One of these findings is that the pain intensity seems to be not dependent on SB polysomnography (PSG) parameters [ 5 ]. Considering pain as one of the most problematic consequences of SB, Ferrillo et al have reported, based on a conducted meta-analysis, that conservative approaches including rehabilitative therapies (like splint appliance and laser therapy) might be effective in the treatment of pain in TMJ disorders [ 6 ]. New treatment methods are emerging, among them regeneration of TMJ with the use of mesenchymal stem cells [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Sleep Bruxism Contributes to Motor Activity Increase during Sleep in Apneic and Nonapneic Patients—A Polysomnographic Study

et al. 2022

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Background: Jaw motor activity (MA) in sleep bruxism (SB) has been demonstrated to accompany lower limb movements. However, it remains unknown whether SB activity coexists with other types of movements and what the possible underlying mechanisms of such temporal coexistence are. In obstructive sleep apnea (OSA), increased movement activity is also reported, including SB activity; however, no studies have compared MA in apneic and nonapneic SB patients. Aim: This cross-sectional study focused on the phenomenon of “big body movements” in patients with either SB or OSA (or both) and intended to identify the primary factors contributing to their appearance, using polysomnography (PSG) recording. Methods: A whole-night videoPSG was carried out in 287 participants, and 124 apneic and 146 nonapneic participants were selected for the study. In both groups, participants were further divided into no SB, moderate SB, and severe SB (SSB) subgroups based on their bruxism episode index (BEI). MA was recorded using a built-in sensor of the central PSG unit located on the participant’s chest during the examination. Results: The presence of SB was related to the higher intensity of MA in both apneic and nonapneic participants, though in general the MA level was higher in apneic participants, with the highest level observed in SSB apneic participants. Conclusions: SB might contribute to MA. The prevalence of SB might be higher in nonapneic patients due to phasic and mixed SB activity, whereas the SB phenotype seems to be less relevant in apneic patients. SB activity is likely to increase MA in non-REM 1 sleep.

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Section: Introductionmentioning

confidence: 99%

Sleep Bruxism Contributes to Motor Activity Increase during Sleep in Apneic and Nonapneic Patients—A Polysomnographic Study

et al. 2022

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“…As the etiopathogenesis of TMDs is not completely understood, the therapeutic options are not always successful [ 46 , 47 , 48 , 49 , 50 ]. Therefore, understanding the etiology, and identifying and eliminating the potential pathogenic factors could make a significant contribution to the knowledge about TMDs.…”

Section: Discussionmentioning

confidence: 99%

Temporomandibular Disorders and Vitamin D Deficiency: What Is the Linkage between These Conditions? A Systematic Review

Ferrillo

Lippi

Giudice

et al. 2022

JCM

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Although a growing body of literature has been emphasizing the role of vitamin D in oral health, there is still a gap of knowledge regarding the correlation between temporomandibular disorders (TMDs) and vitamin D. Therefore, the aim of this systematic review was to assess the linkage between hypovitaminosis D and TMDs to map the current literature in this field. On 10 September 2022, PubMed, Scopus, and Web of Science databases were systematically searched from the date of their inception to identify the studies that had assessed patients with TMDs. The primary outcome assessed in this review was the relationship between hypovitaminosis D and TMDs. Out of the 329 studies identified, 13 studies met the eligibility criteria and were included in the present work. Seven studies assessed the relationship between vitamin D and TMDs, reporting that vitamin D serum levels are lower in patients with TMDs. Our results suggested that vitamin D receptor (VDR) polymorphisms might have a role in TMDs’ development. However, the quality assessed underlined that only one study did not present a serious risk of bias. Further good-quality studies are needed to clarify the linkage between vitamin D deficiency and TMDs, but the evidence currently available has suggested potential correlations.

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“…Concerning the management of patients with TMD, it should be taken into consideration that the main objectives are: decreasing pain, increasing TMJ function, and reducing reflex masticatory muscle spasm/pain [ 24 ]. The first-line treatment for TMD is considered the conservative approach [ 25 , 26 ], including physical therapy [ 27 ], biofeedback [ 28 ], pharmacological drugs [ 29 ], TMJ injections [ 30 ], occlusal splints [ 31 , 32 ], laser therapy [ 33 ], extracorporeal shockwave therapy (ESWT) [ 34 ], transcutaneous electrical nerve stimulation (TENS) [ 35 ], and oxygen–ozone therapy [ 36 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, the scientific literature still lacks strong evidence on the key role of central sensitization for chronic pain in TMD patients affected by TMD [ 19 , 20 ], probably because this phenomenon showed to have a role in the pathophysiology of other chronic diseases [ 21 , 22 , 23 ]. Therefore, the diagnosis and the treatment of the central sensitization should be better investigated, taking into account the positive results that some conservative approaches might have on the central sensitization of TMD pain [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

Section: Introductionmentioning

confidence: 99%

Pain Management and Rehabilitation for Central Sensitization in Temporomandibular Disorders: A Comprehensive Review

Ferrillo

Giudice

Marotta

et al. 2022

IJMS

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Temporomandibular disorders (TMD) are a group of musculoskeletal diseases affecting masticatory muscles and temporomandibular joints (TMJ). In this context, the chronic TMD could be considered as a condition with chronic primary orofacial pain, presenting as myofascial TMD pain or TMJ arthralgia. In this context, myogenous TMD may present overlapping features with other disorders, such as fibromyalgia and primary headaches, characterized by chronic primary pain related to dysfunction of the central nervous system (CNS), probably through the central sensitization. This phenomenon could be defined as an amplified response of the CNS to sensory stimuli and peripheral nociceptive, characterized by hyperexcitability in the dorsal horn neurons in the spinal cord, which ascend through the spinothalamic tract. The main objectives of the management of TMD patients are: decreasing pain, increasing TMJ function, and reducing the reflex masticatory muscle spasm/pain. The first-line treatments are physical therapy, pharmacological drugs, occlusal splints, laser therapy, extracorporeal shockwave therapy, transcutaneous electrical nerve stimulation, and oxygen–ozone therapy. Although all these therapeutic approaches were shown to have a positive impact on the central sensitization of TMD pain, there is still no agreement on this topic in the scientific literature. Thus, in this comprehensive review, we aimed at evaluating the evidence on pain management and rehabilitation for the central sensitization in TMD patients.

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Efficacy of conservative approaches on pain relief in patients with temporomandibular joint disorders: a systematic review with network meta-analysis

Cited by 46 publications

References 53 publications

Sleep Bruxism Contributes to Motor Activity Increase during Sleep in Apneic and Nonapneic Patients—A Polysomnographic Study

Sleep Bruxism Contributes to Motor Activity Increase during Sleep in Apneic and Nonapneic Patients—A Polysomnographic Study

Temporomandibular Disorders and Vitamin D Deficiency: What Is the Linkage between These Conditions? A Systematic Review

Pain Management and Rehabilitation for Central Sensitization in Temporomandibular Disorders: A Comprehensive Review

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