Patient Education and Self-Care for the Management of Jaw Pain upon Awakening: A Randomized Controlled Clinical Trial Comparing the Effectiveness of Adding Pharmacologic Treatment with Cyclobenzaprine or Tizanidine

Junior, F G P Alencar; Viana, Patricia Gabriela Sabino; Zamperini, Camila Andrade; Becker, Anne Buss

doi:10.11607/ofph.963

Cited by 23 publications

(17 citation statements)

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“…Sixteen studies had high risk of bias (Figure ) and were excluded from analysis (Table ). The remaining 41 studies rated as medium or low risk of bias were included in the qualitative analysis for the individual groups: 15 studies on patients classified as TMD‐joint , nine on patients classified as TMD‐muscle and 17 on patients with BMS .…”

Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

“…For the TMD‐muscle group, nine relevant studies were identified . One study had to be excluded from the NMA because only change in relation to placebo was reported, which did not allow inclusion in the network of evidence.…”

Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

“…One study had to be excluded from the NMA because only change in relation to placebo was reported, which did not allow inclusion in the network of evidence. The eight remaining studies were included in the NMA with visual representation of the evidence base in the network of evidence plot (Fig. ).…”

Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

“…The network of evidence for the TMD‐muscle group showed evidence for cyclobenzaprine, albeit with a fairly short follow‐up time of 3 weeks. Cyclobenzaprine is a muscle relaxant that relieves skeletal muscle spasms of local origin and associated acute musculoskeletal pain, most likely without interfering with muscle function.…”

Section: Discussionmentioning

confidence: 99%

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Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

Häggman‐Henrikson

Alstergren

Davidson

et al. 2017

J of Oral Rehabilitation

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This health technology assessment evaluated the efficacy of pharmacological treatment in patients with oro-facial pain. Randomised controlled trials were included if they reported pharmacological treatment in patients ≥18 years with chronic (≥3 months) oro-facial pain. Patients were divided into subgroups: TMD-muscle [temporomandibular disorders (TMD) mainly associated with myalgia]; TMD-joint (TMD mainly associated with temporomandibular joint pain); and burning mouth syndrome (BMS). The primary outcome was pain intensity reduction after pharmacological treatment. The scientific quality of the evidence was rated according to GRADE. An electronic search in PubMed, Cochrane Library, and EMBASE from database inception to 1 March 2017 combined with a handsearch identified 1552 articles. After screening of abstracts, 178 articles were reviewed in full text and 57 studies met the inclusion criteria. After risk of bias assessment, 41 articles remained: 15 studies on 790 patients classified as TMD-joint, nine on 375 patients classified as TMD-muscle and 17 on 868 patients with BMS. Of these, eight studies on TMD-muscle, and five on BMS were included in separate network meta-analysis. The narrative synthesis suggests that NSAIDs as well as corticosteroid and hyaluronate injections are effective treatments for TMD-joint pain. The network meta-analysis showed that clonazepam and capsaicin reduced pain intensity in BMS, and the muscle relaxant cyclobenzaprine, for the TMD-muscle group. In conclusion, based on a limited number of studies, evidence provided with network meta-analysis showed that clonazepam and capsaicin are effective in treatment of BMS and that the muscle relaxant cyclobenzaprine has a positive treatment effect for TMD-muscle pain.

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Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

Section: Results Of the Systematic Review And Network Meta‐analysismentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

Häggman‐Henrikson

Alstergren

Davidson

et al. 2017

J of Oral Rehabilitation

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“…The group acknowledged that in one study SM with medication had a better short‐term outcome than SM alone for jaw muscle pain . This effect, may, however depend on the type of muscle pain , and medication's usage has the undesired potential for patients to believe that the medication, and not the SM, has reduced their pain.…”

Section: Resultsmentioning

confidence: 99%

Self‐management programmes in temporomandibular disorders: results from an international Delphi process

Durham

Al-Baghdadi

Baad‐Hansen

et al. 2016

J of Oral Rehabilitation

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SUMMARY Self-management (SM) programmes are commonly used for initial treatment of patients with temporomandibular disorders (TMD). The programmes described in the literature, however, vary widely with no consistency in terminology used, components of care or their definitions. The aims of this study were therefore to construct an operationalised definition of self-management appropriate for the treatment of patients with TMD, identify the components of that self-management currently being used and create sufficiently clear and non-overlapping standardised definitions for each of those components. A four-round Delphi process with eleven international experts in the field of TMD was conducted to achieve these aims. In the first round, the participants agreed upon six principal concepts of self-management.In the remaining three rounds, consensus was achieved upon the definition and the six components of self-management. The main components identified and agreed upon by the participants to constitute the core of a SM programme for TMD were as follows: education; jaw exercises; massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. This Delphi process has established the principal concepts of selfmanagement, and a standardised definition has been agreed with the following components for use in clinical practice: education; self-exercise; self-massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. The consensus-derived concepts, definitions and components of SM offer a starting point for further research to advance the evidence base for, and clinical utility of, TMD SM.

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Antidepressants for chronic non-cancer pain in children and adolescents

Cooper

Heathcote

Clinch

et al. 2017

Cochrane Database of Systematic Reviews

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We identified only a small number of studies with small numbers of participants and insufficient data for analysis.As we could undertake no meta-analysis, we are unable to comment about efficacy or harm from the use of antidepressants to treat chronic non-cancer pain in children and adolescents. Similarly, we cannot comment on our remaining secondary outcomes: Carer Global Impression of Change; requirement for rescue analgesia; sleep duration and quality; acceptability of treatment; physical functioning; and quality of life.There is evidence from adult randomised controlled trials that some antidepressants, such as amitriptyline, can provide some pain relief in certain chronic non-cancer pain conditions.There is no evidence from randomised controlled trials to support or refute the use of antidepressants to treat chronic non-cancer pain in children or adolescents.

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Patient Education and Self-Care for the Management of Jaw Pain upon Awakening: A Randomized Controlled Clinical Trial Comparing the Effectiveness of Adding Pharmacologic Treatment with Cyclobenzaprine or Tizanidine

Abstract: The use of tizanidine or cyclobenzaprine in addition to self-care management and patient education was not more effective than placebo for the management of patients with myofascial jaw pain upon awakening.

Cited by 23 publications

References 0 publications

Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

Pharmacological treatment of oro‐facial pain – health technology assessment including a systematic review with network meta‐analysis

Self‐management programmes in temporomandibular disorders: results from an international Delphi process

Antidepressants for chronic non-cancer pain in children and adolescents

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