Tournavitis Alexandros, Sandris Evangelos, Theocharidou Anna, Slini Theodora, Kokoti Maria, Koidis Petros, Tortopidis Dimitrios
Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Mechanical Engineering, School of Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Acta Odontol Scand. 2023 May;81(4):286-297. doi: 10.1080/00016357.2022.2138967. Epub 2022 Nov 10.
The aim of this systematic review was to evaluate the effectiveness of conservative different therapeutic modalities for temporomandibular disorders (TMD) pain.
An electronic systematic search was conducted in the MEDLINE (PubMed) database to identify the randomized clinical trials (RCTs) published between 2001 and 2021. The following, simple or multiple conjunctions, search keywords were selected: TMD pain, TMD management or conservative treatment or treatment strategies and TMD pain, therapeutic modalities or interventions and TMD. Studies included must have patients older than 18 years, with painful TMD, which diagnosis was performed by Research Diagnostic Criteria for TMD or Diagnostic Criteria for TMD. Outcome variables were pain relief and post treatment pain intensity reduction. Data were analysed with non-parametric tests and the level of significance was set at <.05.
Out of 1599 articles obtained, 28 RCTs fulfilled all selection criteria and were included. The results of this study show that there was a significant decrease in short-term post-treatment TMD pain with the use of occlusal splint alone or in combination with other therapeutic modalities when compared with the control group. Statistically significant differences were also detected between laser and photobiomodulation group and the control, in short-term treatment TMD-related pain.
The primary findings of the present systematic review showed that the occlusal splint alone or combined with other therapeutic intervention presented positive effect on short-term TMD pain reduction. Secondary outcome suggests that laser and photobiomodulation therapy had, also, a significant role in short term pain relief.
本系统评价旨在评估保守治疗颞下颌关节紊乱病（TMD）疼痛的不同治疗方式的有效性。
在MEDLINE（PubMed）数据库中进行电子系统检索，以确定2001年至2021年间发表的随机临床试验（RCT）。选择了以下简单或复合的搜索关键词：TMD疼痛、TMD管理或保守治疗或治疗策略以及TMD疼痛、治疗方式或干预措施以及TMD。纳入的研究必须有年龄大于18岁、患有疼痛性TMD的患者，其诊断依据TMD研究诊断标准或TMD诊断标准进行。结局变量为疼痛缓解和治疗后疼痛强度降低。采用非参数检验分析数据，显著性水平设定为<.05。
在获得的1599篇文章中，28项RCT符合所有入选标准并被纳入。本研究结果表明，与对照组相比，单独使用咬合板或与其他治疗方式联合使用时，治疗后TMD短期疼痛有显著降低。在短期治疗TMD相关疼痛方面，激光和光生物调节组与对照组之间也检测到统计学上的显著差异。
本系统评价的主要结果表明，单独使用咬合板或与其他治疗干预联合使用对短期减轻TMD疼痛有积极作用。次要结果表明，激光和光生物调节疗法在短期疼痛缓解中也有重要作用。
