Shivakumar Sahana, Abdul Nishath Sayed, Jyoti Bhuvan, Kalburgi Veena, Cicciù Marco, Minervini Giuseppe
Public Health Dentistry, Peoples College of Dental Sciences and Research Centre Peoples University Bhopal, Bhopal, India.
Faculty of Oral Pathology, Department of OMFS and Diagnostic Sciences, Riyadh Elm University Riyadh, Riyadh, Saudi Arabia.
J Oral Rehabil. 2025 Apr;52(4):521-530. doi: 10.1111/joor.13792. Epub 2024 Jul 23.
Temporomandibular disorders (TMDs) are musculoskeletal and neuromuscular conditions affecting the temporomandibular joint and associated structures. Cognitive-behavioural therapy (CBT) has emerged as a potential intervention for TMDs, but its comparative effectiveness against standard treatments remains unclear. This systematic review aimed to evaluate and compare the efficacy of CBT versus standard treatment interventions in managing TMDs.
A comprehensive search was conducted across multiple databases using MeSH keywords and Boolean operators. Inclusion criteria encompassed clinical trials comparing CBT/CBT in combination with standard treatment interventions or a control group in individuals with TMDs. The primary outcome measured was pain. Secondary outcomes such as disability, depression and jaw function were also looked into. Two reviewers independently assessed for the eligibility of the articles and conducted data extraction. Quality assessments were performed using RoB 2.0 for randomised clinical trials.
The initial search identified 623 articles, of which a total of eight clinical studies met the inclusion criteria and were included in the systematic review. Seven out of eight studies demonstrated improvements in outcomes related to TMD. Pain was significantly decreased in studies that showed a positive outcome. Jaw function, quality of life and psychological well-being were superior among individuals receiving CBT alone or in combination with conventional modalities, as well as hypnotic therapy coupled with CBT-based interventions. The quality of studies assessed showed all articles to be of good quality as per RoB-2 evaluation.
This systematic review highlights the potential benefits of CBT in managing TMDs, suggesting its effectiveness in improving pain outcomes and enhancing overall well-being. The findings indicate that CBT may be a valuable adjunct or alternative to standard treatment interventions for individuals with TMDs. However, further research with larger sample sizes and standardised outcome measures is warranted to establish definitive conclusions regarding the comparative efficacy of CBT versus standard treatments in TMD management.
颞下颌关节紊乱病（TMDs）是影响颞下颌关节及相关结构的肌肉骨骼和神经肌肉疾病。认知行为疗法（CBT）已成为治疗TMDs的一种潜在干预措施，但其与标准治疗方法相比的有效性仍不明确。本系统评价旨在评估和比较CBT与标准治疗干预措施在管理TMDs方面的疗效。
使用医学主题词（MeSH）关键词和布尔运算符在多个数据库中进行全面检索。纳入标准包括比较CBT/CBT联合标准治疗干预措施或TMDs患者对照组的临床试验。测量的主要结局是疼痛。还研究了残疾、抑郁和下颌功能等次要结局。两名评审员独立评估文章的 eligibility 并进行数据提取。使用RoB 2.0对随机临床试验进行质量评估。
初步检索确定了623篇文章，其中共有8项临床研究符合纳入标准并被纳入系统评价。8项研究中有7项显示与TMD相关的结局有所改善。显示阳性结局的研究中疼痛显著降低。单独接受CBT或与传统方式联合接受CBT的个体，以及接受催眠疗法与基于CBT的干预措施联合治疗的个体，其下颌功能、生活质量和心理健康状况更佳。根据RoB-2评估，所评估研究的质量显示所有文章质量良好。
本系统评价强调了CBT在管理TMDs方面的潜在益处，表明其在改善疼痛结局和提高整体幸福感方面的有效性。研究结果表明，对于患有TMDs的个体，CBT可能是标准治疗干预措施的有价值辅助手段或替代方法。然而，需要进行更大样本量和标准化结局测量的进一步研究，以确定关于CBT与标准治疗在TMD管理中比较疗效的明确结论。
