Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

22 questions · 28 findings · 1 reviews · Oral and maxillofacial surgery · All outcomes

No studies found 4 · 14.3%GRADE not reported 10 · 35.7%Very low 2 · 7.1%Low 12 · 42.9%Moderate 0 · 0%High 0 · 0%

CBT vs alternative treatment

Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain intensity at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

Relaxation vs Occlusal (oral) appliance

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Relaxation showed no clear difference in pain intensity compared with occlusal (oral) appliance; GRADE not reported.

1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Treatment completion · Adolescents (12-19 years)
    Not pooled. Wahlund 2015: MD 3.70 (95% CI -1.21 to 8.61), n=57 (relaxation 28, appliance 29); Wahlund 2003: MD not reported, n=83 (relaxation 41, appliance 42). Both studies were in adolescents; the occlusal appliance…
    2 studies · 140 participants
    GRADE not reported

CBT vs alternative treatment

Mental distress · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) may leads to lower psychological distress at follow-up compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
  • Only 1 study reported adverse events as an outcome (Litt 2010): it found worsening symptoms in 13 people treated with an oral splint (as part of standard treatment) and 4 people treated with CBT.
    1 study · 101 participants
    Very low

Hope-based intervention vs Pain education

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hope-based intervention showed no clear difference in pain intensity compared with pain education; GRADE not reported.

1 finding from 1 review

Hypnosis vs relaxation

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review

CBT vs alternative treatment

Additional physical symptoms · People aged 12 years and over with painful TMD lasting 3 months or longer

The review found no eligible studies for this question.

1 finding from 1 review

Mindfulness plus medication vs Medication alone

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review

CBT vs alternative treatment

Disability caused by pain at follow-up · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in disability caused by pain at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) may leads to lower pain intensity at follow-up (12 months) compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review

Hypnosis vs relaxation

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hypnosis showed no clear difference in pain intensity compared with relaxation; GRADE not reported.

1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Treatment completion
    Not pooled (clinical heterogeneity). Abrahamsen 2011: MD -1.00 (95% CI -2.27 to 0.27), n=38 (hypnosis 19, relaxation 19); Stam 1984: MD not reported, n=27 (hypnosis 12, relaxation 15).
    2 studies · 65 participants
    GRADE not reported

Habit reversal vs waiting list control

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Habit reversal treatment led to lower pain intensity compared with waiting-list control; GRADE not reported.

1 finding from 1 review

Education vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review

CBT plus hypnosis (combined package) vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

CBT plus hypnosis (combined package) led to lower pain intensity compared with usual care; GRADE not reported.

1 finding from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Disability caused by pain at follow-up · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain disability at treatment completion compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Mental distress · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in psychological distress at follow-up compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review