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Evidence found and GRADE certainty

32 questions · 35 findings · 6 reviews · Oral and maxillofacial surgery

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No studies found 4 · 11.4%GRADE not reported 9 · 25.7%Very low 12 · 34.3%Low 8 · 22.9%Moderate 0 · 0%High 2 · 5.7%

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

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Patients not using rescue medication at 6 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) leads to higher patients not using rescue medication at 6 hours compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg… (high certainty).

1 finding from 1 review

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Use of rescue medication · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) led to higher patients using rescue medication at 8 hours compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg…; GRADE not reported.

1 finding from 1 review

Combined paracetamol plus ibuprofen in a single tablet (e.g. paracetamol 1000 mg/ibuprofen 400 mg or 500/200 mg) vs Single drugs given separately (paracetamol 1000 mg or ibuprofen 400 mg)

Patients not using rescue medication at 8 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Combined paracetamol plus ibuprofen in a single tablet (e.g.… leads to higher patients not using rescue medication at 8 hours compared with single drugs given separately (paracetamol 1000 mg or ibuprofen 400… (high certainty).

1 finding from 1 review

Summary of findings table ‐ Topical capsaicin vs placebo

Maximum pain while on medication (VAS) · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Topical capsaicin (0.025% cream) showed no clear difference in maximum pain while on medication (VAS) compared with placebo; GRADE not reported.

1 finding from 1 review

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Analgesic medication used (type, dose, frequency) · Adults over 18 years of age with fractures of the facial skeleton including the mandible, maxilla, zygoma (malar); studies on fractures of…

The review found no eligible studies for this question.

1 finding from 1 review
  • Resorbable versus titanium plates for facial fractures 2009 · Cochrane All outcomes
    Up to 3 years postoperatively
    Planned primary outcome not assessed: none of the retrieved studies met the inclusion criteria, so no data were available for analysis. Verbatim (Effects of interventions): "Although 53 studies were retrieved in our…
    0 studies
    No studies found

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

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 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

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 alternative treatment

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    SoF: 3 studies reported minor adverse events in the control group; 1 study reported minor adverse events in psychological therapy group; 1 study reported that there were no adverse events. Results: NCT00066937 minor…
    5 studies
    Very low

Primary closure of the extraction socket with a mucoperiosteal flap vs Application of platelet-rich fibrin (PRF) without primary closure

MRONJ (incidence proportion) · People on antiresorptive treatment undergoing tooth extraction (at risk of MRONJ)
1 finding from 1 review
  • Interventions for managing medication‐related osteonecrosis of the jaw 2022 · Cochrane All outcomes
    90 days
    All participants had complete mucosal coverage without any signs of MRONJ at the final control examination 90 days postoperatively (77 randomised; 1 RCT); no case of postoperative MRONJ in either group; effect not…
    1 study · 77 participants
    GRADE not reported

Dental extraction protocol with plasma rich in growth factors (PRGF) inserted into the postextraction alveolus vs Standard dental extraction protocol without PRGF

Complications and side effects · People with cancer treated with intravenous bisphosphonates undergoing dental extractions (at risk of MRONJ)
1 finding from 1 review

Teriparatide 20 microg daily in addition to standard care vs placebo + standard care

Healing of MRONJ · People with established (manifest) MRONJ

Teriparatide 20 microg daily in addition to standard care showed no clear difference in healing of MRONJ (resolution of lesions) compared with placebo in addition to standard care (low certainty).

1 finding from 1 review

Concentrated growth factor (CGF) and primary wound closure vs primary closure

Healing of MRONJ (soft tissue healing) · Women with osteoporosis and established MRONJ

It is very uncertain whether concentrated growth factor (CGF) and primary wound closure changes healing of MRONJ (soft tissue healing) compared with primary wound closure only (very low certainty).

1 finding from 1 review

Platelet-rich fibrin after bone surgery vs Bone surgery alone

Healing of MRONJ (mucosal integrity, absence of infection, and no re-intervention) · People with established (manifest) MRONJ

It is very uncertain whether platelet-rich fibrin after bone surgery changes healing of MRONJ (mucosal integrity, absence of infection, and no… compared with bone surgery alone (very low certainty).

1 finding from 1 review