Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

40 questions · 44 findings · 7 reviews · Oral and maxillofacial surgery · All outcomes

No studies found 14 · 31.8%GRADE not reported 21 · 47.7%Very low 5 · 11.4%Low 4 · 9.1%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

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

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 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

Glucosamine sulfate (oral) vs ibuprofen

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adults (>18 years) with temporomandibular joint osteoarthritis (TMJ OA) diagnosed by RDC/TMD or compatible criteria

Glucosamine sulfate (oral) showed no clear difference in brief Pain Inventory (BPI) - pain intensity, change from baseline compared with ibuprofen (oral); GRADE not reported.

1 finding from 1 review

Oral propranolol vs placebo

Reduction in pain intensity · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Oral propranolol (beta-blocker) led to lower reduction in pain intensity (percentage of patients responding) compared with placebo; GRADE not reported.

2 findings from 1 review

Oral celecoxib (COX-2 inhibitor) vs placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Oral celecoxib (COX-2 inhibitor) showed no clear difference in pain intensity (VAS) compared with placebo; GRADE not reported.

1 finding from 1 review

Naproxen vs placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Oral naproxen (NSAID) led to lower pain intensity (VAS) compared with placebo; GRADE not reported.

1 finding from 1 review

Oral glucosamine hydrochloride/chondroitin sulphate vs placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adult patients aged >=18 years, clinically or radiographically diagnosed with TMD (McNeill 1997 criteria); moderate to severe pain of…

Oral glucosamine hydrochloride/chondroitin sulphate showed no clear difference in pain intensity (VAS) compared with placebo; GRADE not reported.

1 finding from 1 review

Oral paracetamol vs placebo

At least 50% reduction in pain · Patients requiring surgical removal of a lower wisdom tooth or teeth, with baseline moderate to severe pain (surgery under local…

Paracetamol (single oral dose, any dose or formulation; subgroups up… led to higher achieving at least 50% pain relief at 4 hours (using pain intensity… compared with placebo; GRADE not reported.

2 findings from 1 review

Stabilisation splint (SS) vs Non-occluding splint

Pain (unpleasantness/intensity/palpation) · Patients with pain dysfunction syndrome (PDS) of all degrees of severity

Stabilisation splint (SS) showed no clear difference in pain (unpleasantness/intensity/palpation) compared with non-occluding splint; GRADE not reported.

1 finding from 1 review

Occlusal splint vs Physical therapy (ultrasound, exercise, sensorimotor training, laser, TENS, manual therapy)

Self-reported joint pain when chewing · People with temporomandibular disorders (TMD)

The review found no eligible studies for this question.

1 finding from 1 review

Occlusal splint vs Physical therapy (ultrasound, exercise, sensorimotor training, laser, TENS, manual therapy)

Depression · People with temporomandibular disorders (TMD)

Occlusal splint showed no clear difference in depression compared with physical therapy (ultrasound, exercise, sensorimotor training,…; GRADE not reported.

1 finding from 1 review