Cochrane · intervention · CD003812
Occlusal adjustment for treating and preventing temporomandibular joint disorders
Cochrane Database of Systematic Reviews · 2003 · Cochrane Library
Oral HealthOral and maxillofacial surgeryTemporomandibular disorders and sleepAMSTAR 2: not assessed
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
18
current version
GRADE rated
0
No studies
4
Included studies
6
as reported
No studies 4 · 22.2%Ungraded 14 · 77.8%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults aged 18 years or older with clinically diagnosed TMD, required to exhibit two or more listed signs/symptoms (recurrent headache; pain in jaws/face/throat/neck/shoulders/back; ear symptoms; TMJ pain at rest and during chewing; grinding/clenching; vertigo; jaw stiffness; swallowing difficulties; globus symptoms; joint sounds; jaw luxation/locking). For prevention trials: no age restrictions and TMD clinically absent at baseline | 391 patients assessed for TMD (92 in treatment trials; 299 in prevention trials); range 9 to 74 per treatment/control group. Treatment: 3 trials in symptomatic adults; Prevention: 3 trials in healthy young adults, adolescents, and children/adolescents (n=6 trials) |
| Intervention | Occlusal adjustment (OA) - selective grinding of the biting surfaces of the teeth | Occlusal adjustment (n=6 trials) |
| Comparison | No treatment; Placebo; Reassurance | Placebo (n=5 trials); Reassurance (n=1, Vallon 1991); No treatment (n=1, Kerstein 1997 additional arm) |
| Outcomes | Primary: global symptoms; pain (frequency/severity/duration); headache (frequency/severity/duration). Secondary: limitation of movement. Also considered (Objectives): quality of life. Adverse reactions recorded | Pain frequency (n=1); Pain severity (n=1); Headache frequency (n=1); Headache severity (n=1); Relief of globus (n=1); Overall symptoms improvement (n=1); Incidence of symptoms - prevention (n=3); Range of mandibular movement (n=1). No data: quality of life; psychosocial outcomes; costs; adverse reactions |
| Study designs | All randomised controlled trials (RCTs) including quasi-randomised controlled trials | Randomised parallel-group controlled trials (n=6) |
| Timing | At least 3 weeks after the intervention | At least 3 weeks after intervention (follow-up varied by trial) |
Search date: 2002-04. Databases: Cochrane Oral Health Group's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; handsearched journals (Journal of Oral Rehabilitation; Journal of Oral and Maxillofacial Surgery; Journal of Craniomandibular Practice); SIGLE (unpublished)
Questions and results
Occlusal adjustment (OA) vs Placebo
Population: Adults (aged 18 years or older) with clinically diagnosed temporomandibular disorders (TMD)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Headache (severity) | OR 0.90 [0.13, 6.08] | 1 study · 18 participants | Ungraded |
Pain (severity) | OR 0.5 [0.07, 3.85] | 1 study · 18 participants | Ungraded |
Quality of life | There were no data on psychosocial outcomes, costs or quality of life in any of the trials. | 0 studies | No studies |
Relief of globus | OR 6.0 [0.72, 49.84] | 1 study · 17 participants | Ungraded |
Psychosocial outcomes | There were no data on psychosocial outcomes, costs or quality of life in any of the trials. | 0 studies | No studies |
Headache (frequency) | OR 0.90 [0.13, 6.08] | 1 study · 18 participants | Ungraded |
Adverse events | There were no reports of adverse reactions. | 0 studies | No studies |
Cost | There were no data on psychosocial outcomes, costs or quality of life in any of the trials. | 0 studies | No studies |
Pain (frequency) | OR 0.5 [0.07, 3.85] | 1 study · 18 participants | Ungraded |
Occlusal adjustment (OA) vs Reassurance
Population: Adults (aged 18 years or older) with clinically diagnosed temporomandibular disorders (TMD)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Headache (frequency) | OR 1.40 [0.45, 4.35] | 1 study · 50 participants | Ungraded |
Pain (frequency) | OR 0.13 [0.01, 2.58] | 1 study · 50 participants | Ungraded |
Limitation of movement (range of mandibular movement) | Additional clinical outcomes reported included range of mandibular movement (Vallon 1991); no pooled effect estimate was reported. | 1 study | Ungraded |
Overall symptoms improvement | OR 3.12 [0.12, 80.39] | 1 study · 50 participants | Ungraded |
Occlusal adjustment (OA) vs No treatment
Population: Adults (aged 18 years or older) with clinically diagnosed temporomandibular disorders (TMD)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (severity) | OR 0.10 [0.00, 2.15] | 1 study · 17 participants | Ungraded |
Headache (severity) | OR 0.10 [0.00, 2.15] | 1 study · 17 participants | Ungraded |
Pain (frequency) | OR 0.10 [0.00, 2.15] | 1 study · 17 participants | Ungraded |
Headache (frequency) | OR 0.10 [0.00, 2.15] | 1 study · 17 participants | Ungraded |
Occlusal adjustment (OA) vs No treatment or placebo (control)
Population: Healthy subjects without TMD at baseline (children, adolescents and young adults)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of TMD symptoms | OR 0.43 [0.14, 1.37] | 3 studies · 300 participants | Ungraded |