Non-Cochrane · intervention · PM42058481
Pharmacological Interventions in the Management of Temporomandibular Disorders: A Systematic Review and Meta-analysis.
Pereira Cristiana Palmela, Serra Beatriz, Martins João Paulo · Acta stomatologica Croatica · 2026 · PubMed · doi:10.15644/asc60/1/2
Findings
70 findings
| Population | ||||
|---|---|---|---|---|
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Age: <40 years | SMD 0.37 [0.04, 0.70] GRADE not reported 9 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Age: >=40 years | SMD -1.21 [-2.36, -0.07] GRADE not reported 4 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Intervention strategy: Surgery + less invasive | SMD -0.51 [-1.27, 0.24] GRADE not reported 9 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Group of countries: Europe + USA | SMD 0.87 [0.09, 1.65] GRADE not reported 3 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Group of countries: India | SMD -0.89 [-1.33, -0.45] GRADE not reported 3 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Intervention strategy: Surgery + less invasive | SMD 0.44 [-0.14, 0.56] GRADE not reported 4 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Type of intervention: Mechanic | SMD -0.61 [-0.95, -0.27] GRADE not reported 3 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Type of intervention: Surgery + intra-articular injection of drugs | SMD -0.72 [-1.62, 0.18] GRADE not reported 7 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Age: <40 years | SMD -0.40 [-0.71, -0.09] GRADE not reported 15 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · TMD scale: DC/TMD | SMD -0.76 [-1.69, 0.18] GRADE not reported 6 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Presence of dysfunction: Yes | SMD -0.62 [-1.04, -0.20] GRADE not reported 20 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Sex: >=80% female | SMD 0.32 [-0.03, 0.66] GRADE not reported 9 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Type of intervention: Pharmacology | SMD -1.11 [-2.93, 0.71] GRADE not reported 3 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Active principle: Platelet-rich factors | SMD -0.73 [-1.26, -0.20] GRADE not reported 3 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · TMD scale: DC/TMD | SMD 0.30 [-0.25, 0.80] GRADE not reported 4 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Age: >=40 years | SMD 1.33 [1.02, 1.64] GRADE not reported 3 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Type of pain: Myalgia | SMD 0.98 [0.35, 1.61] GRADE not reported 4 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Active principle: Corticosteroids | SMD -0.35 [-0.70, 0.00] GRADE not reported 4 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Intervention strategy: Less invasive | SMD -0.72 [-1.11, -0.32] GRADE not reported 4 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Presence of dysfunction: No | SMD -0.91 [-2.09, 0.27] GRADE not reported 5 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined Unresolved: the two extractors disagree on this row. | SMD -0.68 [-1.09, -0.26] GRADE not reported 17 studies · 1128 participants |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Type of pain: Arthralgia Unresolved: the two extractors disagree on this row. | SMD -0.38 [-0.61, -0.15] Low Downgraded: risk of bias, imprecision, inconsistency 11 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Group of countries: Muslim countries | SMD -0.75 [-1.53, 0.03] GRADE not reported 10 studies |
| Adolescents and adults (12 years or older) with myalgia or arthralgia related to temporomandibular disorders | Pharmacological interventions (NSAIDs, corticosteroids, muscle relaxants, antidepressants, platelet-rich products, hyaluronate, other intra-articular injectables), alone or as adjunct to other treatment | Placebo or other active treatments (saline, splint, arthrocentesis, arthroscopy, other drugs) | Maximum interincisal opening (MIO), unassisted Multiple post-baseline time points combined per study (multilevel random-effects, BLUP) · Nine countries (Europe, USA, Turkey, Egypt, India, Brazil) · Overall pooled effect | SMD 0.51 [0.2, 0.82] Low Downgraded: risk of bias, imprecision, inconsistency 12 studies · 786 participants |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Type of pain: Myalgia Unresolved: the two extractors disagree on this row. | SMD -0.85 [-1.68, -0.01] Low Downgraded: risk of bias, imprecision, inconsistency 7 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · TMD scale: RDC/TMD | SMD -0.49 [-1.50, 0.51] GRADE not reported 5 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Intervention strategy: Less invasive | SMD 0.45 [-0.14, 1.04] GRADE not reported 7 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Type of pain: Arthralgia + Myalgia | SMD -0.46 [-1.80, 0.89] GRADE not reported 4 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Group of countries: Brazil | SMD 0.70 [0.20, 1.20] GRADE not reported 3 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Group of countries: Europe + USA | SMD -0.37 [-0.78, 0.05] GRADE not reported 8 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Sex: <80% female | SMD -0.69 [-0.87, -0.51] GRADE not reported 8 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Active principle: Others | SMD -0.80 [-1.57, -0.03] GRADE not reported 13 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Group of countries: Muslim countries | SMD 0.21 [-0.15, 0.56] GRADE not reported 8 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Type of pain: Arthralgia | SMD 0.31 [-0.08, 0.70] GRADE not reported 8 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Intervention strategy: Conservative | SMD -0.89 [-1.30, -0.09] GRADE not reported 10 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Sex: <80% female | SMD 0.76 [0.27, 1.25] GRADE not reported 7 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · TMD scale: Wilkes classification | SMD -1.07 [-2.21, 0.06] GRADE not reported 5 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Sex: >=80% female | SMD -0.62 [-1.22, -0.01] GRADE not reported 15 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Intervention strategy: Conservative | SMD 0.98 [0.47, 1.49] GRADE not reported 5 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · TMD scale: RDC/TMD | SMD -0.11 [-0.37, 0.15] GRADE not reported 3 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Type of intervention: Intra-articular injection of drugs | SMD -0.72 [-1.11, -0.32] GRADE not reported 4 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Sensitivity: excluding high risk of bias studies (RoB 2) | SMD -0.48 [-0.82, -0.14] GRADE not reported 20 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Sensitivity: excluding high risk of bias studies (RoB 2) | SMD 0.55 [0.19, 0.90] GRADE not reported 13 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · TMD scale: Wilkes classification | SMD 0.57 [0.16, 0.98] GRADE not reported 6 studies |
| Adolescents and adults with temporomandibular disorders (myalgia, arthralgia or mixed) | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Group of countries: Brazil | SMD -0.98 [-2.37, 0.41] GRADE not reported 4 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined | SMD -0.38 [-0.57, -0.18] GRADE not reported Studies not reported |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · TMD scale: RDC/TMD | SMD -0.11 [-0.27, 0.05] GRADE not reported 3 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Intervention strategy: Conservative | SMD -0.34 [-0.64, -0.05] GRADE not reported 3 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Intervention strategy: Less invasive | SMD -0.64 [-0.94, -0.34] GRADE not reported 4 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · TMD scale: DC/TMD | SMD -0.39 [-0.57, -0.21] GRADE not reported 3 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Type of intervention: Surgery + intra-articular injection of drugs | SMD -0.08 [-0.29, 0.13] GRADE not reported 3 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Active principle: Platelet-rich factors | SMD -0.65 [-1.06, -0.24] GRADE not reported 3 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Sex: >=80% female | SMD -0.26 [-0.43, -0.08] GRADE not reported 8 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Group of countries: Muslim countries | SMD -0.24 [-0.36, -0.13] GRADE not reported 6 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Sex: <80% female | SMD 0.90 [0.39, 1.41] GRADE not reported 3 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Active principle: Others | SMD -0.25 [-0.44, -0.06] GRADE not reported 6 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Intervention strategy: Surgery + less invasive | SMD -0.12 [-0.42, 0.17] GRADE not reported 3 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Intervention strategy: Less invasive | SMD 0.42 [-0.15, 0.99] GRADE not reported 4 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined · Sex: >=80% female | SMD -0.07 [-0.30, 0.15] GRADE not reported 5 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Intervention strategy: Surgery + less invasive | SMD -0.10 [-0.30, 0.10] GRADE not reported 4 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Sex: <80% female | SMD -0.65 [-1.06, -0.24] GRADE not reported 3 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Type of intervention: Intra-articular injection of drugs | SMD -0.64 [-0.94, -0.34] GRADE not reported 4 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Group of countries: Europe + USA | SMD -0.29 [-0.66, 0.09] GRADE not reported 3 studies |
| Adults with arthralgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined | SMD 0.19 [-0.20, 0.57] GRADE not reported Studies not reported |
| Adults with myalgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Age: <40 years | SMD -0.33 [-1.12, 0.47] GRADE not reported 4 studies |
| Adults with myalgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Sex: >=80% female | SMD -1.00 [-2.99, 0.99] GRADE not reported 3 studies |
| Adults with myalgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Age: >=40 years | SMD -1.56 [-2.95, -0.17] GRADE not reported 3 studies |
| Adults with myalgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined · Sex: <80% female | SMD -0.74 [-0.99, -0.49] GRADE not reported 4 studies |
| Adults with myalgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Pain intensity (VAS) All post-baseline time points combined | SMD -0.83 [-1.67, 0.02] GRADE not reported Studies not reported |
| Adults with myalgia-only temporomandibular disorders | Pharmacological interventions (alone or as adjunct to conservative or surgical procedures) | Placebo or active comparators (e.g. occlusal splint, arthrocentesis, saline) | Maximum interincisal opening (unassisted) All post-baseline time points combined | SMD 0.96 [0.28, 1.63] GRADE not reported 4 studies |
Included primary studies 27
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Pereira 2021 matched by author and year (probable) | NR | 2 other reviews | not stated | not extracted yet |
| Yapici-Yavuz 2018 A comparison of the effects of Methylprednisolone Acetate, Sodium Hyaluronate and Tenoxicam in the treatment of non-reducing disc… PMID:29680845 | 2018 | 2 other reviews | not stated | not extracted yet |
| Chandra 2021 Minimally invasive intraarticular platelet rich plasma injection for refractory temporomandibular joint dysfunction syndrome in comparison… PMID:34017736 | 2021 | 1 other review | not stated | not extracted yet |
| Isacsson 2019 Pain relief following a single-dose intra-articular injection of methylprednisolone in the temporomandibular joint arthralgia-A… PMID:30240024 | 2019 | 1 other review | not stated | not extracted yet |
| Batabyal 2023 Graft patency after off-pump versus on-pump coronary artery surgery in high-risk patients. PMID:20233137 | 2010 | this review only | not stated | not extracted yet |
| Bechir 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Bilici 2018 Evaluation of the effects of occlusal splint, trigger point injection and arthrocentesis in the treatment of internal derangement patients… DOI:10.1016/j.jcms.2018.03.018 | 2018 | this review only | not stated | not extracted yet |
| Bilici 2018 Evaluation of the effects of occlusal splint, trigger point injection and arthrocentesis in the treatment of internal derangement patients… PMID:29692327 | 2018 | this review only | not stated | not extracted yet |
| Dalewski 2019 Comparison of Early Effectiveness of Three Different Intervention Methods in Patients with Chronic Orofacial Pain: A Randomized,… DOI:10.1155/2019/7954291 | 2019 | this review only | not stated | not extracted yet |
| Dalewski 2019 Comparison of Early Effectiveness of Three Different Intervention Methods in Patients with Chronic Orofacial Pain: A Randomized,… PMID:30984320 | 2019 | this review only | not stated | not extracted yet |
| Dordevic 2019 Occlusal appliances - an alternative in temporomandibular disorders DOI:10.2298/sarh190118064d | 2019 | this review only | not stated | not extracted yet |
| Ferreira 2023 Prediction of duloxetine efficacy in addition to self‐management in painful temporomandibular disorders: A randomised, placebo‐controlled… DOI:10.1111/joor.13628 | 2023 | this review only | not stated | not extracted yet |
| Ferreira 2024 Prediction of duloxetine efficacy in addition to self-management in painful temporomandibular disorders: A randomised, placebo-controlled… PMID:37994185 | 2024 | this review only | not stated | not extracted yet |
| Gibaly 2024 Evaluation of the effect of dextrose prolotherapy versus deep dry needling therapy for the treatment of temporomandibular joint anterior… DOI:10.1007/s00784-024-05830-z | 2024 | this review only | not stated | not extracted yet |
| Gibaly 2024 Evaluation of the effect of dextrose prolotherapy versus deep dry needling therapy for the treatment of temporomandibular joint anterior… PMID:39115583 | 2024 | this review only | not stated | not extracted yet |
| Isacsson 2018 Pain relief following a single‐dose intra‐articular injection of methylprednisolone in the temporomandibular joint arthralgia—A… DOI:10.1111/joor.12718 | 2018 | this review only | not stated | not extracted yet |
| Martins 2023 Assessment of postoperative pain in patients undergoing temporomandibular joint arthroscopy with infiltration of dexamethasone disodium… DOI:10.1016/j.jcms.2023.02.001 | 2023 | this review only | not stated | not extracted yet |
| Martins 2023 Assessment of postoperative pain in patients undergoing temporomandibular joint arthroscopy with infiltration of dexamethasone disodium… PMID:36774309 | 2023 | this review only | not stated | not extracted yet |
| Mosleh 2021 Evaluation of the effect of intra-articular injection of macrolide antibiotics versus corticosteroids on internal derangement of… DOI:10.21608/edj.2021.82698.1692 | 2021 | this review only | not stated | not extracted yet |
| Mosleh 2024 RETRACTED ARTICLE: Treatment of temporomandibular joint internal derangement using MESNA injection DOI:10.1186/s12903-024-04615-w | 2024 | this review only | not stated | not extracted yet |
| Mosleh 2024 Treatment of temporomandibular joint internal derangement using MESNA injection. PMID:39098893 | 2024 | this review only | not stated | not extracted yet |
| Pereira 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Tchivileva 2020 Efficacy and safety of propranolol for treatment of temporomandibular disorder pain: a randomized, placebo-controlled clinical trial DOI:10.1097/j.pain.0000000000001882 | 2020 | this review only | not stated | not extracted yet |
| Tchivileva 2020 Efficacy and safety of propranolol for treatment of temporomandibular disorder pain: a randomized, placebo-controlled clinical trial. PMID:32701836 | 2020 | this review only | not stated | not extracted yet |
| Tepecik 2024 Does the Use of Injectable Platelet-Rich Fibrin Following Arthrocentesis for Disc Displacement Without Reduction Alleviate Pain? DOI:10.1016/j.joms.2024.09.002 | 2024 | this review only | not stated | not extracted yet |
| Tepecik 2024 Does the Use of Injectable Platelet-Rich Fibrin Following Arthrocentesis for Disc Displacement Without Reduction Alleviate Pain? PMID:39366665 | 2024 | this review only | not stated | not extracted yet |
| Venepally 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adolescents and adults (12 years or older) diagnosed with myalgia related to TMD (local myalgia, myofascial pain, myofascial pain with referral) | Adults and adolescents with TMD pain: arthralgia, myalgia, or both; 1,128 participants in 25 treatment arms from 17 RCTs; mean age 27.1 to 52.0 years; 40.9% to 100% female |
| Intervention | Pharmacological interventions: NSAIDs, corticosteroids, antidepressants, centrally acting muscle relaxants, anticonvulsants, benzodiazepines, local anesthetics, other analgesics, combination therapies | Platelet-rich plasma, sodium hyaluronate, methylprednisolone acetate, tenoxicam, dexamethasone, nimesulide, injectable platelet-rich fibrin, ozone, propranolol, clorzoxazone, dextrose, azithromycin, lidocaine, duloxetine, MESNA, often with arthrocentesis, arthroscopy or splint (n=17 RCTs, 25 comparisons) |
| Comparison | Placebo or other active interventions (saline, occlusal splints, intra-articular injectables), clearly defined | Placebo, saline, arthrocentesis, arthroscopy, interocclusal splint, other drugs (n=17 RCTs, 25 comparisons) |
| Outcomes | Pain intensity (VAS); maximum interincisal opening (mm); adverse events (secondary) | Pain VAS (25 comparisons, SMD -0.68, 95% CI -1.09 to -0.26); MIO (12 RCTs, SMD 0.51, 95% CI 0.20 to 0.82); adverse events not pooled |
| Study designs | RCTs reporting at least one quantitative myalgia outcome with validated pain scales, published 2018 to 2024 | 17 RCTs (25 comparisons) published 2018 to 2024 across nine countries |
| Timing | Not specified | Multiple post-baseline time points per study (1 to 7), combined by multilevel model |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Partial Yes | Yes | no |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Low | no |