J Orofac Pain
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Meta Analysis
Critical appraisal of methods used in randomized controlled trials of treatments for temporomandibular disorders.
To evaluate the quality of methods used in randomized controlled trials (RCTs) of treatments for management of pain and dysfunction associated with temporomandibular muscle and joint disorders (TMJD) and to discuss the implications for future RCTs. ⋯ Much of the evidence base for TMJD treatments may be susceptible to systematic bias and most past studies should be interpreted with caution. However, a scatter plot of RCT quality versus year of publication shows improvement in RCT quality over time, suggesting that future studies may continue to improve methods that minimize bias.
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Review Meta Analysis Comparative Study
Systematic review and meta-analysis of randomized controlled trials evaluating intraoral orthopedic appliances for temporomandibular disorders.
To conduct a systematic review with meta-analysis of randomized controlled trials (RCTs) that have assessed the efficacy of intraoral orthopedic appliances to reduce pain in patients with temporomandibular disorders affecting muscle and joint (TMJD) compared to subjects receiving placebo control, no treatment, or other treatments. ⋯ Hard stabilization appliances, when adjusted properly, have good evidence of modest efficacy in the treatment of TMJD pain compared to non-occluding appliances and no treatment. Other types of appliances, including soft stabilization appliances, anterior positioning appliances, and anterior bite appliances, have some RCT evidence of efficacy in reducing TMJD pain. However, the potential for adverse events with these appliances is higher and suggests the need for close monitoring in their use.
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Review Comparative Study
Reviewing the evidence: can cognitive behavioral therapy improve outcomes for patients with chronic orofacial pain?
To review evidence for chronic orofacial pain management using cognitive behavioral therapy (CBT). ⋯ CBT, either alone or in combination with biofeedback, conservative treatment and/or self-care, can improve outcomes for patients with TMD in secondary care. However, further research is needed to assess its effectiveness in primary care and in management of other chronic orofacial pain conditions. Further, the number of sessions needed, mode of delivery, and cost-effectiveness also remain unclear.
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Randomized Controlled Trial
Effects of low-dose intramuscular ketorolac on experimental pain in the masseter muscle of healthy women.
To investigate the effect of a low dose of intramuscular (im) ketorolac compared with lidocaine (LA) in a double-blinded, randomized, and controlled trial. ⋯ A low dose of im ketorolac has a significant and immediate analgesic effect on HS-evoked jaw muscle pain but significantly less than LA. A local anesthetic-like effect may be the underlying mechanism.