Tailored Treatments in Temporomandibular Disorders: Where Are We Now? A Systematic Qualitative Literature Review

• Autores: Ulla Kotiranta, Tuija Suvinen, Heli Forssell
• Localización: Journal of Oral & Facial Pain and Headache, ISSN-e 2333-0376, ISSN 2333-0384, Nº. 1, 2014, págs. 28-37
• Idioma: inglés
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• Resumen

  • Aims: To conduct a systematic review to evaluate the evidence of possible benefits of tailored treatments for temporomandibular disorders (TMD) based on randomized controlled trials (RCTs). Methods: Reports of RCTs investigating treatments tailored to TMD patients' psychosocial characteristics were systematically searched for through March 2013 in the following databases: Cochrane Central Register of Controlled Trials, PubMed, and Web of Science. The methodological quality of the RCTs was assessed using the Cochrane Collaboration's tool for assessing risk of bias.

    Results: Seven reports met the inclusion criteria. In all studies a subgroup of TMD patients, mainly identified by multidimensional diagnostic systems such as the Research Diagnostic Criteria for TMD Axis II or Multidimensional Pain Inventory, were offered a treatment intervention hypothesized to be suitable for that particular patient group. The quality of the trials was compromised in all cases. Two studies focused on well-functioning TMD patients. In both studies, self-care gave results equal to or better than usual conservative TMD treatment. The treatments were targeted for patients with compromised psychosocial adaptation in five studies, and typically included a cognitive behavioral treatment component. In all trials the results supported the efficacy of tailored treatment, albeit in one trial only in the short-term.

    Conclusion: The identified studies offer cautious support to the notion that treatment targeted to different psychosocial subgroups of TMD pain patients may be beneficial.