Interventions promoting coping mechanisms and encouraging physical activity were found to be the most effective in reducing chronic pain correlated with temporomandibular disorders.
A systematic review and network meta-analysis of interventional randomized clinical trials was conducted. Major databases such as MEDLINE, EMBASE, CINAHL, CENTRAL, and SCOPUS were searched until May 2021, and again in January 2023, for studies on chronic pain associated with temporomandibular disorders. Reviewers worked in pairs to identify eligible studies, extract data and assess biases. The research looked into a multitude of patient-important outcomes ranging from pain relief to sleep quality.
The results showed that 233 trials were suitable for review, with 153 trials involving 8713 participants exploring 59 interventions or combinations of interventions included in the meta-analyses. Eight interventions displayed high to moderate certainty evidence for impactfulness on pain. The top three therapies for pain relief were found to be cognitive behavioural therapy combined with biofeedback or relaxation therapy, therapist-assisted jaw mobilisation, and manual trigger point therapy. Five other interventions were less effective but still more impactful than placebos. Furthermore, four interventions, including supervised jaw exercise and stretching, manipulation, acupuncture, and supervised jaw exercise and mobilization, were found likely to improve physical functioning.
