| 1339 Systematic Review of non-surgical approaches to temporomandibular joint disorders | ||
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M. RICHARDSON1, C. HAYES1, A. ANTCZAK-BOUCKOMS2, and J. LAU3, 1Harvard University, Boston, MA, USA, 2University of Connecticut, Farmington, USA, 3New England Medical Center, Boston, MA, USA Introduction: The treatment of temporomandibular joint disorders (TMD) encompasses a wide range of surgical and non-surgical approaches. There is significant variation of practice in this field. Purpose: The purpose of this systematic review is to summarize the current state of knowledge about the effects of non-surgical treatments of TMD. Methods: We searched the MEDLINE database for English language literature from 1966 through July 2000. The search was limited to human studies and utilized textwords and MeSH subheadings to identify relevant TMD studies. We screened the search results for non-surgical treatments. Studies that met our inclusion criteria were critically appraised and summarized. Results: A total of 17 non-surgical articles were included in the study. Of these, 12 were randomized controlled trials, 3 were non-randomized comparison, and the remainders were case series. The total number of patients included in the studies was 1165. Pain was the most common outcome evaluated. Most conservative treatments, including splinting, injections, physical therapy, biofeedback, and TENS, reported a positive treatment outcome most notably a reduction of pain at rest and/or during functional activity, over placebo, with p-values from 0.0013 to <0.05. Different physical therapy methods increased incisal opening in 69-78 % of patients, depending on treatment modality. Splinting was the most effective treatment, showing significant differences in outcome measures, particularly pain levels, over palliative care, biofeedback, and TENS, with p-values ranging from <0.0001 to <0.02. Conclusion: The lack of uniformity in the patient inclusion criteria, treatment comparison, and outcome assessment made it difficult to interpret the results from these studies. These findings indicate that research in the field of non-surgical treatments of TMJ needs to include studies that meet more stringent criteria. These criteria need to be standardized to allow easier comparisons between treatment protocols when reviewing the literature. (supported by NIDCR #RO1DE11646)
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| Seq #128 - Treatment and Outcomes 3:45 PM-5:00 PM, Thursday, 7 March 2002 San Diego Convention Center Exhibit Hall C | ||
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