Occlusal appliance and TMJ disorder

Pain and dysfunction from temporomandibular disorders
(TMJD) is a significant clinical problem for which many
diverse treatments have been used. Numerous articles
evaluating success/failure of these TMJD treatments have
been published with a wide range of success rates and
methods to evaluate outcomes.1-6 Nearly all of these
treatments have been evaluated for efficacy using the highest
level of research evidence from randomized controlled trials
(RCTs). With this available literature, clinicians are faced
with the challenge of reviewing the methods and results of
each study to make evidence-based clinical decisions. This
process is further compounded by considerable variability
with regard to their study designs, treatment techniques, and
outcome measures.
The Guidelines Committee for the American Academy of
Orofacial Pain conducted an evidence-based literature review
to systematically search and review the literature for all
randomized clinical trials for TMJD treatment using methods
derived from the Cochrane Collaboration (www.cochrane.org);
the Oxford Centre for Evidence-based Medicine,
(www.cebm.net); and the Centre for Reviews and Dissemination,
University of York, United Kingdom (www.york.ac.uk/
inst/crd/index.htm). Trials in which placebo, no treatment, or
other treatments were used in the control group were
included as were trials in which postrandomization exclusions
occurred since there was no evidence that these
occurred preferentially in one or other arm of the trials.