Subjects
There were 660 titles identified as being related to the topic. From this, 23 full
reports were reviewed and as a result 6 trials met inclusion criteria and were
included. All included trails were randomized controlled trials (RCTs). These
trials contained 392 patients.
The inclusion criteria required that a report had to state the diagnostic criteria
for temporomandibular disorder (TMD) and for participants to exhibit at least
2 symptoms from a symptom checklist that contained 18 TMD-related symptoms.
Symptoms included pain, headache, joint sounds, jaw deviation, and
others. TMD had to be clinically absent at baseline for prevention studies.
Exposure
Treatment groups received an occlusal adjustment (OA) while the control
group received no treatment, placebo, or reassurance. Studies where splints
were used prior to treatment were excluded.
Main Outcome Measure
The main outcomes were associated with global symptoms, pain, and headache.
Relief from symptoms was assessed using global measures. Pain symptoms were
recorded with regard to frequency, duration, and severity. Headache data were
also recorded with regard to frequency, duration, and severity. At least a 3-week
interval after intervention for resolution of symptoms was required.
Main Results
Studies assessing relief of symptoms for patients with existing TMD showed
that occlusal adjustment did not significantly reduce symptoms of pain, headache,
or other symptoms. Studies assessing the prevention of TMD also showed
that OA did not significantly reduce the incidence of TMD in patients originally
free of symptoms. There were no data on psychosocial outcomes, costs, and
quality of life.
Conclusion
This systematic review found no evidence that OA treats or prevents TMD.
Based on this review, OA cannot be recommended for the treatment or prevention
of TMD.
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