Orofacial pain: pharmacological treatments

The authors sought to review available literature relating to SSRI withdrawal syndromes

This review of pharmacological management of orofacial pain included 41 studies. Evidence suggests that for TMD joint pain NSAIDs, corticosteroids and hyaluronate injections are beneficial and that clonazepam and capsaicin are effective for burning mouth syndrome.

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Temporomandibular disorders: no role for dental occlusion in the pathophysiology

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This review of the association between temporomandibular disorders and dental occlusion included 25 observational studies. No consistent association was found.

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Bruxism: Are botulinum toxin injections helpful?

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Only 5 small low quality studies were included in this review of botulinum toxin (BoNT-A ) injections for sleep bruxism. 3 of the included studies were RCTs and while a potential benefit from use of BoNT-A treatment was suggested the findings should be treated very cautiously.

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Temporomandibular lavage for temporomandibular disorders

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This review of TMJ lavage for temporomandibular disorders only included 5 small RCTs a majority of which were at high risk of bias. While the findings suggest a benefit from lavage this should be interpreted cautiously because of the limited quality of the available evidence.

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Temporomandibular disorders: high prevalence of otologic signs and symptoms

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This review of otologic signs & symptoms in patients with temporomandibular disorders included just 8 studies and highlights a high frequency but the findings should be interpreted with caution because of the limited quality of available studies.

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Temporomandibular joint arthrocentesis with hyaluronic acid- evidence limited.

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This review of intra-articular injections of hyaluronic acid (HA) for temporomandibular disorder only identified 8 small studies of limited quality providing no consensus that HA injections were better than other agents.

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Temporomandibular disorders – insufficient evidence for or against impact of conservative therapies on otologic signs and symptoms

Depression

Eight studies were included in this review of the effect of conservative temporomandibular therapies on otologic symptoms . While most suggested an improvement the quality of the available evidence is limited.

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Manual therapy for temporomandibular disorders

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This review included 8 RCTs with some evidence to show that manual therapy improves pain and maximum mouth opening in patients with TMD. However, the limited number of studies and the heterogeneity of the interventions require further studies with standardised evaluations and better study designs.

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Temporomandibular disorders: is botulinum toxin effective?

Botulinum toxin

This review of botulinum toxin (BTX) for treating temporomandibular disorders identified 5 RCTs involving a total of 117 patients. There was marked heterogeneity between the studies and the therapeutic benefits are unclear. Well reported high quality RCTs are needed.

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Ultrasonography for diagnosing temporomandibular disorders

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This diagnostic test review included 11 studies the majority from 2 research groups. The findings suggest that ultrasonography could be useful for diagnosing anterior disk displacement in patients with temporomandibular disorders.

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