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Open Access 16-12-2023 | Systematic Review

Pharmacological Treatments of Temporomandibular Disorders: A Systematic Review Including a Network Meta-Analysis

Authors: Nikolaos Christidis, Essam Ahmed Al-Moraissi, Golnaz Barjandi, Johanna Svedenlöf, Hajer Jasim, Maria Christidis, Malin Collin

Published in: Drugs | Issue 1/2024

Abstract

Objective

Temporomandibular disorders (TMD) comprise a cluster of conditions with a wide range of etiological factors that causes pain and discomfort in the masticatory muscles (TMD-M) and temporomandibular joints (TMD-J). More than 50% of the patients with TMD report regular usage of drugs. However, there is still no consensus, nor is there any evidence-based support for clinicians when choosing between different drugs. Therefore, this systematic review, including a network meta-analysis (NMA), aimed to evaluate the scientific evidence and discuss the pharmacological treatment options available to treat painful TMD.

Method

An electronic search was undertaken to identify randomized controlled trials (RCTs) investigating pharmacological treatments for TMD-M and/or TMD-J, published until 6 April 2023. Since only 11 articles could be used for an NMA regarding TMD-M, a narrative synthesis was also performed for all 40 included RCTs. The quality of evidence was rated according to Cochrane’s tool for assessing risk of bias, while the certainty of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results

When it comes to TMD-M, evidence arises for wet needling therapies with BTX-A, granisetron, and PRP as well as muscle relaxants. For TMD-J, evidence points toward pharmacological treatment approaches including non-steroidal antiinflammatory drugs (NSAIDs) and glucocorticosteriods (for inflammatory conditions) as well as hyaluronic acid and dextrose.

Conclusions

The evidence clearly indicates that the pharmacological treatment approaches differ between TMD-M and TMD-J. Therefore, it is of great importance to first try to uncover each patient’s individual and multifactorial etiology and then employ a multifaceted treatment strategy, including pharmacological treatment approaches.

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Title: Pharmacological Treatments of Temporomandibular Disorders: A Systematic Review Including a Network Meta-Analysis
Authors: Nikolaos Christidis
Essam Ahmed Al-Moraissi
Golnaz Barjandi
Johanna Svedenlöf
Hajer Jasim
Maria Christidis
Malin Collin
Publication date: 16-12-2023
Publisher: Springer International Publishing
Published in: Drugs / Issue 1/2024
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI: https://doi.org/10.1007/s40265-023-01971-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pharmacological Treatments of Temporomandibular Disorders: A Systematic Review Including a Network Meta-Analysis

Abstract

Objective

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Method

Results

Conclusions

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