Is the therapeutic effect of occlusal stabilization appliances more than just placebo effect in the management of painful temporomandibular disorders? A network meta-analysis of randomized clinical trials

ConclusionsThis network meta-analysis showed no significant difference in reported pain intensity at follow-ups between the treatment of painful TMDs with stabilization appliances or nonoccluding appliances (active placebo). However, a significant difference in participants reporting treatment satisfaction with reduced pain, and a significantly lower number needed to treat in favor of stabilization appliances were found. Patient-reported treatment satisfaction probably included more domains than just pain intensity, such as improvements in physical functioning and psychosocial factors, and deserves further investigation. The authors concluded that stabilization appliances treatment efficacy is beyond the placebo effect.Clinical ImplicationsStabilization appliances seem to have a treatment efficacy beyond the placebo effect and can be suggested as one of the initial treatment approaches for patients with painful temporomandibular disorders. However, the evaluation of the effect of the treatment must include more domains than just change the pain intensity. Based on the outcome of this systematic review as well as that of other studies, pain intensity is not an appropriate treatment outcome measure by itself but should be used in combination with other domains such as physical functioning. 
Source: Dental Technology Blog - Category: Dentistry Source Type: news