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Quintessence Publishing: Journals: OFPH
Journal of Oral & Facial Pain and Headache

Edited by Barry J. Sessle, BDS, MDS, BSc, PhD, FRSC

Official Journal of the American Academy of Orofacial Pain,
the European, Asian, and Ibero-Latin Academies of Craniomandibular
Disorders, and the Australian Academy of Orofacial Pain

ISSN 2333-0384 (print) • ISSN 2333-0376 (online)

Publication:
Fall 2003
Volume 17 , Issue 4

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Pharmacologic Interventions in the Treatment of Temporomandibular Disorders, Atypical Facial Pain, and Burning Mouth Syndrome. A Qualitative Systematic Review

Thomas List, DDS, Odont Dr/Susanna Axelsson, DDS, Odont Dr/Göran Leijon, MD, PhD

Pages: 301-310
PMID: 14737874

Aims: To carry out a systematic review of the literature in order to assess the pain-relieving effect and safety of pharmacologic interventions in the treatment of chronic temporomandibular disorders (TMD), including rheumatoid arthritis (RA), as well as atypical facial pain (AFP), and burning mouth syndrome (BMS). Methods: Study selection was based on randomized clinical trials (RCTs). Inclusion criteria included studies on adult patients ( 18 years) with TMD, RA of the temporomandibular joint (TMJ), AFP, or BMS and a pain duration of  3 months. Data sources included Medline, Cochrane Library, Embase, and PsychLitt. Results: Eleven studies with a total of 368 patients met the inclusion criteria. Four trials were on TMD patients, 2 on AFP, 1 on BMS, 1 on RA of the TMJ, and 3 on mixed groups of patients with TMD and AFP. Of the latter, amitriptyline was effective in 1 study and benzodiazepine in 2 studies; the effect in 1 of the benzodiazepine studies was improved when ibuprofen was also given. One study showed that intra-articular injection with glucocorticoid relieved the pain of RA of the TMJ. In 1 study, a combination of paracetamol, codeine, and doxylamine was effective in reducing TMD pain. No effective pharmacologic treatment was found for BMS. Only minor adverse effects were reported in the studies. Conclusion: The common use of analgesics in TMD, AFP, and BMS is not supported by scientific evidence. More large RCTs are needed to determine which pharmacologic interventions are effective in TMD, AFP, and BMS. J OROFAC PAIN 2003;17:301C310.

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