Home Subscription Services
 
   

 
Journal of Oral & Facial Pain and Headache
OFPH Home Page
About the Editor
Editorial Board
Accepted Manuscripts
Submit
Author Guidelines
Submission Form
Reprints / Articles
Permissions
Advertising
MEDLINE Search
 
 
 
 
 
FacebookTwitter
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:
Winter 2004
Volume 18 , Issue 1

Back
Share Abstract:

Application of Principles of Evidence-Based Medicine to Occlusal Treatment for Temporomandibular Disorders: Are There Lessons to Be Learned?

Heli Forssell, DDS, PhD, Eija Kalso, MD, PhD

Pages: 922
PMID: 15022533

Critical evaluation of treatment methods has become an important part of health care and will certainly have a major influence on decisions about acceptable treatment methods in the future. Evidence-based medicine (EBM) means the systematic, explicit, and judicious implementation of the best evidence in patient care. The most reliable sources of evidence are high-quality systematic reviews and randomized controlled trials (RCTs). A systematic EBM approach could be particularly useful in the treatment of temporomandibular disorders (TMD), where controversial and conflicting ideas about management are common. In this field, concerns about the lack of evidence are often expressed. This article aims to elucidate and discuss the application of EBM to the treatment of TMD, using the most controversial treatments (ie, occlusal treatments) as an example. By applying the principles of EBM to TMD treatments, we wish to highlight some of the important issues that form the basis for high-quality care in this field. A systematic review of occlusal treatments (occlusal splints and occlusal adjustment) updated to January 2003 revealed 16 RCTs of occlusal splints and 4 of occlusal adjustment. The overall quality of the trials was fairly low. Recently, however, some high-quality RCTs of occlusal splints have been published. The most obvious methodologic shortcomings in published trials included problems in defining the patient population, inadequacies in performing randomization and blinding, problems in defining the therapies or appropriate control treatments, short follow-ups, and problems in monitoring patient compliance. Occlusal splint studies yielded equivocal results. Even in the most studied area, stabilization splints for myofascial face pain, the results do not justify definite conclusions about the efficacy of splint therapy. Their clinical effectiveness to relieve pain also seems modest when compared with pain treatment methods in general. None of the occlusal adjustment studies provided evidence supporting the use of this treatment method. The clinical implications of the findings and future perspectives are discussed. J OROFAC PAIN 2004;18:922.

Full Text PDF File | Order Article

 

 
Get Adobe Reader
Adobe Acrobat Reader is required to view PDF files. This is a free program available from the Adobe web site.
Follow the download directions on the Adobe web site to get your copy of Adobe Acrobat Reader.
  © 2014 Quintessence Publishing Co Inc
 

Home | Subscription Services | Books | Journals | Multimedia | Events | Blog
Terms of Use | Privacy Policy | About Us | Contact Us | Advertising | Help | Sitemap | Catalog