No significant differences between conservative interventions and surgical interventions for TMJ disc displacement...

Area of Science:

• Dental research
• Clinical trials methodology
• Evidence-based dentistry

Background:

• Temporomandibular disorders (TMD) encompass a range of conditions affecting the temporomandibular joint (TMJ) and masticatory muscles.
• Current treatment strategies for TMD vary widely, from conservative management to surgical interventions, with limited comparative effectiveness data.

Purpose of the Study:

• To systematically review and synthesize evidence on the effectiveness of various interventions for temporomandibular disorders (TMD).
• To compare the efficacy of conservative versus surgical treatments for TMD regarding pain and maximum mouth opening.

Main Methods:

• A systematic literature search was conducted across major databases (CENTRAL, Medline, Embase, Scopus) and hand searches.
• Randomized or quasi-randomized controlled trials involving patients with diagnosed TMD, undergoing any intervention, were included.
• Primary outcomes assessed were TMJ pain intensity and maximum mouth opening (MMO); data were analyzed using risk ratios and mean differences with 95% confidence intervals.

Main Results:

• Twenty studies with 1305 patients were included, with most studies exhibiting high or unclear risk of bias.
• Significant clinical heterogeneity was observed among studies.
• Meta-analyses for four comparisons revealed no statistically significant differences between interventions for primary outcomes at short- or long-term follow-up.

Conclusions:

• Most interventions appear to offer similar symptom relief for TMD, irrespective of invasiveness.
• Given the limited and low-quality evidence, initial management should prioritize the least invasive interventions.
• Further high-quality research is needed to clarify treatment effectiveness and guide clinical decision-making for TMD.