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Conservative Versus Surgical Treatment for Pain Alleviation in Anterior Disc Displacement Without Reduction: An
Rong Ren1,2, Ruoyi Wang1, Zhan Su1,2
1State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Background:
Anterior disc displacement without reduction (ADDwoR) is a prevalent temporomandibular joint disorder (TMD) and a significant source of orofacial pain. Despite its frequency, there is a lack of comprehensive reviews that establish standardised, evidence-based treatment strategies specifically for pain management in this condition.
Methods:
This systematic review compared the efficacy of conservative versus surgical treatments for pain alleviation in ADDwoR. A literature search was conducted in PubMed, ScienceDirect and MEDLINE, supplemented by additional resources, following PICOS criteria. Twenty studies were selected and categorised to address the following: (1) the difference in pain relief between conservative and surgical treatments and (2) the effectiveness of surgical treatment after conservative treatment failure. Studies on combination therapies were also included. Methodological quality was assessed using the Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale. Data were synthesised through a qualitative narrative synthesis.
Results:
The synthesised evidence indicates no significant difference in pain relief between conservative and surgical treatments for ADDwoR. Notably, arthrocentesis and various combination therapies demonstrated considerable therapeutic potential.
Conclusion:
Conservative and surgical treatments are comparable in their efficacy for pain relief in ADDwoR. Based on these findings, a standardised treatment model is proposed to improve pain management. The promising results of arthrocentesis and combination therapies highlight important directions for future research and the development of innovative treatment strategies.
