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Prioritizing Topics and Questions for Evidence-Informed Guidelines in Temporomandibular Disorders: Results of an
Vicente Wielandt1,2,3, Francisca Verdugo-Paiva4,5, Alonso Carrasco-Labra4
1Orofacial Pain & TMD Program, Faculty of Odontology, Andres Bello University, Santiago, Chile.
Objective:
Evidence-informed guidelines require a transparent and systematic development process. Given limited resources, prioritizing the most relevant topics and questions is essential to ensure that efforts are directed toward areas of greatest impact. This study aimed to identify and prioritize temporomandibular disorder (TMD) topics and questions to inform the development of future evidence-informed guidelines.
Methods:
TMD researchers, clinicians, educators, students, and a policymaker were invited to participate in a two-stage prioritization process. In the first stage, participants ranked pre-identified TMD clinical topics through an online survey using a five-point Likert scale according to their perceived importance. Once the highest-ranked topic was established, relevant clinical questions were collated from the literature, guideline organizations, and participant suggestions. In the second stage, participants ranked pre-defined questions during an open in-person workshop held as a satellite symposium of the IADR General Session (Barcelona, Spain; June 2025), from 1 to 10 according to prioritization criteria. Final priority ranking was determined based on the aggregated ordinal rankings.
Results:
A total of 35 participants completed the first prioritization phase, in which "Primary Care Management of TMD in Paediatric Patients" was identified as the highest-priority topic for guideline development. In phase 2, 55 participants contributed to prioritizing research questions within this topic. The three highest-ranked questions addressed the effectiveness of self-management strategies, behavioural interventions, and occlusal splints compared with no intervention or placebo. Prioritization was driven by areas of clinical uncertainty, variation in practice, emerging evidence, and the potential impact on patient outcomes and healthcare resource use.
Conclusions:
The findings of this study provide a structured and stakeholder-informed foundation for the development of trustworthy clinical practice guidelines for TMD. By systematically identifying high-priority topics and research questions, this process ensures that future guideline efforts are directed toward the areas of greatest clinical relevance and potential impact.
