Intervenciones avanzadas, farmacológicas y complementarias para afecciones de dolor orofacial crónico o recurrente:...

Área de la Ciencia:

• Orofacial Pain Management
• Evidence Synthesis
• Interventional Therapies

Sus antecedentes:

• Chronic orofacial pain (OP) management increasingly uses advanced technologies and complementary interventions.
• Comparative evidence for these interventions is fragmented across diagnoses, modalities, and outcomes.
• Systematic review and meta-analysis are needed to consolidate fragmented evidence.

Objetivo del estudio:

• To systematically map evidence for advanced and complementary interventions for chronic orofacial pain (OP).
• To conduct selective meta-analyses to estimate intervention effects and certainty of evidence.
• To identify research gaps and inform future clinical practice and trial design.

Principales métodos:

• Systematic evidence map with selective meta-analyses (PROSPERO CRD420251270501) following PRISMA 2020 guidelines.
• Searched six databases for randomized and non-randomized studies in adults with TMD, BMS, TN, and other OP phenotypes.
• Extracted data on pain intensity, disability, function, quality of life, and adverse events; assessed risk of bias and certainty with GRADE.

Principales resultados:

• Included 130 studies (n=6879 participants). Low risk of bias and consistent reporting of outcomes were uncommon.; Photobiomodulation/low-level laser therapy (PBM/LLLT) showed short-term pain reduction in BMS (SMD -0.81), but with moderate certainty and a null-crossing prediction interval.; Evidence for other BMS interventions, TMD, TN, and digital therapeutics was sparse, inconsistent, or of low/very low certainty, with inconsistent adverse event reporting.

Conclusiones:

• PBM/LLLT demonstrates the clearest short-term analgesic signal for BMS, though its transportability is uncertain.
• Future research should standardize outcomes, extend follow-up, and transparently report harms for diagnosis-stratified care.
• More high-quality evidence is needed for effective and safe management of various chronic orofacial pain conditions.