Nonpharmacological Interventions for Pain in Patients with Temporomandibular Joint Disorders: A Systematic Review

Abstract

This systematic review aimed to compare the efficacy of nonpharmacological therapies for painful temporomandibular joint disorders. The protocol was registered on International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020171364). The search was performed on the electronic databases PubMed, Google Scholar, Clinical Trials, and Web of Science. The eligibility criteria were randomized controlled trials in patients diagnosed with painful temporomandibular joint disorders comparing the pain relief between conventional treatment and nonpharmacological therapies such as acupuncture, physiotherapy, low-level laser, and massage. Fourteen articles were included in this review. At the overall bias of the studies included, 71.42% exhibited some concerns and 28.57% had high risk. The efficacy of nonpharmacological interventions was found to be moderate in the short term and variable in the long term for pain reduction in patients with temporomandibular joint disorders. The evidence pointed out that acupuncture, laser therapy, and physiotherapy are potentially useful interventions for pain relief in patients with temporomandibular joint disorders. However, there is a lack of consistency and short-term follow-up in the studies to determine the lasting of such effect.

Keywords

dentistry - physiotherapy - complementary - pain - temporomandibular joint

Publikationsverlauf

Artikel online veröffentlicht:
08. März 2022

• References

• 1 Østensjø V, Moen K, Storesund T, Rosén A. Prevalence of painful temporomandibular disorders and correlation to lifestyle factors among adolescents in Norway. Pain Res Manag 2017; 2017: 2164825
• 2 Manfredini D, Lombardo L, Siciliani G. Temporomandibular disorders and dental occlusion. A systematic review of association studies: end of an era?. J Oral Rehabil 2017; 44 (11) 908-923
• 3 Greene CS. Managing the care of patients with temporomandibular disorders: a new guideline for care. J Am Dent Assoc 2010; 141 (09) 1086-1088
• 4 Garrigós-Pedrón M, Elizagaray-García I, Domínguez-Gordillo AA, Del-Castillo-Pardo-de-Vera JL, Gil-Martínez A. Temporomandibular disorders: improving outcomes using a multidisciplinary approach. J Multidiscip Healthc 2019; 12: 733-747
• 5 Osiewicz MA, Lobbezoo F, Loster BW, Loster JE, Manfredini D. Frequency of temporomandibular disorders diagnoses based on RDC/TMD in a Polish patient population. Cranio 2018; 36 (05) 304-310
• 6 Kotiranta U, Forssell H, Kauppila T. Painful temporomandibular disorders (TMD) and comorbidities in primary care: associations with pain-related disability. Acta Odontol Scand 2019; 77 (01) 22-27
• 7 Nguyen TT, Vanichanon P, Bhalang K, Vongthongsri S. Pain duration and intensity are related to coexisting pain and comorbidities present in temporomandibular disorder pain patients. J Oral Facial Pain Headache 2019; 33 (02) 205-212
• 8 Shokri A, Zarch HH, Hafezmaleki F, Khamechi R, Amini P, Ramezani L. Comparative assessment of condylar position in patients with temporomandibular disorder (TMD) and asymptomatic patients using cone-beam computed tomography. Dent Med Probl 2019; 56 (01) 81-87
• 9 Hampton T. Improvements needed in management of temporomandibular joint disorders. JAMA 2008; 299 (10) 1119-1121
• 10 Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. New York: Wiley; 2011
• 11 Sterne JAC, Savović J, Page MJ. et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019; 366: l4898
• 12 Guyatt G, Oxman AD, Akl EA. et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol 2011; 64 (04) 383-394
• 13 Pietropaoli D, Cooper BC, Ortu E, Monaco A, Ortu E, Monaco A. I.A.P.N.O.R.. A device improves signs and symptoms of TMD. Pain Res Manag 2019; 2019: 5646143
• 14 da Costa LMR, Schimit EFD, Souza C. et al. Effect of the Pilates method on women with temporomandibular disorders: a study protocol for a randomized controlled trial. J Bodyw Mov Ther 2016; 20 (01) 110-114
• 15 Nagata K, Hori S, Mizuhashi R. et al. Efficacy of mandibular manipulation technique for temporomandibular disorders patients with mouth opening limitation: a randomized controlled trial for comparison with improved multimodal therapy. J Prosthodont Res 2019; 63 (02) 202-209
• 16 Coskun Benlidayi I, Salimov F, Kurkcu M, Guzel R. Kinesio Taping for temporomandibular disorders: single-blind, randomized, controlled trial of effectiveness. J Back Musculoskeletal Rehabil 2016; 29 (02) 373-380
• 17 Matys J, Jaszczak E, Flieger R, Kostrzewska-Kaminiarz K, Grzech-Leśniak K, Dominiak M. Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch-a randomized clinical controlled trial. Lasers Med Sci 2020; 35 (02) 487-496
• 18 Celakil T, Muric A, Gokcen Roehlig B, Evlioglu G, Keskin H. Effect of high-frequency bio-oxidative ozone therapy for masticatory muscle pain: a double-blind randomised clinical trial. J Oral Rehabil 2017; 44 (06) 442-451
• 19 Tortelli SAC, Saraiva L, Miyagaki DC. Effectiveness of acupuncture, ozonio therapy and low-intensity laser in the treatment of temporomandibular dysfunction of muscle origin: a randomized controlled trial. Rev Odontol UNESP 2019; 48: e20190107
• 20 Ramakrishnan SN, Aswath N. Comparative efficacy of analgesic gel phonophoresis and ultrasound in the treatment of temporomandibular joint disorders. Indian J Dent Res 2019; 30 (04) 512-515
• 21 Elkholy AN, Abd El-Moniem N, Hassan S, Enite A. Effect of plasma rich in growth factors intra articular injection in management of patients with internal derangement of TMJ using CT guided puncture versus conventional technique. Al-Azhar Dental Journal for Girls. 2019; 6 (04) 427-435
• 22 Rezazadeh F, Hajian K, Shahidi S, Piroozi S. Comparison of the effects of transcutaneous electrical nerve stimulation and low-level laser therapy on drug-resistant temporomandibular disorders. J Dent (Shiraz) 2017; 18 (03) 187-192
• 23 Oliveira LB, Lopes TS, Soares C. et al. Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised-controlled trial. J Oral Rehabil 2015; 42 (10) 723-732
• 24 Ferreira AP, Costa DR, Oliveira AI. et al. Short-term transcutaneous electrical nerve stimulation reduces pain and improves the masticatory muscle activity in temporomandibular disorder patients: a randomized controlled trial. J Appl Oral Sci 2017; 25 (02) 112-120
• 25 Leal de Godoy CH, Motta LJ, Santos Fernandes KP, Mesquita-Ferrari RA, Deana AM, Bussadori SK. Effect of low-level laser therapy on adolescents with temporomandibular disorder: a blind randomized controlled pilot study. J Oral Maxillofac Surg 2015; 73 (04) 622-629
• 26 Borges RMM, Cardoso DS, Flores BC. et al. Effects of different photobiomodulation dosimetries on temporomandibular dysfunction: a randomized, double-blind, placebo-controlled clinical trial. Lasers Med Sci 2018; 33 (09) 1859-1866
• 27 Dalewski B, Kamińska A, Szydłowski M, Kozak M, Sobolewska E. Comparison of early effectiveness of three different intervention methods in patients with chronic orofacial pain: a randomized, controlled clinical trial. Pain Res Manag 2019; 2019: 7954291
• 28 Brochado FT, Jesus LH, Carrard VC, Freddo AL, Chaves KD, Martins MD. Comparative effectiveness of photobiomodulation and manual therapy alone or combined in TMD patients: a randomized clinical trial. Braz Oral Res 2018; 32: e50
• 29 De Carli BM, Magro AK, Souza-Silva BN. et al. The effect of laser and botulinum toxin in the treatment of myofascial pain and mouth opening: a randomized clinical trial. J Photochem Photobiol B 2016; 159: 120-123
• 30 Douglas De Oliveira DW, Lages FS, Guimarães RC. et al. Do TMJ symptoms improve and last across time after treatment with red (660 nm) and infrared (790 nm) low level laser treatment (LLLT)? A survival analysis. Cranio 2017; 35 (06) 372-378
• 31 Herpich CM, Leal-Junior ECP, Gomes CAFP. et al. Immediate and short-term effects of phototherapy on pain, muscle activity, and joint mobility in women with temporomandibular disorder: a randomized, double-blind, placebo-controlled, clinical trial. Disabil Rehabil 2018; 40 (19) 2318-2324
• 32 Diraçoğlu D, Saral IB, Keklik B. et al. Arthrocentesis versus nonsurgical methods in the treatment of temporomandibular disc displacement without reduction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108 (01) 3-8
• 33 Öhrnell Malekzadeh B, Johansson Cahlin B, Widmark G. Conservative therapy versus arthrocentesis for the treatment of symptomatic disk displacement without reduction: a prospective randomized controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128 (01) 18-24
• 34 Tavera AT, Montoya MC, Calderón EF, Gorodezky G, Wixtrom RN. Approaching temporomandibular disorders from a new direction: a randomized controlled clinical trial of the TMDes ear system. Cranio 2012; 30 (03) 172-182
• 35 Zotelli VL, Grillo CM, Gil ML, Wada RS, Sato JE, da Luz Rosário de Sousa M. Acupuncture effect on pain, mouth opening limitation and on the energy meridians in patients with temporomandibular dysfunction: a randomized controlled trial. J Acupunct Meridian Stud 2017; 10 (05) 351-359
• 36 van Grootel RJ, Buchner R, Wismeijer D, van der Glas HW. Towards an optimal therapy strategy for myogenous TMD, physiotherapy compared with occlusal splint therapy in an RCT with therapy-and-patient-specific treatment durations. BMC Musculoskelet Disord 2017; 18 (01) 76
• 37 Shousha TM, Soliman ES, Behiry MA. The effect of a short term conservative physiotherapy versus occlusive splinting on pain and range of motion in cases of myogenic temporomandibular joint dysfunction: a randomized controlled trial. J Phys Ther Sci 2018; 30 (09) 1156-1160
• 38 Nadershah M, Abdel-Alim HM, Bayoumi AM, Jan AM, Elatrouni A, Jadu FM. Photobiomodulation therapy for myofascial pain in temporomandibular joint dysfunction: a double-blinded randomized clinical trial. J Maxillofac Oral Surg 2020; 19 (01) 93-97
• 39 Khalighi HR, Mortazavi H, Mojahedi SM, Azari-Marhabi S, Moradi Abbasabadi F. Low level laser therapy versus pharmacotherapy in improving myofascial pain disorder syndrome. J Lasers Med Sci 2016; 7 (01) 45-50
• 40 Sancakli E, Gökçen-Röhlıg B, Balık A, Öngül D, Kıpırdı S, Keskın H. Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study. BMC Oral Health 2015; 15 (01) 131
• 41 Wänman A, Marklund S. Treatment outcome of supervised exercise, home exercise and bite splint therapy, respectively, in patients with symptomatic disc displacement with reduction: a randomised clinical trial. J Oral Rehabil 2020; 47 (02) 143-149
• 42 Oliveira SSI, Pannuti CM, Paranhos KS. et al. Effect of occlusal splint and therapeutic exercises on postural balance of patients with signs and symptoms of temporomandibular disorder. Clin Exp Dent Res 2019; 5 (02) 109-115
• 43 Grace EG, Sarlani E, Reid B. The use of an oral exercise device in the treatment of muscular TMD. Cranio 2002; 20 (03) 204-208
• 44 Marini I, Gatto MR, Bonetti GA. Effects of superpulsed low-level laser therapy on temporomandibular joint pain. Clin J Pain 2010; 26 (07) 611-616
• 45 Madani AS, Ahrari F, Nasiri F, Abtahi M, Tunér J. Low-level laser therapy for management of TMJ osteoarthritis. Cranio 2014; 32 (01) 38-44
• 46 Del Vecchio A, Floravanti M, Boccassini A. et al. Evaluation of the efficacy of a new low-level laser therapy home protocol in the treatment of temporomandibular joint disorder-related pain: A randomized, double-blind, placebo-controlled clinical trial. Cranio 2021; 39 (02) 141-150
• 47 Kulekcioglu S, Sivrioglu K, Ozcan O, Parlak M. Effectiveness of low-level laser therapy in temporomandibular disorder. Scand J Rheumatol 2003; 32 (02) 114-118
• 48 Bertolucci LE, Grey T. Clinical analysis of mid-laser versus placebo treatment of arthralgic TMJ degenerative joints. Cranio 1995; 13 (01) 26-29
• 49 Venancio RdeA, Camparis CM, Lizarelli RdeF. Low intensity laser therapy in the treatment of temporomandibular disorders: a double-blind study. J Oral Rehabil 2005; 32 (11) 800-807
• 50 Mazzetto MO, Carrasco TG, Bidinelo EF, de Andrade Pizzo RC, Mazzetto RG. Low intensity laser application in temporomandibular disorders: a phase I double-blind study. Cranio 2007; 25 (03) 186-192
• 51 Carrasco TG, Mazzetto MO, Mazzetto RG, Mestriner Jr W. Low intensity laser therapy in temporomandibular disorder: a phase II double-blind study. Cranio 2008; 26 (04) 274-281
• 52 Stiesch-Scholz M, Fink M, Tschernitschek H, Rossbach A. Medical and physical therapy of temporomandibular joint disk displacement without reduction. Cranio 2002; 20 (02) 85-90
• 53 Ismail F, Demling A, Hessling K, Fink M, Stiesch-Scholz M. Short-term efficacy of physical therapy compared to splint therapy in treatment of arthrogenous TMD. J Oral Rehabil 2007; 34 (11) 807-813
• 54 Haketa T, Kino K, Sugisaki M, Takaoka M, Ohta T. Randomized clinical trial of treatment for TMJ disc displacement. J Dent Res 2010; 89 (11) 1259-1263
• 55 Craane B, Dijkstra PU, Stappaerts K, De Laat A. Randomized controlled trial on physical therapy for TMJ closed lock. J Dent Res 2012; 91 (04) 364-369
• 56 de Resende CMBM, de Oliveira Medeiros FGL, de Figueiredo Rêgo CR, Bispo ASL, Barbosa GAS, de Almeida EO. Short-term effectiveness of conservative therapies in pain, quality of life, and sleep in patients with temporomandibular disorders: A randomized clinical trial. Cranio 2021; 39 (04) 335-343
• 57 Vicente-Barrero M, Yu-Lu SL, Zhang B. et al. The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome. Med Oral Patol Oral Cir Bucal 2012; 17 (06) e1028-e1033
• 58 Conlan MJ, Rapley JW, Cobb CM. Biostimulation of wound healing by low-energy laser irradiation. A review. J Clin Periodontol 1996; 23 (05) 492-496
• 59 Chen J, Huang Z, Ge M, Gao M. Efficacy of low-level laser therapy in the treatment of TMDs: a meta-analysis of 14 randomised controlled trials. J Oral Rehabil 2015; 42 (04) 291-299
• 60 Ahmad SA, Hasan S, Saeed S, Khan A, Khan M. Low-level laser therapy in temporomandibular joint disorders: a systematic review. J Med Life 2021; 14 (02) 148-164
• 61 Hróbjartsson A, Kaptchuk TJ, Miller FG. Placebo effect studies are susceptible to response bias and to other types of biases. J Clin Epidemiol 2011; 64 (11) 1223-1229
• 62 Armijo-Olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of manual therapy and therapeutic exercise for temporomandibular disorders: systematic review and meta-analysis. Phys Ther 2016; 96 (01) 9-25
• 63 Herrmann M, Engelke K, Ebert R. et al. Interactions between muscle and bone-where physics meets biology. Biomolecules 2020; 10 (03) E432
• 64 Miyaguchi M, Kobayashi A, Kadoya Y, Ohashi H, Yamano Y, Takaoka K. Biochemical change in joint fluid after isometric quadriceps exercise for patients with osteoarthritis of the knee. Osteoarthritis Cartilage 2003; 11 (04) 252-259
• 65 Sen EI, Esmaeilzadeh S, Eskiyurt N. Effects of whole-body vibration and high impact exercises on the bone metabolism and functional mobility in postmenopausal women. J Bone Miner Metab 2020; 38 (03) 392-404
• 66 Grech D, Li Z, Morcillo P. et al. Intraoperative low-frequency electroacupuncture under general anesthesia improves postoperative recovery in a randomized trial. J Acupunct Meridian Stud 2016; 9 (05) 234-241
• 67 Seca S, Miranda D, Cardoso D. et al. Effectiveness of acupuncture on pain, physical function and health-related quality of life in patients with rheumatoid arthritis: a systematic review of quantitative evidence. Chin J Integr Med 2019; 25 (09) 704-709
• 68 Abuye NO, Sánchez-Pérez I. Effectiveness of acupuncture and auriculotherapy to reduce the level of depression, anxiety and stress in emergency health personnel during the COVID-19. Revista Internacional de Acupuntura; 2021
• 69 Tuta-Quintero E, Zuleta-Sánchez N, Guerron-Gómez G, Vega-Corredor C, Restrepo-Escobar J. Review of clinical trials and cohort studies for the treatment of migraine with acupuncture. Revista Internacional de Acupuntura; 2021
• 70 Ulloa L, Quiroz-Gonzalez S, Torres-Rosas R. Nerve Stimulation: immunomodulation and control of inflammation. Trends Mol Med 2017; 23 (12) 1103-1120
• 71 Yu JS, Zeng BY, Hsieh CL. Acupuncture stimulation and neuroendocrine regulation. Int Rev Neurobiol 2013; 111: 125-140
• 72 Torres-Rosas R, Yehia G, Peña G. et al. Dopamine mediates vagal modulation of the immune system by electroacupuncture. Nat Med 2014; 20 (03) 291-295
• 73 Arriaga-Pizano L, Gómez-Jiménez DC, Flores-Mejía LA. et al. Low back pain in athletes can be controlled with acupuncture by a catecholaminergic pathway: clinical trial. Acupunct Med 2020; 38 (06) 388-395
• 74 Flores-Mejía LA, Cabrera-Rivera GL, Ferat-Osorio E. et al. Function is dissociated from activation-related immunophenotype on phagocytes from patients with SIRS/sepsis syndrome. Shock 2019; 52 (05) e68-e75
• 75 Naik PN, Kiran RA, Yalamanchal S, Kumar VA, Goli S, Vashist N. Acupuncture: an alternative therapy in dentistry and its possible applications. Med Acupunct 2014; 26 (06) 308-314
• 76 Jung A, Shin BC, Lee MS, Sim H, Ernst E. Acupuncture for treating temporomandibular joint disorders: a systematic review and meta-analysis of randomized, sham-controlled trials. J Dent 2011; 39 (05) 341-350
• 77 Fernandes AC, Duarte Moura DM, Da Silva LGD, De Almeida EO, Barbosa GAS. Acupuncture in temporomandibular disorder myofascial pain treatment: a systematic review. J Oral Facial Pain Headache 2017; 31 (03) 225-232
• 78 La Touche R, Goddard G, De-la-Hoz JL. et al. Acupuncture in the treatment of pain in temporomandibular disorders: a systematic review and meta-analysis of randomized controlled trials. Clin J Pain 2010; 26 (06) 541-550
• 79 Al-Moraissi EA, Alradom J, Aladashi O, Goddard G, Christidis N. Needling therapies in the management of myofascial pain of the masticatory muscles: a network meta-analysis of randomised clinical trials. J Oral Rehabil 2020; 47 (07) 910-922
• 80 Torres-Rosas R, Torres-Gómez N, García-Contreras R, Scougall-Vilchis RJ, Domínguez-Díaz LR, Argueta-Figueroa L. Copper nanoparticles as nanofillers in an adhesive resin system: an in vitro study. Dent Med Probl 2020; 57 (03) 239-246
• 81 González-Pedroza MG, Sánchez-Mendieta V, Morales-Valencia JA. et al. X-ray photoelectron spectroscopy study of interactions between gold nanoparticles and epidermal growth factor for potential use in biomedicine. Journal of Bionanoscience. 2017; 11 (02) 141-147
• 82 Gama-Lara SA, Morales-Luckie RA, Argueta-Figueroa L, Hinestroza JP, García-Orozco I, Natividad R. Synthesis, characterization, and catalytic activity of platinum nanoparticles on bovine-bone powder: a novel support. J Nanomater 2018; 2018: 6482186
• 83 Argueta-Figueroa L, Torres-Gómez N, Scougall-Vilchis R, Garcia-Contreras R. Biocompatibility and nanotoxicology of titanium dioxide in the oral cavity: Systematic review. Invest Clin 2018; 59: 352
• 84 Guilherme VA, Ribeiro LNM, Alcântara ACS. et al. Improved efficacy of naproxen-loaded NLC for temporomandibular joint administration. Sci Rep 2019; 9 (01) 11160
• 85 Mujakperuo HR, Watson M, Morrison R, Macfarlane TV. Pharmacological interventions for pain in patients with temporomandibular disorders. Cochrane Database Syst Rev 2010; (10) CD004715