RESUMO
OBJECTIVES: The aim of this superiority trial was to investigate the clinical outcomes of arthrocentesis as an early treatment supported by use of an occlusal splint vs use of an occlusal splint only in the management of temporomandibular joint (TMJ) arthralgia. METHODS: Ninety-five adults presenting with TMJ arthralgia were recruited into the study and randomised into 2 groups: Group 1 received arthrocentesis as an early treatment supported by use of an occlusal splint, whereas group 2 received treatment with an occlusal splint only. Seventy-four patients (group 1: n = 37; group 2: n = 37) completed the 1-year follow-up schedule and were included in the final analysis. Reduction of pain intensity measured by a numeric rating scale and increase in mouth opening distance (unassisted maximal, assisted maximal, and pain-free) was seen in both treatment groups. RESULTS: In group 1, pain intensity significantly decreased at 6 weeks and all subsequent time points compared with group 2. In terms of mouth opening distance, a significant improvement was observed in both groups during the course of treatment, but statistical significance was not seen between the 2 treatment groups. CONCLUSIONS: Early arthrocentesis supported by use of an occlusal splint is superior to use of an occlusal splint alone in the treatment of TMJ arthralgia. Arthrocentesis with occlusal splint support could be discussed as first-line treatment for arthralgia of the TMJ, which may co-occur with various painful and nonpainful conditions of TMJ disorders.
RESUMO
Many studies have shown mutual interaction between temporomandibular disorders (TMD) and psychological distress. However, evidence on the effectiveness of therapeutic interventions for TMD on psychological outcomes is scarce. This review aimed to summarise the best evidence on the association between interventions for TMD and psychological outcomes regarding symptoms of anxiety and depression. Electronic search was carried out in databases, including Pubmed, Web of Science, Medline, Cochrane Library, and Scopus. All eligible studies were included for narrative synthesis. Eligible randomised controlled trials (RCTs) were included for the meta-analysis. The overall effect size of interventions for TMD was analysed in standardised mean difference (SMD) in levels of anxiety and depression. Ten studies were included in the systematic review. Of these, nine were included in the narrative analysis and four were included in the meta-analysis. All included studies and the result of the narrative analysis showed a statistically significant beneficial effect of interventions for TMD on improving symptoms of anxiety and depression (p < 0.0001); however, a statistically significant overall effect was not found in the meta-analyses. Current evidence is in favour of the interventions for TMD in improving symptoms of depression and anxiety. However, the effect is statistically uncertain and warrants future studies to enable the best synthesis of the evidence.
