Summary Review/TMD
Evidence-Based Dentistry (2003) 4, 32; doi:10.1038/sj.ebd.6400177
There is no evidence to support use of occlusal adjustment for prevention or treatment of TMD
Is occlusal adjustment effective for the treatment and prevention of temporomandibular joint disorders (TMD)?
Address for correspondence: Emma Tavender, Review Group Co-ordinator, Cochrane Oral Health Group, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, UK. E-mail: emma.tavender@man.ac.uk
Heli Forssell1
1Department of Oral Diseases, Turku University Central Hospital, Turku, Finland
Koh H, Robinson PG. Occlusal adjustment for treating and preventing temporomandibular joint disorders (Cochrane Review). The Cochrane Library 2003; Issue 1. Oxford: Update Software
Abstract
Data sources The Cochrane Library, MEDLINE (1966–2002), EMbase (1980–2002) and searches by hand were used to identify relevant studies.
Study selection Randomised controlled trials (RCT) or quasi-RCT were selected that compared occlusal adjustment with placebo or reassurance or no treatment in adults who had TMD. The outcomes were global measures of symptoms, pain, headache and limitation of movement.
Data extraction and synthesis Data were independently extracted by two reviewers, the authors were contacted for details of randomisation and withdrawals and a quality assessment was carried out. The Cochrane Oral Health Group's statistical guidelines were followed. From the data provided in the published reports, symptom-based outcomes were extracted from trials that studied treatment. Data for the incidence of symptoms were extracted from trials on prevention.
Results More than 660 trials were identified by the initial search. Six of these trials (392 patients), were suitable for inclusion. No differences were found between occlusal adjustment and control groups.
Conclusions There is an absence of evidence, from RCT, that occlusal adjustment treats or prevents TMD. Occlusal adjustment cannot be recommended for the management or prevention of TMD. Future trials should use standardised diagnostic criteria and outcome measures when evaluating TMD.
