title: A systematic review and meta-analysis of usual treatment versus psychosocial interventions in the treatment of myofascial temporomandibular disorder pain.
abstract: OBJECTIVE
  To carry out a systematic review and meta-analysis comparing the effects of occlusal splint therapy ("usual treatment") and psychosocial interventions for the treatment of myofascial temporomandibular disorder (TMD) pain in adult patients.
  
  
  METHODS
  Independent screening and evaluation of randomized clinical trials included comparisons between "usual treatment" based on splint therapy and psychosocial interventions for TMD treatment within electronic databases (PubMed/MEDLINE, CENTRAL, EMBASE), ongoing trials databases (Current Controlled Trials, ClinicalTrials.gov), and additional sources. The outcomes selected for the systematic review were self-reported pain, pain interference, unassisted jaw opening without pain, muscle pain upon palpation, depression, and somatization. The effect measures were analyzed using a random-effect model (Review Manager computer program).
  
  
  RESULTS
  The outcomes "longterm self-reported pain" and "long-term depression" were significantly different for the comparisons of "usual treatment" and psychosocial interventions, and they favored the latter (P < .005 and P < .05, respectively). These results must be viewed with caution due to the limited number of studies available. A tendency toward greater improvements of psychological outcomes was observed for psychosocial interventions, while physical functioning was slightly more responsive to "usual treatment."
  
  
  CONCLUSIONS
  No evidence was found to distinguish the clinical effectiveness between "usual treatment" and psychosocial interventions for myofascial TMD pain. Future studies of TMD and related subdiagnoses should be reported according to core standardized outcomes to facilitate comparisons.
authors: Carolina
authors: C
authors: Roldán-Barraza
authors: Steffani
authors: S
authors: Janko
authors: Julio
authors: J
authors: Villanueva
authors: Ignacio
authors: I
authors: Araya
authors: Hans-Christoph
authors: HC
authors: Lauer
mesh_terms: D003863:Depression / Q000523:psychology; D006801:Humans; D017090:Occlusal Splints; D010147:Pain Measurement; D011613:Psychotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016059:Range of Motion, Articular / Q000502:physiology; D013001:Somatoform Disorders / Q000523:psychology; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome