Application of principles of evidence-based medicine to occlusal treatment for temporomandibular disorders: are there lessons to be learned?

摘要: Critical evaluation of treatment methods has become an important part health care and will certainly have a major influence on decisions about acceptable in the future. Evidence-based medicine (EBM) means systematic, explicit, judicious implementation best evidence patient care. The most reliable sources are high-quality systematic reviews randomized controlled trials (RCTs). A EBM approach could be particularly useful temporomandibular disorders (TMD), where controversial conflicting ideas management common. In this field, concerns lack often expressed. This article aims to elucidate discuss application TMD, using treatments (i.e., occlusal treatments) as example. By applying principles TMD treatments, we wish highlight some issues that form basis for field. review (occlusal splints adjustment) updated January 2003 revealed 16 RCTs 4 adjustment. overall quality was fairly low. Recently, however, been published. obvious methodologic shortcomings published included problems defining population, inadequacies performing randomization blinding, therapies or appropriate control short follow-ups, monitoring compliance. Occlusal splint studies yielded equivocal results. Even studied area, stabilization myofascial face pain, results do not justify definite conclusions efficacy therapy. Their clinical effectiveness relieve pain also seems modest when compared with general. None adjustment provided supporting use method. implications findings future perspectives discussed.