Objective To assess the evidence of Cochrane systematic reviews on the treatment of temporomandibular disorders (TMD) as well as the methodological quality of all randomized controlled trials (RCTs) of the included systematic reviews.
Methods The Cochrane Library (Issue 3, 2008) was searched for systematic reviews on the treatment of temporomandibular disorders. The risk of bias was assessed independently by two authors.
Results Three systematic reviews involving 25 RCTs were included. The methods of 23 studies were rated as of lower quality with high risk of various biases. Only 2 studies were of high quality.
Conclusion There is insufficient or inconsistent evidence to support the use of hyaluronate, occlusal adjustment, and stabilization splint therapy for the treatment of TMD. The overall quality of RCTs about the treatment of TMD is generally low. Analysis of the included trials showed that some trials had no clear description of randomization methods, allocation concealment, sample size calculation, and intention-to-treat analysis. To improve the quality of the reporting of RCTs, clinical trial registration and the revised Consolidated Standards of Reporting Trials (CONSORT) statement should be introduced into the trial design and strictly followed.
Citation：
ZHANG Xiaoge,YANG Fan,WU Taixiang,SHI Zongdao,YI Xinzhu. Evidence of Cochrane Systematic Reviews on the Treatment
of Temporomandibular Disorders. Chinese Journal of Evidence-Based Medicine, 2008, 08(12): 1130-1132. doi: 10.7507/1672-2531.20080244
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Copyright © the editorial department of Chinese Journal of Evidence-Based Medicine of West China Medical Publisher. All rights reserved
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Al-AniMZ, Davies SJ, Gray RJM, et al. Stabilisation splint therapy for temporomandibular pain dysfunction syndrome. Cochrane Database of Systematic Reviews, 2004, Issue 1.
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Bertolami CN, Gay T, Clark GT, et al. Use of sodiumhyaluronate in treating temporomandibular joint disorders: a randomized, double-blind, placebo controlled clinical trial. Journal of Oral and Maxillofacial Surgery, 1993, 51: 232-242.
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Hepguler S, Akkoc YS, Pehlivan M, et al. The efficacy of intraarticular sodium hyaluronate in patients with recucing displaced disc. Journal of Oral Rehabilitation, 2002, 29(1): 80-86.
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Catherine DA, Jeffrey MD, Frank A, et al. Is This Clinical Trial Fully Registered?:A Statement form the International Committee of Medical Journal Editors.s http: //www.icmje. org/ clin -trialup.htm.
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Moher D, Schulz KF, Altman DG, et al. The CONSORT statement: revised recommendation for improving the quality of reports of parallel-group randomized trials. Lancet, 2001, 357(9263): 1191-1194.
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- 1. 易新竹. 牙合学. 北京: 人民卫生出版社, 2008, 94, 111, 125, 131.
- 2. 史宗道. 循证口腔医学. 北京: 人民卫生出版社, 2008, 160-168.
- 3. Higgins JPT, Green S, editors. Application of quality assessment criteria. Cochrane Handbook for Systematic Reviews of Interventions 2008.
- 4. 吴泰相, 刘关键. 隐蔽分组(分配隐藏)和盲法的概念实施与报告. 中国循证医学杂志, 2007, 7(3): 222-225.
- 5. Shi Z, Guo C, Awad M. Hyaluronate for temporomandibular joint disorders. Cochrane Database of Systematic Reviews, 2003, (1).
- 6. Koh H, Robinson PG. Occlusal adjustment for treating and preventing temporomandibular joint disorders. The Cochrane Database of Systematic Reviews, 2003, Issue 1.
- 7. Al-AniMZ, Davies SJ, Gray RJM, et al. Stabilisation splint therapy for temporomandibular pain dysfunction syndrome. Cochrane Database of Systematic Reviews, 2004, Issue 1.
- 8. Bertolami CN, Gay T, Clark GT, et al. Use of sodiumhyaluronate in treating temporomandibular joint disorders: a randomized, double-blind, placebo controlled clinical trial. Journal of Oral and Maxillofacial Surgery, 1993, 51: 232-242.
- 9. Hepguler S, Akkoc YS, Pehlivan M, et al. The efficacy of intraarticular sodium hyaluronate in patients with recucing displaced disc. Journal of Oral Rehabilitation, 2002, 29(1): 80-86.
- 10. Catherine DA, Jeffrey MD, Frank A, et al. Is This Clinical Trial Fully Registered?:A Statement form the International Committee of Medical Journal Editors.s http: //www.icmje. org/ clin -trialup.htm.
- 11. Moher D, Schulz KF, Altman DG, et al. The CONSORT statement: revised recommendation for improving the quality of reports of parallel-group randomized trials. Lancet, 2001, 357(9263): 1191-1194.
