International journal of oral and maxillofacial surgery
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Int J Oral Maxillofac Surg · Aug 2020
Meta AnalysisEffectiveness of occlusal splint therapy in the management of temporomandibular disorders: network meta-analysis of randomized controlled trials.
A network meta-analysis (NMA) of randomized controlled trials (RCTs) was performed to assess the effectiveness of various types of occlusal splint in the management of temporomandibular disorders (TMDs) and to rank them according to their effectiveness. An electronic search was undertaken to identify RCTs published until August 2019. Predictor variables were control, non-occluding splint, hard stabilization splint (HSS), soft stabilization splint (SSS), prefabricated splint, mini-anterior splint, anterior repositioning splint (ARS), and counselling therapy (CT) with or without HSS. ⋯ For myogenous TMDs, they were mini-anterior splints (86.8%, low quality evidence), CT+HSS (61.2%, very low quality evidence), and HSS alone (59.7%, moderate quality evidence). Based on this NMA of 48 RCTs, there is moderate to very low quality evidence confirming the effectiveness of occlusal splint therapy in the treatment of TMDs. Multimodal therapy consisting of CT+HSS may produce the maximum improvement for TMD patients.
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Int J Oral Maxillofac Surg · Jan 2016
Review Meta AnalysisSystematic review and meta-analysis of the efficacy of hilotherapy following oral and maxillofacial surgery.
Craniofacial surgery causes immediate postoperative pain, oedema, and functional limitations. Hilotherapy delivers cooled water to the face at 15°C and may reduce the postoperative recovery time. This work presents a meta-analysis of short-term postoperative outcomes after hilotherapy. ⋯ Patients preferred hilotherapy to other cooling methods (P<0.010). Hilotherapy appears to be effective in reducing postoperative facial pain, oedema, and trismus, and in improving patient-reported outcomes. Well-designed randomized controlled clinical trials are required to clarify the procedure-specific efficacy of postoperative hilotherapy and optimal durations of treatment.
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Int J Oral Maxillofac Surg · Jul 2015
Review Meta AnalysisThe diagnostic value of high-resolution ultrasonography for the detection of anterior disc displacement of the temporomandibular joint: a meta-analysis employing the HSROC statistical model.
The study aimed to assess the diagnostic value of high-resolution ultrasonography (HR-US) in the detection of anterior disc displacement (ADD) of the temporomandibular joint. Relevant trials reported in MEDLINE, the Chinese National Knowledge Infrastructure Database, the Chinese Biomedical Literature Database, and Embase were identified. A manual search was also performed. ⋯ HR-US may serve as a new method for the rapid diagnosis of ADD. The method has the advantages of simplicity and low cost. Given the uncertainty in some of the estimated values, more high-quality studies are needed to assess that diagnostic efficacy.
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Int J Oral Maxillofac Surg · Apr 2015
Review Meta AnalysisImmediately loaded non-submerged versus delayed loaded submerged dental implants: a meta-analysis.
The purpose of the present meta-analysis was to test the null hypothesis of no difference in the implant failure rate, postoperative infection, and marginal bone loss for patients being rehabilitated with immediately loaded non-submerged dental implants or delayed loaded submerged implants, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. ⋯ Twenty-three studies were judged to be at high risk of bias, one at moderate risk of bias, and four studies were considered at low risk of bias. The difference between procedures (submerged vs. non-submerged implants) significantly affected the implant failure rate (P = 0.02), with a RR of 1.78 (95% confidence interval (CI) 1.12-2.83). There was no apparent significant effect of non-submerged dental implants on the occurrence of postoperative infection (P = 0.29; RR 2.13, CI 0.52-8.65) or on marginal bone loss (P = 0.77; MD -0.03, 95% CI -0.23 to 0.17).