J Orofac Pain
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Review Comparative Study
Reviewing the evidence: can cognitive behavioral therapy improve outcomes for patients with chronic orofacial pain?
To review evidence for chronic orofacial pain management using cognitive behavioral therapy (CBT). ⋯ CBT, either alone or in combination with biofeedback, conservative treatment and/or self-care, can improve outcomes for patients with TMD in secondary care. However, further research is needed to assess its effectiveness in primary care and in management of other chronic orofacial pain conditions. Further, the number of sessions needed, mode of delivery, and cost-effectiveness also remain unclear.
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Review Meta Analysis Comparative Study
Systematic review and meta-analysis of randomized controlled trials evaluating intraoral orthopedic appliances for temporomandibular disorders.
To conduct a systematic review with meta-analysis of randomized controlled trials (RCTs) that have assessed the efficacy of intraoral orthopedic appliances to reduce pain in patients with temporomandibular disorders affecting muscle and joint (TMJD) compared to subjects receiving placebo control, no treatment, or other treatments. ⋯ Hard stabilization appliances, when adjusted properly, have good evidence of modest efficacy in the treatment of TMJD pain compared to non-occluding appliances and no treatment. Other types of appliances, including soft stabilization appliances, anterior positioning appliances, and anterior bite appliances, have some RCT evidence of efficacy in reducing TMJD pain. However, the potential for adverse events with these appliances is higher and suggests the need for close monitoring in their use.
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To summarize literature data about the role of psychosocial factors in the etiology of bruxism. ⋯ Wake clenching seems to be associated with psychosocial factors and a number of psychopathological symptoms, while there is no evidence to relate sleep bruxism with psychosocial disorders. Future research should be directed toward the achievement of a better distinction between the two forms of bruxism in order to facilitate the design of experimental studies on this topic.
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This article presents a comprehensive review of the topic of placebos, with a special focus on placebo analgesia. It includes a discussion of how placebos work (the placebo effect) and how patients react to them (the placebo response). A literature search was performed to identify relevant literature and publications related to the topic, and a qualitative assessment of papers was undertaken based on accepted rules for scientific evidence. ⋯ Acupuncture and splint therapy can be good examples of powerful placebos in the field of TMD, and both of these are discussed in detail. Present knowledge suggests that every treatment for pain contains a placebo component, which sometimes is as powerful as the so-called "active" counterpart. While the deceptive use of placebos must be considered unethical, every health provider who is treating pain patients must be aware of this important phenomenon in order to harness its huge potential.
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This topical review presents an overview of orofacial manifestations associated with the more common connective tissue diseases affecting multiple organs. The orofacial manifestations associated with these autoimmune disorders include oral mucosa alterations, salivary gland pathosis, sensory neuropathies, headaches, and temporomandibular disorders. ⋯ An understanding of the orofacial manifestations associated with these systemic diseases will enable the pain practitioner to establish an appropriate diagnosis within the context of the underlying systemic disease. This will allow the practitioner the opportunity to contribute and collaborate as a member of a multidisciplinary health-care team in the management of these systemic autoimmune diseases.