To estimate the efficacy of pharmacological treatments for oro-facial pain.
Burning mouth syndrome (BMS) is neuropathic disorder diagnosed with
symptoms of oral mucosal burning. There is the number of pharmacological
treatments is available for relieving facial-pain, but it is essential to know
which treatment is effective. Therefore, in this review, the author showed that
clonazepam and capsaicin are effective for BMS while cyclobenzaprine, a muscle
relaxant, has a positive treatment effect on the joint pain.
To estimate the efficacy of pharmacological treatments
for oro-facial pain.
The Cochrane Library, the National Health Service
Economic Evaluation Database, PubMed, HTA, and Embase were searched till March
2017. A hand search of original articles was also done. Grey literature was not added. The analysis
involved the randomised controlled trials which comprised more than ten
participants having oro-facial pain for more than three months and categorised
as TMD-joint pain (TMD-j), burning mouth syndrome (BMS), TMD-muscle pain
(TMD-m), and other oro-facial pain. The studies may involve the comparison of
any pharmacological treatment with non-pharmacological treatment, another
pharmacological, no treatment, or placebo. Change in the pain intensity was
taken as primary endpoint and impact on the quality of life considered as the
secondary endpoint. Three review pairs were made by the three authors that
checked for inclusion independently. The risk of bias was assessed separately
by four pairs of reviewers using the Assessment of Social Services tool and
Swedish Agency for Health Technology Assessment. The data extraction also was
done independently by two authors and evaluated as per a modified GRADE system.
A total of forty-one studies involved in qualitative
analysis on patients with BMS, TMD-j pain, and TMD-m pain found to have medium
to low risk of bias. For the TMD-j group, nine studies support Corticosteroid
and Hyaluronate injections and five support NSAIDs. A network meta-analysis
included eight of the nine TMD-m studies that support Botulinum toxin
injections, topical treatment with Ping-On ointment, and Cyclobenzaprine. Out
of 17 BMS studies, five involved in a NMA support topical capsaicin and
clonazepam. Out of left 12 studies, eight studies support Clonazepam, SSRIs,
Alpha lipoic acid, Amisulpride, and Gabapentin, whereas five exhibited no
effect.
Capsaicin and Clonazepam are efficacious for BMS while
cyclobenzaprine shows a positive impact on TMJ-m. For TMD-j pain,
Corticosteroid, Hyaluronate injections, and NSAIDs show significant efficacy.
Evid Based Dent.
Are pharmacological treatments for oro-facial pain effective?
Debra Fischoff et al.
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