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Master Thesis

Place de l’acupuncture et des orthèses occlusales dans la prise en charge des dysfonctions temporo-mandibulaires : analyse de la littérature

Abstract : Introduction: temporal mandibular dysfunction (TMD) is the most common cause of orofacial pain, just after dental pain. It can be responsible for particularly disabling acute or chronic pain. Current guidelines suggest the use, as first, to reversible and non-invasive procedures. The aim of our study was to assess the methodological quality and level of evidence of studies evaluating acupuncture and splint therapy in TMDs, and to determine whether the results were consistent with the recommendations and clinical practice. Methods: descriptive and comparative review of systematic reviews and recommendations evaluating acupuncture and splint therapy in TMD, from PubMed, Acudoc2 and Cochrane databases. Results: eight studies evaluating splint therapy (seven systematic reviews, one review of review) and ten studies evaluating acupuncture (eight systematic reviews, one narrative review and one review of review) were included in this work, i.e. eighteen reviews and two hundred four randomized clinical trials in total. Seven expert guidelines were consulted. The methodological quality, the level of evidence of the studies and the risk of bias were assessed for systematic reviews (AMSTAR2 tool) and for the included randomized clinical trials. Although having less power, the quality indices (AMSTAR2 score, proportion of studies vs placebo, bias control) were on average higher in studies evaluating acupuncture. Acupuncture was also recommended with fewer limitations than splint therapy by international experts. Discussion and conclusion: in this work, considering quality and level of evidence in TMD pain, acupuncture studies are not lower, even higher, than splint therapy studies. One possible explanation is because research in acupuncture is active and rigorous. Better quality studies are necessary to specify the role of these therapies in TMDs.
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Master Thesis
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Submitted on : Monday, January 18, 2021 - 4:38:03 PM
Last modification on : Tuesday, February 2, 2021 - 3:12:13 AM
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  • HAL Id : dumas-03113953, version 1



Jean-Marie d'Elbée. Place de l’acupuncture et des orthèses occlusales dans la prise en charge des dysfonctions temporo-mandibulaires : analyse de la littérature. Médecine humaine et pathologie. 2020. ⟨dumas-03113953⟩



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