Orofacial smärta och käkfunktionsstörningar. Riktlinjer för behandling
Engelsk titel: Guidelines in the management of orofacial pain/TMD: An evidence-based approach
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Författare:
Wänman, Anders
;
Ernberg, Malin
;
List, Thomas
Email: anders.wanman@umu.se
Språk: Swe
Antal referenser: 102
Dokumenttyp:
Översikt
UI-nummer: 16033457
Sammanfattning
Pain and dysfunction related to the jaw joint and
jaw muscles are conditions dentists face regularly
in their dental practice. It is essential that the patient
is examined from both a dental and a psychosocial
perspective, since co-morbidities between
temporomandibular disorders (TMD) and other
conditions, such as widespread pain, systemic inflammatory
disorders, and depression, as well as
impaired general health, are common.
The Swedish government initiated an extensive
review of the scientific literature in dentistry, for the
purpose of developing national guidelines in dentistry.
One policy area was orofacial pain and TMD.
The investigation included systematic reviews,
randomized clinical trials, clinical trials and observational
studies of high quality published between
1965 and 2014. The review was unique since it also
included health economic analyses and a directive
to derive at a statement for every possible condition
that may be encountered in the dental clinic, even
when the scientific evidence was insufficient for an
evidence-based statement.
Counseling and behavioral approaches, which
aim to change maladaptive behaviors, were considered
first-line interventions. Evidence of the
effect and analyses of cost effectiveness, support
the use of occlusal appliances and jaw exercises,
which for limited periods, may be combined with
non-steroidal anti-inflammatory drugs.