Effect Of Cognitive-behavioral Therapy On Temporomandibular Disorders: A Systematic Review

Objective:To evaluate the efficacy of cognitive-behavioral therapy (CBT) for temporomandibular disorders (TMD). Methods:Pubmed(1990～2009,6), OVID(1960～2009,6), EMBASE(1974-2009,6), and Cochrane Central Register of Controlled Trial(2009), CBM(1978～2009,6),CNKI(1994～2009,10)were searched to collect randomized and quasi-randomized controlled trials. Quality assessment and data extraction were performed by two reviewers independently. Meta-analysis will be performed for the results of homogeneous studies by the Cochrane Collaboration's software RevMan 5.0 and the heterogeneous data conducted for a descriptive qualitative analysis. Results:The search strategy resulted in 323 studies, of which 5 met the inclusion criteria, with 3 randomized controlled trials (RCTs) and 2 quasi-randomized controlled trials (qRCT).The methodological quality varied among the studies,2 studies as B,3 studies as C. The quality of included studies was not high. Meta-analysis was not performed due to the apparent heterogeneity, such as different time of therapy, follow time and control groups. A descriptive qualitative analysis was performed. The efficacy of CBT for TMD was not superior to control group. The efficacy of follow-up was not uncertain due to different outcome in the included studies. Conclusions:On basis of current evidence the efficacy of CBT for TMD was not uncertain. Thus, further design strict and high-quality clinical trial are required to provide more reliable evidence.