Evaluation of different treatment modalities in patients with disc displacement with reduction using systematic review and meta-analysis

Introduction
Temporomandibular disorders is a collective term for a group of musculoskeletal conditions, involving pain and/or dysfunction in the masticatory muscles, temporomandibular joints, and associated structures. These symptoms include joint and muscle pain, restricted mandibular movements, and joint sounds.

Objective
To compare and evaluate different treatment modalities in patients with disc displacement with reduction (DDwR) using meta-analysis.

Material and methods
PubMed/Medline, Cochrane, Scopus, and Embase databases were explored for stu­dies from January 2011 to September 2024. A thorough search was carried out, and articles were screened for eligibility by two review-ers. Randomized controlled clinical trials were included, evaluating the efficacy of lasers, splint therapy, and ultrasounds compared with a controlled line of treatment and other conventional therapy, assessing out-comes in reduction of pain and maximum mouth opening. Where appropriate, a meta analysis was performed and standardized mean differences were calculated.

Results
Five out of 245 titles were found to meet the eligibility criteria. There was a substantial risk of bias across most domains, with high risk in selective reporting and incomplete outcome data. Through the pooled estimate, it was observed that laser was inferior to splints, with mean and standard deviation of [–0.37 (–0.88 to 0.14)], laser was inferior to ultrasound [–0.22 (–1.86 to 1.41)], and splints were inferior to ultrasound [–1.36 to 1.28)]. In terms of maximum mouth opening (MMO), laser was inferior to splints [0.47 (–0.86 to 0.08)], while ultra-sound showed greater MMO than splints [1.43 (–1.84 to 4.69)].

Conclusions
The findings of this study shed valuable light on the role of splints and ultrasound, particularly in terms of pain reduction and improvement in MMO, and suggest that splints and ultrasound both hold promise as viable therapeutic options for patients suffering from DDwR.