Comparative effectiveness of traditional East Asian medicine treatments for temporomandibular joint disorders: A systematic review and network meta-analysis

Background: Temporomandibular joint disorders (TMDs) cause pain and functional restrictions in the temporomandibular joint that interfere with daily activities. The aim of this study was to evaluate and compare the effectiveness and safety of various traditional East Asian medicine treatments, inclu...

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Main Authors: Seojung Ha, Sung-Woo Kang, Sanghoon Lee
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Integrative Medicine Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213422024000945
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author Seojung Ha
Sung-Woo Kang
Sanghoon Lee
author_facet Seojung Ha
Sung-Woo Kang
Sanghoon Lee
author_sort Seojung Ha
collection DOAJ
description Background: Temporomandibular joint disorders (TMDs) cause pain and functional restrictions in the temporomandibular joint that interfere with daily activities. The aim of this study was to evaluate and compare the effectiveness and safety of various traditional East Asian medicine treatments, including acupuncture, electroacupuncture, moxibustion, and herbal medicine, in the management of TMD. Methods: We included searches of MEDLINE, CENTRAL, EMBASE, AMED, CINAHL, OASIS, KISS, RISS, KMbase, KCI, CNKI, and CiNii from inception to November 12, 2023, for randomized controlled trials of traditional East Asian medicine treatments in patients with TMD. A network meta-analysis was performed via frequentist methods, and the confidence in network meta-analysis methodology was employed to assess evidence quality. Results: Forty-five studies with 2,211 participants were ultimately included. Compared with sham treatment, acupotomy (mean difference (MD) of -5.07, 95% confidence interval (CI) of -7.37 to -2.78) and acupuncture (MD of -1.18, 95% CI of -2.28 to -0.09) significantly improved pain intensity. According to the SUCRA rankings, acupotomy was considered the most effective treatment, followed by electroacupuncture, acupuncture, manipulation, laser therapy and occlusal splint. A total of 12 studies reported the incidence of adverse events, and none reported serious adverse events. Conclusions: Acupotomy and acupuncture could be more beneficial than sham treatment for pain relief and might be better options than occlusal splints. However, future rigorous, well-designed trials are needed to draw clear conclusions. Protocol registration: PROSPERO (CRD42023467340).
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spelling doaj-art-6b5edb99138442d1b6636c00c7d35efa2025-08-20T02:07:17ZengElsevierIntegrative Medicine Research2213-42202025-03-0114110111410.1016/j.imr.2024.101114Comparative effectiveness of traditional East Asian medicine treatments for temporomandibular joint disorders: A systematic review and network meta-analysisSeojung Ha0Sung-Woo Kang1Sanghoon Lee2Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Sangji University, Wonju, Republic of KoreaDepartment of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of KoreaDepartment of Medical Education, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea; WHO Collaborating Center for Traditional Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Republic of Korea; Corresponding author at: Department of Medical Education, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea.Background: Temporomandibular joint disorders (TMDs) cause pain and functional restrictions in the temporomandibular joint that interfere with daily activities. The aim of this study was to evaluate and compare the effectiveness and safety of various traditional East Asian medicine treatments, including acupuncture, electroacupuncture, moxibustion, and herbal medicine, in the management of TMD. Methods: We included searches of MEDLINE, CENTRAL, EMBASE, AMED, CINAHL, OASIS, KISS, RISS, KMbase, KCI, CNKI, and CiNii from inception to November 12, 2023, for randomized controlled trials of traditional East Asian medicine treatments in patients with TMD. A network meta-analysis was performed via frequentist methods, and the confidence in network meta-analysis methodology was employed to assess evidence quality. Results: Forty-five studies with 2,211 participants were ultimately included. Compared with sham treatment, acupotomy (mean difference (MD) of -5.07, 95% confidence interval (CI) of -7.37 to -2.78) and acupuncture (MD of -1.18, 95% CI of -2.28 to -0.09) significantly improved pain intensity. According to the SUCRA rankings, acupotomy was considered the most effective treatment, followed by electroacupuncture, acupuncture, manipulation, laser therapy and occlusal splint. A total of 12 studies reported the incidence of adverse events, and none reported serious adverse events. Conclusions: Acupotomy and acupuncture could be more beneficial than sham treatment for pain relief and might be better options than occlusal splints. However, future rigorous, well-designed trials are needed to draw clear conclusions. Protocol registration: PROSPERO (CRD42023467340).http://www.sciencedirect.com/science/article/pii/S2213422024000945Temporomandibular joint disordersTraditional East Asian medicineAcupunctureSystematic reviewNetwork meta-analysis
spellingShingle Seojung Ha
Sung-Woo Kang
Sanghoon Lee
Comparative effectiveness of traditional East Asian medicine treatments for temporomandibular joint disorders: A systematic review and network meta-analysis
Integrative Medicine Research
Temporomandibular joint disorders
Traditional East Asian medicine
Acupuncture
Systematic review
Network meta-analysis
title Comparative effectiveness of traditional East Asian medicine treatments for temporomandibular joint disorders: A systematic review and network meta-analysis
title_full Comparative effectiveness of traditional East Asian medicine treatments for temporomandibular joint disorders: A systematic review and network meta-analysis
title_fullStr Comparative effectiveness of traditional East Asian medicine treatments for temporomandibular joint disorders: A systematic review and network meta-analysis
title_full_unstemmed Comparative effectiveness of traditional East Asian medicine treatments for temporomandibular joint disorders: A systematic review and network meta-analysis
title_short Comparative effectiveness of traditional East Asian medicine treatments for temporomandibular joint disorders: A systematic review and network meta-analysis
title_sort comparative effectiveness of traditional east asian medicine treatments for temporomandibular joint disorders a systematic review and network meta analysis
topic Temporomandibular joint disorders
Traditional East Asian medicine
Acupuncture
Systematic review
Network meta-analysis
url http://www.sciencedirect.com/science/article/pii/S2213422024000945
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AT sungwookang comparativeeffectivenessoftraditionaleastasianmedicinetreatmentsfortemporomandibularjointdisordersasystematicreviewandnetworkmetaanalysis
AT sanghoonlee comparativeeffectivenessoftraditionaleastasianmedicinetreatmentsfortemporomandibularjointdisordersasystematicreviewandnetworkmetaanalysis