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Diverse therapies for disc displacement of temporomandibular joint: A systematic review and network meta-analysis

      Abstract

      The aim of this systematic review and network meta-analysis was to comprehensively evaluate and compare the effectiveness of diverse therapies for disc displacement of temporomandibular joint. An electronic search of PubMed, Embase, the Cochrane Library, CNKI and Wanfang databases was performed to identify relevant studies available up to July 31, 2021. Study selection, data extraction and quality assessment were performed for all included studies, while the outcomes of interest contained post-therapeutic maximum mouth opening and pain intensity. Interventions consisted of arthrocentesis, injections with diverse drugs, occlusal splints or combination of two to three therapies above. Controls were regarded as oral analgesic, self-exercise, massage or health instruction. Twenty-six studies appeared to meet the inclusion criteria and were subjected to further examination. Our data of the entire network demonstrated that most invasive therapies performed better than noninvasive therapies, while arthrocentesis + platelet-rich plasma injection and platelet-rich plasma injection in Grade I performed excellent in both mouth opening improvement and pain alleviation. Platelet-rich plasma injection is probably the overall best treatment for patients with DD owing to its anti-inflammatory, analgesic and lubrication effects.

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