Authors: Michaela Simone Aeschlimann, Silvano Martino Del-Prete
Supervisor: PD Dr. med. Dr. iur. Antoine Roggo
Title: Can an osteopathic treatment affect symptoms of pain in adults with craniomandibular dysfunction?
Authors: Michaela Simone Aeschlimann / Silvano Martino Del-Prete
Research design: Systematic literature review
Background: Craniomandibular dysfunction (CMD) denotes a wide range of symptoms with as yet largely unclear underlying cause. In Germany, there are about 7 million individuals suffering from CMD, and an estimated 30 million people in the Western world. So far, an effective standard therapy is lacking.
Objectives: To scrutinize whether an osteopathic treatment can affect symptoms of pain in adult patients suffering from CMD, and if possible, to pool the results of different trials in a qualitative and/or quantitative – manner. Methodology: Randomised and non-randomised intervention studies were considered without limitation in terms of publication date or language. Medical data bases MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials as well as two major osteopathic databases (the Osteopathic Research Web and OSTMED.DR) were electronically accessed and searched. Additionally, several schools and professional associations in the field of osteopathy were approached for material on CMD. Finally, a handsearch of two osteopathic journals was undertaken. All publications included in this review were tested for internal validity by means of the PEDro scale, the “Cochrane risk of bias tool” and the „Original quality Items” scale provided by the Cochrane Back Review Group.
Results: A total number of five studies qualified for this review. Four of them reported a more pronounced decrease in pain intensity in the osteopathic treatment groups compared to controls on a visual analogue scale.
Conclusions: Small sample sizes and a considerable heterogeneity concerning duration of studies and the osteopathic approach preclude as yet reliable conclusions as well as quantitative pooling in a meta-analysis. The results of this study may, however, serve as a helpful basis and scientific motivation for larger, high quality trials into the subject focusing on test-dependent osteopathic treatments resembling the osteopathic real life situation.
Keywords: Craniomandibular dysfunction, temporomandibular joint dysfunction syndrome, pain, systematic literature review, osteopathic treatment