Biofeedback, Acupuncture and Transcutaneous Electric Nerve Stimulation in the Management of Temperomandibular Disorders: A Systematic Review

Abstract

The aim of this systematic review was to assess the efficacy of biofeedback, acupuncture and transcutaneous electric nerve stimulation in the management of temporomandibular disorders. Articles evaluating the efficacy of biofeedback, acupuncture and transcutaneous electric nerve stimulation in temporomandibular disorders were obtained from the databases Medline, Cinahl, Embase, PsycINFO and Cochrane Controlled Trials register up to May 2002. Seven controlled clinical trials met the criteria for inclusion. The patients included in the studies ranged from 19–100. Three studies assessed the efficacy of biofeedback, three studies assessed the efficacy of acupuncture and one study assessed the efficacy of transcutaneous electric nerve stimulation. A criteria list was used to assess the internal validity of these studies. The studies were considered to be of high quality if at least five of the ten criteria were fulfilled and otherwise were considered to be low quality. The results of the studies were considered positive, negative or indifferent based on the statistical significance of between-group differences. None of the seven studies were of high quality. An analysis of the degree of evidence of the results revealed no evidence for the efficacy of biofeedback, acupuncture or transcutaneous electric nerve stimulation in the management of temporomandibular disorders.