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Title Treating TMD Can Relieve Non-Otologic Otalgia
Clinical Question In an otherwise healthy patient, will providing TMD therapy, compared to no therapy, result in relief of non-otologic otalgia? (See Comments on the CAT below)
Clinical Bottom Line Patients seeking treatment for non-otologic otalgia may find relief from TMD therapy. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 11050868Wright/2000U.S. Air Force otologic patientsCase Series
Key resultsU.S. Air Force patients with complaints of tinnitus, dizziness, and/or nonotologic otalgia without known cause were treated with a dental orthotic and given TMD self-care instructions. Based on 3 and 6 month follow-up, the authors concluded that these patients may benefit from conservative, reversible TMD therapy.
#2) 18468271de FelĂ­cio/2008eight asymptomatic subjects and 20 subjects with articular TMDRandomized Controlled Trial
Key resultsSubjects were randomly assigned to control or orofacial myofunctional therapy (OMT) groups. The authors found that a reduction of otologic symptoms was seen only in the OMT group.
#3) 12222651 Kuttila/200236 subjectsRandomized Controlled trial
Key resultsSubjects were randomly assigned to stabilization splint or control splint groups. After 10 weeks, the results indicated that stabilization splint therapy resulted in reduction of secondary otalgia symptoms.
Evidence Search ("Temporomandibular Joint Disorders"[Mesh] AND "Earache"[Mesh]) AND "therapy "[Subheading]
Comments on
The Evidence
The study performed by Wright et. al., lacked randomization and control but the other two studies contained both these elements. All studies came to the same conclusion that treatment of TMD may help provide relief of ear pain. Although this evidence is not as strong as we would like, it is the best evidence currently available on the topic.
Applicability These results are clinically very applicable if the practitioner can identify the conditions in which otologic symptoms appear. These factors are dependent on age, specific otologic symptoms, duration, etc. If patients are correctly identified, it may be possible to treat their otologic symptoms with TMD therapy.
Specialty/Discipline (General Dentistry)
Keywords TMD, earache, non-otologic otalgia, TMD therapy, TMD symptoms
ID# 494
Date of submission: 01/13/2010spacer
Author Bahman Norouzinia
Co-author(s) Elizabeth Wallmann
Co-author(s) e-mail elizabeth.wallmann@gmail.com
Faculty mentor/Co-author Edward F. Wright, DDS, MS
Faculty mentor/Co-author e-mail WrightE2@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Travis McAlister (San Antonio, TX) on 04/09/2012
I conducted a PubMed search on this topic on April 9th 2012 and found that the publications listed in your CAT represent the best and most up to date evidence to answer your PICO question. Great job!

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