Authors: Boujoual, Wahid OH, AL Jalil Z, Aazazi C, Andoh A, Moussaoui H.
Introduction: Temporomandibular joint disorder is a benign pathology, with polymorphic expression and subject to multiple factors that contribute to its etiology, which makes a diagnosis of certainty difficult. Wide ranges of therapeutic options are available, including orthoses, physiotherapy, pharmacotherapy (analgesics, muscle relaxants, anxiolytics, antidepressants, etc.)
Objective: The aim of our work is to conduct a systematic review evaluating the clinical efficacy of anxiolytics and antidepressants in the treatment of temporomandibular disorders in the light of Evidence Based Dentistry.
Methods: The collection of data from the scientific literature was carried out among the production that appeared during the period from 2000 to 2023. The literature search was carried out by exploiting databases accessible via the Internet, namely: Medline through its search engine Pubmed, Elsevier, Google scholar, Research for life and Web of science. A bottom-up manual search covering the same study period was carried out in order to expand our bibliography. The writing of this systematic review followed the guidelines of PRISMA Statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
Results: 11 relevant articles were retained after critical reading guided by CASP-type reading grids. Then, the articles were classified in 3 categories; Administration of anxiolytics and antidepressants alone or in association with cognitive-behavioral therapy or in association with the wearing of occlusal trays, and classified in tables according to the PICO criteria (Participants/Interventions/ Comparison/ Results "Outcomes").The results of our study show a significant decrease in the intensity of pain and depression as well as an improvement in the quality of life and sleep in patients treated with anxiolytics and antidepressants.
Discussion: The results of our studies concerning the efficacy of anxiolytics and antidepressants in temporomandibular disorders are corroborated by other systematic reviews and meta-analyses. However, the conduct of new research with a longer observation period, a large sample size and following a correct methodology remains necessary.
Conclusion: The lack of valid evidence evaluating the efficacy of anxiolytics and antidepressants in the treatment of AMD is disproportionate to the importance of the psychological dimension in the management of these disorders.