The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache - Where do we stand? A qualitative systematic review of the literature

ABSTRACT: BACKGROUND: The NTI-tss device is an anterior bite stop, which, according to the manufacturer, is indicated for the prevention and treatment of bruxism, temporomandibular disorders (TMDs), tension-type headaches, and migraine. The aim of this systematic review was to appraise the currently available evidence regarding the efficacy and safety of the NTI-tss splint. METHODS: We performed a systematic search in nine electronic databases and in NTI-tss-associated websites (last update: December 31, 2007). The reference lists of all relevant articles were perused. Five levels of scientific quality were distinguished. Reporting quality of articles about randomized controlled trials (RCTs) was evaluated using the Jadad score. To identify adverse events, we searched in the identified publications and in the MAUDE database. RESULTS: Nine of 68 relevant publications reported about the results of five different RCTs. Two RCTs concentrated on electromyographic (EMG) investigations in patients with TMDs and concomitant bruxism (Baad-Hansen et al 2007, Jadad score: 4) or with bruxism alone (Kavakli 2006, Jadad score: 2); in both studies, compared to an occlusal stabilization splint the NTI-tss device showed significant reduction of EMG activity. Two RCTs focused exclusively on TMD patients; in one trial (Magnusson et al 2004, Jadad score: 3), a stabilization appliance led to greater improvement than an NTI-tss device, while in the other study (Jokstad et al 2005, Jadad score: 5) no difference was found. In one RCT (Shankland 2002, Jadad score: 1), patients with tension-type headache or migraine responded more favorably to the NTI-tss splint than to a bleaching tray. NTI-tss-induced complications related predominantly to single teeth or to the occlusion. CONCLUSION: Evidence from RCTs suggests that the NTI-tss device may be successfully used for the management of bruxism and TMDs. However, to avoid potential unwanted effects, it should be chosen only if certain a patient will be compliant with follow-up appointments. The NTI-tss bite splint may be justified when a reduction of jaw closer muscle activity (e.g., jaw clenching or tooth grinding) is desired, or as an emergency device in patients with acute temporomandibular pain and, possibly, restricted jaw opening

The prevalence of and factors associated with inclusion of non-English language studies in Campbell systematic reviews:a survey and meta-epidemiological study

BACKGROUND: Studies published in languages other than English are often neglected when research teams conduct systematic reviews. Literature on how to deal with non-English studies when conducting reviews have focused on the importance of including such studies, while less attention has been paid to the practical challenges of locating and assessing relevant non-English studies. We investigated the factors which might predict the inclusion of non-English studies in systematic reviews in the social sciences, to better understand how, when and why these are included/excluded.METHODS: We appraised all Campbell Collaboration systematic reviews (n = 123) published to July 2016, categorising each by its language inclusiveness. We sought additional information from review authors via a questionnaire and received responses concerning 47 reviews. Data were obtained for 17 factors and we explored correlations with the number of non-English studies in the reviews via statistical regression models. Additionally, we asked authors to identify factors that support or hinder the inclusion of non-English studies.RESULTS: Of 123 reviews, 108 did not explicitly exclude, and of these, 17 included non-English language studies. One factor correlated with the number of included non-English studies across all models: the number of countries in which the members of the review team work (B-value = 0.56; SE B = 0.24; 95% CI = 0.07-1.03; p = 0.02). This indicates that reviews which included non-English studies were more likely to be produced by international review teams. Our survey showed a dominance of researchers from English-speaking countries (52.9%) and review teams consisting only of team members from these countries (65.9%). The most frequently mentioned challenge to including non-English studies was a lack of resources (funding and time) followed by a lack of language resources (e.g. professional translators).CONCLUSION: Our findings may indicate a connection between the limited inclusion of non-English studies and a lack of resources, which forces review teams to rely on their limited language skills rather than the support of professional translators. If unaddressed, review teams risk ignoring key data and introduce bias in otherwise high-quality reviews. However, the validity and interpretation of our findings should be further assessed if we are to tackle the challenges of dealing with non-English studies.</p

Zum Zusammenhang zwischen Myoarthropathien des Kausystems und Ohrenbeschwerden (Otalgie, Tinnitus)

In der (zahn)medizinischen Literatur wird seit langem über einen möglichen Zusammenhang zwischen Myoarthropathien (MAP) des Kausystems und Otalgien bzw. Tinnitus gemutmaßt. Ziel dieses Beitrags ist es, den aktuellen Stand zu dieser Frage darzustellen. Eine Analyse relevanter, zwischen 1947 und 1996 veröffentlichter Studien zeigt, daß in dem überwiegenden Teil der Untersuchungen von einer relativ hohen Prävalenz von Ohrenschmerzen bzw. Ohrgeräuschen bei MAP-Patienten berichtet wurde. Eine kausale Beziehung konnte bislang allerdings nicht hergestellt werden. Auch bleiben Erklärungsversuche, die das gleichzeitige Auftreten von MAP- und Ohrsymptomen, vor allem Ohrgeräuschen, auf eine gemeinsame Ursache zurückführen, spekulativ. Zu berücksichtigen ist, daß ein zufälliges Zusammentreffen von MAP- und auralen Symptomen aufgrund ihrer weiten Verbreitung möglich ist. Ein methodischer Schwachpunkt der meisten Studien besteht in der Nichtberücksichtigung von Vergleichsgruppen. Behauptungen zur Wirksamkeit bestimmter zahnärztlicher Maßnahmen für die Behandlung von Otalgien und Tinnitus bei MAP-Patienten finden angesichts fehlender prospektiver, kontrollierter und randomisierter Untersuchungen bislang wenig Unterstützung. Speculations concerning a possible association between temporomandibular disorders (TMDs) and ear symptoms of otalgia and tinnitus have been made in the dental and medical literature for a long time. Current understanding of this association is reviewed. An analysis of relevant studies published between 1947 and 1996 shows that a relatively high percentage of TMD patients reported the presence of ear pain and noise. However, a cause-effect relationship has not been established to date. Theories that try to explain the concurrence of TMD symptoms and ear symptoms (particularly tinnitus) by a common underlying cause remain speculative. It has to be taken into consideration that due to their high prevalence, TMDs and ear symptoms in a given patient may be present by chance alone. A methodological weakness of most of the studies available is the fact that control groups were not considered. Owing to the lack of prospective, controlled, and randomized studies, statements regarding the effectiveness of certain dental measures for the treatment of otalgia and tinnitus in TMD patients are not well supported.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41873/1/106-46-4-303_80460303.pd

Greater disability with increased pain involvement, pain intensity and depressive preoccupation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90117/1/S1090-3801_97_90036-7.pd