Evidence map›Paper›PMID 40495521›Full record

SynthesisPain management2025

Efficacy of intra-articular opioid injections for managing temporomandibular joint nociception: a systematic review.

Madhuli Bhide, P Emile Rossouw, Fawad Javed

Abstract readSystematic Review
In one paragraph

Synthesis in Pain management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Madhuli BhideDepartment of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.ORCID 0009-0007-7735-106X
P Emile RossouwDepartment of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.ORCID 0000-0002-2518-2766
Fawad JavedDepartment of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.ORCID 0000-0002-9253-1989

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThis systematic review evaluated randomized controlled trials (RCTs) investigating the effectiveness of intra-articular opioid injections for managing temporomandibular joint (TMJ) pain.

methodsA comprehensive search of indexed databases and Google Scholar was conducted following PRISMA guidelines. Included studies assessed self-reported TMJ pain and maximum mouth opening (MMO) as primary and secondary outcomes, respectively. Risk of bias (RoB) was evaluated using the Cochrane tool, and evidence certainty was rated using the GRADE framework.

resultsTen RCTs met the inclusion criteria, with follow-up periods ranging from 30 minutes to 6 months. Six trials demonstrated significant pain reduction after opioid injections, while one reported no difference following morphine use. Another study found mepivacaine more effective than morphine or saline. Regarding MMO, one trial showed no effect of morphine, whereas two trials found that 1 mg morphine or 1 ml buprenorphine led to greater improvements than 0.1 mg morphine. In three trials, opioids enhanced MMO more than sodium hyaluronate. All studies exhibited low RoB. Certainty of evidence was moderate in six RCTs and low in three.

conclusionThere is no credible evidence for the benefit of intra-articular opioid-injections for managing TMJ nociception. PROTOCOL REGISTRATION: www.crd.tork.ac.uk/prospero identified is CRD42024598035.

Indexed as

Analgesics, OpioidNociceptionTemporomandibular Joint DisordersHumansInjections, Intra-ArticularRandomized Controlled Trials as TopicTemporomandibular JointAnalgesics, Opioidand opioidsintra-articularmorphinenociceptionpainTemporomandibular joint

Identifiers

PMID40495521
PMCPMC12218567

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.