ArticleActa stomatologica Croatica2026
Pharmacological Interventions in the Management of Temporomandibular Disorders: A Systematic Review and Meta-analysis.
Article in Acta stomatologica Croatica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Temporomandibular Disorders (TMDs) encompass a set of conditions affecting the masticatory muscles and the temporomandibular joint (TMJ), with an impact on both functionality and individuals' quality of life. Myalgia is a diagnosis of TMD with multifactorial etiology, and treatment strategies aim primarily to relieve pain and restore function. Pharmacological therapy is commonly considered a second-line option, thus complementing conservative measures. Objectives: Assess the efficacy of pharmacological interventions in the management of myalgia associated with temporomandibular disorders, in adolescents and adults, while exploring differential effects across TMD subtypes through subgroup analyses, using a systematic review and meta-analysis of randomized controlled trials (RCTs). Materials and Methods: A systematic review with meta-analysis was conducted in accordance with the Results and Discussion: A total of 1,128 participants were analyzed across 25 treatment arms. Pharmacological interventions were associated with a significant reduction in pain (SMD = -0.68; 95% CI: -1.09 to -0.26; p < 0.001) and an improvement in MIO (SMD = 0.51; 95% CI: 0.20 to 0.82; p < 0.001). Subgroup analyses indicated that interventions were more consistent and effective in arthralgia-only populations, showing lower heterogeneity and a more predictable therapeutic response, whereas myalgia-only populations exhibited smaller and less consistent benefits. Conservative therapies demonstrated a consistent advantage, thus aligning with international recommendations that prioritize such approaches. Subgroup analyses demonstrated more consistent and homogeneous effects in arthralgia-dominant populations, whereas myalgia-only studies showed greater heterogeneity and less predictable responses. Conclusion: Pharmacological therapy provides a moderate overall beneficial effect in reducing pain and improving mandibular function in TMD, with stronger and more consistent evidence in arthralgia-dominant populations, while myalgia-related outcomes remain more variable, thus indicating the need for tailored treatment strategies. Further high-quality RCTs with standardized protocols are needed.
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