The Agency for Healthcare Research and Quality (AHRQ) contracted with The Lewin Group to conduct a study of the per-patient cost and efficacy/effectiveness of treatment for TMJ.
This study was carried out at the request of the Senate Appropriations Committee to further clarify the TMJ issue and to follow-up on relevant developments since the 1996 NIH Technology Assessment Conference.
The report prepared by the Lewin Group, April 30, 2001, confirms certain findings of the 1996 NIH Technology Assessment Conference and of certain other reviews of this subject. Their findings reinforce previous conclusions that few randomized clinical trials or other types of rigorous studies exist for determining the effectiveness of treatments for TMJ.
Published reports of clinical research on TMJ consist primarily of non-randomized uncontrolled trials, case series, case reports, and anecdotal descriptions of treatment techniques. Among the factors affecting the body of evidence on TMJ treatments are insufficient understanding or consensus regarding the etiology, course of disease, and diagnosis of TMJ. This report is available below:
Another study, conducted by the Emergency Care Research Institute (ECRI), a nonprofit Pennsylvania organization, found that most treatments for TMJ disorders lack sound research support for the surgeries, injections, splints, and other procedures for joint problems which TMJ patients undergo each year.
“The available evidence suggests that approximately half of the patients who initially develop TMD symptoms will experience significant improvement or spontaneous resolution of their symptoms within a period of weeks or months,” ECRI researchers concluded. “Although noninvasive procedures may provide an additional benefit for some patients, the evidence of benefit for splint therapy is weak.” The institute, formerly an emergency medicine research agency, has since the 1970s served as an independent organization committed to advancing the quality of health care.
The ECRI study found these conclusions:
The ECRI Technology Assessment Report “Temporomandibular Articular Disorders: Selected Treatments” is available for purchase from ECRI at 5200 Butler Pike, Plymouth Meeting, PA 19462-1298. Telephone: (610) 825-6000. Unfortunately the ECRI report is very costly to obtain, costing several thousands of dollars.