Topical nonsteroidal anti-inflammatory medications for treatment of temporomandibular joint degenerative pain: a systematic review

To evaluate the efficacy of topical nonsteroidal anti-inflammatory drugs (NSAID) to relieve temporomandibular joint (TMJ) degenerative joint disease (DJD) pain. A search of the literature was made using electronic databases complemented with a manual search. Clinical trials comparing topical NSAID with either placebo or an alternative active treatment to treat TMJ DJD pain were identified. Outcomes evaluated were pain reduction/pain control and/or incidence of side effects. A single study (double-blind randomized placebo-controlled trial) with 20 patients was identified that evaluated the efficacy of a topically prepared NSAID over a 12-week duration, measuring functional pain intensity, voluntary and assisted mouth opening, pain disability index, and a brief pain inventory analysis. This study revealed a pain intensity decrease within treatment groups but no significant difference between treatment groups. Presently, there is insufficient evidence to support the use of topically applied NSAID medications to palliate TMJ DJD pain.