Oral and maxillofacial radiology
The efficacy of anticonvulsants on orofacial pain: a systematic review

https://doi.org/10.1016/j.tripleo.2011.01.033Get rights and content

Objective

Controversy exists about the effectiveness of anticonvulsants for the management of orofacial pain disorders. To ascertain appropriate therapies, a systematic review was conducted of existing randomized controlled trials.

Study design

Trials were identified from PubMed, Cochrane, and Ovid Medline databases from 1962 through March 2010, from references in retrieved reports, and from references in review articles. Eight useful trials were identified for this review. Six studies were randomized placebo-controlled trials and 2 studies were randomized active-controlled. Two independent investigators reviewed these articles by using a 15-item checklist.

Results

Four studies were classified as “high quality.” However, heterogeneity of the trials and the small sample sizes precluded the drawing of firm conclusions about the efficacy of the interventions studied on orofacial pain patients.

Conclusions

There is limited to moderate evidence supporting the efficacy of commonly used anticonvulsants for treatment of patients with orofacial pain disorders. More randomized controlled trials are needed on the efficacy of anticonvulsants.

Section snippets

Selection of studies

A computer-assisted search of the Cochrane, PubMed, and Ovid Medline database from 1966 through March 2010 was conducted, using the key words “orofacial pain,” “oral pain,” “facial pain,” “neuralgia,” “trigeminal neuralgia,” “tendomandibular dysfunction,” “burning mouth syndrome,” “odontalgia,” “(post) herpetic neuralgia,” “stomatodynia,” “atypical facial pain,” “cancer facial pain” in combination with “anticon*” and “(facial) pain.” The following limits were applied. Type of article:

Results

The search resulted in 16 RCTs with a variety of diagnoses, including neuropathic pain, such as refractory trigeminal neuralgia, neuropathic cancer pain, and postherpetic neuralgia, chronic masticatory myalgia, stomatodynia, traumatic nerve injury pain, and glossopharyngeal neuralgia.10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 In 8 studies the patient population consisted not only of patients with orofacial pain but also patients with other pain disorders.10, 11, 12, 13, 14,

Discussion

The present study was designed to provide information on the use of anticonvulsants in orofacial pain disorders.

Generally, the value of a review of the literature depends on the success on obtaining the results of all studies that have been conducted on the subject at issue. Reviews are subject to bias caused by the outcomes of published and unpublished studies differing (publication bias). Although much effort was put into obtaining all available studies, some important published and

References (26)

Cited by (0)

View full text