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Length of Study
Since TMD is a chronic
pain condition, designing an RCT to assess the outcome of the
interventions for 3 months or less is not meaningful. Longitudinal
studies show TMD is commonly a fluctuating condition, characterized
by intermittent periods of relief and temporary success from a
wide variety of treatments (Ohrbach
and Dworkin, 1998). With this clinical course and natural
history in mind, it becomes clear that it is essential that changes
in clinical status be evaluated not only right after treatment
has been completed but also for some time longer.
A minimal follow up
period of one year is recommended for RCTs evaluating TMD clinical
interventions. However, less than 25% of the 22 published RCTs
on occlusal splints reported their findings beyond three months.
Practical obstacles to longer trials include dealing with the
problem of loss to follow up; yet planning on how to cope with
these hurdles is advised, rather than conducting a short trial
with low loss to follow up that may not offer much useful information
for this long-standing condition.
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