Efficacy of different treatments for burning mouth syndrome: network meta-analysis using minimally contextualized approa

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Objective: This systematic review of randomized con trolled trials (RCTs) aimed to assess the effectiveness of treat ments to relieve pain caused by burning mouth syndrome (BMS). Study Design: five databases and grey literature were searched, and the reference lists of included studies were manu ally searched. Independent reviewers selected studies, extracted data, and assessed risk of bias (RoB 2.0). The main outcome was pain relief. For the network meta-analysis (NMA), four compara ble interventions were grouped into different geometries to ensure the transitivity assumption: laser, alpha lipoic acid (ALA), phytotherapics, and anxiolytics/antidepressants. The certainty of evidence was assessed using the GRADE approach for NMA with GRADE minimally contextualized framework. Results: The anxiolytic medicine (clonazepam) likely reduces pain caused by BMS when compared to placebo (MD: -1.97; 95% CI: -2.31; -1.64; moderate certainty). Although laser, ALA, and phytoterapics proved to be better when compared to placebos, the certainty was low or very low. Conclusion: among all tested treatments, only clonaze pan is likely to reduce pain caused by BMS when compared to placebos. Most other treatments had low and very low certainty, mainly due to imprecision and indirectness. More RCTs compar ing treatments against placebo are encouraged to confirm the evidence.

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Clonazepam, Anti-anxiety agents, Phytotherapeutic drugs, Network meta-analysis, Antidepressive agents, Systematic review

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https://www.sciencedirect.com/science/article/pii/S2212440323001980

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