Research Waste in Temporomandibular Disorders Among Registered Randomised Controlled Trials: A Meta-Epidemiologic Study.

BACKGROUND

Temporomandibular disorders (TMDs) are multifactorial conditions with diverse clinical presentations, making standardised treatment approaches difficult to establish. Despite an increasing number of randomised controlled trials (RCTs) globally, methodological inconsistencies and research waste remain significant obstacles to evidence integration.

OBJECTIVE

This study systematically analysed 103 TMDs-related RCTs registered on ClinicalTrials.gov (2005-2025) to identify contributors to research waste and propose mitigation strategies.

METHODS

The analysis covered trial characteristics, publication status, adherence to CONSORT guidelines, and Cochrane risk-of-bias assessments. Statistical analyses included chi-square or Fisher's exact tests and logistic regression.

RESULTS

There was a clear upward trend in RCT registrations and subsequent publications. The majority focused on pain-related TMDs (85.52%) and non-invasive interventions (85.44%). However, 31.07% of pain-related TMDs trials lacked clear subdiagnosis. Published trials and those without design flaws were more likely to include invasive interventions (p = 0.001) and open-label designs (p = 0.015). Pharmacological and larger sample sizes, multi-arm designs, and open-label protocols were identified as potential contributors to research waste.

CONCLUSION

Future research should emphasise clinician training in TMDs subdiagnosis and adopt feasibility-driven trial designs, including comprehensive assessments of recruitment capacity and intervention feasibility. Addressing these factors may optimise RCTs quality and reduce research waste.