Efficacy Of Occlusal Splints In The Treatment Of Temporomandibular Disorders

Objective:This systematic review and meta-analysis aimed to assess the efficacy of occlusal splints in the treatment of temporomandibular disorders(TMD).Methods:This systematic review and meta-analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis(PRISMA)guidelines.Four databases(Medline via Pubmed,Web of Science,Embase and Scopus)were searched,the last search was conducted on February 2021.Randomised controlled trials(RCT)employing the Diagnostic Criteria for Temporomandibular Disorders(DC/TMD)or Research Diagnostic Criteria for Temporomandibular Disorders(RDC/TMD)as diagnostic criteria and including occlusal splint as one of the experimental groups were included in the present study.The data from the included studies were extracted,assessed for risk of bias and meta-analysis.Results:Eleven studies were included.The sample size ranged from 12 to 96subjects.The male to female ratio was 0 to 25%.The mean length of follow-up was4 months(range,1 week–12 months).Qualitative analysis shows that occlusal splint had a positive effect on mandibular movements in all included studies.Seven studies showed a positive effect of occlusal splint on chronic pain reduction and pain intensity,while two others showed improvement of temporomandibular joint clicking sounds and locking of the jaws.Moreover,improvements in mouth opening,depression,and anxiety symptoms,were reported in four studies.Quantitative analysis(meta-analysis)shows that there were no statistically significant differences in pain relief between occlusal splints grous and education group[SMD:-1.70,95%CI(-4.06,0.66),P=0.16,I~2=97%],and there were no statistically significant differences in pain relief and emotion improvement between occlusal splints grous and manual therapy group[SMD:-0.07,95%CI(-0.52,0.37),P=0.75,I~2=0%][SMD:-0.28,95%CI(-0.71,0.16),P=0.22,I~2=0%].Conclusions:An occlusal splint can be considered as a non-invasive treatment approach for patients with TMD,especially those with signs and symptoms of restriction of mandibular movement and pain.Moreover,the present findings highlighted an urgent need of a standardised consensus regarding the prognostic evaluation of TMD.