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Efficacy of Occlusal Splints in Managing Temporomandibular Disorders


Affiliations
1 Prosthodontics and Crown and Bridge, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS,Kochi, 682041, India
2 Department of Public Health Dentistry, India
3 Oral & Maxillofacial Surgery, India
4 Amrita School of Dentistry Amrita Vishwa Vidyapeetham AIMS, Kochi, India
     

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Objective: To compare the efficiency of Occlusal Splints, with placebo treatment with Stabilization splints (SS) or no treatment, for reduction in pain, in adults with TMD.

Method: This systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and the patient, intervention, comparison, outcomes (PICO). It was limited to randomized controlled trials (RCTs) with randomization at individual level. Included studies were those with participants who were adults >18 years. The intervention group consisted of subjects using stabilization splints or, a modified stabilization splint or, a combination of splint. The control group may be using the non-stabilization splints or placebos. We performed an evaluation of the heterogeneity of the data using Cochran’s Q statistic, a chi-square test, with a threshold p-value of less than 0.10 (Huedo-Medina et al. 2006 Jun 1). The consistency of the results was assessed visually using forest plots and by the I2 statistic. The I2 statistic describes the proportion of variation in point estimates attributable to heterogeneity as compared to sampling error.

Results: The 23 RCTs comprised of 1,512 patients. Overall in 5 pooled studies involving 381 adults participants in control group were more likely to experience a reduction in TMD signs and symptoms compared to those using stabilization splints [SMD 16.16, 95% CI (16.08 to 16.23)],but there was heterogeneity among studies (100%). The results did not favor stabilization splints when compared to control group.

Conclusion: All trials individually reported positive results on reducing TMD signs and symptoms for both stabilisation splints and control groups, with stabilisation splint being more effective. But there was no significant difference in the meta-analysis of pooled estimates.


Keywords

Temporomandibular Disorders, Pain, Splints.
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  • Efficacy of Occlusal Splints in Managing Temporomandibular Disorders

Abstract Views: 279  |  PDF Views: 0

Authors

S. K. Saranya
Prosthodontics and Crown and Bridge, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS,Kochi, 682041, India
Chandrashekar Janakiram
Department of Public Health Dentistry, India
Anil Mathew
Prosthodontics and Crown and Bridge, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, AIMS,Kochi, 682041, India
Pramod Subash
Oral & Maxillofacial Surgery, India
Priya K. Nair
Amrita School of Dentistry Amrita Vishwa Vidyapeetham AIMS, Kochi, India

Abstract


Objective: To compare the efficiency of Occlusal Splints, with placebo treatment with Stabilization splints (SS) or no treatment, for reduction in pain, in adults with TMD.

Method: This systematic review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement and the patient, intervention, comparison, outcomes (PICO). It was limited to randomized controlled trials (RCTs) with randomization at individual level. Included studies were those with participants who were adults >18 years. The intervention group consisted of subjects using stabilization splints or, a modified stabilization splint or, a combination of splint. The control group may be using the non-stabilization splints or placebos. We performed an evaluation of the heterogeneity of the data using Cochran’s Q statistic, a chi-square test, with a threshold p-value of less than 0.10 (Huedo-Medina et al. 2006 Jun 1). The consistency of the results was assessed visually using forest plots and by the I2 statistic. The I2 statistic describes the proportion of variation in point estimates attributable to heterogeneity as compared to sampling error.

Results: The 23 RCTs comprised of 1,512 patients. Overall in 5 pooled studies involving 381 adults participants in control group were more likely to experience a reduction in TMD signs and symptoms compared to those using stabilization splints [SMD 16.16, 95% CI (16.08 to 16.23)],but there was heterogeneity among studies (100%). The results did not favor stabilization splints when compared to control group.

Conclusion: All trials individually reported positive results on reducing TMD signs and symptoms for both stabilisation splints and control groups, with stabilisation splint being more effective. But there was no significant difference in the meta-analysis of pooled estimates.


Keywords


Temporomandibular Disorders, Pain, Splints.



DOI: https://doi.org/10.37506/v10%2Fi12%2F2019%2Fijphrd%2F191997