Indian Journal of Public Health Research & Development

S. K. Saranya ¹, Chandrashekar Janakiram ², Anil Mathew ¹, Pramod Subash ³, Priya K. Nair ⁴

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

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.

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Ipe Sabu ¹, S. K. Saranya ¹, Anil Mathew ¹, Pramod Subash ², Chandrashekar Janakiram ³

Affiliations
1 Department of Prosthodontics and Crown and Bridge, PSM College of Dental Sciences and Research, Thrissur, Kerala, IN
2 Oral & Maxillofacial Surgery, IN
3 Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ponekkara, Kochi, Kerala, IN

Abstract

The purpose of this randomized control trial was to compare the efficacy of splints fabricated in maximum intercuspation position and bite plane induced occlusal position with splints fabricated in centric relation (control group) in the treatment of temporomandibular disorders. 30 patients with Temporomandibular disorder (TMD), were randomized into three groups by computer generated random sequence. Thus, 10 patients were allocated to any of the three groups–Splints fabricated in biteplate induced occlusal position, splints fabricated in maximum intercuspation and splints fabricated in centric relation. The variables-pain, head position and amplitude of mandibular movements were measured before insertion of splints and later after one week, one month and three months of treatment. There was statistically significant reduction in pain (p<0.05) after three months of treatment, statistically significant improvement in maximum mouth opening and head position within the three splint groups. The splints fabricated in three different mandibular positions were equally effective in reducing the symptoms in temporomandibular disorder patients.

Keywords

Temporomandibular Disorder, Occlusal Splints, Centric Relation, Maximum Intercuspation.

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