IADR Abstract Archives
Oral Splints For TMD Or Bruxism: A Systematic Review
Objectives: To evaluate the clinical effectiveness of splints for patients with TMD or bruxism.
Methods: Four databases including MEDLINE and EMBASE were searched until 1 October 2018 for randomised clinical trials. Cochrane review methods were used for the systematic review. Standardised mean differences (SMD) were pooled for the primary outcome pain, using random effects models in TMD patients.
Results: Fifty-two trials were included in the systematic review. The evidence identified was of very low quality with unclear reporting by TMD sub-type. When all sub-types of TMD were pooled into one global TMD group there was no evidence to suggest that splints reduced pain for this global group (SMD (up to 3 months) -0.18 (95% CI -0.42 to 0.06); substantial heterogeneity). There was also no evidence that other outcomes including TMJ noises, decreased mouth opening, quality of life, and headaches were improved by the use of splints. Adverse events were generally not reported, but seemed infrequent when reported.
There was a large variation in the diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these limitations did not indicate a reduction in pain.
There were no studies measuring tooth wear in patients with bruxism. One small study looked at pain and found a reduction in the splint group, mean difference (on 0 to 10 Numerical Rating Scale) -2.01 (95%CI -1.40 to -2.62; very low-quality evidence).
Conclusions: The very low-quality evidence identified did not demonstrate that splints reduced pain in TMD as a group of conditions; data were poorly reported for different TMD sub-types. There is insufficient evidence to determine whether splints reduce tooth wear in patients with bruxism.
Methods: Four databases including MEDLINE and EMBASE were searched until 1 October 2018 for randomised clinical trials. Cochrane review methods were used for the systematic review. Standardised mean differences (SMD) were pooled for the primary outcome pain, using random effects models in TMD patients.
Results: Fifty-two trials were included in the systematic review. The evidence identified was of very low quality with unclear reporting by TMD sub-type. When all sub-types of TMD were pooled into one global TMD group there was no evidence to suggest that splints reduced pain for this global group (SMD (up to 3 months) -0.18 (95% CI -0.42 to 0.06); substantial heterogeneity). There was also no evidence that other outcomes including TMJ noises, decreased mouth opening, quality of life, and headaches were improved by the use of splints. Adverse events were generally not reported, but seemed infrequent when reported.
There was a large variation in the diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these limitations did not indicate a reduction in pain.
There were no studies measuring tooth wear in patients with bruxism. One small study looked at pain and found a reduction in the splint group, mean difference (on 0 to 10 Numerical Rating Scale) -2.01 (95%CI -1.40 to -2.62; very low-quality evidence).
Conclusions: The very low-quality evidence identified did not demonstrate that splints reduced pain in TMD as a group of conditions; data were poorly reported for different TMD sub-types. There is insufficient evidence to determine whether splints reduce tooth wear in patients with bruxism.