Oral splints for temporomandibular disorder or bruxism: a systematic review

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Elisabet Jacobsen
  • Clare Robertson
  • Justin Durham
  • Stephen Davis
  • Helen Petersen
  • Dwayne Boyers

Abstract

Objectives: To evaluate the clinical-effectiveness of oral splints for patients with TMD or bruxism for the primary outcomes: pain (TMD) and tooth wear (bruxism).
Data sources: Four databases including MEDLINE and EMBASE were searched until 1 October 2018.

Data selection and extraction: Randomised controlled trials comparing all types of splints versus no/minimal treatment for patients with TMD or bruxism were eligible. Standard Cochrane review methods were used. Standardised mean differences (SMD) were pooled for the primary outcome pain, using random effects models in TMD patients.

Data synthesis: Thirty-seven trials were included and the evidence identified was of very low certainty using GRADE assessments. When all sub-types of TMD were pooled into one global TMD group, there was no evidence that splints reduced pain: SMD (up to 3 months) -0.18 (95% CI -0.42 to 0.06); 13 trials, 1076 participants. There was no evidence that any other outcomes improved when using splints. There was no evidence of adverse events associated with splints, but reporting was poor regarding this outcome.

No trials measured tooth wear in patients with bruxism.

There was a large variation in diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these factors did not indicate a reduction in pain.

Conclusions: The very low-certainty evidence identified did not demonstrate that splints reduced pain in TMD as a group of conditions. There is insufficient evidence to determine whether splints reduce tooth wear in patients with bruxism.

Bibliographical metadata

Original languageEnglish
Pages (from-to)191-197
Number of pages7
JournalBDJ
Volume228
Issue number3
Early online date14 Feb 2020
DOIs
Publication statusPublished - Feb 2020