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. 2020 Apr 30;46(2):87-98.
doi: 10.5125/jkaoms.2020.46.2.87.

No evidence on the effectiveness of oral splints for the management of temporomandibular joint dysfunction pain in both short and long-term follow-up systematic reviews and meta-analysis studies

Atef Abdel Hameed Fouda  1
Affiliations

No evidence on the effectiveness of oral splints for the management of temporomandibular joint dysfunction pain in both short and long-term follow-up systematic reviews and meta-analysis studies

Atef Abdel Hameed Fouda. J Korean Assoc Oral Maxillofac Surg. .

Abstract

The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, P=0.002, I2=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.

Keywords: Meta-analysis; Occlusal splints; Pain; Review.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. Flow chart diagram. Adapted from the article of Moher et al. (PLoS Med 2009;6:e1000097) in accordance with the Creative Commons Attribution license. (RCT: randomized controlled trial, MMO: maximum mouth opening)
Fig. 2
Fig. 2. Forest plot of continuous pain analysis at different intervals with risk of bias for the included studies. (SD: standard deviation, CI: confidence interval, df: degree of freedom)
Fig. 3
Fig. 3. Forest plot of dichotomous pain analysis at different intervals with risk of bias for the included studies. (M–H: Mantel-Haenszel test, CI: confidence interval, df: degree of freedom)
Fig. 4
Fig. 4. Forest plot result of comparisons of the splint group vs control group in maximum mouth opening at both short and long term durations according to the total subgroup analysis. (SD: standard deviation, CI: confidence interval, df: degree of freedom)
Fig. 5
Fig. 5. Funnel plot comparison: splint group vs control group in continuous pain assessment to detect publication bias of the studies. (SE: standard error, SMD: standardized mean difference)
See this image and copyright information in PMC

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