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Meta-Analysis
. 2024 Sep 16;9(9):CD012850.
doi: 10.1002/14651858.CD012850.pub2.

Occlusal interventions for managing temporomandibular disorders

Balendra P Singh  1 , Nishi Singh  2 , Srinivasan Jayaraman  3 , Richard Kirubakaran  4 , Suja Joseph  5 , M S Muthu  6   7 , Hemant Jivnani  8 , Fang Hua  9
Affiliations
Meta-Analysis

Occlusal interventions for managing temporomandibular disorders

Balendra P Singh et al. Cochrane Database Syst Rev. .

Abstract

Background: Temporomandibular disorders (TMD) are conditions related to the musculoskeletal structure of the temporomandibular joint, which may lead to muscle or joint pain and other health issues. TMD may present in muscles only (myogenous), joints only (arthrogenous), or both (mixed), and may affect one side or both sides of the face. Myogenous TMD may present with or without limited mouth opening. Arthrogenous TMD may present as disc displacement with or without reduction ('reduction' meaning the articular disc resumes its normal position when the jaw is moving). Occlusal interventions change the occlusal relationship of maxillary and mandibular teeth to improve the alignment of the tooth contact, with the aim of relieving pain, and improving psychosocial functioning and quality of life. Occlusal interventions include splints and adjustments. Occlusal splints are specially designed mouth guards; they are generally classified as stabilisation, reflex or repositioning splints. Occlusal adjustment is the grinding down of teeth to improve occlusion.

Objectives: To assess the effects of occlusal interventions in people diagnosed with temporomandibular disorders (TMD), compared to other interventions or no treatment, on joint pain, muscle pain at rest and when chewing, quality of life, discomfort, and recurrence.

Search methods: Cochrane Oral Health's Information Specialist searched following sources up to 9 August 2022: Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via Ovid, Embase via Ovid, and two trials registers.

Selection criteria: We included randomised controlled trials (RCTs) of occlusal interventions (splints or adjustment) for managing TMD compared with no treatment, placebo, occlusal splint with a different mechanism of action, or other active treatments.

Data collection and analysis: We adopted standard Cochrane methods to select studies, extract and analyse data, assess the risk of bias in the studies, and judge the certainty of the evidence. We reported outcomes as short term (three months or less) or long term (more than three months).

Main results: We included 57 studies (2846 participants) that compared occlusal splints with no treatment, placebo, or another treatment. Most of the studies evaluated full hard stabilisation splint (FHSS) as the occlusal splint. We judged only one study to be at low risk of bias. Our key outcomes of interest were self-reported joint pain when chewing, muscle pain at rest and when chewing, discomfort, severity and frequency of joint noise, and recurrence rate. The duration of the studies ranged from 5 weeks to 84 months. The key results presented below were measured between 4.4 weeks and 4 months. It is important to note that we have very low certainty in the evidence for all comparisons and outcomes assessed. There may be little to no difference in self-reported joint pain when chewing between occlusal splint (FHSS) and placebo (non-occlusal splint) (RR 1.88, 95% CI 0.94 to 3.75; 1 study, 60 participants with mixed TMD), or pharmacological therapy (diclofenac) (RR 2.10, 95% CI 0.83 to 5.30; 1 study, 29 participants with osteoarthritis), but the evidence is very uncertain. Occlusal splint (FHSS) may reduce muscle pain when chewing compared to no treatment (MD -1.97, 95% CI -2.37 to -1.57; 1 study, 84 participants with disc displacement without reduction), but may have little to no effect when compared to physical therapy (low-level laser) (RR 0.17, 95% CI 0.02 to 1.26; 1 study, 40 participants) or acupuncture (with needles) (MD 0.10, 95% CI -0.80 to 1.00, 1 study, 40 participants) in people with myofascial pain TMD, but the evidence is very uncertain. There may be little to no difference in muscle pain at rest when occlusal splint (FHSS) is compared to no treatment (MD -11.63, 95% CI -29.37 to 6.11; 1 study, 37 participants) or physical therapy (physiotherapy) (MD -0.19, 95% CI -1.25 to 0.87; 1 study, 72 participants) in myofascial pain TMD, but the evidence is very uncertain. There may be little to no difference in severity of joint noise when occlusal splint (FHSS) is compared to no treatment, but the evidence is very uncertain (MD -0.58, 95% CI -7.09 to 5.93; 1 study, 20 participants). When FHSS is compared to physical therapy (specifically, orofacial myofunctional therapy), physical therapy may reduce severity of joint noise, but the evidence is very uncertain (MD 5.92, 95% CI 0.18 to 11.66; 1 study, 20 participants with mixed TMD). There may be little to no difference in frequency of joint noise when occlusal splint (FHSS) is compared to placebo (non-occlusal splint) (RR 1.18, 95% CI 0.63 to 2.20; 1 study, 60 myofascial pain TMD participants), occlusal splint with a different mechanism of action (RR 0.80, 95% CI 0.07 to 9.18; 1 study, 9 participants with disc displacement with reduction), or physical therapy (jaw exercise) (RR 1.50, 95% CI 0.32 to 6.94; 1 study, 18 participants with myofascial pain TMD), but the evidence is very uncertain. Discomfort and recurrence rate were not reported in any study. We judged the certainty of the evidence to be very low for all outcomes in all comparisons due to limitations in study design and imprecision.

Authors' conclusions: This review included 57 RCTs with 2846 participants, but the final results are inconclusive, so the research questions remain unanswered. Occlusal splints of the FHSS type may reduce muscle pain when chewing compared to no treatment, but the evidence is very uncertain. Orofacial myofunctional therapy may reduce severity of joint noise compared to occlusal splint (FHSS), but the evidence is very uncertain. For all other comparisons and outcomes, there may be little or no difference between groups, although the evidence is also very uncertain for these findings. Overall, we found insufficient evidence to reach conclusions regarding the effectiveness of occlusal interventions for managing symptoms of TMD, despite the available studies including almost 3000 participants. To make a useful contribution to the debate about the best way to treat TMD, any further research must be well-designed, with enough participants to reach the optimal information size for meaningful results; it requires recruitment from primary care, consensus around key outcomes and measures, and, ideally, long-term follow-up of three to five years, plus inclusion of a cost-effectiveness component.

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Conflict of interest statement

Balendra Pratap Singh: no relevant conflict of interest to disclose

Nishi Singh: no relevant conflict of interest to disclose

Srinivasan Jayaraman: no relevant conflict of interest to disclose

Richard Kirubakaran: no relevant conflict of interest to disclose

Suja Joseph: no relevant conflict of interest to disclose

MS Muthu: no relevant conflict of interest to disclose

Hemant Jivanani: no relevant conflict of interest to disclose

Fang Hua: none known. I am an editor with Cochrane Oral Health, but I was not involved in the editorial processing of this review.

Figures

1
1
Study flow diagram
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
1.1
1.1. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 1: Self‐reported joint pain at rest (dichotomous data)
1.2
1.2. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 2: Self‐reported joint pain at rest (continuous data)
1.3
1.3. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 3: Clinically assessed joint pain at rest
1.4
1.4. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 4: Clinically assessed joint pain at rest
1.5
1.5. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 5: Self‐reported joint pain at mastication (dichotomous data)
1.6
1.6. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 6: Muscle pain at rest (dichotomous data)
1.7
1.7. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 7: Muscle pain at rest (continuous data)
1.8
1.8. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 8: Muscle pain at rest (continuous data)
1.9
1.9. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 9: Muscle pain at rest (continuous data)
1.10
1.10. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 10: Muscle pain at rest (continuous data)
1.11
1.11. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 11: Muscle pain at rest (continuous data)
1.12
1.12. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 12: Muscle pain at rest (continuous data)
1.13
1.13. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 13: Muscle pain at mastication (dichotomous data)
1.14
1.14. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 14: Muscle pain at mastication (dichotomous data)
1.15
1.15. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 15: Muscle pain at mastication (continuous data)
1.16
1.16. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 16: Severity of joint noise
1.17
1.17. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 17: Frequency of joint noise
1.18
1.18. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 18: Frequency of joint noise
1.19
1.19. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 19: Frequency of joint noise
1.20
1.20. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 20: Frequency of joint noise
1.21
1.21. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 21: Range of mandibular motion (maximum unassisted (mandibular) opening
1.22
1.22. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 22: Range of mandibular motion (unassisted (mandibular) opening without pain)
1.23
1.23. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 23: Range of mandibular motion (unassisted (mandibular) opening without pain)
1.24
1.24. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 24: Range of mandibular motion (unassisted (mandibular) opening without pain)
1.25
1.25. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 25: Range of mandibular motion (unassisted (mandibular) opening without pain)
1.26
1.26. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 26: Range of mandibular motion (unassisted (mandibular) opening without pain)
1.27
1.27. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 27: Range of mandibular motion (maximum assisted (mandibular opening)
1.28
1.28. Analysis
Comparison 1: Occlusal splint vs no treatment or placebo, Outcome 28: Depression
2.1
2.1. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 1: Self‐reported joint pain at rest
2.2
2.2. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 2: Self‐reported joint pain at rest
2.3
2.3. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 3: Self‐reported joint pain at rest
2.4
2.4. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 4: Clinically assessed joint pain at rest
2.5
2.5. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 5: Clinically assessed joint pain at rest
2.6
2.6. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 6: Participant satisfaction or quality of life
2.7
2.7. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 7: Frequency of joint noise
2.8
2.8. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 8: Frequency of joint noise
2.9
2.9. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 9: Range of mandibular motion (maximum assisted (mandibular opening)
2.10
2.10. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 10: Range of mandibular motion (maximum unassisted (mandibular) opening
2.11
2.11. Analysis
Comparison 2: Occlusal splint vs other splints (of different mechanism of action), Outcome 11: Range of mandibular motion (unassisted (mandibular) opening without pain)
3.1
3.1. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 1: Self‐reported joint pain at rest
3.2
3.2. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 2: Self‐reported joint pain at rest
3.3
3.3. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 3: Self‐reported joint pain at rest
3.4
3.4. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 4: Self‐reported joint pain at rest
3.5
3.5. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 5: Clinically assessed joint pain at rest
3.6
3.6. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 6: Muscle pain at rest (dichotomous)
3.7
3.7. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 7: Muscle pain at rest
3.8
3.8. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 8: Muscle pain at rest
3.9
3.9. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 9: Muscle pain at rest
3.10
3.10. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 10: Muscle pain at rest
3.11
3.11. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 11: Muscle pain at mastication
3.12
3.12. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 12: Muscle pain at mastication
3.13
3.13. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 13: Participant satisfaction or quality of life
3.14
3.14. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 14: Severity of joint noise
3.15
3.15. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 15: Frequency of joint noise
3.16
3.16. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 16: Frequency of joint noise
3.17
3.17. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 17: Frequency of joint noise
3.18
3.18. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 18: Range of mandibular motion (maximum assisted (mandibular opening)
3.19
3.19. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 19: Range of mandibular motion (maximum assisted (mandibular opening)
3.20
3.20. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 20: Range of mandibular motion (maximum unassisted (mandibular) opening
3.21
3.21. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 21: Range of mandibular motion (maximum unassisted (mandibular) opening
3.22
3.22. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 22: Range of mandibular motion (unassisted (mandibular) opening without pain)
3.23
3.23. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 23: Range of mandibular motion (unassisted (mandibular) opening without pain)
3.24
3.24. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 24: Depression
3.25
3.25. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 25: Depression
3.26
3.26. Analysis
Comparison 3: Occlusal splint vs physical therapy (ultrasound, exercise, sensorimotor, laser, TENS, manual therapy), Outcome 26: Somatisation
4.1
4.1. Analysis
Comparison 4: Occlusal splint vs behavioural therapy (psychological, counselling, palliative care, biofeedback)), Outcome 1: Self‐reported joint pain at rest
4.2
4.2. Analysis
Comparison 4: Occlusal splint vs behavioural therapy (psychological, counselling, palliative care, biofeedback)), Outcome 2: Participant satisfaction or quality of life
4.3
4.3. Analysis
Comparison 4: Occlusal splint vs behavioural therapy (psychological, counselling, palliative care, biofeedback)), Outcome 3: Range of mandibular motion (unassisted opening without pain)
5.1
5.1. Analysis
Comparison 5: Occlusal splint vs acupuncture, Outcome 1: Muscle pain at mastication
5.2
5.2. Analysis
Comparison 5: Occlusal splint vs acupuncture, Outcome 2: Participant satisfaction or quality of life
5.3
5.3. Analysis
Comparison 5: Occlusal splint vs acupuncture, Outcome 3: Range of mandibular motion (unassisted opening without pain)
5.4
5.4. Analysis
Comparison 5: Occlusal splint vs acupuncture, Outcome 4: Range of mandibular motion (maximum assisted opening)
6.1
6.1. Analysis
Comparison 6: Occlusal splint vs pharmacological therapy, Outcome 1: Clinically assessed joint pain at rest (dichotomous)
6.2
6.2. Analysis
Comparison 6: Occlusal splint vs pharmacological therapy, Outcome 2: Clinically assessed joint pain at rest (continuous)
6.3
6.3. Analysis
Comparison 6: Occlusal splint vs pharmacological therapy, Outcome 3: Self‐reported joint pain at mastication
6.4
6.4. Analysis
Comparison 6: Occlusal splint vs pharmacological therapy, Outcome 4: Range of mandibular motion (maximum assisted opening)
6.5
6.5. Analysis
Comparison 6: Occlusal splint vs pharmacological therapy, Outcome 5: Range of mandibular motion (maximum unassisted opening)
6.6
6.6. Analysis
Comparison 6: Occlusal splint vs pharmacological therapy, Outcome 6: Range of mandibular motion (unassisted opening without pain)
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD012850

References

References to studies included in this review

Ahmed 2016 {published data only}
    1. Ahmed MA, Rahman QB, Uddin MW, Asaduzzaman M, Ali MH. Efficacy of acrylic splint in management of internal derangement of temporomandibular joint. Bangladesh Medical Research Council Bulletin 2016;42(2):72-7. [DOI: 10.3329/bmrcb.v42i2.32040] - DOI
Aksakalli 2015 {published data only}
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Alajbeg 2018 {published data only}
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Alajbeg 2020 {published data only}
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Altindis 2019 {published data only}
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Amin 2016 {published data only}
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Aroca 2022 {published data only}
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    1. RBR-69ynnw. Effect of acupuncture with needles on the physical and psychological and emotional aspects of patients with problems in the articulation of the jaw [Efeito da acupuntura com agulhas sobre os aspectos físicos e psicológicos e emocionais de pacientes com problemas na articulação do queixo]. ensaiosclinicos.gov.br/rg/RBR-69ynnw (first received 5 April 2018).
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Celakil 2017 {published data only}
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    1. NCT02997410. Ozone therapy for masticatory muscle pain (OTMMP). clinicaltrials.gov/ct2/show/NCT02997410 (first received 13 December 2016).
Christidis 2014 {published data only}
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Conti 2005 {published data only}
    1. Conti PCR, Miranda JES, Conti ACCF, Pegoraro LF, Arau C. Partial time use of anterior repositioning splints in the management of TMJ pain and dysfunction: a one-year controlled study. Journal of Applied Oral Science 2005;13(4):345-50. - PubMed
Conti 2006 {published data only}
    1. Conti PC, Dos Santos CN, Kogawa EM, De Castro Ferreira Conti AC, De Araujo C dos R. The treatment of painful temporomandibular joint clicking with oral splints: a randomized clinical trial. Journal of the American Dental Association (1939) 2006;137(8):1108-14. - PubMed
Costa 2021 {published data only}
    1. Costa DR, Pessoa DR, Seefeldt VB, Maia DTL, Dos Santos Maciel T, Mota BBM, et al. Orofacial evaluation of individuals with temporomandibular disorder after LED therapy associated or not of occlusal splint: a randomized double-blind controlled clinical study. Lasers in Medical Science 2021;36(8):1681-9. [DOI: 10.1007/s10103-021-03269-2] - DOI - PubMed
    1. RBR-3bs2g4. Evaluation of patients with pain in the muscles of the face and ear after light therapy associated or not with the occlusal plaque [Avaliação pacientes com dor nos músculos do rosto e ouvido após Terapia com Luz LED associada ou não a Placa Oclusal]. ensaiosclinicos.gov.br/rg/RBR-3bs2g4 (first received 20 July 2017).
Dao 1994 {published data only}
    1. Dao TT, Lavigne GJ, Charbonneau A, Feine JS, Lund JP. The efficacy of oral splints in the treatment of myofascial pain of the jaw muscles: a controlled clinical trial. Pain 1994;56(1):85-94. - PubMed
De Felicio 2010 {published data only}
    1. De Felicio CM, De Oliveira MM, Da Silva MA. Effects of orofacial myofunctional therapy on temporomandibular disorders. Cranio : the Journal of Craniomandibular Practice 2010;28(4):249-59. [DOI: 10.1179/crn.2010.033] - DOI - PubMed
Demirkol 2015 {published data only}
    1. Demirkol N, Sari F, Bulbul M, Demirkol M, Simsek I, Usumez A. Effectiveness of occlusal splints and low-level laser therapy on myofascial pain. Lasers in Medical Science 2015;30(3):1007-12. - PubMed
De Resende 2019 {published data only}
    1. De Resende CMBM, De Oliveira Medeiros FGL, De Figueiredo Rego CR, Bispo ASL, Barbosa GAS, De Almeida EO. Short-term effectiveness of conservative therapies in pain, quality of life, and sleep in patients with temporomandibular disorders: a randomized clinical trial. Cranio : the Journal of Craniomandibular Practice 2019;39(4):335-43. - PubMed
    1. RBR-6vyb3f. Functional, psychosocial and related to the sleep effects of different therapies in TMD: randomized clinical trial. ensaiosclinicos.gov.br/rg/RBR-6vyb3f (first received 3 July 2019).
Devi 2017 {published data only}
    1. Devi J, Verma M, Gupta R. Assessment of treatment response to splint therapy and evaluation of TMJ function using joint vibration analysis in patients exhibiting TMJ disc displacement with reduction: a clinical study. Indian Journal of Dental Research 2017;28(1):33-43. - PubMed
Doepel 2012 {published data only}
    1. Doepel M, Nilner M, Ekberg E, Vahlberg T, Le Bell Y. Headache: short- and long-term effectiveness of a prefabricated appliance compared to a stabilization appliance. Acta Odontologica Scandinavica 2011;69(3):129-36. [DOI: 10.3109/00016357.2010.538719] - DOI - PubMed
    1. Doepel M, Nilner M, Ekberg E, YLE Bell. Long-term effectiveness of a prefabricated oral appliance for myofascial pain. Journal of Oral Rehabilitation 2012;39(4):252-60. [DOI: 10.1111/j.1365-2842.2011.02261.x] - DOI - PubMed
    1. Nilner M, Ekberg E, Doepel M, Andersson J, Selovuo K, Le Bell Y. Short-term effectiveness of a prefabricated occlusal appliance in patients with myofascial pain. Journal of Orofacial Pain 2008;22(3):209-18. [PMID: ] - PubMed
Ekberg 2002 {published data only}
    1. Ekberg E, Nilner M. A 6- and 12-month follow-up of appliance therapy in TMD patients: a follow-up of a controlled trial. International Journal of Prosthodontics 2002;15(6):564-70. - PubMed
    1. Ekberg E, Nilner M. The influence of stabilisation appliance therapy and other factors on the treatment outcome in patients with temporomandibular disorders of arthrogeneous origin. Swedish Dental Journal 1999;23(1):39-47. [PMID: ] - PubMed
    1. Ekberg E. TMD query of your published article (personal communication). Email to: B Singh 22 June 2020.
    1. Ekberg EC, Sabet ME, Petersson A, Nilner M. Occlusal appliance therapy in a short-term perspective in patients with temporomandibular disorders correlated to condyle position. International Journal of Prosthodontics 1998;11(3):263-8. [PMID: ] - PubMed
    1. Ekberg EC, Vallon D, Nilner M. Occlusal appliance therapy in patients with temporomandibular disorders. A double-blind controlled study in a short-term perspective. Acta Odontologica Scandinavica 1998;56(2):122-8. [DOI: 10.1080/00016359850136102] - DOI - PubMed
Ekberg 2004 {published data only}
    1. Ekberg E, Nilner M. Treatment outcome of appliance therapy in temporomandibular disorder patients with myofascial pain after 6 and 12 months. Acta Odontologica Scandinavica 2004;62(6):343-9. [DOI: 10.1080/00016350410010063] - DOI - PubMed
    1. Ekberg E, Vallon D, Nilner M. The efficacy of appliance therapy in patients with temporomandibular disorders of mainly myogenous origin. A randomized, controlled, short-term trial. Journal of Orofacial Pain 2003;17(2):133-9. [PMID: ] - PubMed
El Zawahry 2021 {published data only}
    1. El Zawahry NO, Salah Fayed MM, Abouelezz AM, Aboulfotouh MH. Comparison of disability score and chronic pain grading with different treatment modalities in a sample of temporomandibular joint disc displacement with reduction patients. Indian Journal of Public Health Research and Development 2021;12(3):603-10.
    1. NCT03576079. Effect of laser therapy versus anterior re-positioning splint in the treatment of disc displacement with reduction. clinicaltrials.gov/ct2/show/NCT03576079 (first received 9 June 2018).
Eraslan 2021 {published data only}
    1. Eraslan R, Kilic K, Zararsiz G. Effects of different therapeutic modalities on the clicking sound and quantitative assessment of the vertical and lateral mandibular movements of patients with internal derangements of the temporomandibular joint. International Journal of Prosthodontics 2021;34(2):173-82. - PubMed
Fayed 2004 {published data only}
    1. Fayed MM, El-Mangoury NH, El-Bokle DN, Belal AI. Occlusal splint therapy and magnetic resonance imaging. World Journal of Orthodontics 2004;5(2):133-40. - PubMed
Gavish 2002 {published data only}
    1. Gavish A, Winocur E, Ventura YS, Halachmi M, Gazit E. Effect of stabilization splint therapy on pain during chewing in patients suffering from myofascial pain. Journal of Oral Rehabilitation 2002;29(12):1181-6. - PubMed
Giannakopoulos 2018 {published data only}
    1. Giannakopoulos NN, Rauer AK, Hellmann D, Hugger S, Schmitter M, Hugger A. Comparison of device-supported sensorimotor training and splint intervention for myofascial temporomandibular disorder pain patients. Journal of Oral Rehabilitation 2018;45(9):669-76. [DOI: 10.1111/joor.12662] - DOI - PubMed
Glaros 2007 {published data only}
    1. Glaros AG, Kim-Weroha N, Lausten L, Franklin KL. Comparison of habit reversal and a behaviorally-modified dental treatment for temporomandibular disorders: a pilot investigation. Applied Psychophysiology and Biofeedback 2007;32(3-4):149-54. [DOI: 10.1007/s10484-007-9039-5] - DOI - PubMed
Grillo 2015 {published data only}
    1. Grillo CM, Canales Gde L, Wada RS, Alves MC, Barbosa CM, Berzin F, Sousa Mda L. Could acupuncture be useful in the treatment of temporomandibular dysfunction? JAMS Journal of Acupuncture and Meridian Studies 2015;8(4):192-9. [DOI: 10.1016/j.jams.2014.12.001] - DOI - PubMed
Huhtela 2020 {published data only}
    1. Huhtela OS, Koivisto N, Hagg V, Sipila K. Effectiveness of applied relaxation method vs splint in treatment of temporomandibular disorders in Finnish students. Journal of Oral Rehabilitation 2020;47(2):123-31. [DOI: 10.1111/joor.12884] - DOI - PubMed
    1. ISRCTN11790049. Comparing the effectiveness of two different treatment methods in treating pain in facial muscles and joints of the jaw. www.isrctn.com/ISRCTN11790049 (first received 21 March 2019).
Lam 2020 {published data only}
    1. Lam J, Svensson P, Alstergren P. Internet-based multimodal pain program with telephone support for adults with chronic temporomandibular disorder pain: randomized controlled pilot trial. Journal of Medical Internet Research 2020;22(10):e22326. [DOI: 10.2196/22326] - DOI - PMC - PubMed
    1. NCT04363762. An internet-based multimodal pain program for chronic temporomandibular disorder pain. https://clinicaltrials.gov/study/NCT04363762 (first received 20 April 2020).
Linde 1995 {published data only}
    1. Linde C, Isacsson G, Jonsson BG. Outcome of 6-week treatment with transcutaneous electric nerve stimulation compared with splint on symptomatic temporomandibular joint disk displacement without reduction. Acta Odontologica Scandinavica 1995;53(2):92-8. - PubMed
Magnusson 1999 {published data only}
    1. Magnusson T, Syren M. Therapeutic jaw exercises and interocclusal appliance therapy. A comparison between two common treatments of temporomandibular disorders. Swedish Dental Journal 1999;23(1):27-37. - PubMed
Manfredini 2017 {published data only}
    1. Manfredini D, Favero L, Cocilovo F, Monici M, Guarda-Nardini L. A comparison trial between three treatment modalities for the management of myofascial pain of jaw muscles: a preliminary study. Cranio 2018;36:327-31. - PubMed
Maracci 2020 {published data only}
    1. Maracci LM, Stasiak G, Oliveira Chami V, Franciscatto GJ, Milanesi J, Figueiro C, et al. Treatment of myofascial pain with a rapid laser therapy protocol compared to occlusal splint: a double-blind, randomized clinical trial. Cranio : the Journal of Craniomandibular Practice 2020;40(3):1-7. - PubMed
    1. RBR-5mgv4k. Treatment of temporomandibular disorder with laser therapy and occlusal splint: double-blind randomized clinical trial. ensaiosclinicos.gov.br/rg/RBR-5mgv4k (first received 20 July 2017).
Mejersjo 2008 {published data only}
    1. Mejersjo C, Wenneberg B. Diclofenac sodium and occlusal splint therapy in TMJ osteoarthritis: a randomized controlled trial. Journal of Oral Rehabilitation 2008;35(10):729-38. [DOI: 10.1111/j.1365-2842.2008.01863.x] - DOI - PubMed
Melo 2020 {published data only}
    1. Melo RA, De Resende CMBM, Rego CRF, Bispo ASL, Barbosa GAS, De Almeida EO. Conservative therapies to treat pain and anxiety associated with temporomandibular disorders: a randomized clinical trial. International Dental Journal 2020;70(4):245-53. [DOI: 10.1111/idj.12546] - DOI - PMC - PubMed
Michelotti 2012 {published data only}
    1. Michelotti A, Iodice G, Vollaro S, Steenks MH, Farella M. Evaluation of the short-term effectiveness of education versus an occlusal splint for the treatment of myofascial pain of the jaw muscles. Journal of the American Dental Association (1939) 2012;143(1):47-53. - PubMed
Nilsson 2011 {published data only}
    1. Limchaichana N, Nilsson H, Petersson A, Ekberg E. Resilient appliance-therapy treatment outcome in patients with TMD pain correlated to MRI-determined changes in condyle position. Cranio : the Journal of Craniomandibular Practice 2009;27(3):185-93. [DOI: 10.1179/crn.2009.028] - DOI - PubMed
    1. Nilsson H, Limchaichana N, Nilner M, Ekberg EC. Short-term treatment of a resilient appliance in TMD pain patients: a randomized controlled trial. Journal of Oral Rehabilitation 2009;36(8):547-55. [DOI: 10.1111/j.1365-2842.2009.01973.x] - DOI - PubMed
    1. Nilsson H, Vallon D, Ekberg EC. Long-term efficacy of resilient appliance therapy in TMD pain patients: a randomised, controlled trial. Journal of Oral Rehabilitation 2011;38(10):713-21. [DOI: 10.1111/j.1365-2842.2011.02210.x] - DOI - PubMed
Oliveira Peixoto 2021 {published data only}
    1. Oliveira Peixoto K, Da Silva Bezerra A, Albuquerque Melo R, Bastos Machado de Resende CM, De Almeida EO, Seabra Barbosa GA. Short-term effect of scalp acupuncture on pain, sleep disorders and quality of life in patients with temporomandibular disorders: a randomized clinical trial. Pain Medicine (Malden, Mass.) 2021;22(4):905-14. [DOI: 10.1093/pm/pnab048] - DOI - PubMed
Oz 2010 {published data only}
    1. Oz S, Gokcen-Rohlig B, Saruhanoglu A, Tuncer EB. Management of myofascial pain: low-level laser therapy versus occlusal splints. Journal of Craniofacial Surgery 2010;21(6):1722-8. [DOI: 10.1097/SCS.0b013e3181f3c76c] - DOI - PubMed
Rampello 2013 {published data only}
    1. Rampello A, Saccucci M, Falisi G, Panti F, Polimeni A, Di Paolo C. A new aid in temporomandibular joint disorders' therapy: the universal neuromuscular immediate relaxing appliance. Journal of Biological Regulators and Homeostatic Agents 2013;27(4):1011-9. - PubMed
Rampello 2018 {published data only}
    1. Rampello A, Papi P, Pompa G, Polimeni A, Di Paolo C. A novel universal device "LINGUAL RING Ri.P.A.Ra" for TMDs and cranio-cervico-mandibular pains: preliminary results of a randomized control clinical trial. European Review for Medical and Pharmacological Sciences 2018;22(5):1180-90. [DOI: 10.26355/eurrev_201803_14456] - DOI - PubMed
Rodrigues 2019 {published data only}
    1. Rodrigues MDF, Rodrigues ML, Bueno KS, Aroca JP, Camilotti V, Busato MCA, et al. Effects of low-power laser auriculotherapy on the physical and emotional aspects in patients with temporomandibular disorders: a blind, randomized, controlled clinical trial. Complementary Therapies in Medicine 2019;42:340-6. [DOI: 10.1016/j.ctim.2018.12.010] - DOI - PubMed
Rohida 2010 {published data only}
    1. Rohida NS, Bhad W. A clinical, MRI, and EMG analysis comparing the efficacy of twin blocks and flat occlusal splints in the management of disc displacements with reduction. World Journal of Orthodontics 2010;11(3):236-44. - PubMed
Schmitter 2005 {published data only}
    1. Schmitter M, Zahran M, Duc JM, Henschel V, Rammelsberg P. Conservative therapy in patients with anterior disc displacement without reduction using 2 common splints: a randomized clinical trial. Journal of Oral and Maxillofacial Surgery 2005;63(9):1295-303. [DOI: 10.1016/j.joms.2005.05.294] - DOI - PubMed
Shousha 2021 {published data only}
    1. NCT04831346. Effects of low-level laser therapy versus soft occlusive splints on mouth opening and surface electromyography in females with temporomandibular dysfunction: a randomized-controlled study. https://clinicaltrials.gov/study/NCT04831346 (first received 1 April 2021). - PMC - PubMed
    1. Shousha T, Alayat M, Moustafa I. Effects of low-level laser therapy versus soft occlusive splints on mouth opening and surface electromyography in females with temporomandibular dysfunction: a randomized-controlled study. PloS One 2021;16(10 October):e0258063. [DOI: 10.1371/journal.pone.0258063] - DOI - PMC - PubMed
Stiesch Scholz 2005 {published data only}
    1. Stiesch-Scholz M, Kempert J, Wolter S, Tschernitschek H, Rossbach A. Comparative prospective study on splint therapy of anterior disc displacement without reduction. Journal of Oral Rehabilitation 2005;32(7):474-9. [DOI: 10.1111/j.1365-2842.2005.01452.x] - DOI - PubMed
Tavera 2012 {published data only}
    1. ISRCTN61111416. Acupuncture and pain relief in temporomandibular joint dysfunction syndrome. www.isrctn.com/ISRCTN61111416 (first received 12 September 2003).
    1. NCT00815776. Treatment outcomes for temporomandibular disorders (TMD) via the Clayton Intra-aural Device (CID) clinical trial. clinicaltrials.gov/study/NCT00815776 (first received 29 December 2008).
    1. Tavera AT, Montoya MC, Calderon EF, Gorodezky G, Wixtrom RN. Approaching temporomandibular disorders from a new direction: a randomized controlled clinical trial of the TMDes ear system. Cranio : the Journal of Craniomandibular Practice 2012;30(3):172-82. - PubMed
Tecco 2010 {published data only}
    1. Tecco S, Tete S, Crincoli V, Festa MA, Festa F. Fixed orthodontic therapy in temporomandibular disorder (TMD) treatment: an alternative to intraoral splint. Cranio : the Journal of Craniomandibular Practice 2010;28(1):30-42. [DOI: 10.1179/crn.2010.005] - DOI - PubMed
Van Grootel 2017 {published data only}
    1. ISRCTN17469828. Myogenous temporomandibular disorders (TMD), I. physiotherapy compared with occlusal splint therapy, and II. occlusal adjustment compared with occlusal splint therapy combined with occlusal adjustment, using therapy-and-patient-specific treatment duration. www.isrctn.com/ISRCTN17469828 (first received 19 October 2016).
    1. Van Grootel RJ, Buchner R, Wismeijer D, Van der Glas HW. Towards an optimal therapy strategy for myogenous TMD, physiotherapy compared with occlusal splint therapy in an RCT with therapy-and-patient-specific treatment durations. BMC Musculoskeletal Disorders 2017;18(1):76. - PMC - PubMed
    1. Van der Glas HW, Buchner R, Van Grootel RJ. [Comparison of treatment options for myogenous temporomandibular dysfunction]. Nederlands tijdschrift voor tandheelkunde 2000;107(12):505-12. - PubMed
Vrbanovic 2019 {published data only}
    1. Banovic E. Cochrane review: TMD article query (personal communication). Email to B Singh 12 January 2021.
    1. Vrbanovic E, Alajbeg IZ. Long-term effectiveness of occlusal splint therapy compared to placebo in patients with chronic temporomandibular disorders. Acta Stomatologica Croatica 2019;53(3):195-206. [DOI: 10.15644/asc53/3/1] - DOI - PMC - PubMed
Wanman 2020 {published data only}
    1. Wanman A, Marklund S. Treatment outcome of supervised exercise, home exercise and bite splint therapy, respectively, in patients with symptomatic disc displacement with reduction: a randomised clinical trial. Journal of Oral Rehabilitation 2020;47(2):143-9. [DOI: 10.1111/joor.12888] - DOI - PMC - PubMed
Wassell 2006 {published data only}
    1. Wassell RW, Adams N, Kelly PJ. The treatment of temporomandibular disorders with stabilizing splints in general dental practice: one-year follow-up. Journal of the American Dental Association (1939) 2006;137(8):1089-98; quiz 1168-9. - PubMed
    1. Wassell RW, Adams N, Kelly PJ. Treatment of temporomandibular disorders by stabilising splints in general dental practice: results after initial treatment. British Dental Journal 2004;197(1):35-41. [DOI: 10.1038/sj.bdj.4811420] - DOI - PubMed
Winocur 2002 {published data only}
    1. Winocur E, Gavish A, Emodi-Perlman A, Halachmi M, Eli I. Hypnorelaxation as treatment for myofascial pain disorder: a comparative study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics 2002;93(4):429-34. - PubMed
Wright 1995 {published data only}
    1. Wright E, Anderson G, Schulte J. A randomized clinical trial of intraoral soft splints and palliative treatment for masticatory muscle pain. Journal of Orofacial Pain 1995;9(2):192-9. - PubMed
Yu 2016 {published data only}
    1. Yu CH, Qian HX. Evaluation of short term efficacy of the stabilized splint and the combination of manipulative and physical therapies for temporomandibular joint disc displacement without reduction. Journal of Shanghai Jiaotong University (Medical Science) 2016;36(6):850-5.
Zhang 2013 {published data only}
    1. Zhang FY, Wang XG, Dong J, Zhang JF, Lu YL. Effect of occlusal splints for the management of patients with myofascial pain: a randomized, controlled, double-blind study. Chinese Medical Journal 2013;126(12):2270-5. - PubMed

References to studies excluded from this review

Alencar 2009 {published data only}
    1. Alencar F, Becker A. Evaluation of different occlusal splints and counselling in the management of myofascial pain dysfunction. Journal of Oral Rehabilitation 2009;36(2):79-85. [DOI: 10.1111/j.1365-2842.2008.01913.x] - DOI - PubMed
Algabr 2017 {published data only}
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Biasotto Gonzalez 2013 {published data only}
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Buchner 2000 {published data only}
    1. Buchner R, Van der Glas HW, Van Grootel RJ, Steenks MH, Lambert H, Olthoff LW. Long-term efficacy of solely occlusal therapy versus a combination of splint and occlusal therapy in patients with myogenous temporomandibular disorders [abstract]. Journal of Oral Rehabilitation 2000;27(5):434.
Bumann 2000 {published data only}
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Carmeli 2001 {published data only}
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Cattaneo 2019 {published data only}
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Chen 2013 {published data only}
    1. Chen T, Liao TA, Zhan RJ, Wu LN. Effect of two different kinds of occlusal splints on temporomandibular disorders. Shanghai kou qiang yi xue [Shanghai Journal of Stomatology] 2013;22(5):547-50. - PubMed
ChiCTR‐INR‐17012135 {published data only}
    1. ChiCTR-INR-17012135. Joint-occlusion combined treatment for juvenile malocclusion with disc displacement: a multicenter randomized controlled clinical trial. www.chictr.org.cn/showprojEN.html?proj=20725 (first received 25 July 2017).
CTRI201802012069 {published data only}
    1. CTRI/2018/02/012069. A study to assess the best treatment modality for patients with jaw muscle pain. https://ctri.nic.in/Clinicaltrials/advsearch2.php (first received 22 February 2018).
    1. Sharma D, Nirmal NJ, Arora H, Mehta S, Jishnu S, Raj R. An in-vivo study to evaluate the onset of relief from ibuprofen, placebo and occlusal splint in patients with acute myalgia in muscles related to temporomandibular joint: a comparative pilot study. Journal of Pierre Fauchard Academy (India Section) 2021;35(4):111-8. [DOI: 10.18311/jpfa/2021/27136] - DOI
CTRI202108035519 {published data only (unpublished sought but not used)}
    1. CTRI/2021/08/035519. Comparison of effectiveness of soft and hard splints in the symptomatic management of temporomandibular joint disorders. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=56014&EncHid=&u... (first received 9 August 2021).
    1. Poorna TA, John B, Joshna EK, Rao A. Comparison of the effectiveness of soft and hard splints in the symptomatic management of temporomandibular joint disorders: a randomized control study. International Journal of Rheumatic Diseases 2022;25(9):1053-9. [DOI: 10.1111/1756-185X.14379] - DOI - PubMed
Cuccia 2010 {published data only}
    1. Cuccia AM, Caradonna C, Annunziata V, Caradonna D. Osteopathic manual therapy versus conventional conservative therapy in the treatment of temporomandibular disorders: a randomized controlled trial. Journal of Bodywork and Movement Therapies 2010;14(2):179-84. - PubMed
Da Costa 2016 {published data only}
    1. Da Costa LMR, Schimit EFD, Souza C, Wagner Neto ES, De Souza da Silva L, et al. Effect of the pilates method on women with temporomandibular disorders: a study protocol for a randomized controlled trial. Journal of Bodywork and Movement Therapies 2016;20(1):110-4. [DOI: 10.1016/j.jbmt.2015.06.011] - DOI - PubMed
    1. Pivotto LR, Candotti CT, Sedrez JA, Detogni Schmit EF, Resende Da Costa LM, Loss JF. Effects of pilates method on the posture, postural habits, and neck and back pain of women with temporomandibular dysfunction: a randomized clinical trial. International Journal of Spine Research 2020;2(1):014-022. [DOI: 10.17352/ijsr.000009] - DOI
Daif 2012 {published data only}
    1. Daif ET. Correlation of splint therapy outcome with the electromyography of masticatory muscles in temporomandibular disorder with myofascial pain. Acta Odontologica Scandinavica 2012;70(1):72-7. [DOI: 10.3109/00016357.2011.597776] - DOI - PubMed
Daif 2016 {published data only}
    1. Daif E. Correlation of splint therapy outcome with the electromyography of masticatory muscles in temporomandibular disorder with myofascial pain. Pain Practice 2016;16:87. - PubMed
Doepel 2010 {published data only}
    1. Doepel M, Le Bell Y, Ekberg EC, Nilner M. Effectiveness of prefabricated occlusal appliance in TMD patients with headache. In: IADR General Session; 2010, Jul 14-17; Barcelona, Spain. 2010:3605.
Doepel 2018 {published data only}
    1. Doepel M, Nilner M, Vahlberg T, Le Bell Y. Similar treatment outcome in myofascial TMD patients with localized and widespread pain. Acta Odontologica Scandinavica 2018;76(3):175-82. [DOI: 10.1080/00016357.2017.1399215] - DOI - PubMed
Dogu 2009 {published data only}
    1. Dogu B, Yilmaz F, Karan A, Ergoz E, Kuran B. Comparative the effectiveness of occlusal splint and TENS treatments on clinical findings and pain threshold of temporomandibular disorders secondary to bruxism. Turkiye fiziksel tip ve rehabilitasyon dergisi 2009;55(1):1-7.
Ekberg 1998 {published data only}
    1. Ekberg, E. Treatment of temporomandibular disorders of arthrogeneous origin. Controlled double-blind studies of a non-steroidal anti-inflammatory drug and a stabilisation appliance. Swedish Dental Journal. Supplement 1998;131:1-57. - PubMed
Ekberg 2002a {published data only}
    1. Ekberg E, Nilner M, Vallon D. The efficacy of occlusal appliance therapy in patients with temporomandibular disorders of mainly myogenous pain. A randomized-controlled trial in a short-term perspective [abstract]. Journal of Oral Rehabilitation 2002;29(9):874.
Ekberg 2009 {published data only}
    1. Ekberg EC, Doepel M, Le Bell Y, Nilner M. Effectiveness of a prefabricated occlusal appliance, relax, in the long-term. In: 87th general session and exhibition of IADR/AADR/CADR; 2009, Apr 1-4; Miami, Florida, United States. 2009:868.
Ekici 2021 {published data only}
    1. Ekici O, Dundar U, Gokay GD, Buyukbosna M. Evaluation of the efficiency of different treatment modalities in individuals with painful temporomandibular joint disc displacement with reduction: a randomised controlled clinical trial. British Journal of Oral & Maxillofacial Surgery 2021;60:350-6. [DOI: 10.1016/j.bjoms.2021.08.001] - DOI - PubMed
Elsharkawy 1995 {published data only}
    1. Elsharkawy TM, Ali NM. Evaluation of acupuncture and occlusal splint therapy in the treatment of temporomandibular joint disorders. Egyptian Dental Journal 1995;41(3):1227-32. - PubMed
Erbasar 2017 {published data only}
    1. Hasanoglu Erbasar GN, Alpaslan C, Eroglu Inan G. Can an NTI-tss device be effective as a first-line therapy in patients with TMD myofascial pain? Journal of Oral Rehabilitation 2017;44(8):589-93. [DOI: 10.1111/joor.12524] - DOI - PubMed
Erixon 2013 {published data only}
    1. Erixon CL, Ekberg E. Self-perceived effects of occlusal appliance therapy on TMD patients: an eight-year follow-up. Swedish Dental Journal 2013;37(1):13-22. - PubMed
Haketa 2010 {published data only}
    1. Haketa T, Kino, K, Sugisaki M, Takaoka M, Ohta, T. Randomized clinical trial of treatment for TMJ disc displacement. Journal of Dental Research 2010;89(11):1259-63. [DOI: 10.1177/0022034510378424] - DOI - PubMed
Hosgor 2017 {published data only}
    1. Hosgor H, Bas B, Celenk C. A comparison of the outcomes of four minimally invasive treatment methods for anterior disc displacement of the temporomandibular joint. International Journal of Oral and Maxillofacial Surgery 2017;46(11):1403-10. - PubMed
Huggins 1997 {published data only}
    1. Huggins KH, Truelove EL, Dworkin SF, LeResche L, et al. Randomized clinical trail (RCT) of a soft splint for TMD [abstract]. Journal of Dental Research 1997;76(Spec Iss 1):389, Abstract no: 3005.
Jokstad 2005 {published data only}
    1. Jokstad A, Mo A, Krogstad BS. Clinical comparison between two different splint designs for temporomandibular disorder therapy. Acta Odontologica Scandinavica 2005;63(4):218-26. [DOI: 10.1080/00016350510019982] - DOI - PubMed
JPRN UMIN000002711 {published data only}
    1. JPRN-UMIN000002711. Randomized trial to evaluate the effects of splint therapy for temporomandibular disorders. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R00000... (first received 27 November 2009).
Kerstein 1997 {published data only}
    1. Kerstein RB, Chapman R, Klein M. A comparison of ICAGD (immediate complete anterior guidance development) to mock ICAGD for symptom reductions in chronic myofascial pain dysfunction patients. Cranio : the Journal of Craniomandibular Practice 1997;15(1):21-37. - PubMed
Korkmaz 2016 {published data only}
    1. Korkmaz YT, Altintas, NY, Korkmaz FM, Candirli C, Coskun U, Durmuslar MC. Is hyaluronic acid Injection effective for the treatment of temporomandibular joint disc displacement with reduction? Journal of Oral and Maxillofacial Surgery 2016;74(9):1728-40. [DOI: 10.1016/j.joms.2016.03.005] - DOI - PubMed
Lindfors 2020 {published data only}
    1. Lindfors E, Magnusson T, Ernberg M. Effect of therapeutic jaw exercises in the treatment of masticatory myofascial pain: a randomized controlled study. Journal of Oral & Facial Pain and Headache 2020;34(4):364-73. [DOI: 10.11607/ofph.2670] - DOI - PubMed
List 1992 {published data only}
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Lundh 1985 {published data only}
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Lundh 1988 {published data only}
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Lundh 1992 {published data only}
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Machon 2011 {published data only}
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Madani 2011 {published data only}
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Magnusson 2004 {published data only}
    1. Magnusson T, Adiels AM, Nilsson HL, Helkimo M. Treatment effect on signs and symptoms of temporomandibular disorders--comparison between stabilisation splint and a new type of splint (NTI). A pilot study. Swedish Dental Journal 2004;28(1):11-20. - PubMed
Martins 2019 {published data only}
    1. Martins L, Cordeiro A, Almeida A, Felix S. Pilot study: ETPS therapy effectiveness versus oral splint. Annals of Medicine 2019;Conference: 3rd International Congresses of CiiEM "Research and Innovation in Human and Health Sciences" and the "UNESCO Chair for Teaching and Research in Digital Anatomy Paris Descartes. Portugal. 51(Supplement 1):S122-3.
Mazzeto 2009 {published data only}
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McArdle 1984 {published data only}
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Mora 2010 {published data only}
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NCT00769561 {published data only}
    1. NCT00769561. Biofeedback-based cognitive behavioral treatment for temporomandibular disorders. https://ClinicalTrials.gov/show/NCT00769561 (first received 8 October 2008).
NCT00899717 {published data only}
    1. NCT00899717. Occlusal adjustment as treatment for chronic orofacial pain. https://ClinicalTrials.gov/show/NCT00899717 (first received 11 May 2009).
NCT00936338 {published data only}
    1. NCT00936338. Randomized clinical trial of treatment for temporomandibular joint (TMJ) disc displacement. https://ClinicalTrials.gov/show/NCT00936338 (first received 9 July 2009).
NCT01409850 {published data only}
    1. NCT01409850. Comparison study of two splints used for treatment of acute temporomandibular pain. https://ClinicalTrials.gov/show/NCT01409850 (first received 3 August 2011).
NCT01544439 {published data only}
    1. NCT01544439. Occlusal splint and counseling to temporomandibular disorder. https://clinicaltrials.gov/ct2/show/NCT01544439 (first received 23 February 2012).
NCT01874041 {published data only}
    1. NCT01874041. Effect of massage therapy and occlusal splint therapy on the electromyographic activity and mandibular range of motion in individuals with temporomandibular disorder. https://ClinicalTrials.gov/show/NCT01874041 (first received 6 June 2013).
NCT02251015 {published data only}
    1. NCT02251015. Effects of the use of occlusal splint on the postural balance of individuals with temporomandibular disorder. https://ClinicalTrials.gov/show/NCT02251015 (first received 6 November 2013).
NCT02380105 {published data only}
    1. NCT02380105 2015. Effectiveness of a counseling program for temporomandibular disorders (TMD) treatment. https://clinicaltrials.gov/ct2/show/NCT02380105 (first received 14 November 2014).
NCT02397070 {published data only}
    1. NCT02397070. Effectiveness of a jaw exercise program in temporomandibular disorders patients. https://clinicaltrials.gov/ct2/show/NCT02397070 (first received 18 March 2015).
NCT02637544 {published data only}
    1. NCT02637544. Treatment efficiency of acupuncture in non chronified pain patients with TMDs. https://ClinicalTrials.gov/show/NCT02637544 (first received 1 October 2015).
NCT02960048 {published data only}
    1. NCT02960048. Clinical evaluation of stabilizing splint (Michigan-type occlusal splint) versus anterior repositioning splint. https://ClinicalTrials.gov/show/NCT02960048 (first received 7 November 2016).
NCT02991326 {published data only}
    1. NCT02991326. Osteopathic manipulative treatment in individuals with temporomandibular disorder who make use of occlusal splints. https://ClinicalTrials.gov/show/NCT02991326 (first received 7 December 2016).
NCT02997410 {published data only}
    1. NCT02997410. Ozone therapy for masticatory muscle pain (OTMMP). https://ClinicalTrials.gov/show/NCT02997410 (first received 13 December 2016).
NCT03180671 {published data only}
    1. NCT03180671. Anterior deprogrammers for reducing pain and masticatory muscles tension. https://ClinicalTrials.gov/show/NCT03180671 (first received 3 June 2017).
Nelson 1988 {published data only}
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Nilner 2002 {published data only}
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Nilsson 2010a {published data only}
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Okeson 1983 {published data only}
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PACTR201804003264155 {published data only}
    1. PACTR201804003264155. Physiotherapy for temporomandibular joint dysfunction (TMD). https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=3264 (first received 29 March 2018).
Padamsee 1996 {published data only}
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Pettengill 1998 {published data only}
    1. Pettengill CA, Growney MR Jr, Schoff R, Kenworthy CR. A pilot study comparing the efficacy of hard and soft stabilizing appliances in treating patients with temporomandibular disorders. Journal of Prosthetic Dentistry 1998;79(2):165-8. [DOI: 10.1016/s0022-3913(98)70211-2] - DOI - PubMed
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Sabu 2019 {published data only}
    1. Sabu I, Saranya SK, Mathew A, Subash P, Janakiram C. Comparative evaluation of the efficacy of occlusal splints fabricated in different temporomandibular positions for treatment in temporomandibular disorder patients. Indian Journal of Public Health Research and Development 2019;10(12):470-6. [DOI: 10.37506/v10/i12/2019/ijphrd/191998] - DOI
Schiffman 2007 {published data only}
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    1. Tecco S, Tete S, D'Attilio M, Perillo L, Festa F. Surface electromyographic patterns of masticatory, neck, and trunk muscles in temporomandibular joint dysfunction patients undergoing anterior repositioning splint therapy. European Journal of Orthodontics 2008;30(6):592-7. [DOI: 10.1093/ejo/cjn052] - DOI - PubMed
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Tsolka 1992 {published data only}
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References to ongoing studies

ChiCTR2000032699 {published data only}
    1. ChiCTR2000032699. Clinical randomized controlled study on the effects of digital SIP splint on masticatory muscle pain. www.chictr.org.cn/showprojen.aspx?proj=53352 (first received 7 May 2020).
ChiCTR2000034997 {published data only}
    1. ChiCTR2000034997. The effect of soft and hard occlusal splint in the treatment of temporomandibular joint disorder: a randomized controlled trial. www.chictr.org.cn/hvshowproject.aspx?id=45122 (first received 27 July 2020).
IRCT2016110730761N1 {published data only}
    1. IRCT2016110730761N1. The effect of splint and electrical stimulating on temporomandibular joint disorders [Comparing the treatment efficacy of splint and electrical stimulating on temporomandibular joint disorders]. trialsearch.who.int/Trial2.aspx?TrialID=IRCT2016110730761N1 (first received 15 December 2016).
IRCT20180513039631N1 {published data only}
    1. IRCT20180513039631N1. Comparison of the effect of different thickness of soft and hard occlusal splints on reducing clinical symptoms in patients with temporomandibular joint disorders. trialsearch.who.int/Trial2.aspx?TrialID=IRCT20180513039631N1 (first received 5 January 2019).
IRCT20211010052719N1 {published data only}
    1. IRCT20211010052719N1. Investigation of the effects of three conservative treatment methods on temporomandibular disorders. trialsearch.who.int/Trial2.aspx?TrialID=IRCT20211010052719N1 (first received 26 October 2021).
IRCT20211020052823N1 {published data only}
    1. IRCT20211020052823N1. Comparative effectiveness of transcutaneous electrical nerve stimulation, low level laser therapy and occlusal splint in the treatment of muscular TMJ disorders. trialsearch.who.int/Trial2.aspx?TrialID=IRCT20211020052823N1 (first received 22 December 2021).
NCT01725867 {published data only}
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NCT01949064 {published data only}
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NCT02992379 {published data only}
    1. NCT02992379. Clinical evaluation of stabilizing splint versus pivot splint as jaw exercise together with stabilizing splint. clinicaltrials.gov/show/nct02992379 (first received 14 December 2016).
NCT03096301 {published data only}
    1. NCT03096301. Photobiomodulation in temporomandibular disorder. clinicaltrials.gov/ct2/show/NCT03096301 (first received 30 March 2017).
    1. Sobral APT, Godoy CLH, Fernandes KPS, Bussadori SK, Ferrari RAM, Horliana ACRT et al. Photomodulation in the treatment of chronic pain in patients with temporomandibular disorder: protocol for cost-effectiveness analysis. BMJ Open 2018;8(5):e018326. [DOI: 10.1136/bmjopen-2017-018326] - DOI - PMC - PubMed
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NCT04116255 {published data only}
    1. NCT04116255. Effects of occlusal splint and therapeutic home exercises. clinicaltrials.gov/show/nct04116255 (first received 4 October 2019).
NCT04456946 {published data only}
    1. NCT04456946. Prospective investigation of the effects of different treatment techniques on myofascial trigger points in patients with temporomandibular dysfunction (TMD). clinicaltrials.gov/show/NCT04456946 (first received 7 July 2020).
NCT04588636 {published data only}
    1. NCT04588636. Behavioral therapy and self-care vs thermoformed occlusal splints in the treatment of masticatory muscles pain. clinicaltrials.gov/show/NCT04588636 (first received 19 October 2020).
NCT04777838 {published data only}
    1. NCT04777838. Myofascial pain patients' response to the administration of low doses of amitriptyline and citalopram compared with the use of bite splint. clinicaltrials.gov/show/NCT04777838 (first received 2 March 2021).
NCT05228327 {published data only}
    1. NCT05228327. Occlusal splint and masticatory muscle injection in myofacial pain. clinicaltrials.gov/show/NCT05228327 (first received 11 January 2022).
NCT05362877 {published data only}
    1. NCT05362877. The effect of earplugs on myogenous temporomandibular disorders. clinicaltrials.gov/ct2/show/NCT05362877 (first received 5 May 2022).

Additional references

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References to other published versions of this review

Singh 2017a
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