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healthy_back1) https://pmc.ncbi.nlm.nih.gov/articles/PMC7222619/
J Korean Assoc Oral Maxillofac Surg. 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
2) https://pubmed.ncbi.nlm.nih.gov/11870599/
Anat Rec. 2002 Mar 1;266(3):167-76. doi: 10.1002/ar.10050.
Morphologic changes in the TMJ following splint wear
Betty J Sindelar 1 , Stan Edwards, Susan W Herring
Affiliations PMID: 11870599 DOI: 10.1002/ar.10050
Young adult, female miniature pigs were divided into three groups: open-bite splint, protrusive-bite splint, and unsplinted control. Splints were worn for 2 months, after which the TMJ discs were harvested for histological examination and stereological analysis, and the skulls were cleaned. Although the splints had no effect on skull dimensions, changes were seen in the TMJs. The discs of the protrusively-splinted group showed an increased thickness of the posterior band (P < 0.015) and minor changes in collagen orientation of the anterior band. The most striking change was the presence of a degenerative osseous defect on the medial side of the mandibular condyle in half of the splinted animals. These results indicate that prolonged splint wear can induce remodeling and even injury of TMJ tissues.
3) https://pubmed.ncbi.nlm.nih.gov/32065109/
Health Technol Assess. 2020 Feb;24(7):1-224.
doi: 10.3310/hta24070.
Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation
Philip Riley 1, Anne-Marie Glenny 1, Helen V Worthington 1, Elisabet Jacobsen 2, Clare Robertson 3, Justin Durham 4, Stephen Davies 5, Helen Petersen 6, Dwayne Boyers 2
Affiliations PMID: 32065109 PMCID: PMC7049908 DOI: 10.3310/hta24070
Conclusions: The very low-quality evidence identified did not demonstrate that splints reduced pain in temporomandibular disorders as a group of conditions. There is insufficient evidence to determine whether or not splints reduce tooth wear in patients with bruxism. There remains substantial uncertainty surrounding the most plausible incremental cost-effectiveness ratio.
4) https://pubmed.ncbi.nlm.nih.gov/31982236/
Int J Oral Maxillofac Surg. 2020 Aug;49(8):1042-1056.
doi: 10.1016/j.ijom.2020.01.004. Epub 2020 Jan 22.
Effectiveness of occlusal splint therapy in the management of temporomandibular disorders: network meta-analysis of randomized controlled trials
E A Al-Moraissi 1 , R Farea 2 , K A Qasem 3 , M S Al-Wadeai 4 , M E Al-Sabahi 4 , G M Al-Iryani 5
Affiliations PMID: 31982236 DOI: 10.1016/j.ijom.2020.01.004
A network meta-analysis (NMA) of randomized controlled trials (RCTs) was performed to assess the effectiveness of various types of occlusal splint in the management of temporomandibular disorders (TMDs) and to rank them according to their effectiveness. An electronic search was undertaken to identify RCTs published until August 2019. Predictor variables were control, non-occluding splint, hard stabilization splint (HSS), soft stabilization splint (SSS), prefabricated splint, mini-anterior splint, anterior repositioning splint (ARS), and counselling therapy (CT) with or without HSS. Outcome variables were pain improvement, post-treatment pain intensity, improvement in mouth opening, and disappearance of temporomandibular joint (TMJ) sounds. Forty-eight RCTs were included. There was a significant decrease in post-treatment pain intensity in arthrogenous TMDs after ARS (low quality evidence), CT+HSS (moderate quality evidence), mini-anterior splints (very low quality evidence), and HSS alone (low quality evidence), when compared to the control. There was a significant decrease in post-treatment pain intensity in myogenous TMDs with mini-anterior splints (very low quality evidence), SSS (very low quality evidence), CT alone (moderate quality evidence), CT+HSS (moderate quality evidence), and HSS alone (moderate quality evidence), when compared to control. ARS and CT were superior in decreasing TMJ clicking than control and HSS alone. The three highest-ranked treatments for post-treatment pain reduction in arthrogenous TMDs were ARS (92%, very low quality evidence), CT+HSS (67.3%, low quality evidence), and HSS alone (52.9%, moderate quality evidence). For myogenous TMDs, they were mini-anterior splints (86.8%, low quality evidence), CT+HSS (61.2%, very low quality evidence), and HSS alone (59.7%, moderate quality evidence). Based on this NMA of 48 RCTs, there is moderate to very low quality evidence confirming the effectiveness of occlusal splint therapy in the treatment of TMDs. Multimodal therapy consisting of CT+HSS may produce the maximum improvement for TMD patients.
5) https://pmc.ncbi.nlm.nih.gov/articles/PMC6820445/
Acta Stomatol Croat. 2019 Sep;53(3):195–206. doi: 10.15644/asc53/3/1
Long-term Effectiveness of Occlusal Splint Therapy Compared to Placebo in Patients with Chronic Temporomandibular Disorders
Ema Vrbanović 1,✉, Iva Z Alajbeg 1 PMCID: PMC6820445 PMID: 31749451
During 6-month period, SS was more effective than PS in reducing spontaneous pain and improving self-perceived quality of life and functional limitations of the lower jaw. Moreover, significantely higher values of pain-free mouth opening were observed in patients treated with stabilization splint. While placebo might be partly responsible for improving the symptoms of TMD, it seems that itcannot maintain a continual long-term positive therapeutic effect.
J Korean Assoc Oral Maxillofac Surg. 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
2) https://pubmed.ncbi.nlm.nih.gov/11870599/
Anat Rec. 2002 Mar 1;266(3):167-76. doi: 10.1002/ar.10050.
Morphologic changes in the TMJ following splint wear
Betty J Sindelar 1 , Stan Edwards, Susan W Herring
Affiliations PMID: 11870599 DOI: 10.1002/ar.10050
Young adult, female miniature pigs were divided into three groups: open-bite splint, protrusive-bite splint, and unsplinted control. Splints were worn for 2 months, after which the TMJ discs were harvested for histological examination and stereological analysis, and the skulls were cleaned. Although the splints had no effect on skull dimensions, changes were seen in the TMJs. The discs of the protrusively-splinted group showed an increased thickness of the posterior band (P < 0.015) and minor changes in collagen orientation of the anterior band. The most striking change was the presence of a degenerative osseous defect on the medial side of the mandibular condyle in half of the splinted animals. These results indicate that prolonged splint wear can induce remodeling and even injury of TMJ tissues.
3) https://pubmed.ncbi.nlm.nih.gov/32065109/
Health Technol Assess. 2020 Feb;24(7):1-224.
doi: 10.3310/hta24070.
Oral splints for patients with temporomandibular disorders or bruxism: a systematic review and economic evaluation
Philip Riley 1, Anne-Marie Glenny 1, Helen V Worthington 1, Elisabet Jacobsen 2, Clare Robertson 3, Justin Durham 4, Stephen Davies 5, Helen Petersen 6, Dwayne Boyers 2
Affiliations PMID: 32065109 PMCID: PMC7049908 DOI: 10.3310/hta24070
Conclusions: The very low-quality evidence identified did not demonstrate that splints reduced pain in temporomandibular disorders as a group of conditions. There is insufficient evidence to determine whether or not splints reduce tooth wear in patients with bruxism. There remains substantial uncertainty surrounding the most plausible incremental cost-effectiveness ratio.
4) https://pubmed.ncbi.nlm.nih.gov/31982236/
Int J Oral Maxillofac Surg. 2020 Aug;49(8):1042-1056.
doi: 10.1016/j.ijom.2020.01.004. Epub 2020 Jan 22.
Effectiveness of occlusal splint therapy in the management of temporomandibular disorders: network meta-analysis of randomized controlled trials
E A Al-Moraissi 1 , R Farea 2 , K A Qasem 3 , M S Al-Wadeai 4 , M E Al-Sabahi 4 , G M Al-Iryani 5
Affiliations PMID: 31982236 DOI: 10.1016/j.ijom.2020.01.004
A network meta-analysis (NMA) of randomized controlled trials (RCTs) was performed to assess the effectiveness of various types of occlusal splint in the management of temporomandibular disorders (TMDs) and to rank them according to their effectiveness. An electronic search was undertaken to identify RCTs published until August 2019. Predictor variables were control, non-occluding splint, hard stabilization splint (HSS), soft stabilization splint (SSS), prefabricated splint, mini-anterior splint, anterior repositioning splint (ARS), and counselling therapy (CT) with or without HSS. Outcome variables were pain improvement, post-treatment pain intensity, improvement in mouth opening, and disappearance of temporomandibular joint (TMJ) sounds. Forty-eight RCTs were included. There was a significant decrease in post-treatment pain intensity in arthrogenous TMDs after ARS (low quality evidence), CT+HSS (moderate quality evidence), mini-anterior splints (very low quality evidence), and HSS alone (low quality evidence), when compared to the control. There was a significant decrease in post-treatment pain intensity in myogenous TMDs with mini-anterior splints (very low quality evidence), SSS (very low quality evidence), CT alone (moderate quality evidence), CT+HSS (moderate quality evidence), and HSS alone (moderate quality evidence), when compared to control. ARS and CT were superior in decreasing TMJ clicking than control and HSS alone. The three highest-ranked treatments for post-treatment pain reduction in arthrogenous TMDs were ARS (92%, very low quality evidence), CT+HSS (67.3%, low quality evidence), and HSS alone (52.9%, moderate quality evidence). For myogenous TMDs, they were mini-anterior splints (86.8%, low quality evidence), CT+HSS (61.2%, very low quality evidence), and HSS alone (59.7%, moderate quality evidence). Based on this NMA of 48 RCTs, there is moderate to very low quality evidence confirming the effectiveness of occlusal splint therapy in the treatment of TMDs. Multimodal therapy consisting of CT+HSS may produce the maximum improvement for TMD patients.
5) https://pmc.ncbi.nlm.nih.gov/articles/PMC6820445/
Acta Stomatol Croat. 2019 Sep;53(3):195–206. doi: 10.15644/asc53/3/1
Long-term Effectiveness of Occlusal Splint Therapy Compared to Placebo in Patients with Chronic Temporomandibular Disorders
Ema Vrbanović 1,✉, Iva Z Alajbeg 1 PMCID: PMC6820445 PMID: 31749451
During 6-month period, SS was more effective than PS in reducing spontaneous pain and improving self-perceived quality of life and functional limitations of the lower jaw. Moreover, significantely higher values of pain-free mouth opening were observed in patients treated with stabilization splint. While placebo might be partly responsible for improving the symptoms of TMD, it seems that itcannot maintain a continual long-term positive therapeutic effect.