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Title Self-care Treatment Without Intraoral Splint Appliance Is Comparable To Self-Care Treatment With Intraoral Splint Appliance In Treating Patients With TMD
Clinical Question In patients with temporomandibular disorders, is self-care treatment without intraoral appliance less effective than self-care treatment with an intraoral appliance such as splint therapy?
Clinical Bottom Line There was no significant difference between self-care treatment with appliance or without. All patients improved over time with all signs and symptoms equally being reduced over the course of the trial.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 16873325Truelove/2006Patients with TMDRandomized Controlled Trial
Key resultsSplint therapy did not provide a greater benefit than self-care treatment without splint therapy for patients with TMD.
#2) 18976268Alencar/2009Patients’ with myofascial pain dysfunctionRandomized Controlled Trial
Key resultsBoth occlusal splints and non-occlusal splint therapy improved all patients with myofascial pain over time and was able to equally reduce the symptoms myofascial pain.
Evidence Search (("Temporomandibular Joint Disorders"[Mesh]) AND "Occlusal Splints"[Mesh]) AND "Self Care"[Mesh] Limits: Randomized Controlled Trial
Comments on
The Evidence
The evidence excluded any patients with arthritis, disk displacement without reduction, systemic arthritis, or other serious medical complications, full dentures, major psychological disorders or patients that did not speak English. Also, patients that had current splints that they were able to use satisfactorily were excluded.
Applicability The studies show that patients diagnosed with TMD should first be prescribed with a self-care treatment without any intraoral splint appliances.
Specialty/Discipline (General Dentistry)
Keywords Temporomandibular disorder, Occlusal splints,
ID# 2234
Date of submission: 04/11/2012spacer
E-mail nguyenkh@livemail.uthscsa.edu
Author Khoa Nguyen
Co-author(s) e-mail
Faculty mentor/Co-author Adriana V. Green, DDS, MPH
Faculty mentor/Co-author e-mail greenav@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Keaton Shin and Jesse Gonzalez (San Antonio, TX) on 11/28/2017
A PubMed search in November 2017 yielded a meta- analysis by Pficer et al. 2017 (PubMed ID 2816625.) The authors concluded that occlusal splints provided patients' with the short term benefits of pain reduction and intensity. Additional studies with outcomes for the long term benefits of occlusal splints would provide valuable to clinical decision making on this topic.
by Keaton Shin and Jesse Gonzalez (San Antonio, TX) on 11/30/2017
A PubMed search on this topic in November 2017 Two pieces of higher level evidence were found: a meta-analysis by Pficer et al. 2017 (PubMed ID 28166255) and a SR with MA by Ebrahim et.al (2012) All authors concluded that occlusal splints provided patients with short term benefits in reduction of pain and pain intensity. This reduction could be attributed to the amount of time an individual wore the splint Additionally, further studies with standardized criteria for patient recruitment and outcomes assessed need to be conducted in order to show the long-term benefits of occlusal splints, as there was no significant difference between those using occlusal splints versus not.

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