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Title Equal Efficacy Of Occlusal Splints Fabricated In Centric Relation Or Maximum Intercuspation In Temporomandibular Disorders Patients
Clinical Question In patients with temporomandibular joint disorders, is fabricating occlusal splints in CR more effective in alleviating pains and symptoms compared to occlusal splints fabricated in MI?
Clinical Bottom Line Occlusal splints made in either MI or CR are equally affective in treating TMD patients. (See Comments on the CAT below)
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) 19148403Hamata/200920 TMD PatientsRandomized Controlled Trial
Key resultsThe intensity, duration, and frequency of pain were reduced significantly in both group 1 (MI) and group 2 (CR). Electromyographic examination showed no significant differences (p>0.05) between the 2 groups (MI and CR). Electrognathographic examinations of group 1 (MI) showed significant differences only at maximum left lateral movement (p<0.05), while group 2 (CR) showed significant differences only at maximum right lateral movement (P<0.05).
Evidence Search "Temporomandibular Joint Disorders"[Mesh]) AND "Occlusal Splints"[Mesh]) AND "Centric Relation"[Mesh] ...view in PubMed
Comments on
The Evidence
This is a randomized controlled trial that included 20 TMD patients of myogenous origin which also all had bruxism. The patients were randomly divided into 2 groups of 10. Both groups had a female predominance. One group was treated with occlusal splints made in MI while the other group was treated with occlusal splints made in CR. All of the patients completed the research study and adequate follow up was provided in order to evaluate the occlusal stability of the splints.
Applicability Patients with TMD
Specialty/Discipline (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Temporomandibular disorder, occlusal splints, centric occlusion, maximum intercuspation
ID# 786
Date of submission: 04/12/2011spacer Revised: 09/21/2011
E-mail dingy3@livemail.uthscsa.edu
Author Yunyi Ding
Co-author(s) e-mail
Faculty mentor/Co-author Edward F. Wright, DDS, MS
Faculty mentor/Co-author e-mail WrightE2@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 Edward Wright, DDS (San Antonio, TX) on 05/02/2015
The Conti et al. study (PMID: 16873326) randomly assigned 57 TMD patients with painful TMJ clicks into three splint groups: bilateral balanced, canine guidance, and non-occluding. The type of guidance did not influence the pain reduction and both occluding splints were superior to the non-occluding splint, on the basis of the VAS. The results of this study suggests bilateral balanced and canine guidance occlusions are equally effective designs for splints.
by Jeff Paz, DDS (San Antonio, TX) on 04/29/2015
Upon delivery of device; what type of occlusion is observed? Balanced, canine, group?
by Evan Grodin (San Antonio, Texas) on 08/01/2011
Upon performing a PubMed Mesh search, it appears as though the Hamata, 2009 article (PMID: 19148403) remains the most current, valid, and relevant article regarding the effectiveness of occlusal splints fabricated to the position of CR or MIP.

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