|
Title |
Occlusal Splints And The Effects On TMD |
Clinical Question |
Is an occlusal splint beneficial for my TMD patient as opposed to a non-splint treatment? |
Clinical Bottom Line |
An occlusal splint appliance is beneficial for reducing pain, TMJ locking and clicking. (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) 17138397 | Fricton/2006 | TMD patients | Meta-Analysis | Key results | Stabilization splints when used for short term were equally effective in reducing T
temporomandibular joint disorder pain compared to behavior medicine, physical medicine, and acupuncture therapy for temporomandibular joint disorder. Anterior positioning and soft splints have some evidence to suggest that they are effective in reducing temporomandibular pain when compared to a placebo control group. When compared, anterior positioning splints were equal or more effective in treating TMJ locking and clicking than stabilization splints. | |
Evidence Search |
"Occlusal Splints"[Mesh] AND "Temporomandibular Joint Disorders"[Mesh] and utilizing Meta-Analysis on limits. ...view in PubMed |
Comments on
The Evidence |
Thirty-nine randomized control trials were reviewed and supports my clinical question. Only 5% of randomized controlled trials for the temporomandibular joint disorder met all the level I criteria. Least common criteria that were met were a lack of blinded randomization process (9%), lack of follow ups (14%), no consideration of cross overs and attrition (36%), ceiling and/or floor effect were not considered (41%), incomplete data analysis (48%), and no sample size calculation with outcome measures (9%). In general, methodological issues used for the RCTs make the results questionable and suggest the need for better-controlled studies with improved methodology. The mean quality score (0-1) of the studies was low at 0.53. |
Applicability |
The results suggest that dental splints are applicable to compliant TMD patients with pain, TMJ locking or clicking. The affordability and availability of the dental splint material would make it feasible for patients to acquire it. |
Specialty/Discipline |
(General Dentistry) |
Keywords |
|
ID# |
609 |
Date of submission: |
05/03/2010 |
E-mail |
rubiof@uthscsa.edu |
Author |
Francisco Rubio |
Co-author(s) |
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Co-author(s) e-mail |
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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 | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Eldon Lamb, Mohammed Alsaati (San Antonio, TX) on 08/08/2013 A new PubMed search performed in August 2013 revealed two more recent systematic reviews/meta-analyses. Ebrahim, 2012 (PMID 22855899 ) and Fricton, 2010 (PMID 20664825 ) both support the findings of this CAT. These systematic reviews conclude by stating that while there is a fair amount of evidence to support using hard intraoral appliances for relief of TMD pain, long-term clinical trials are needed to reduce bias. | |
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