ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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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) 17138397Fricton/2006TMD patientsMeta-Analysis
Key resultsStabilization 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: 05/03/2010spacer
E-mail rubiof@uthscsa.edu
Author Francisco Rubio
Co-author(s)
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
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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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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