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Journal of Dental Anesthesia and Pain... Jun 2021This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA... (Review)
Review
Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis.
This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with "general HA." Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.
PubMed: 34136641
DOI: 10.17245/jdapm.2021.21.3.183 -
Journal of the American Dental... Aug 2012The authors conducted a systematic review of all published randomized controlled trials in which investigators compared the effectiveness of splint therapy with that of... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The authors conducted a systematic review of all published randomized controlled trials in which investigators compared the effectiveness of splint therapy with that of minimal or no treatment in patients with temporomandibular disorders (TMDs).
TYPES OF STUDIES REVIEWED
The authors searched MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for studies published from inception of each database through August 2011. In eligible studies, investigators enrolled adult patients with TMDs and assigned them randomly to splint therapy or a control group receiving minimal or no treatment.
RESULTS
Of 1,567 potentially eligible studies, 11 proved eligible and were included. Moderate-quality evidence suggests that splint therapy reduced pain in the temporomandibular joint (TMJ) area (standardized response mean = -0.93, 95 percent confidence interval [CI], -1.33 to -0.53; risk difference for having continued pain = -0.35, 95 percent CI, -0.21 to -0.46; mean change on the 100-millimeter visual analog scale = -11.5 mm, 95 percent CI, -16.5 mm to -6.6 mm). Low to very low quality of evidence showed no significant differences between the splint therapy and control groups in terms of quality of life or depression. None of the trial reports described effect on function.
CONCLUSIONS
Although overall results are promising for the reduction of pain, establishing the role of splints for patients with TMDs will require large trials with stronger safeguards against bias.
Topics: Humans; Occlusal Splints; Randomized Controlled Trials as Topic; Temporomandibular Joint Disorders
PubMed: 22855899
DOI: 10.14219/jada.archive.2012.0289 -
Journal of Prosthodontic Research Jan 2024Purpose Temporomandibular disorders (TMDs) are frequent stomatological disorders. However, their treatment is controversial. Therefore, we compared the efficacy of... (Meta-Analysis)
Meta-Analysis
Purpose Temporomandibular disorders (TMDs) are frequent stomatological disorders. However, their treatment is controversial. Therefore, we compared the efficacy of combination therapy (splint therapy along with physiotherapy, manual therapy, and counseling) with physiotherapy, manual therapy, and counseling alone. The extent of mouth opening and pain perception were the outcomes.Study selection Systematic searches for English publications were performed using four major literature databases (Cochrane Library, EMBASE, PubMed, and Web of Science). We included randomized controlled trials. We calculated mean differences with 95% confidence interval (CI) for pain perception and maximum mouth opening (MMO) for the two groups. The Hartung-Knapp adjustment was used for cases comprising at least five studies.Results Six articles were included in the pain perception category, and four were reviewed for MMO at baseline. Four articles assessed pain perception, and two assessed MMO at 1 month. Five articles were analyzed upon comparing pain perception at baseline and 1-month follow-up. The mean difference was -2.54 [95% CI: -3.38; to -1.70] in the intervention group and -2.33 [95% CI: -4.06; to -0.61] in the control group. Two articles were analyzed upon comparing MMO at baseline and 1-month follow-up. The mean difference in the intervention group was 3.69 [95% CI: -0.34; 7.72], whereas that in the control group was 3.62 [95% CI: -3.43; 10.67].Conclusions Both therapies can be used in the management of myogenic TMD. Due to the marginal differences between the baseline and 1-month values, our results could not confirm the efficacy of combination therapy.
Topics: Humans; Splints; Treatment Outcome; Randomized Controlled Trials as Topic; Temporomandibular Joint Disorders; Pain
PubMed: 37286515
DOI: 10.2186/jpr.JPR_D_22_00264 -
Cranio : the Journal of... Nov 2023To evaluate current studies to establish and compare the efficacy of traditional and laser acupuncture in reducing the signs and symptoms of temporomandibular disorders...
OBJECTIVE
To evaluate current studies to establish and compare the efficacy of traditional and laser acupuncture in reducing the signs and symptoms of temporomandibular disorders (TMD).
METHODS
PubMed, Cochrane, Scopus, and Web of Science databases were searched. Clinical, controlled, and randomized trials written in English and having used traditional or laser acupuncture as therapy for TMD and RDC/TMD or DC/TMD as a diagnostic criterion for TMD were included.
RESULTS
Six studies that evaluated the intensity of pain and the level of mouth opening of the patients submitted to acupuncture were selected, and all showed improvement. However, similar results were also observed in the groups treated with occlusal splint and placebo acupuncture. Only one study evaluated laser acupuncture and showed a higher proportion of patients with remission of symptoms in the experimental group.
CONCLUSION
The traditional acupuncture seems to relieve the signs and symptoms of TMD, as well as laser acupuncture when associated with occlusal splint. However, more rigorous and high-quality clinical trials are needed.
Topics: Humans; Temporomandibular Joint Disorders; Acupuncture Therapy; Pain; Occlusal Splints; Lasers; Treatment Outcome
PubMed: 33433268
DOI: 10.1080/08869634.2021.1873605 -
Archives de Pediatrie : Organe Officiel... Jan 2022Primary sleep bruxism (SB) affects between 6 and 30% of children and adolescents. Its frequency increases with age, reaching a peak at 10-14 years of age, after which it... (Review)
Review
AIM
Primary sleep bruxism (SB) affects between 6 and 30% of children and adolescents. Its frequency increases with age, reaching a peak at 10-14 years of age, after which it drops until adulthood. The treatment of SB has not been extensively documented, resulting in a lack of reference points and legitimate concerns for dentists in their everyday practice. The aim of this literature review was to summarize the available evidence on the management of SB in children and adolescents and the efficacy of the different approaches.
METHOD
A systematic literature search was conducted according to PRISMA guidelines from January 2006 to December 2020 using the PubMed, The Cochrane Library, Science Direct, and Google Scholar databases. All types of SB treatment were accepted. Eight studies were selected for their protocol quality, according to the PICOS tool.
RESULTS
Several treatment methods were assessed from the eight clinical studies selected, such as occlusal splint, palatal expansion, and pharmacological treatment. Assessment of the treatment methods was difficult because only eight studies were selected, and both the treatment methods and the study protocols used were different. The therapeutic strategies found in the literature were based on the general condition of the case. Treatment approaches were distinguished into treatments for isolated SB and those for SB associated with ventilatory disorders.
CONCLUSION
The current study shows the need to define diagnostic criteria adapted to SB in children in order to improve epidemiological surveys and subsequently clinical practice. To overcome the difficulties related to SB diagnostic criteria, a multidisciplinary approach, involving pediatricians, otorhinolaryngologists, and dental practitioners, is essential for a better management and follow-up of young patients. A case-by-case approach, taking into account the specificities of each young patient, seems the most appropriate management today.
Topics: Adolescent; Child; Dentists; Humans; Occlusal Splints; Palatal Expansion Technique; Professional Role; Sleep Bruxism
PubMed: 34955303
DOI: 10.1016/j.arcped.2021.11.014 -
Journal of Oral Rehabilitation Sep 2013An extensive search for randomised controlled clinical trials was accomplished to compare dental prostheses and occlusal splints constructed with or without face-bow... (Review)
Review
An extensive search for randomised controlled clinical trials was accomplished to compare dental prostheses and occlusal splints constructed with or without face-bow transfer, and question whether face-bow transfer may present better clinical results than simpler approaches. Studies were identified by searching electronic databases (PubMed/MEDLINE, Latin American and Caribbean Literature on the Health Science, and Brazilian Bibliography of Dentistry). The keywords 'dental articulator', 'semi-adjustable articulator', 'face-bow', 'jaw relation record' and 'occlusal splint therapy' were used. The minimum inclusion requirements were (i) randomised controlled trials with patients of any age, (ii) comparison between dental prostheses or occlusal splints constructed with or without face-bow transfer and (iii) assessment of clinician's time, number of occlusal contacts, patient satisfaction or masticatory function. The search resulted in the identification of 8779 articles. Subsequently, 8763 articles were excluded on the basis of title and abstract. By the end of the search phase, eight randomised controlled trials were considered eligible. Current scientific evidence suggests that face-bow transfer is not imperative to achieve better clinical results in prosthodontics. Randomised clinical trials suggest that simpler approaches for the construction of complete dentures and occlusal splints may present acceptable results, while no clinical study has investigated its use in fixed and removable partial dentures.
Topics: Aged; Aged, 80 and over; Dental Prosthesis; Humans; Middle Aged; Occlusal Splints; Prosthodontics; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 23829310
DOI: 10.1111/joor.12081 -
European Journal of Oral Sciences Apr 2024This systematic review answers the question: "Does occlusal appliance use influence masticatory muscle function of dentate individuals with sleep bruxism?". The... (Meta-Analysis)
Meta-Analysis Review
This systematic review answers the question: "Does occlusal appliance use influence masticatory muscle function of dentate individuals with sleep bruxism?". The literature search included six databases, grey literature, and manual search for articles. Randomized and non-randomized clinical trials were included comparing muscle function of sleep bruxers before and after receiving occlusal appliances. Risk of bias was assessed with risk of bias assessment for randomized and non-randomized clinical trials tool. Twelve studies, three represent randomized clinical trials, were included. Risk of bias was considered low, moderate, or serious. Meta-analyses indicated that soft and hard appliances did not influence muscle activity and bite force of bruxers. Qualitative analysis showed that occlusal appliance use did not influence masticatory performance and muscle volume. However, it was effective in reducing tongue force. Certainty of evidence was considered very low for muscle activity when evaluated with hard appliances, and for bite force evaluated with both appliance materials. Low certainty of evidence was observed for muscle activity with soft appliances. Based on the findings of this meta-analysis, occlusal appliances do not affect masticatory muscle function of sleep bruxers. Regardless of appliance material, the activity of masseter and temporal, and bite force of sleep bruxers was not influenced.
Topics: Humans; Sleep Bruxism; Masticatory Muscles; Masseter Muscle; Occlusal Splints; Sleep
PubMed: 38421263
DOI: 10.1111/eos.12979 -
Journal of Oral & Facial Pain and... 2014To carry out a systematic review and meta-analysis comparing the effects of occlusal splint therapy ("usual treatment") and psychosocial interventions for the treatment... (Meta-Analysis)
Meta-Analysis Review
AIMS
To carry out a systematic review and meta-analysis comparing the effects of occlusal splint therapy ("usual treatment") and psychosocial interventions for the treatment of myofascial temporomandibular disorder (TMD) pain in adult patients.
METHODS
Independent screening and evaluation of randomized clinical trials included comparisons between "usual treatment" based on splint therapy and psychosocial interventions for TMD treatment within electronic databases (PubMed/MEDLINE, CENTRAL, EMBASE), ongoing trials databases (Current Controlled Trials, ClinicalTrials.gov), and additional sources. The outcomes selected for the systematic review were self-reported pain, pain interference, unassisted jaw opening without pain, muscle pain upon palpation, depression, and somatization. The effect measures were analyzed using a random-effect model (Review Manager computer program).
RESULTS
The outcomes "longterm self-reported pain" and "long-term depression" were significantly different for the comparisons of "usual treatment" and psychosocial interventions, and they favored the latter (P < .005 and P < .05, respectively). These results must be viewed with caution due to the limited number of studies available. A tendency toward greater improvements of psychological outcomes was observed for psychosocial interventions, while physical functioning was slightly more responsive to "usual treatment."
CONCLUSION
No evidence was found to distinguish the clinical effectiveness between "usual treatment" and psychosocial interventions for myofascial TMD pain. Future studies of TMD and related subdiagnoses should be reported according to core standardized outcomes to facilitate comparisons.
Topics: Depression; Humans; Occlusal Splints; Pain Measurement; Psychotherapy; Randomized Controlled Trials as Topic; Range of Motion, Articular; Somatoform Disorders; Temporomandibular Joint Dysfunction Syndrome; Treatment Outcome
PubMed: 25068215
DOI: 10.11607/ofph.1241 -
Healthcare (Basel, Switzerland) Apr 2022There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients.... (Review)
Review
There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web of Science, and Scopus were systematically searched from inception until 5 January 2022 to identify observational studies with a longitudinal study design presenting: patients with diagnosis of TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); occlusal splint therapy as intervention; postural assessment as outcome. Out of 133 records identified, 104 were suitable for data screening, and only 7 articles were included satisfying the eligibility criteria. We found that occlusal splints might have a positive effect on posture in TMD patients, albeit there is little evidence of appropriate investigation for postural assessment. This systematic review suggested that the occlusal splint might be considered a non-invasive therapeutic approach for patients with TMD. However, the low number of studies with high-quality methodology in these patients showed an urgent need for further research using combined force platform stabilometry and kinematic evaluation of the spine to investigate the impact of occlusal splints on posture.
PubMed: 35455916
DOI: 10.3390/healthcare10040739 -
Journal of Oral Rehabilitation Feb 2013There are few review articles in the area of human research that focus on the interactions between occlusion and brain function. This systematic review discusses the... (Review)
Review
There are few review articles in the area of human research that focus on the interactions between occlusion and brain function. This systematic review discusses the effect of occlusion on the health of the entire body with a focus on brain function. Available relevant articles in English from 1999 to 2011 were assessed in an online database and as hard copies in libraries. The selected 19 articles were classified into the following five categories: chewing and tongue movements, clenching and grinding, occlusal splints and occlusal interference, prosthetic rehabilitation, and pain and stimulation. The relationships between the brain activity observed in the motor and sensory cortices and movements of the oral and maxillofacial area, such as those produced by gum chewing, tapping and clenching, were investigated. It was found that the sensorimotor cortex was also affected by the placement of the occlusal interference devices, splints and implant prostheses. Brain activity may change depending on the strength of the movements in the oral and maxillofacial area. Therefore, mastication and other movements stimulate the activity in the cerebral cortex and may be helpful in preventing degradation of a brain function. However, these findings must be verified by evidence gathered from more subjects.
Topics: Bruxism; Cerebral Cortex; Dental Occlusion; Dental Occlusion, Traumatic; Dental Prosthesis; Health Status; Humans; Mastication; Occlusal Splints; Tongue; Toothache
PubMed: 22624951
DOI: 10.1111/j.1365-2842.2012.02316.x