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Cited by 67Temporomandibular Joint DisordersOrthodontics and Dentofacial OrthopedicsDental Trauma and Treatments

Oral splints for temporomandibular disorder or bruxism: a systematic review

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Riley, Philip, Glenny, Anne-Marie, Worthington, Helen V., Jacobsen, Elisabet, Robertson, Clare, Durham, Justin, Davies, Stephen, Petersen, Helen +1 more·2020·British Dental Journal
DOI 10.1038/s41415-020-1250-2PMC PMC7718146
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Abstract

Objectives To evaluate the clinical-effectiveness of oral splints for patients with TMD or bruxism for the primary outcomes: pain (TMD) and tooth wear (bruxism). Data sources Four databases including MEDLINE and EMBASE were searched from inception until 1 October 2018. Data selection and extraction Randomised controlled trials comparing all types of splints versus no/minimal treatment for patients with TMD or bruxism were eligible. Standard Cochrane review methods were used. Standardised mean differences (SMD) were pooled for the primary outcome of pain, using random effects models in TMD patients. Data synthesis Thirty-seven trials were included and the evidence identified was of very low certainty using GRADE assessments. When all subtypes of TMD were pooled into one global TMD group, there was no evidence that splints reduced pain: SMD (up to 3 months) -0.18 (95% CI -0.42 to 0.06); 13 trials, 1,076 participants. There was no evidence that any other outcomes improved when using splints. There was no evidence of adverse events associated with splints, but reporting was poor regarding this outcome. No trials measured tooth wear in patients with bruxism. There was a large variation in diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these factors did not indicate a reduction in pain. Conclusions The very low-certainty evidence identified did not demonstrate that splints reduced pain in TMD as a group of conditions. There is insufficient evidence to determine whether splints reduce tooth wear in patients with bruxism.

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  • Of the five most recently published temporomandibular disorder guidelines, four do not report the methodology used for their development and provide lists of available treatments without information on comparative effectiveness or certainty of evidence.

    “Of the five most recently published guidelines, four do not report the methodology used for their development, and they provide lists of available conservative and invasive treatments for TMD without information on comparative effectiveness or certainty of evidence.”

    From Management of chronic pain associated with temporomandibular disorders: a clinical practice guideline (2023) · cites this paper as [20]

    The Methods (Sensitivity analysis; page unavailable) mention TMD diagnostic guidelines, while the Discussion (Alternative treatment options for TMD; page unavailable) lists treatments. Neither assesses five recently published treatment guidelines or says that four omit development methods, comparative effectiveness, or certainty of evidence. Searches for those specific guideline claims found no passage addressing them. (LLM, conf=0.75)

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Authors
Riley, P., Glenny, A.-M., Worthington, H. V., Jacobsen, E., Robertson, C., Durham, J., Davies, S., Petersen, H., & Boyers, D.
Affiliations
  • University of Manchester (GB)
  • University of Aberdeen (GB)
  • Newcastle University (GB)
Corresponding author
Riley, Philip
ORCID
Venue
British Dental Journal
Publisher
Springer Science and Business Media LLC
Published
2020-02
Volume
228
Issue
3
Pages
191-197
ISSN
  • 0007-0610 (ISSN-L)
  • 1476-5373
DOI
10.1038/s41415-020-1250-2
PMC
PMC7718146
OpenAlex
W2990334865
Cited by
67
References
53
Citations by year
2026: 12 · 2025: 12 · 2024: 10 · 2023: 16 · 2022: 9 · 2021: 3 · 2020: 5
FWCI
2.62
Type
journal article
Language
en
Open access
Licence
Locations
  • BDJ (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion, other-oa)
  • Aberdeen University Research Archive (Aberdeen University) (submittedVersion)
  • Newcastle University ePrints (Newcastle Univesity) (cc-by)
Funders
  • Scottish Government
  • National Institute for Health and Care Research (HTA/16/146/06, 16/146/06, NIHR-CS-011-003, CL-2008-01-007)
  • Chief Scientist Office, Scottish Government Health and Social Care Directorate
  • Health Technology Assessment Programme (16/146/06)
Topics
  • Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
  • Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
  • Health Sciences › Health Professions › Emergency Medical Services › Dental Trauma and Treatments
Keywords
temporomandibular disorders, bruxism, TMD pain, tooth wear, adverse events
MeSH terms
Bruxism, Humans, Splints, Temporomandibular Joint Disorders, Tooth Attrition

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