Evaluation of the effectiveness of a semi-finished occlusal appliance – a randomized, controlled clinical trial

Ficnar, Tobias; Middelberg, Claudius; Rademacher, B.; Hessling, Stefan; Koch, Raphael; Figgener, L

doi:10.1186/1746-160x-9-5

Cited by 20 publications

(18 citation statements)

References 19 publications

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“…One reasons for the difference between the two conclusions is that RCTs supporting the effectiveness of splint therapy have typically employed a non‐contact control splint for the control group, whereas we used a combination of other treatments as a control. Our findings are in accord with those of many RCTs and systematic reviews reporting no superiority of splint therapy over other treatments. Indeed, such studies used jaw self‐exercise and patient education as a control.…”

Section: Discussionsupporting

confidence: 92%

“…If other types of splints had been used, or if the timing had been different (e.g. the splint had been applied at the patient's first visit) , the conclusions might have been different. Additional investigation is necessary to evaluate the effectiveness of other types of splints (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…When considering the complex effects of splint therapy combined with self‐care, previous RCTs have failed to demonstrate a distinct positive effect of splints . In comparison with other TMD treatments, the effect of the splint was shown to be equal to or weaker than the outcomes of other treatments.…”

Section: Introductionmentioning

confidence: 95%

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Efficacy of stabilisation splint therapy combined with non‐splint multimodal therapy for treating RDC/TMD axis I patients: a randomised controlled trial

Nagata

Maruyama

Mizuhashi

et al. 2015

J of Oral Rehabilitation

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JapanSUMMARY Stabilisation splint therapy has long been thought to be effective for the management of temporomandibular disorders (TMD). However, the superiority of stabilisation splint therapy compared to other TMD treatments remains controversial. The aim of this study was to determine the efficacy of stabilisation splint therapy combined with non-splint multimodal therapy for TMD. A total of 181 TMD participants were randomly allocated to a non-splint multimodal therapy (NS) group (n = 85) or a nonsplint multimodal therapy plus stabilisation splint (NS+S) group (n = 96). Non-splint multimodal therapy included self-exercise of the jaw, cognitive-behavioural therapy, self-management education and additional jaw manipulation. Three outcome measurements were used to assess treatment efficacy: mouth-opening limitation, orofacial pain and temporomandibular joint sounds. A two-factor repeated-measures analysis of variance (ANOVA) was used to evaluate the efficacy of the two treatment modalities (NS vs. NS+S), and

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Efficacy of stabilisation splint therapy combined with non‐splint multimodal therapy for treating RDC/TMD axis I patients: a randomised controlled trial

Nagata

Maruyama

Mizuhashi

et al. 2015

J of Oral Rehabilitation

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“…However, the predominantly used criteria were the RDC, 6 used in 17 studies. 11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27 The DC criteria 7 were used in two studies, 28,29 and an additional three studies used criteria that approximated to the RDC (either by citing the instrument and/or their description matched a similar process). 30,31,32 No studies used the AAOP criteria.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Oral splints for temporomandibular disorder or bruxism: a systematic review

et al. 2020

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This systematic review comprehensively summarised the best available evidence from randomised controlled trials on the effects of oral splints for temporomandibular disorders (TMD) and bruxism.There is no evidence to support the use of oral splints for either condition based on the results found.For TMD patients, sensitivity analyses were conducted to explore the effects of differences in: 1) diagnostic criteria; 2) splint types; and 3) outcome measures used and reported. There were no differences in the results based on these factors. AbstractObjectives 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 extractionRandomised 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 synthesisThirty-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. ConclusionsThe 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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“…The four most widely used approaches to bio-behavioral assessment of chronic pain patients are: Observational, self-report, selfmonitoring, and multiaxial [ Figure 3]. [31] [21] Between groups, randomized, comparative SOA (n=12), SRT (n=12) [28] Randomized controlled study (n=63); Group 1 -Conservative therapy=21, Group 2 -Conservative+ occlusally adjusted=21, Group 3 -Conservative+ non-occlusally adjusted=21 2 weeks, with a follow-up after 2.5 months…”

Section: Bio-behavioral Therapymentioning

confidence: 99%

The management of temporomandibular disorder using occlusal splint therapy and bio-behavioral therapy

Nayak¹

2016

JCRI

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Temporomandibular disorder (TMD) is a collective term that includes a number of clinical complaints involving the muscles of mastication, the temporomandibular joint, and associated orofacial structures. Diagnosing orofacial pain can be quite difficult as patients may have multiple pain complaints and often present with a confusing constellation of signs and symptoms. Management of TMD is based on certain basic principles that include the formulation of an accurate diagnosis, gradual escalation of therapy, restraining from irreversible forms of treatment and the psychophysiological aspects of the disease. A multidisciplinary model that includes patient awareness and self-care, cognitive behavioral intervention, occlusal splint therapy (OST) is endorsed for the management of most patients. The current article reviews the management of TMD by the OST and bio-behavioral therapies. KeywordsBio-behavioral therapy, occlusal splint therapy, temporomandibular disorder, temporomandibular joint Correspondence Dr.

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Evaluation of the effectiveness of a semi-finished occlusal appliance – a randomized, controlled clinical trial

Cited by 20 publications

References 19 publications

Efficacy of stabilisation splint therapy combined with non‐splint multimodal therapy for treating RDC/TMD axis I patients: a randomised controlled trial

Efficacy of stabilisation splint therapy combined with non‐splint multimodal therapy for treating RDC/TMD axis I patients: a randomised controlled trial

Oral splints for temporomandibular disorder or bruxism: a systematic review

The management of temporomandibular disorder using occlusal splint therapy and bio-behavioral therapy

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