Stabilization Splint Therapy for the Treatment of Temporomandibular Myofascial Pain: A Systematic Review

Abstract

The aim of this review is to establish the effectiveness of stabilization splint (SS) therapy in reducing symptoms in patients with myofascial pain. Searching of electronic databases, handsearching of relevant key journals, and screening of reference lists of included studies were undertaken. There was no language restriction, and unpublished research was sought. The selection criteria were randomized controlled trials comparing splint therapy to either no treatment or another active treatment. Data extraction and validity assessment were carried out independently and in duplicate. Studies were grouped according to treatment type. Twenty potentially relevant Randomized Controlled Trials (RCTs) were identified. Only twelve met the inclusion criteria. There is insufficient evidence either for or against the use of stabilization splint therapy over other active interventions for the treatment of temporomandibular myofascial pain. However, it appears that stabilization splint therapy may be beneficial for reducing pain severity at rest and on palpation and depression when compared to no treatment. The authors suggested the need for well conducted RCTs that pay attention to method of allocation, blind outcome assessment, sample size, and duration of follow-up. Various measures were adopted to assess the outcomes of treatment. Standardization of the methods used to measure outcomes of the treatment of myofascial pain should be established in future RCTs. M yofascial pain is the most common temporomandibular disorder (TMD). There are many synonyms for this condition including facial arthromylagia, TMJ dysfunction syndrome, myofacial pain dysfunction syndrome, craniomandibular dysfunction, pain dysfunction syndrome (PDS), and myofacial pain dysfunction. 1 The etiology of myofascial pain is multifactorial. Consequently, many different therapies, some conservative and reversible, others irreversible, have been advocated for patients with myofascial pain. A number of successful treatment outcomes have been reported, including occlusal splints, physiotherapy, muscle-relaxing appliances, and pharmacological interventions.

Temporomandibular disorders assessment: medicolegal considerations in the evidence‐based era

“…Systematic reviews on TMD treatments covered the arguments of the effectiveness of several treatment modalities, viz., occlusal treatments ( n = 5) (45, 81, 83, 84, 123), orthognathic surgery ( n = 2) (124, 125), arthrocentesis ( n = 2) (125, 126), NTI‐tss devices ( n = 1) (127), simple versus multimodal therapies ( n = 1) (128), any intervention’s effect on quality of life ( n = 1) (129), exercise and relaxation therapy ( n = 1) (130), physical therapy ( n = 1) (131), pharmacological therapy ( n = 1) (132), total TMJ prosthesis ( n = 1) (27) (Table 2).…”

“…As for oral appliances, which are the most widely diffused therapeutic modality for TMD, evidence for their subjective effectiveness seems to be supported by the systematic reviews (45, 81, 83, 123), but they are not unequivocally superior to either treatments. Oral appliances have been also the subject of a recent comprehensive review (133), which suggested that many of the available types of splints and appliances may be reasonably efficacious in the clinical setting, even though the actual mechanism through which they provide pain relief are not well known.…”

Efficacy of stabilisation splint treatment on the oral health‐related quality of life–A randomised controlled one‐year follow‐up trial

“…Some short‐term randomised controlled trials (RCTs) have found evidence of the pain‐relieving effect of SS versus other treatment methods or no treatment on TMD pain, both of arthrogeneous and myogenous origin . On the other hand, some studies have shown that there is only a small or no additional benefit on TMD pain relief with SS treatment versus placebo, control splints (eg non‐occluding splint) or other treatment methods (eg acupuncture, counselling, masticatory muscle exercises) …”

Temporomandibular Joint Pain Syndrome; Effect of Occlusal Splint Therapy

“…Mouth opening was measured on first appointment, second appointment and last appointment and all patients were given stabilization splint. 12,3…”