Anatomical Changes After Stabilisation Splint Therapy: A Systematic Review and Meta-analysis

Stabilisation splint therapy (SST) is one of the treatment options for patients with temporomandibular disorder (TMD) and has strong evidence supporting its benefits. However, there is still limited scientific understanding of the unintended consequences of SST that may lead to alterations of the surrounding structures. This study aims to evaluate the available evidence regarding structural and positional changes in various anatomical regions, including the skeletal system, temporomandibular joint (TMJ), upper pharyngeal airway, hyoid bone, craniocervical alignment, dentoalveolar structures, and soft tissues following SST for TMD patients.

The PubMed, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) online databases were systematically searched from inception until 18 December 2024. Abstracts that met the selection criteria were chosen by consensus. To ensure thoroughness, a manual search of their references was also conducted. Stata version 18.0 was used to perform the pooled analysis.

Fifteen articles were finally included. A significant weighted mean difference was found for the superior joint space of TMJ (0.15 mm, z = 1.99, P = .05) with moderate heterogeneity (τ² = 0.02, I² = 48.41%). SST may cause forward and downward movements of the condyle, allowing recapturing anterior disc displacement with reduction after treatment, promoting midline correction of the mandible, and improving bone density in TMD patients. There was little evidence of appropriate investigation for upper airway assessment.

SST appears to cause a significant increase in superior TMJ joint space, while changes in other dimensions were not significant. Due to study limitations and variability, further controlled research is needed to confirm these findings.